The link between climate and physical health is obvious. For example, we know that more common wildfire smoke that occurs in hot, dry, windy conditions can aggravate asthma. Strokes are also well-known results of exposure to heat and dehydration.
Now, an equally urgent narrative is developing: the profound impact of climate change on mental health.
The psychological effects of climate-related factors are as undeniable as physical effects. For example, some studies have shown that elevated ambient temperatures are associated with suicide incidents and mental disorders in hospital visits, and worsening of community mental health outcomes. Another study revealed the association between higher temperatures and risks of violent and nonviolent crime.
The news started this year is that the world has experienced the hottest January on record. Therefore, with the development of the year, the relationship between health and climate is positioned as the central stage. Healthcare professionals must seize opportunities to expand the concept of “all-person” health by assessing the role of climate on physical health and mental health.
The impact of climate on mental health
Nature plays a powerful role in health and well-being. For example, we understand the calm effects many people experience while sitting under dark trees and listening to brabling streams. There is good reason why mindfulness apps try to mimic natural sounds to support happiness. Research provides evidence that active participation in daily natural environments can improve individual mental health outcomes.
But when climate change destroys our lives and livelihoods, the opposite is true.
Many people who survive extreme climate events such as floods, tornados, droughts or wildfires experience anxiety, depression, post-traumatic stress disorder (PTSD), and even suicide thoughts. Similar mental illnesses are often found even when people are indirectly exposed to extreme climate events.
More than two-thirds of U.S. adults report some concerns about climate change and its impact. Similarly, there is evidence that concerns about the environment are increasingly causing young people to suppress with so-called “ecological anxiety.” In a study of young people aged 16-25 in 10 countries, more than 45% said that feeling about climate change has negatively impacted their daily lives and operations.
All of this anxiety and stress can in turn lead to behavioral health outcomes. For people who already have mental illness, the ability to cope with change may be more difficult, as they are also more likely to suffer from poverty and/or drug use disorders. Furthermore, researchers found a correlation between high temperatures and more hospital visits related to alcohol and drug use. According to one analysis, at least five different ways can enable climate change to aggravate the use of harmful substances.
New training to meet rising demand
Fortunately, in the case of climate change, clinicians can take some steps to improve the use of evidence-based medical practices. A recent JAMA Insights article states that clinicians can:
- Through continuing education opportunities, professional associations and online resources, educate how the climate affects the health and well-being of patients.
- Integrate social and environmental history into their patient practice.
- The use of environmental information (such as weather data) as well as patient demographic data is encouraged to identify patients at higher risk for climate-related diseases.
While much work remains to be done to collect data and implement evidence-based approaches to manage health risks of climate change, the growing awareness of the link between climate and health has led to new health training programs.
Many medical schools have begun to incorporate climate health education into clinical courses. The percentage of medical schools that require climate change and health programs jumped from 27% to 65% between the 2019 and 2022 school years.
Especially for primary care providers (PCPs), equipment must be able to understand how climate affects their patient care.
For example, suppose a patient tells their PCP on an annual exam: “I’ve been very upset lately.” Such statements can represent new anxiety symptoms that require psychotherapy or prescription. On the other hand, patients’ worries may stem from the fact that they can’t fall asleep at night because their home is too hot. Without asking about heat-related triggers, the diagnosis may be wrong and the treatment is ineffective.
Therefore, the PCP should be trained to propose such as, “What is the temperature in your home now? Can you use air conditioners?” Answers may suggest that the best treatment involves connecting patients to community resources rather than writing prescriptions.
Continuously developing care for a changing world
In many ways, the effects of climate change provide a great example of why we must continue to prioritize collaborative, “whole person” care delivery models. Its impact touches every aspect of human health and well-being. Because we know that the Earth’s climate is dynamic, we must be prepared to acknowledge and address its impact on physical health, and also on mental health.
For clinicians, understanding the complex link between climate and mental health is no longer optional – it is essential. The urgency is obvious. From the ecological anxiety of young people to the vulnerability of people with mental illness, climate change is reshaping mental health. Incorporating climate awareness into clinical education and clinical practice is not only an advance, but also an advancement. This is an indispensable development in mental health care.
Image: Flickr user Kevin Dooley
Caroline Carney, MD, MSC, FAPA, FAPM, CPHQ is President of Behavioral Health and Chief Medical Officer of Magellan Health, a clinical first company committed to improving the quality and delivery of behavioral health care. She is an active clinician and is certified in both psychiatry and internal medicine. Prior to joining Magellan, Dr. Carney served as the medical director of Indiana’s Office of Medicaid Policy and Programs, where she helped launch the Medicaid expansion products and the behavioral health transformation of community mental health services in the state and served on the Governor’s Mental Health Commission. Earlier, she was a tenured associate professor of internal medicine and psychiatry at Indiana University, where she developed a psychosocial oncology program for NCI-accredited Cancer Center. Dr. Carney received her degree in medicine and master’s degree from the University of Iowa.
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