The Silent Mental Health Crisis of Climate Change

The connection between climate and physical health is evident. We know, for instance, that asthma is exacerbated by exposure to wildfire smoke that occurs more commonly during hot, dry, windy conditions. Heat stroke is also a well-known outcome of exposure to heat and dehydration. 

Now, an equally urgent narrative is unfolding: climate change’s profound influence on mental health.

The psychological impacts of climate-related factors are just as undeniable as the physical effects. For example, some studies suggest that rising ambient temperatures are associated with an increase in suicide events and hospital visits for mental disorders, as well as worsening community mental health outcomes. Another study reveals an association between higher temperatures and both violent and non-violent crime risks. 

This year started off with the news that the world experienced the hottest January on record. Therefore, as the year unfolds, the relationship between health and climate is positioned to take center stage. Healthcare professionals must seize the opportunity to expand their concept of “whole-person” health by evaluating the role of climate on not just physical health, but mental health, too. 

Climate’s impact on mental health

Nature plays a powerful role in health and well-being. For instance, we understand the calming effect many people experience when sitting under a shady tree and listening to a babbling brook. There is a good reason why mindfulness apps try to mimic nature sounds to support well-being. Studies offer evidence that active engagement with everyday natural environments can improve individuals’ mental health outcomes. 

However, the opposite is also true when climate changes disrupt our lives and livelihoods. 

Many of those who survive the loss, devastation, and displacement of an extreme climate event — such as a flood, tornado, drought, or wildfire — experience anxiety, depression, post-traumatic stress disorder (PTSD), and even suicidal 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 feeling some worry about climate change and its effects. Likewise, there is evidence that concerns about the environment are increasingly weighing down young people with what has been called “eco-anxiety.” In one study of youth aged 16-25 across 10 countries, more than 45% said their feelings about climate change negatively impacted their daily lives and functioning. 

All of this anxiety and stress may, in turn, contribute to adverse behavioral health outcomes. The ability to cope with change may be more difficult for individuals already living with mental illness because they are also more likely to experience poverty and/or substance use disorders. Furthermore, researchers have found a correlation between higher temperatures and more hospital visits related to alcohol and substance use. According to one analysis, there are at least five different ways in which climate change could exacerbate harmful substance use behaviors.

New training to address rising needs

Fortunately, there are steps clinicians can take to improve the use of evidence-based medical practice in the context of a changing climate. A recent JAMA Insights article notes that clinicians can: 

• Educate themselves about how climate can impact patients’ health and well-being through continuing education opportunities, professional associations, and online resources. 
• Incorporate social and environmental histories into their patient practices.
• Encourage the use of environmental information (e.g., weather data) along with patient demographics to identify patients at higher risk for climate-related illness. 

While there is still much work to be done to collect data and implement evidence-based approaches for managing the health risks of climate change, the growing awareness of the links between climate and health is leading to new medical training programs. 

Many medical schools have begun incorporating climate health education into clinical curricula. Between the 2019 and 2022 academic years, the percentage of medical schools requiring a curriculum on climate change and health jumped from 27% to 65%.

Primary care providers (PCPs), especially, must be equipped to understand how climate might affect their approach to patient care. 

For example, suppose a patient tells their PCP, “I feel really irritable lately” during their annual exam. Such a statement could represent a new symptom of anxiety that warrants psychotherapy or a prescription. On the other hand, the patient’s irritability could stem from the fact that they can’t sleep at night because their home is too hot. Without asking about heat-related triggers, the diagnosis can be wrong and the treatment ineffective.  

So, PCPs should be trained to ask questions such as, “What’s the temperature in your home right now? Do you have access to air conditioning?” The answers might reveal that the best treatment options involve connecting the patient to community resources rather than writing a prescription.

Evolving care for a changing world

In many ways, climate change’s effects offer an excellent example of why we must continue to prioritize collaborative, “whole person” care delivery models. Its impacts touch every aspect of human health and well-being. Because we know that Earth’s climate is dynamic, we must be prepared to acknowledge and address its influence on not just physical health, but mental health as well.  

For clinicians, understanding the intricate links between climate and mental health is no longer optional — it’s essential. The urgency is clear. From eco-anxiety in youth to heightened vulnerabilities in individuals with existing mental illnesses, climate change is reshaping the mental health landscape. Integrating climate awareness into clinical education and clinical practices is not just an advancement; it’s a necessary evolution in mental healthcare.

Image: flickr user Kevin Dooley

Caroline Carney, MD, MSc, FAPA, FAPM, CPHQ, is the President of Behavioral Health and Chief Medical Officer at Magellan Health, a clinical first company focused on improving the quality and delivery of behavioral healthcare. An active clinician, she is board-certified in both psychiatry and internal medicine. Prior to joining Magellan, Dr. Carney served as the medical director for the Indiana Office of Medicaid Policy and Planning, where she helped to launch the Medicaid expansion product as well as the behavioral health transformation for the state’s community mental health services 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 the psychosocial oncology program for the university’s NCI accredited cancer center. Dr. Carney earned her medical and master’s degrees at the University of Iowa.

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