Climate experts and health professionals are drawing links between climate change and its impact on mental health for people all over the world. Peadar O’Grady takes a look at this phenomenon.
In light of the growing public acceptance of the reality of climate change and the emissions causing it, the health effects of climate change are more and more relevant. In 2009 the prestigious medical journal The Lancet published a report by its own ‘Commission on Health and Climate Change’ who described climate change as: “The biggest global health threat of the 21st century”.
In its 2016 update they outline the effects of climate change on mental health:
Climate change affects mental health through various pathways by inflicting natural disasters on human settlements and by causing anxiety-related responses, and later chronic and severe mental health disorders, and implications for mental health systems.”
This adds pressure to the need for action in curbing emissions and the need for a focus on health and the needs of people where they live and work. Whether climate change is a threat or an opportunity, and whether or not our anxiety is proportionate, are crucial questions. Those drawing attention to climate change point to the lack of sufficient concern on the part of governments and corporations but what of the anxiety about the future felt by most ordinary people, including children? There appears to be a mismatch between what most people are worried about and what those with political or economic power are worried about. Those with immediate access to power: rich individuals, corporations and establishment politicians are least concerned and those with the least immediate access to power: children, workers, students and local communities are most concerned about climate change.
Most people worry about how the future might bring negative changes to the things they already worry about. Most everyday anxieties are about money. Current and future money sources. Money for accommodation, food, socialising and maintaining relationships with those we care about. The recent concerns about anxiety in children has focussed on their social media use and almost completely ignored their precarious future, not just in climate terms, but also in concerns that their peers who are a little older, in their late teens and twenties, are finding it increasingly difficult to get jobs that will pay rent or offer any security like sick-pay or a pension. And that is before economic stagnation and a potential economic crash are taken into account. Children’s anxieties are often related to those around them being anxious. Denial of everyday concerns is mirrored by denial of global concerns. Children seem to have taken the lead in this regard at least by increasingly taking an activist approach to dealing with anxiety about climate change, arguing for urgency and responsibility by those with power.
The Lancet commission suggests: “Government and agencies now emphasise psychological and psychosocial interventions within disaster response and emergency management.” However, the main response of current mental health services to human distress is centred on long-term drug use and short-term counselling, usually CBT or nothing, with little if any emphasis on social change even though the commission emphasises that: “these effects will fall disproportionately on individuals who are already vulnerable, especially for indigenous people and those living in low-resource settings.” Despite the countermovements of social prescribing and service-user activism, the mainstream mental health services—already struggling to respond to rising demand—are poorly positioned to respond to any major increase in demands on health services predicted by The Lancet commission report. They draw attention to ‘sostalgia’ a term coined by philosopher Glenn Albrecht in 2005 to describe people’s anxiety and loss of security in the future of their immediate environment “when their land is damaged and they lose amenity and opportunity”. Sostalgia has been used to describe the increased anxiety in areas subjected to repeated drought or mining in Australia but it also captures the combined local and global experience of loss of security in our environment, that is, more feelings of threat than opportunity. People living in the area immediately surrounding coal mines are reported to have higher rates of depression. Depression is often strongly connected to anxiety, particularly where the anxiety is long-term and obstacles to change lead to feelings of helplessness and hopelessness.
There is good news and bad news but fortunately they are connected. The bad news is that capitalism is addicted to profit and the change we need in emissions will come up against foot-dragging on cutting fossil fuel use and implementing better energy, transport and agriculture policies, for the sake of ‘Growth’ at all costs. The good news is that there is increasing agreement between what the climate experts and public health experts are advocating and that there are local health benefits to be gained from political activism to force our intransigent ruling classes to make changes in transport, energy and agricultural policies, in addition to the global effects of reducing extreme weather events and their consequences globally such as floods, fires, storms, heatwaves, droughts, famine, cholera and malaria. Physical and mental health are intimately connected and improvements to one are always a benefit to the other.
The benefits of political activism for mental health are first the benefits of active social engagement in changing your environment, challenging feelings of helplessness and hopelessness.
Second, for each area advocated to reduce emissions there are additional immediate benefits to health, including mental health:
Air pollution: reducing fossil fuel Carbon Dioxide emissions means also reducing the other toxic particles and gases in these emissions reducing lung and heart diseases like asthma, lung cancer, heart attacks and strokes.
Safer free public transport with trains, trams, electric buses, bicycles and walkways reduce the trauma of road traffic accidents, improve health through increased exercise, particularly walking, and reduce the anxiety and cost of unpredictable and unpleasant commutes.
Affordable renewable energy and improvements in preventing heat loss from homes through improved insulation reduces the costs of heating and the fear caused by fuel insecurity.
Agriculture reform will mean cheaper, fresher, more locally produced, better quality food, improving physical health and reducing the fear caused by food insecurity.
Improved access to food, shelter and transport would massively reduce the money anxiety which is the most immediate concern for most people.
Climate change forces us to address the increased risk of poverty and inequality as the other main global threat to health and a focus on the benefits of a redistribution of wealth could have an enormous benefit on health and mental health.
Finally, political activism to improve public services will tend to highlight the gross inefficiencies of private provision of public services and potentially greatly improve welfare including in health, housing, transport and agriculture. The debunking of climate denial may encourage the necessary debunking of the denial of the value of public control of public services as, in the past, health workers and political activists debunked the denial of the toxicity of tobacco and HIV. In a rising movement against climate change there will also, inevitably, be a challenge to the massive waste of privately funded and controlled healthcare, as championed in the US presidential primaries by Bernie Sanders. Mental health would also specifically benefit from shining the light of science on the overly-narrow focus in mental health on individual fixes aimed to get us to passively adapt to change rather than respond actively to change. The long-term use of drugs with a weak, short-term evidence base and the short-term use, if any, of psychological and social supports focused on dynamic change in our environments, despite their long-term benefits, must change.
The voices of the experts in both climate and public health science are increasingly united in the urgency and importance of political activism to force change from the bottom up. This pressure will increase with each passing month and year. The actions taken by striking school-children is a lead for us all to follow. The editor of The Lancet, Dr Richard Horton, put out a call in October 2019 for all health professionals to engage in social protest to protect people from the environmental damage of climate change. Workplace and community political activism is going to be necessary to urgently transform our society. We can be confident that if we can unite and harness the power of workplaces and communities, we can live better, happier lives.