Climate Change and Mental Health: A Scoping Review

Effect of wildfire on the prevalence of opioid misuse through anxiety among young adults in the United States: a modeling study

BACKGROUND

Exposure to climate change events like wildfires can lead to health and mental health problems. While conceptual frameworks have been hypothesized describing the potential relationship between disaster exposure and substance use, the association remains under-researched and unquantified.

METHODS

We constructed a quantitative portrayal of one proposed conceptual framework that focuses on the intermediary role of anxiety. We used the Monte Carlo simulation to estimate the impact of wildfire exposure on opioid misuse outcomes through increased anxiety. We searched for and extracted prior empirical evidence on the associations between wildfire anxiety and anxiety-opioid misuse. Three scenarios were devised: in S1 the impact of wildfire on opioid misuse was limited to increasing anxiety incidence; in S2 we also considered the additive role of altered anxiety phenotype; and in S3 we further considered the role of increased opioid-related consequences of pre-existing anxiety due to wildfire exposure.

RESULTS

Models show that the prevalence of opioid misuse post-wildfire may rise to 6.0%-7.2% from a baseline of 5.3%. In S1, the opioid misuse prevalence ratio was 1.12 (95% uncertainty interval [UI]: 1.00 - 1.27). The two exploratory scenarios, with less stringent assumptions, yielded prevalence ratios of 1.23 (95% UI: 1.00 - 1.51) and 1.34 (95% UI: 1.11 - 1.63).

CONCLUSIONS

Our modeling study suggests that exposure to wildfires may elevate opioid misuse through increasing anxiety incidence and severity. This can lead to substantial health burdens, possibly beyond the duration of the wildfire event, which may offset recent gains in opioid misuse prevention.

Urban heatwave, green spaces, and mental health: A review based on environmental health risk assessment framework

Utilizing the framework of environmental health risk assessment and healing, the article reviews the effectiveness and potential of green space systems in mitigating the impact of high temperatures, promoting mental health, and improving the risk characteristics of high-temperature heat waves. We utilized CiteSpace software to conduct a time-zone analysis of the relationship between heatwaves, green spaces, and health using clustered data from 2001 to 2023. This study evaluates the role of green space systems in mitigating high temperatures and enhancing mental health within the environmental health risk assessment framework. Using CiteSpace software, we analyzed literature from 2001 to 2023, focusing on the interactions among heatwaves, green spaces, and health. Our results indicate that most existing research concentrates on hazard identification, with insufficient exploration of the dose-response relationships between green spaces and temperature reduction. Quantitative studies on green space design and spatial optimization are scarce, and guidance on effective configurations remains limited. Additionally, the health impacts of heatwaves vary by region, with a noticeable imbalance in research focus; Asia and Africa, in particular, are underrepresented in studies addressing heatwave effects. We conclude that effective mitigation strategies require: (1) a comprehensive environmental health risk assessment framework that integrates advanced methods like big data analysis and geospatial simulations to improve green space planning and design; (2) further theoretical exploration into the mechanisms by which green spaces regulate temperature and mental health, including detailed analysis of spatiotemporal patterns and the functional optimization of green space structures; and (3) the development of robust parameterized design guidance based on specific therapeutic dosages (green space stimulus) to optimize configurations and enhance the effectiveness of green spaces in mitigating adverse mental health impacts from deteriorating thermal environments. Future research should prioritize underrepresented regions, focusing on exposure levels, dose-response relationships, and high-temperature warning systems while fostering multidisciplinary collaboration to develop effective urban planning and climate adaptation strategies.

Impact of drought on mental and behavioral disorders, contributions of research in a climate change context. A narrative review

Mental and behavioral disorders are an important public health problem and constitute a priority for the WHO, whose recommendations include the surveillance of their risk factors. On the other hand, drought episodes have been increasing in frequency and severity in Europe since 1980. Therefore, to review the present knowledge about the impact of drought on mental and behavioral disorders, in the present climate change context, and to underline potential research gaps, could be of major interest. Thus, we performed a narrative review using online academic databases with the aim of identifying relevant literature about the impact of drought on mental and behavioral disorders. To the best of our knowledge, no study in Europe quantifies the potential association between drought and mental disorders. A limited number of studies have found significant associations between droughts (with different temporal ranges) and various measures of mental health. However, according to our review, only three of them quantified the association between drought and objective mental health outcomes, such as number of emergencies due to clinically diagnosed mental disorders or suicides. Additionally, few studies used specific indices as a measure of drought; and finally, as far as authors are aware, none of them has analyzed this relationship adjusting for various other potential environmental confounders. Moreover, the eventual association could vary between different geographical areas within the same country. Therefore, national and regional studies would be especially necessary. Thus, there is a need for specific national and regional studies, in Europe and globally, that assess the impact of specific indices of drought (with different temporal ranges) on objective mental health outcomes controlling for potential environmental confounders. Moreover, the quantification of its cost would be necessary for health prioritization, evidence-based policies and strategic health planning.

A consulting room with a view: Psychotherapy and the ecological context

BACKGROUND

The field of psychotherapy is witnessing a lively debate today. The literature on the efficacy of psychological interventions has grown exponentially, but the assumptions of the prevailing research paradigms have been criticised from many points of view. One of the main concerns is that of a too often simplistic conception of psychotherapy, viewed as a set of specific methods for the treatment of point-like problems or symptoms.

LITERATURE REVIEW ON MENTAL HEALTH AND THE ECOLOGICAL CONTEXT

Instead, emerging perspectives are trying to promote a more complex view on psychotherapy, as a process based on the therapeutic potential of relationships, which takes place in relevant social and cultural contexts. Even the ecological context is taken in greater consideration, as growing evidence exists about the detrimental effects of ecological threats-such as climate change and other environmental challenges-on mental health.

CONCLUSIONS

Psychotherapists and psychotherapy associations are now paying due attention to such issues, as well as to social justice and other dimensions that no longer can be thought of as mere elements of the scenario in which psychotherapy is practiced. Rather they are dimensions that exert a strong influence on psychological well-being, and thus must be properly acknowledged and assessed to connect clinical work with the communities and ecological contexts in which people live.

Environmental pollution and extreme weather conditions: insights into the effect on mental health

Environmental pollution exposures, including air, soil, water, light, and noise pollution, are critical issues that may implicate adverse mental health outcomes. Extreme weather conditions, such as hurricanes, floods, wildfires, and droughts, may also cause long-term severe concerns. However, the knowledge about possible psychiatric disorders associated with these exposures is currently not well disseminated. In this review, we aim to summarize the current knowledge on the impact of environmental pollution and extreme weather conditions on mental health, focusing on anxiety spectrum disorders, autism spectrum disorders, schizophrenia, and depression. In air pollution studies, increased concentrations of PM2.5, NO2, and SO2 were the most strongly associated with the exacerbation of anxiety, schizophrenia, and depression symptoms. We provide an overview of the suggested underlying pathomechanisms involved. We highlight that the pathogenesis of environmental pollution-related diseases is multifactorial, including increased oxidative stress, systematic inflammation, disruption of the blood-brain barrier, and epigenetic dysregulation. Light pollution and noise pollution were correlated with an increased risk of neurodegenerative disorders, particularly Alzheimer's disease. Moreover, the impact of soil and water pollution is discussed. Such compounds as crude oil, heavy metals, natural gas, agro-chemicals (pesticides, herbicides, and fertilizers), polycyclic or polynuclear aromatic hydrocarbons (PAH), solvents, lead (Pb), and asbestos were associated with detrimental impact on mental health. Extreme weather conditions were linked to depression and anxiety spectrum disorders, namely PTSD. Several policy recommendations and awareness campaigns should be implemented, advocating for the advancement of high-quality urbanization, the mitigation of environmental pollution, and, consequently, the enhancement of residents' mental health.

Assessing climate change and health provisions among staff in higher education institutions: A preliminary investigation

Climate change can have direct and indirect effects on human health. Direct effects can include an increase in extreme weather events, such as heatwaves and floods, as well as an increase in the spread of vector-borne and infectious diseases, which may lead to a set of health problems and diseases. Indirect effects can include changes in air quality, water availability, and food production and distribution. These changes can lead to an increase in respiratory problems, malnutrition, and increased food insecurity. There is a perceived need to investigate the extent to which Higher Education Institutions (HEIs) are engaged in efforts to foster a greater understanding of the connections between climate change and health. In this context, this preliminary investigation offers an overview of the relationships between climate change and health. By means of a survey among teaching staff and researchers at HEIs from 42 countries across all continents working on the connection between climate change and health. The study has investigated the extent to which current provisions for education and training on the connection between climate change and health are being considered and how current needs in terms of policy development, research, and training are being met. A series of case studies illustrate how universities worldwide are actively developing strategies and implementing measures to address climate change and health. The study concludes by providing specific recommendations aimed at facilitating the handling of issues related to climate change and health in a higher education context.

Short-term changes in mental health help-seeking behaviors following exposure to multiple social stressors and a natural disaster

In 2020, unprecedented circumstances led to significant mental health consequences. Individuals faced mental health stressors that extended beyond the devastating impact of the COVID-19 pandemic, including widespread social unrest following the murder of George Floyd, an intense hurricane season in the Atlantic, and the politically divisive 2020 election. The objective of this analysis was to consider changes in help-seeking behavior following exposure to multiple social stressors and a natural disaster. Data from Crisis Text Line (CTL), a national text-based mental health crisis counseling service, was used to determine how help-seeking behavior changed in the wake of each event. Wilcoxon rank sum tests assessed changes in help-seeking behavior for each event in 2020 as compared to the same period in 2019. AutoRegressive Integrated Moving Average (ARIMA) models examined if changes in crisis conversation volumes following each event differed. Higher median conversation volumes noted for the COVID-19 pandemic (+1 to +5 conversations), Hurricane Laura (+1 to +7 conversations) and the 2020 Election (+1 to +26 conversations). ARIMA models show substantial increases in help-seeking behavior following the declaration of a national emergency for the COVID-19 pandemic (+4.3 to +38.2%) and following the 2020 election (+3 to +24.44%). Our analysis found that the mental health response following social stressors may be distinct from natural events, especially when natural disasters occur in the context of multiple social stressors. This analysis adds to the growing body of literature considering the mental health impact of exposure to multiple co-occurring societal stressors, like police violence and a global pandemic.

The mental health of Australians bereaved during the first two years of the COVID-19 pandemic: a latent class analysis

BACKGROUND

The COVID-19 pandemic disrupted many areas of life, including culturally accepted practices at end-of-life care, funeral rites, and access to social, community, and professional support. This survey investigated the mental health outcomes of Australians bereaved during this time to determine how these factors might have impacted bereavement outcomes.

METHODS

An online survey indexing pandemic and bereavement experiences, levels of grief, depression, anxiety, and health, work, and social impairment. Latent class analysis (LCA) was used to identify groups of individuals who shared similar symptom patterns. Multinomial regressions identified pandemic-related, loss-related, and sociodemographic correlates of class membership.

RESULTS

1911 Australian adults completed the survey. The LCA identified four classes: low symptoms (46.8%), grief (17.3%), depression/anxiety (17.7%), and grief/depression/anxiety (18.2%). The latter group reported the highest levels of health, work, and social impairment. The death of a child or partner and an inability to care for the deceased due to COVID-19 public health measures were correlated with grief symptoms (with or without depression and anxiety). Preparedness for the person's death and levels of pandemic-related loneliness and social isolation differentiated all four classes. Unemployment was associated with depression/anxiety (with or without grief).

CONCLUSIONS

COVID-19 had profound impacts for the way we lived and died, with effects that are likely to ricochet through society into the foreseeable future. These lessons learned must inform policymakers and healthcare professionals to improve bereavement care and ensure preparedness during and following future predicted pandemics to prevent negative impacts.

Exploring the relationship between nursing students' knowledge and attitudes towards climate change and their psychological distress: a cross-national investigation

BACKGROUND

Climate change poses a worldwide challenge with anticipated exacerbation in the future, resulting in irreversible consequences. Nursing students may be vulnerable to experiencing psychological effects associated with climate change.

AIM

The current study aimed to investigate the relationship between nursing students' knowledge and attitudes toward climate change and their psychological distress.

METHOD

This descriptive cross-sectional study recruited 377 nursing students from three universities located in Saudi Arabia, Jordan, and Egypt in the Middle East. Data collection was conducted using scales for assessing nursing students' knowledge and attitudes towards climate change and their psychological distress. Correlations were assessed and multiple regression analysis was conducted to explore the predictors of students' psychological distress.

RESULTS

The current study showed that knowledge regarding climate change significantly and positively correlated to the attitude toward climate change (r = 0.213), then again, the score of psychological distress significantly and negatively correlated to the score of students' knowledge and attitude regarding climate change (r = - 0.182 and - 0.110 respectively). Regression analyses showed that academic achievement had the strongest positive impact on students' psychological distress, while knowledge regarding climate change and attitude toward climate change had negative impacts (β = 0.381, β=-0.205, and β=-0.045 respectively). Moreover, knowledge and attitude regarding climate change were found to be significant predictors of students' psychological distress, collectively accounting for 18.2% of the observed variance.

CONCLUSIONS/IMPLICATION FOR FUTURE PRACTICE

The findings highlight the importance of incorporating climate change into nursing education programs. By enhancing nursing students' knowledge and attitudes towards climate change, there is potential to reduce their psychological distress. This study underscores the need for curriculum reforms that integrate climate change topics, aiming to foster a well-informed and resilient future nursing workforce.

How does the macroenvironment influence brain and behaviour-a review of current status and future perspectives

The environment influences brain and mental health, both detrimentally and beneficially. Existing research has emphasised the individual psychosocial 'microenvironment'. Less attention has been paid to 'macroenvironmental' challenges, including climate change, pollution, urbanicity, and socioeconomic disparity. Notably, the implications of climate and pollution on brain and mental health have only recently gained prominence. With the advent of large-scale big-data cohorts and an increasingly dense mapping of macroenvironmental parameters, we are now in a position to characterise the relation between macroenvironment, brain, and behaviour across different geographic and cultural locations globally. This review synthesises findings from recent epidemiological and neuroimaging studies, aiming to provide a comprehensive overview of the existing evidence between the macroenvironment and the structure and functions of the brain, with a particular emphasis on its implications for mental illness. We discuss putative underlying mechanisms and address the most common exposures of the macroenvironment. Finally, we identify critical areas for future research to enhance our understanding of the aetiology of mental illness and to inform effective interventions for healthier environments and mental health promotion.

Taking a trauma and adversity perspective to climate change mental health

The European Journal of Psychotraumatology has had a long interest in advancing the science around climate change and traumatic stress. In this special issue, we include papers that responded to a special call in this area. Six major themes emerge from these papers and together they contribute to trauma and adversity model of the mental health impacts of climate change. We argue that, in addition to individual vulnerability factors, we must consider the (i) cumulative trauma burden that is associated with exposure to ongoing climate change-related impacts; (ii) impact of both direct and indirect stressors; (iii) individual and community protective factors. These factors can then guide intervention models of recovery and ongoing resilience.

Young adults from disadvantaged groups experience more stress and deterioration in mental health associated with polycrisis

The recent polycrisis (COVID-19, Ukraine war, climate change, economic crisis) has been associated with mental health through cumulative stress, with young people being particularly vulnerable. We surveyed 403 college students from Poland to examine their psychological responses to the experienced crises. The results showed that polycrisis was associated with worse mental health of college students from disadvantaged groups (based on gender, sexual orientation, and financial situation) compared to other college students, in four areas: sense of proximity to the crises, stress caused by the crises, sense of responsibility for mitigating the crises, and experiencing everyday moral dilemmas regarding the crises. These young adults also suffered more in terms of negative affectivity, depressive symptoms, and subjective physical and mental health. Our findings suggest that when discussing public mental health perspectives, it is important to consider consequences of cumulative stress and its greater impact on young people from disadvantaged groups.

The impact of climate change and related extreme weather on people with limb loss

The human health consequences of climate change and extreme weather events are well documented. Published literature details the unique effects and necessary adaptation planning for people with physical disabilities in general; however, the specific impacts and plans for people with limb loss have yet to be explored. In this article, we discuss the impacts related to threats due to heat, cold, severe storms, and power outages. We describe how climate change uniquely affects people with limb loss and underscore the need for rehabilitation care providers and researchers to: (1) study the health impacts of climate change on people with lower limb loss; (2) educate themselves and patients on the climate crisis and climate preparedness; (3) co-develop resiliency strategies with patients, governments, and community organizations to improve adaptive capacity; and (4) advocate for policy changes that will enact protections for this at-risk population.

Climate change-related concerns in psychotherapy: therapists' experiences and views on addressing this topic in therapy

BACKGROUND

While adverse impacts of climate change on physical health are well-known, research on its effects on mental health is still scarce. Thus, it is unclear whether potential impacts have already reached treatment practice. Our study aimed to quantify psychotherapists' experiences with patients reporting climate change-related concerns and their views on dealing with this topic in psychotherapy.

METHODS

In a nationwide online survey, responses were collected from 573 psychotherapists from Germany. Therapists reported on the presence of such patients, their socio-demographic characteristics, and climate change-related reactions. Psychotherapists' views on dealing with this topic in psychotherapy were also assessed. Descriptive statistics were used to analyse the responses.

RESULTS

About 72% (410/573) of psychotherapists indicated having had patients expressing concerns about climate change during treatment. Out of these therapists, 41% (166/410) stated that at least one patient sought treatment deliberately because of such concerns. Patients were mainly young adults with higher education. Most frequent primary diagnoses were depression, adjustment disorder, and generalized anxiety disorder. Psychotherapists having encountered such patients differed from those without such encounters in their views on potential functional impairment and the necessity to target the concerns in treatment. Although 79% (326/415) of all respondents felt adequately prepared by their current therapeutic skills, 50% (209/414) reported a lack of information on how to deal with such concerns in therapy.

CONCLUSIONS

Results indicate that psychotherapists are frequently confronted with climate change-related concerns and regard the mental health impact of climate change on their patients as meaningful to psychotherapeutic care. Regular care could be improved by a continuous refinement of the conceptualization and knowledge of the mental health influences of climate change. This would allow providing tailored methods of assessing and addressing climate change-related concerns in practice.

Change in emotional distress, anxiety, depression and PTSD from pre- to post-flood exposure in women residing in low-income settings in South Africa

Floods are increasing in frequency and may increase the risk for experiencing emotional distress, anxiety, depression and PTSD. The aim of this study was to determine the extent of damage, loss, injury and death resulting from floods that occurred in and around the city of Durban, South Africa, in April 2022, and associated changes in mental health pre- to post-floods in a low-income setting. Seventy-three women between the ages of 18 and 45, residing in flood affected, low-income settings, were interviewed prior to the floods occurring. Mental health measures were repeated with 69 of the 73 women during the post-flood interview along with a questionnaire measuring flood-related exposures. Loss of infrastructure (lacked access to drinking water, electricity, fresh food, could not travel to work, had to stay in a shelter and could not get hold of friends or family) was a predictor of post-flood change in levels of emotional distress and anxiety. Higher levels of prior trauma exposure were associated with higher post-flood levels of emotional distress. Higher pre-flood food insecurity was also associated with higher post-flood anxiety. Women affected by poverty, food insecurity and a history of trauma are vulnerable to the additive adverse mental health effects of floods. Proactive approaches to diminishing the impact of floods on the livelihood of women is needed and post-flood relieve efforts may be more affective if they are enhanced by providing mental health support.

Advancing disability-inclusive climate research and action, climate justice, and climate-resilient development

Globally, more than 1 billion people with disabilities are disproportionately and differentially at risk from the climate crisis. Yet there is a notable absence of climate policy, programming, and research at the intersection of disability and climate change. Advancing climate justice urgently requires accelerated disability-inclusive climate action. We present pivotal research recommendations and guidance to advance disability-inclusive climate research and responses identified by a global interdisciplinary group of experts in disability, climate change, sustainable development, public health, environmental justice, humanitarianism, gender, Indigeneity, mental health, law, and planetary health. Climate-resilient development is a framework for enabling universal sustainable development. Advancing inclusive climate-resilient development requires a disability human rights approach that deepens understanding of how societal choices and actions-characterised by meaningful participation, inclusion, knowledge diversity in decision making, and co-design by and with people with disabilities and their representative organisations-build collective climate resilience benefiting disability communities and society at large while advancing planetary health.

Effect of Environmental and Socioeconomic Factors on Increased Early Childhood Blood Lead Levels: A Case Study in Chicago

This study analyzes the prevalence of elevated blood lead levels (BLLs) in children across Chicagoland zip codes from 2019 to 2021, linking them to socioeconomic, environmental, and racial factors. Wilcoxon tests and generalized additive model (GAM) regressions identified economic hardship, reflected in per capita income and unemployment rates, as a significant contributor to increased lead poisoning (LP) rates. Additionally, LP rates correlate with the average age of buildings, particularly post the 1978 lead paint ban, illustrating policy impacts on health outcomes. The study further explores the novel area of land surface temperature (LST) effects on LP, finding that higher nighttime LST, indicative of urban heat island effects, correlates with increased LP. This finding gains additional significance in the context of anthropogenic climate change. When these factors are combined with the ongoing expansion of urban territories, a significant risk exists of escalating LP rates on a global scale. Racial disparity analysis revealed that Black and Hispanic/Latino populations face higher LP rates, primarily due to unemployment and older housing. The study underscores the necessity for targeted public health strategies to address these disparities, emphasizing the need for interventions that cater to the unique challenges of these at-risk communities.

Exposure to heat wave risks across time and places: Seasonal variations and predictors of feelings of threat across heat wave geographical susceptibility locations

Vulnerability to heat waves and their negative effects on health vary not only due to individual factors but also due to situational factors, such as time and geography. Hence, we explored seasonal variations and predictors of heat wave feelings of threat across different heat wave geographical susceptibility locations in Portugal. A total of 238 Portuguese residents responded to a web-based longitudinal survey: before the summer, during a heat wave in the summer, during the summer, and after the summer. Geographical location was used as an indicator of risk exposure, operationalized as heat wave occurrence susceptibility (low, moderate, high). Heat wave demands and resources perceptions were assessed to compute an indicator of heat wave feelings of threat. During the heat wave, feelings of threat were higher among participants in high-susceptibility locations, with demands outweighing resources perceptions, suggesting greater distress and coping difficulty. Regression analysis suggested that older participants and female participants living in moderate-high-susceptibility locations had greater difficulty in recovering. Heat wave risk perception and positive affect about heat were identified as the most consistent predictors of heat wave feelings of threat, with risk perception increasing and positive affect decreasing such feelings. Participants with (individual and geographical) vulnerability profiles, who had greater difficulty in coping and recovering from heat waves, could benefit from resource-building/enhancing interventions. In a climatic crisis context, monitoring psychological responses to heat waves (e.g., threat) may enable anticipated action to build resilience before, rather than after, the effects become damaging to physical and psychological health.

Mental health and psychosocial interventions in the context of climate change: a scoping review

The evidence on the impacts of climate change on mental health and wellbeing is growing rapidly. The objective of this scoping review is to understand the extent and type of existing mental health and psychosocial interventions aimed at addressing the mental health and psychosocial impacts of climate change. A scoping review methodology was followed. MEDLINE, PsycINFO, and Web of Science databases were searched from inception to May 2022. Comprehensive gray literature search, including expert consultation, was conducted to identify interventions for which peer-reviewed academic literature may not yet be available. Data on intervention type, setting, climate stressor, mental health outcome, evaluation, and any other available details were extracted, and results were summarized narratively. Academic literature search identified 16 records and gray literature search identified a further 24 records. Altogether, 37 unique interventions or packages of interventions were identified. The interventions act at the levels of microsystem, mesosystem, exosystem, and macrosystem through diverse mechanisms. While most interventions have not been formally evaluated, promising preliminary results support interventions in low- and middle-income-country settings disproportionately affected by climate disasters. Interventions from multidisciplinary fields are emerging to reduce psychological distress and enhance mental health and wellbeing in the context of climate change. This scoping review details existing evidence on the interventions and summarizes intervention gaps and lessons learned to inform continued intervention development and scale-up interventions.

When eco-anger (but not eco-anxiety nor eco-sadness) makes you change! A temporal network approach to the emotional experience of climate change

Research on the emotional experience of climate change has become a hot topic. Yet uncertainties remain regarding the interplay between climate change-related emotions (i.e., eco-anxiety, eco-anger, eco-sadness), general emotions (i.e., regardless of climate change), and pro-environmental behaviors. Most previous research has focused on cross-sectional studies, and eco-emotions in everyday life have seldom been considered. In this preregistered study, 102 participants from the general population rated their eco-emotions (i.e., eco-anxiety, eco-anger, eco-sadness), general emotions (i.e., anxiety, anger, sadness), and pro-environmental intentions and behaviors daily over a 60-day period. Using a multilevel vector autoregressive approach, we computed three network models representing temporal (i.e., from one time-point to the next), contemporaneous (i.e., during the same time-frame), and between-subject (i.e., similar to cross-sectional approach) associations between variables. Results show that eco-anger was the only predictor of pro-environmental intentions and behaviors over time. At the contemporaneous level, the momentary experience of each eco-emotion was associated with the momentary emotional experience of the corresponding general emotion, indicating the distinctiveness of each eco-emotion and the correspondence between its experience and that of its general, non-climate-related emotion. Overall, our findings 1) emphasize the driving role of eco-anger in prompting pro-environmental behaviors over time, 2) suggest a functional and experiential distinction between eco-emotions, and 3) provide data-driven clues for the field's larger quest to establish the scientific foundations of eco-emotions.

Health equity in pediatrics: Current concepts for the care of children in the 21st century (Dis Mon)

This is an analysis of important aspects of health equity in caring for children and adolescents written by a multidisciplinary team from different medical centers. In this discussion for clinicians, we look at definitions of pediatric health equity and the enormous impact of social determinants of health in this area. Factors involved with pediatric healthcare disparities that are considered include race, ethnicity, gender, age, poverty, socioeconomic status, LGBT status, living in rural communities, housing instability, food insecurity, access to transportation, availability of healthcare professionals, the status of education, and employment as well as immigration. Additional issues involved with health equity in pediatrics that are reviewed will include the impact of the COVID-19 pandemic, behavioral health concepts, and the negative health effects of climate change. Recommendations that are presented include reflection of one's own attitudes on as well as an understanding of these topics, consideration of the role of various healthcare providers (i.e., community health workers, peer health navigators, others), the impact of behavioral health integration, and the need for well-conceived curricula as well as multi-faceted training programs in pediatric health equity at the undergraduate and postgraduate medical education levels. Furthermore, ongoing research in pediatric health equity is needed to scrutinize current concepts and stimulate the development of ideas with an ever-greater positive influence on the health of our beloved children. Clinicians caring for children can serve as champions for the optimal health of children and their families; in addition, these healthcare professionals are uniquely positioned in their daily work to understand the drivers of health inequities and to be advocates for optimal health equity in the 21st century for all children and adolescents.

Effect of wildfire on the prevalence of opioid misuse through anxiety among young adults in the United States: A modeling study

Background

Exposure to climate change events like wildfires can lead to health and mental health problems. While conceptual frameworks have been hypothesized describing the potential relationship between disaster exposure and substance use, the association remains under-researched and unquantified.

Methods

We constructed a quantitative portrayal of one proposed conceptual framework that focuses on the intermediary role of anxiety. We used the Monte Carlo simulation to estimate the impact of wildfire exposure on opioid misuse outcomes through increased anxiety. We searched for and extracted prior empirical evidence on the associations between wildfire anxiety and anxiety-opioid misuse. A base case scenario (S1) was devised in which the impact of wildfire on opioid misuse was limited to increasing anxiety incidence. Two exploratory scenarios investigated the additive roles of altered anxiety phenotype (S2) and increased severity of pre-existing anxiety (S3) due to wildfire exposure.

Results

Models show that the prevalence of opioid misuse post-wildfire may rise to 6.0%-7.2%. In S1 (base case), the opioid misuse prevalence ratio was 1.12 (95% uncertainty interval [UI]: 1.00 - 1.27). The two exploratory scenarios, with less stringent assumptions, yielded prevalence ratios of 1.23 (95% UI: 1.00 - 1.51) and 1.34 (95% UI: 1.11 - 1.63).

Conclusions

Our modeling study suggests that exposure to wildfires may elevate opioid misuse through increasing anxiety incidence and severity. This may lead to substantial health burdens that may persist long after the initial wildfire event, which may offset recent gains in opioid misuse prevention.

Measuring long-term exposure to wildfire PM2.5 in California: Time-varying inequities in environmental burden

Wildfires have become more frequent and intense due to climate change and outdoor wildfire fine particulate matter (PM2.5) concentrations differ from relatively smoothly varying total PM2.5. Thus, we introduced a conceptual model for computing long-term wildfire PM2.5 and assessed disproportionate exposures among marginalized communities. We used monitoring data and statistical techniques to characterize annual wildfire PM2.5 exposure based on intermittent and extreme daily wildfire PM2.5 concentrations in California census tracts (2006 to 2020). Metrics included: 1) weeks with wildfire PM2.5 < 5 μg/m3; 2) days with non-zero wildfire PM2.5; 3) mean wildfire PM2.5 during peak exposure week; 4) smoke waves (≥2 consecutive days with <15 μg/m3 wildfire PM2.5); and 5) mean annual wildfire PM2.5 concentration. We classified tracts by their racial/ethnic composition and CalEnviroScreen (CES) score, an environmental and social vulnerability composite measure. We examined associations of CES and racial/ethnic composition with the wildfire PM2.5 metrics using mixed-effects models. Averaged 2006 to 2020, we detected little difference in exposure by CES score or racial/ethnic composition, except for non-Hispanic American Indian and Alaska Native populations, where a 1-SD increase was associated with higher exposure for 4/5 metrics. CES or racial/ethnic × year interaction term models revealed exposure disparities in some years. Compared to their California-wide representation, the exposed populations of non-Hispanic American Indian and Alaska Native (1.68×, 95% CI: 1.01 to 2.81), white (1.13×, 95% CI: 0.99 to 1.32), and multiracial (1.06×, 95% CI: 0.97 to 1.23) people were over-represented from 2006 to 2020. In conclusion, during our study period in California, we detected disproportionate long-term wildfire PM2.5 exposure for several racial/ethnic groups.

Keeping Sane in a Changing Climate: Assessing Psychologists' Preparedness, Exposure to Climate-Health Impacts, Willingness to Act on Climate Change, and Barriers to Effective Action

Evidence of the impact of climate change on mental health is growing rapidly, and healthcare professionals are being called to be active participants in protecting the population's health. Yet, little is known about psychologists' understanding of climate-health impacts and their role in mitigation actions. We surveyed Australian psychologists (N = 59) to examine preparedness in identifying and managing the impact of climate change on mental health, exposure to climate-health impacts, willingness to act, and barriers to acting on climate change. Data was analysed through descriptive and associative methods. We found that participants are not prepared to identify and manage mental health presentations related to climate change, and they are not engaged in climate change mitigation. We identified that a lack of knowledge of climate-health impacts and tackling and mitigation strategies, in addition to ethical concerns, were the main barriers to engagement with communication and advocacy. With the impacts of climate change on mental health expected to soar, there is a clear and urgent need to prepare the psychological workforce to address this public health issue by establishing professional education programs and reframing climate change as a health crisis.

The perceived impact of climate change on mental health and suicidality in Kenyan high school students

BACKGROUND

Climate change has psychological impacts but most of the attention has been focused on the physical impact. This study was aimed at determining the association of climate change with adolescent mental health and suicidality as reported by Kenyan high school students.

METHODS

This was a cross sectional study with a sample size of 2,652. The participants were high school students selected from 10 schools in 3 regions of Kenya. A questionnaire was used to assess climate change experiences, mental health problems, and suicidality of the youth. Data were analyzed descriptively and with logistic regression to determine various associations of the different variables and the predictors of the various scores of SDQ and suicidality at 95% CI.

RESULTS

Significant differences were observed between gender and two of the threats of climate change - worry and being afraid as subjectively experienced by the participants. Females were more worried and afraid of climate change than males. On univariate and multivariate logistic regression, we found that various experiences of climate change were significantly associated with various scores of SDQ and much fewer of the experiences predicted SDQ scores. The same pattern was reflected in suicidality.

CONCLUSION

Climate change appears to be associated with mental health concerns and suicidality according to Kenyan high school students' reports with gender differences in some associations.

Climate Change and Human Health in Africa in Relation to Opportunities to Strengthen Mitigating Potential and Adaptive Capacity: Strategies to Inform an African "Brains Trust"

Background

Africa faces diverse and complex population/human health challenges due to climate change. Understanding the health impacts of climate change in Africa in all its complexity is essential for implementing effective strategies and policies to mitigate risks and protect vulnerable populations. This study aimed to outline the major climate change-related health impacts in Africa in the context of economic resilience and to seek solutions and provide strategies to prevent or reduce adverse effects of climate change on human health and well-being in Africa.

Methods

For this narrative review, a literature search was conducted in the Web of Science, Scopus, CAB Abstracts, MEDLINE and EMBASE electronic databases. We also searched the reference lists of retrieved articles for additional records as well as reports. We followed a conceptual framework to ensure all aspects of climate change and health impacts in Africa were identified.

Results

The average temperatures in all six eco-regions of Africa have risen since the early twentieth century, and heat exposure, extreme events, and sea level rise are projected to disproportionately affect Africa, resulting in a larger burden of health impacts than other continents. Given that climate change already poses substantial challenges to African health and well-being, this will necessitate significant effort, financial investment, and dedication to climate change mitigation and adaptation. This review offers African leaders and decision-makers data-driven and action-oriented strategies that will ensure a more resilient healthcare system and safe, healthy populations-in ways that contribute to economic resiliency.

Conclusions

The urgency of climate-health action integrated with sustainable development in Africa cannot be overstated, given the multiple economic gains from reducing current impacts and projected risks of climate change on the continent's population health and well-being. Climate action must be integrated into Africa's development plan to meet the Sustainable Development Goals, protect vulnerable populations from the detrimental effects of climate change, and promote economic development.

Anxiety and Worry about Six Categories of Climate Change Impacts

The occurrence of severe and extreme weather events that have been attributed to a changed climate system and the widespread dissemination of the impacts of these events in the media can lead people to experience concern, worry, and anxiety, which we examined in two studies. In Study 1, we observed that people more frequently expressed worry than anxiety about the impacts of climate change in six areas. People were more frequently worried and anxious about the effects of climate change on future generations and about societal responses (or lack of a response) to climate change. The levels of anxiety that people expressed were significantly higher than the worry people reported when anxiety was their modal response. In Study 2, we observed that both climate change worry and anxiety were negatively correlated with psychological distance from climate change. Overall, climate change worry and psychological distance significantly predicted climate-sustainable behaviors. Our study was among the first to use developed measures of climate change worry, anxiety, and psychological distance to examine peoples' responses across some of the possible impact and consequence areas of climate change.

The impact of climate change on country and community and the role of mental health professionals working with Aboriginal communities in recovery and promoting resilience

This paper emerged from discussions between the authors about our shared and different perspectives of climate change and its impact on the social, emotional, physical, spiritual and cultural wellbeing of Aboriginal Peoples and mental health services in a rural region, heavily impacted in recent years by bushfires and floods. Here we discuss, from the lead authors personal perspective as a Gamilaraay Woman, the experience of Solastalgia as a critical impact of climate change on wellbeing. Specifically, we discuss the relationship of a connection to country from a Gamilaraay, first person perspective through a series of diary entries from the lead author. Authors are researchers from different cultural backgrounds, connected through a medical research futures fund research project, to promote resilience within Aboriginal communities and the health services sector in the New England, North West region. The lead author has cultural connections to some of the communities we work with and our work is informed by these connections. While this paper was written to express an Aboriginal perspective on climate change and wellbeing, it reflects our shared perspectives of how disasters such as bushfires impact the wellbeing of Aboriginal peoples. We also explore the connection between the impact of localised, recurring natural disasters and the increasing demands on mental health services in regional and rural areas and discuss what this means with Aboriginal and non-Indigenous mental health nurses and researchers working in regional and rural areas where access to mental health services often poses considerable challenges. From our perspective, mental health research and nursing play an important role in walking alongside Aboriginal Peoples as we explore, respond and create resilience to the ever-present influence that climate change is having on our lives, communities, country and workplaces.

Measuring young individuals' responses to climate change: validation of the Slovenian versions of the climate anxiety scale and the climate change worry scale

Introduction

While increasing awareness of climate change is needed to address this threat to the natural environment and humanity, it may simultaneously negatively impact mental health. Previous studies suggest that climate-specific mental health phenomena, such as climate anxiety and worry, tend to be especially pronounced in youth. To properly understand and address these issues, we need valid measures that can also be used in non-Anglophone samples. Therefore, in the present paper, we aimed to validate Slovenian versions of the Climate Anxiety Scale (CAS) and the Climate Change Worry Scale (CCWS) among Slovenian youth.

Method

We conducted an online survey in which 442 young individuals (18-24 years) from Slovenia filled out the two central questionnaires and additional instruments capturing other relevant constructs (e.g., general anxiety, neuroticism, and behavioral engagement).

Results

The confirmatory factor analyses results supported the hypothesized factorial structure of the CAS (two factors) and the CCWS (one factor). Both scales also demonstrated great internal reliability. Moreover, the analyses exploring both constructs' nomological networks showed moderate positive associations with similar measures, such as anxiety and stress (convergent validity), and very weak associations with measures they should not be particularly related to, such as narcissism (discriminant validity). Lastly, we found that the CAS and, even more so, the CCWS have unique predictive value in explaining outcomes such as perceived threat, support for climate policies, and behavioral engagement (incremental validity).

Discussion

Overall, Slovenian versions of the CAS and the CCWS seem to be valid, reliable, and appropriate for future studies tackling young individuals' responses to climate change. Limitations of the study and areas for future research are discussed.

The mental health impacts of human-ecosystem-animal relationships: A systematic scoping review of Eco-, Planetary, and One Health approaches

The threats to human and animal health, biodiversity conservation, and our living planet's future are ever-present and increasingly more severe due to climate change and environmental degradation. There is an emerging discourse exploring the mental health dimensions contained within these changes. To better understand and respond to these impacts requires novel and creative methodological approaches built on conceptual frameworks that integrate perspectives from the social and natural sciences. Three of the most influential interdisciplinary frameworks at the human-animal-ecosystem interface include: One Health, EcoHealth, and Planetary Health. These frameworks report mental health as an integral component within overall health-related outcomes. However, a comprehensive synthesis of the state of the literature that examines how mental health is explored within these approaches does not currently exist. A systematic scoping review was therefore conducted to obtain clear understandings of patterns, gaps, and broad themes, and to highlight future research needs and considerations. Standardized PRISMA guidelines, including explicitly defined inclusion/exclusion criteria and dual screening/extractions, were used. 13 papers were included: seven using the One Health Framework, with Planetary and EcoHealth each represented by three. Trends observed include a predominate focus on companion animals as interventions, "sense of place" used as a component of mental well-being, and non-physical health-related measurements of animal well-being as an outcome within One Health research. The lack in retrieved studies also highlight the dearth in literature on mental health as a pillar of these three well established frameworks. Compiling what is known in the evidence-base as a launching point for scientific engagement, this review describes guidance for investigators on how to conduct mental health research within these framework parameters so that future studies can elucidate mechanisms underpinning the intersections between the biosphere and human mental-health and data-driven interventions and policy recommendations that simultaneously address mental health and global change can be proposed and enacted.

Projections of Temperature-Related Suicide under Climate Change Scenarios in Japan

BACKGROUND

The impact of climate change on mental health largely remains to be evaluated. Although growing evidence has reported a short-term association between suicide and temperature, future projections of temperature-attributable suicide have not been thoroughly examined.

OBJECTIVES

We aimed to project the excess temperature-related suicide mortality in Japan under three climate change scenarios until the 2090s.

METHODS

Daily time series of mean temperature and the number of suicide deaths in 1973-2015 were collected for 47 prefectures in Japan. A two-stage time-stratified case-crossover analysis was used to estimate the temperature-suicide association. We obtained the modeled daily temperature series using five general circulation models under three climate change scenarios from the latest Coupled Model Intercomparison Project Phase 6 (CMIP6) Shared Socioeconomic Pathways scenarios (SSPs): SSP1-2.6, SSP2-4.5, and SSP5-8.5. We projected the excess temperature-related suicide mortality until 2099 for each scenario and evaluated the net relative changes compared with the 2010s.

RESULTS

During 1973-2015, there was a total of 1,049,592 suicides in Japan. Net increases in temperature-related excess suicide mortality were estimated under all scenarios. The net change in 2090-2099 compared with 2010-2019 was 1.3% [95% empirical confidence interval (eCI): 0.6, 2.4] for the intermediate-emission scenario (SSP2-4.5), 0.6% (95% eCI: 0.1, 1.6) for a low-emission scenario (SSP1-2.6), and 2.4% (95% eCI: 0.7, 3.9) for the extreme scenario (SSP5-8.5). The increases were greater the more extreme the scenarios were, with the highest increase under the most extreme scenario (SSP5-8.5).

DISCUSSION

This study indicates that Japan may experience a net increase in excess temperature-related suicide mortality, especially under the intermediate and extreme scenarios. The findings underscore the importance of mitigation policies. Further investigations of the future impacts of climate change on mental health including suicide are warranted. https://doi.org/10.1289/EHP11246.

Minding our futures: Understanding climate-related mental wellbeing using systems science

INTRODUCTION

Climate change impacts mental wellbeing through complex pathways and young people are among the most vulnerable to climate-related anxiety. Minding our Futures used methods from systems science to explore this issue and identify actions to promote mental wellbeing for young Australians (18-24 years).

METHODS

This qualitative study used Group Model Building via three online facilitated workshops recruiting health, youth and climate practitioners and researchers engaged with young people around climate change and/or mental wellbeing (N = 14). Analysis created a systems map and rich description of the relationships between causal factors and their impact on young people.

RESULTS

Three themes emerged; "Government, Services and Structures" highlighted underlying structural issues including capitalism and political powerlessness; "Social Norms, Communication and Taking Action" reflected social media and misinformation; and "Personal Experience of Environmental Disasters" described the impact of climate-related disasters and importance of nature and place connection. Participants specified connections between the themes and mental health outcomes.

CONCLUSION

This novel applied translational research process supported key informants to design structural responses to a complex and critical public health issue. Their vision was a multi-faceted approach, co-led with young people, drawing on Indigenous knowledges and change-focused policy, community empowerment and nature-based interventions.

The influence of climate change on mental health in populations of the western Pacific region: An umbrella scoping review

The Western Pacific Region (WPR) is on the front line of climate change challenges. Understanding how these challenges affect the WPR populations' mental health is essential to design effective prevention and care policies. Thus, the present study conducted an umbrella scoping review that examined the influence of climate change on mental health in the WPR, using review articles as a source of information. Ten review articles were selected according to eligibility criteria, and the findings were synthesized according to the socio-economic status of the countries identified: Australia, the Republic of Korea, the Philippines, Vietnam, the Pacific Islands (broadly), and China. The findings revealed that each country and sub-region has its own unique profile of climate change-related challenges and vulnerable populations, highlighting the need for specific approaches to mental health care. Specifically, the influence of climate-related challenges differed according to populations' region (e.g., rural populations), demographic characteristics (e.g., age and gender), culture (e.g., traditional tights to land), and employment (e.g., farmers and fishers). The most frequently reported mental health outcomes in response to climate change-related challenges such as droughts, floods, storms, tornadoes, typhoons, and climate-related migration were the decline in mental well-being and the increase in post-traumatic stress disorder symptoms. In addition, using the GRADE framework for assessing the certainty of the findings, we identified that the number of articles discussing associations between a given climate change challenge and a mental health outcome was overall limited. Based on our findings and findings on a global scale, we identified several key research gaps in WPR and provided recommendations for future research and policy strategies.

Impacts of Climate Change on Work Health and Safety in Australia: A Scoping Literature Review

This scoping review explores the extant literature on climate change impacts on Workplace Health and Safety (WHS) in Australia. It maps the coverage of climate hazards, occupations at risk, and health and socio-economic impacts with the aim of identifying climate change impacts on WHS in Australia and associated knowledge gaps. We used a scoping review approach to identify and investigate 41 scholarly works at the nexus between climate change and WHS in Australia. Thematic template analysis and the NVivo software helped us identify and structure the main themes and systematically document the analysis process. The review highlighted a research focus on the impacts on WHS of heat and extreme weather events resulting from climate change. Agriculture and construction emerged as the most examined occupations, emphasising climate-related diseases and productivity loss. Other climate-related hazards, occupations, and health and socio-economic impacts were largely overlooked in the included research literature. The analysis revealed there is scope for further research relating to climate change impacts on occupational hazards (e.g., air pollution), occupations (e.g., indoor settings at risk), worker health (e.g., injuries), and socio-economic impacts (e.g., change in social practice). Furthermore, the results highlight that the main themes (hazards, occupations, health, and productivity) are interconnected, and the impacts of climate change can be 'cascading', adding complexity and severity. Hence, it is important to look at WHS as a multifaceted phenomenon in a holistic way to understand the risks and support required.

Estimating climate change and mental health impacts in Canada: A cross-sectional survey protocol

Climate change has severe and sweeping impacts on mental health. Although research is burgeoning on mental health impacts following climate and weather extremes, less is known about how common these impacts are outside of extreme events. Existing research exploring the prevalence of psychosocial responses to climate change primarily examines university students and uses non-random sampling methods. Herein, our protocol outlines an approach to data collection, processing, and analysis to estimate the population prevalence, magnitude, and distribution of mental health responses to climate change in Canada. A cross-sectional survey of youth and adults aged 13 years and older in Canada will be administered over the course of one year. The questionnaire will take approximately 10 minutes to complete orally and will be administered in English, French, and Inuktitut. The survey will consist of six sections: (1) self-reported past experiences of climate change; (2) self-reported climate-related emotions; (3) self-reported past and current impacts, anticipatory impacts, and vicarious experiences; (4) self-reported subclinical outcomes; (5) self-reported behavioural responses; and (6) demographics. A multi-stage, multi-stratified random probability sampling method will be used to obtain a sample representative of the Canadian population. We will use two different modes of recruitment: an addressed letter sent by postal mail or a telephone call (landlines and cellular). Population-weighted descriptive statistics, principal component analysis, and weighted multivariable regression will be used to analyse the data. The results of this survey will provide the first national prevalence estimates of subclinical mental health responses to climate change outcomes of people living in Canada.

How does the macroenvironment influence brain and behaviour - a review of current status and future perspectives

The environment influences mental health, both detrimentally and beneficially. Current research has emphasized the individual psychosocial 'microenvironment'. Less attention has been paid to 'macro-environmental' challenges including climate change, pollution, urbanicity and socioeconomic disparity. With the advent of large-scale big-data cohorts and an increasingly dense mapping of macroenvironmental parameters, we are now in a position to characterise the relation between macroenvironment, brain, and behaviour across different geographic and cultural locations globally. This review synthesises findings from recent epidemiological and neuroimaging studies, aiming to provide a comprehensive overview of the existing evidence between the macroenvironment and the structure and functions of the brain, with a particular emphasis on its implications for mental illness. We discuss putative underlying mechanisms and address the most common exposures of the macroenvironment. Finally, we identify critical areas for future research to enhance our understanding of the aetiology of mental illness and to inform effective interventions for healthier environments and mental health promotion.

Solastalgia and Forest Fires

One of the important problems created by climate change is forest fires. Forest fires occur due to both natural and anthropogenic causes. Forest fires, which occur with the effects of climate change such as an increase in temperature, drought, heat waves, and climatic conditions, are increasing gradually. Acute and chronic effects caused by forest fires cause significant life changes. As a result of the fire, not only forests are damaged, but also flora, wildlife, water resources, soil, climate, areas used by people for recreational purposes, and settlements near and around forested areas. As a result, changes such as increases in temperature, pollution, epidemics, drought, food shortage, and forest fires, affect mental and physical health. While exposure to forest fires creates a direct traumatic effect; indirectly, it affects mental health for a number of social, political and economic reasons such as poverty, unemployment and housing. Forest fires also create an environmental change. This environmental change creates a sense of loss, the sense of belonging is lost, it cannot connect with the new environment, it becomes difficult to adapt and causes distress.Uncertainty about the future, helplessness, stress, anxiety, post-traumatic stress disorder and depression are common psychological problems due to climate change. It defines some new mental health concepts as the consequences of climate change affect mental health. "Solastalgia" is one pf these new concepts. Solastalgia is defined as a term that expresses the pain and distress caused by the loss of the thing/things that people find solace and environmental change. Solastalgia is a necessary concept for mental health professionals to understand the links between ecosystem health and human health, especially the cumulative effects of climatic and environmental change on mental, emotional and spiritual health.

Scoping review of climate change and mental health in Germany - Direct and indirect impacts, vulnerable groups, resilience factors

Background

Climate change is a major threat to human health and has direct and indirect impacts on the human psyche.

Methods

To assess the state of knowledge on the impact of climate change on mental health in Germany, a scoping review was conducted for the focus topics extreme weather events, temperature increase, intra-psychological processing, sociological aspects, and resilience factors. Ten studies met the inclusion criteria of the searches in the databases Academic Search Complete, CINAHL, PubPsych, PubMed, and PsychInfo. The majority of the studies looked at correlative relationships in a cross-sectional design.

Results

There are indications of an accumulation of psychiatric disorders after extreme weather events; in addition, the risk of suicide increases with higher temperatures and it appears there is an increase in aggressive behaviour. The majority of people surveyed in Germany report concerns about the consequences of climate change, although these currently rarely lead to clinically significant impairments in mental health.

Conclusions

Overall, the evidence for Germany must be classified as insufficient. In addition to the absolute priority of climate protection (mitigation) by reducing emissions, there is a particular need for additional research with a focus on vulnerable groups and possibilities for prevention and adaptation.

Impacts of Covid-19 on mental health service provision in the Western Cape, South Africa: The MASC study

In the context of an already large treatment gap in South Africa, this study aimed to examine how Covid-19 and the related lockdown measures affected the availability, accessibility, quality, and continuity of mental health services in the Western Cape province in South Africa. A mixed-methods design was employed, using narrative surveys, quantitative surveys, and qualitative semi-structured interviews, with 17 public mental health providers, and secondary data from the District Health Information System. We analysed and combined the data using descriptive statistics, template analysis and methodological triangulation. Results showed that Covid-19 and the lockdowns had negative impacts on mental health service provision at all levels of care, such as reduced access to services, increased stigma and discrimination, disrupted medication supply, increased workload and stress for providers, and the closure of psychosocial and therapeutic services. Innovations used by providers to mitigate these impacts included telehealth, online training, peer support groups, and community outreach. The study concludes that Covid-19 and the lockdowns exposed and exacerbated the existing gaps and challenges in mental health service provision in South Africa. Key recommendations for policy formation and response to future pandemics in the public mental health sector include: classifying psychological treatments as essential services, establishing an intersectoral mental health emergency response plan, involving mental health care users in the development of pandemic responses, creating policies for managing health emergencies in psychiatric facilities, and increasing resources for the mental health sector in South Africa. These recommendations are relevant for South Africa and other LMICs in ensuring adequate mental health care during public health emergencies.

Transforming mental health systems globally: principles and policy recommendations

A burgeoning mental health crisis is emerging globally, regardless of each country's human resources or spending. We argue that effectively responding to this crisis is impeded by the dominant framing of mental ill health through the prism of diagnostic categories, leading to an excessive reliance on interventions that are delivered by specialists; a scarcity of widespread promotive, preventive, and recovery-oriented strategies; and failure to leverage diverse resources within communities. Drawing upon a series of syntheses, we identify five principles to transform current practices; namely, address harmful social environments across the life course, particularly in the early years; ensure that care is not contingent on a categorical diagnosis but aligned with the staging model of mental illness; empower diverse front-line providers to deliver psychosocial interventions; embrace a rights-based approach that seeks to provide alternatives to violence and coercion in care; and centre people with lived experience in all aspects of care. We recommend four policy actions which can transform these principles into reality: a whole of society approach to prevention and care; a redesign of the architecture of care delivery to provide a seamless continuum of care, tailored to the severity of the mental health condition; investing more in what works to enhance the impact and value of the investments; and ensuring accountability through monitoring and acting upon a set of mental health indicators. All these actions are achievable, relying-for the most part-on resources already available to every community and country. What they do require is the acceptance that business as usual will fail and the solutions to transforming mental health-care systems are already present within existing resources.

The Impact of Climate Change on Asthma and Allergic-Immunologic Disease

PURPOSE OF REVIEW

This review discusses climate change-related impacts on asthma and allergic-immunologic disease, relevant US public health efforts, and healthcare professional resources.

RECENT FINDINGS

Climate change can impact people with asthma and allergic-immunologic disease through various pathways, including increased exposure to asthma triggers (e.g., aeroallergens, ground-level ozone). Climate change-related disasters (e.g., wildfires, floods) disrupting healthcare access can complicate management of any allergic-immunologic disease. Climate change disproportionately affects some communities, which can exacerbate disparities in climate-sensitive diseases like asthma. Public health efforts include implementing a national strategic framework to help communities track, prevent, and respond to climate change-related health threats. Healthcare professionals can use resources or tools to help patients with asthma and allergic-immunologic disease prevent climate change-related health impacts. Climate change can affect people with asthma and allergic-immunologic disease and exacerbate health disparities. Resources and tools are available to help prevent climate change-related health impacts at the community and individual level.

Extreme Heat and Suicide Watch Incidents Among Incarcerated Men

Importance

Extreme heat poses a distinct risk to the 2.1 million incarcerated people in the United States, who have disparately high rates of behavioral health conditions. Suicide is a leading cause of death among people in prisons.

Objective

To examine associations of extreme heat, solitary confinement, and an indicator of suicidal behaviors among incarcerated men in a Deep South US prison system.

Design, Setting, and Participants

This longitudinal case series panel study included adult men in prisons in Louisiana, a state with one of the largest prison systems in the United States that has been engaged in litigation due to lack of air conditioning and extreme heat. The unit of analysis was prison facility-days. A facility-level data set was created by merging administrative data files, which included demographic characteristics, health classification, housing location and movement, disciplinary records, and involvement in suicide-watch incidents for all incarcerated men in Louisiana during the observation period. Individual-level variables were aggregated to facility-days to merge in daily maximum heat index data from the US Local Climatological Data, which were linked to the zip codes of prisons. The observation period was January 1, 2015, to December 31, 2017. Data set construction occurred from August 2020 to September 2022, and analysis was conducted from December 2022 to February 2023.

Exposure

The focal exposure was extreme heat days. Daily maximum heat index data were categorized into 6 bins (<30 °F, 30-39 °F, 40-49 °F, 50-59 °F, 70-79 °F, and ≥80 °F) and as an indicator for any facility-day where the maximum heat index exceeded the 90th percentile of heat indices for total days in observation period. Conditional fixed-effects negative binomial regression models were used to calculate incident rate ratios to test associations between extreme heat and suicide watch incidents, while controlling for covariates.

Main Outcomes and Measures

The focal outcome was daily count of suicide watch incidents that were recorded in a carceral system database. Covariates included daily percentages of incarcerated persons at each prison with serious mental illness diagnosis, daily rate of solitary confinement, and total facility population.

Results

The sample of 6 state-operated prisons provided 6576 facility-days for the analysis. Results suggest a dose-responsive association between extreme heat and daily counts of suicide-watch incidents; compared with days with temperatures between 60 and 69 °F, the rate of daily suicide incidents increased by 29% when the heat index reached the level of caution (ie, 80-89 °F) and by 36% when reaching extreme caution (90-103 °F) (80-89 °F: incidence rate ratio [IRR], 1.29; 95% CI, 1.17-1.43; P < .001; 90-103 °F: IRR, 1.36; 95% CI, 1.15-1.61; P < .001). Compared with other days, those with the extreme heat indicator were significantly associated with a 30% increase in the incident rate of daily suicide-watch incidents (IRR, 1.30; 95% CI, 1.18-1.45; P < .001).

Conclusions and Relevance

Findings suggest an association between extreme heat and an indicator of suicidality among an incarcerated sample, contribute to an emerging literature exploring linkages between climatological events and health outcomes in prisons, and may have implications for legal interventions and advocacy seeking to abate heat-induced morbidity and mortality in carceral contexts.

Climate anxiety, coping strategies and planning for the future in environmental degree students in the UK

Introduction

There is increasing recognition of the mental health burden of climate change and the effects on general well-being, even in those who have not (yet) experienced direct impacts. Climate anxiety, which is prominent among young people in particular, describes a state of heightened distress about the (future) effects of climate change. Despite evidence of a link between engagement in climate change issues and heightened climate anxiety, there is a dearth of knowledge on how this affects emerging professionals preparing for careers in the environmental sector. Furthermore, there is a paucity of literature regarding the extent to which young adults are coping with their thoughts and feelings about climate change, and the extent to which they consider climate change in making future plans.

Methods

The aim of this study was to understand the occurrence and personal management of climate anxiety in UK university students through an online questionnaire. This study was the first to investigate the association between climate anxiety, coping strategies and future planning in university students.

Results and discussion

Environmental degree students (n = 249) reported greater levels of climate anxiety, more frequent employment of all three examined coping strategies and in particular considered climate change as a factor in their career plans, as compared to their non-environmental degree counterparts (n = 224). Problem-focused coping was the most commonly endorsed strategy, although the prior literature on coping suggests that this may not be sustainable for individually intractable problems. Highly climate-anxious students were more likely to consider climate change in all five decision-making domains, including family planning, long-term habitation, career, financial and travel decisions. This study has identified a need to communicate effective climate anxiety coping strategies to environmental practitioners, university students and educators. Additional research is required to validate the study findings and investigate what motivates students to incorporate climate change into future plans.

Pathways from climate change to emotional wellbeing: A qualitative study of Kenyan smallholder farmers living with HIV

Climate change is associated with adverse mental and emotional health outcomes. Social and economic factors are well-known drivers of mental health, yet comparatively few studies examine the social and economic pathways through which climate change affects mental health. There is additionally a lack of research on climate change and mental health in sub-Saharan Africa. This qualitative study aimed to identify potential social and economic pathways through which climate change impacts mental and emotional wellbeing, focusing on a vulnerable population of Kenyan smallholder farmers living with HIV. We conducted in-depth, semi-structured interviews with forty participants to explore their experience of climate change. We used a thematic analytical approach. We find that among our study population of Kenyan smallholder farmers living with HIV, climate change is significantly affecting mental and emotional wellbeing. Respondents universally report some level of climate impact on emotional health including high degrees of stress; fear and concern about the future; and sadness, worry, and anxiety from losing one's home, farm, occupation, or ability to support their family. Climate-related economic insecurity is a main driver of emotional distress. Widespread economic insecurity disrupts systems of communal and family support, which is an additional driver of worsening mental and emotional health. Our study finds that individual adaptive strategies used by farmers in the face of economic and social volatility can deepen economic insecurity and are likely insufficient to protect mental health. Finally, we find that agricultural policies can worsen economic insecurity and other mental health risk factors. Our proposed conceptual model of economic and social pathways relevant for mental health can inform future studies of vulnerable populations and inform health system and policy responses to protect health in a changing climate.

Community indicators for mental health in Europe: a scoping review

Background

Community indicators may predict and influence individuals` mental health, and support or impede mental health management. However, there is no consensus on which indicators should be included in predictions, prognostic algorithms, or management strategies for community-based mental health promotion and prevention approaches. Therefore, this scoping review provides an overview of relevant community-level indicators for mental health in the general as well as risk populations in a European context.

Methods

We conducted a scoping review in the following electronic databases: PubMed, Embase, and PsycInfo. Eligible studies focused on context factors such as either the physical or social environment, reporting at least one mental health outcome and referring to a European population. Publications between 2012 and March 8, 2022 are considered.

Results

In total, the search yielded 12,200 identified records. After the removal of duplicates, 10,059 records were screened against the eligibility criteria. In total, 169 studies were included in the final analysis. Out of these included studies, 6% focused on pan-European datasets and 94% on a specific European country. Populations were either general or high-risk populations (56 vs. 44%, respectively) with depressive disorder as the main reported outcome (49%), followed by general mental health (33%) and anxiety (23%). Study designs were cross-sectional studies (59%), longitudinal (27%), and others (14%). The final set of indicators consisted of 53 indicators, which were grouped conceptually into 13 superordinate categories of community indicators. These were divided into the domains of the physical and social environment. The most commonly measured and reported categories of community indicators associated with mental health outcomes were social networks (n = 87), attitudinal factors toward vulnerable groups (n = 76), and the characteristics of the built environment (n = 56).

Conclusion

This review provides an evidence base of existing and novel community-level indicators that are associated with mental health. Community factors related to the physical and social environment should be routinely recorded and considered as influencing factors or potentially underestimated confounders. The relevance should be analyzed and included in clinical outcomes, data, monitoring and surveillance as they may reveal new trends and targets for public mental health interventions.

Global Mental Health: Where We Are and Where We Are Going

PURPOSE OF REVIEW

To summarize recent findings in global mental health along several domains including socioeconomic determinants, inequities, funding, and inclusion in global mental health research and practice.

RECENT FINDINGS

Mental illness continues to disproportionately impact vulnerable populations and treatment coverage continues to be low globally. Advances in integrating mental health care and adopting task-shifting are accompanied by implementation challenges. The mental health impact of recent global events such as the COVID-19 pandemic, geo-political events, and environmental change is likely to persist and require coordinated care approaches for those in need of psychosocial support. Inequities also exist in funding for global mental health and there has been gradual progress in terms of building local capacity for mental health care programs and research. Lastly, there is an increasing effort to include people with lived experiences of mental health in research and policy shaping efforts. The field of global mental health will likely continue to be informed by evidence and perspectives originating increasingly from low- and middle-income countries along with ongoing global events and centering of relevant stakeholders.

Climate Change and Substance-Use Behaviors: A Risk-Pathways Framework

Climate change is undermining the mental and physical health of global populations, but the question of how it is affecting substance-use behaviors has not been systematically examined. In this narrative synthesis, we find that climate change could increase harmful substance use worldwide through at least five pathways: psychosocial stress arising from the destabilization of social, environmental, economic, and geopolitical support systems; increased rates of mental disorders; increased physical-health burden; incremental harmful changes to established behavior patterns; and worry about the dangers of unchecked climate change. These pathways could operate independently, additively, interactively, and cumulatively to increase substance-use vulnerability. Young people face disproportionate risks because of their high vulnerability to mental-health problems and substance-use disorders and greater number of life years ahead in which to be exposed to current and worsening climate change. We suggest that systems thinking and developmental life-course approaches provide practical frameworks for conceptualizing this relationship. Further conceptual, methodological, and empirical work is urgently needed to evaluate the nature and scope of this burden so that effective adaptive and preventive action can be taken.

Measuring negative emotional responses to climate change among young people in survey research: A systematic review

BACKGROUND

Climate change is a threat to the mental and emotional wellbeing of all humans, but young people are particularly vulnerable. Emerging evidence has found that young people's awareness of climate change and the danger it poses to the planet can lead to negative emotions. To increase our understanding about this, survey instruments are needed that measure the negative emotions young people experience about climate change.

RESEARCH QUESTIONS

(1) What survey instruments are used to measure negative emotional responses to climate change in young people? (2) Do survey instruments measuring young people's negative emotional responses to climate change have evidence of reliability and validity? (3) What factors are associated with young people's negative emotional responses to climate change?

METHODS

A systematic review was conducted by searching seven academic databases on November 30, 2021, with an update on March 31, 2022. The search strategy was structured to capture three elements through various keywords and search terms: (1) negative emotions, (2) climate change, and (3) surveys.

RESULTS

A total of 43 manuscripts met the study inclusion criteria. Among the 43 manuscripts, 28% focused specifically on young people, while the other studies included young people in the sample but did not focus exclusively on this population. The number of studies using surveys to examine negative emotional responses to climate change among young people has increased substantially since 2020. Survey instruments that examined worry or concern about climate change were the most common.

CONCLUSION

Despite growing interest in climate change emotions among young people, there is a lack of research on the validity of measures of such emotions. Further efforts to develop survey instruments geared to operationalize the emotions that young people are experiencing in relation to climate change are needed.