Climate change is an “unappreciated mental health emergency” with inequitable impacts.[1,2] Climate-related disasters like wildfires, hurricanes, and heat waves disrupt lives, communities, and access to the land.[2,3] Slow-moving disasters like rising sea levels and drought lead to displacement, migration, and the loss of landscapes and biodiversity; the anticipation of future climate impacts further harms mental health.[2,3]

As the primary driver of the climate crisis, poor air quality from fossil fuel combustion is associated with increased risk of depressive, anxiety, and neurodegenerative disorders, as well as relapse of psychotic illness.[3] Extreme heat is linked to heightened aggression and violence, higher suicide rates, and elevated risk of morbidity and mortality for those with mental disorders.[3] Globally, mental illness attributed to climate-related threats, air pollution, and poor green space access is predicted to cost US$47 billion per year by 2030.[4] Populations impacted by changes to the land, such as Indigenous populations; agricultural and outdoor workers; and youth, refugees, immigrants, and those with lower socioeconomic status are at greater risk.[3]

Eco-distress—distress from changes to the environment—is a normal reaction to threatened and actual loss of individuals, communities, and ecosystems. Clinicians should validate patients’ concerns about the impacts of climate change and offer climate-aware mental health suggestions, including the following:

• Learning to recognize and name climate-related emotions, including anger, sadness, and fear, as well as positive emotions, like gratitude.[3,5] Patients may appear apathetic or indifferent when emotionally overwhelmed, which may represent a skill deficit in managing emotions. These patients may benefit from working with a climate-aware therapist or participating in programs like Mind Space (https://mind-space.ca [14]) to cultivate skills for managing emotions in the face of adversity.
• Preparing for disasters, both individually and at the community level, to help reduce anxiety and improve social connectedness and resilience.
• Reducing excessive exposure to media about climate disasters and seeking out positive climate-related stories.
• Making positive personal choices that have co-benefits for the planet and the individual, such as biking or walking instead of driving[3] and eating more plant-based foods.
• Participating in collective action focused on solutions to the climate crisis, adaptation, and systems change, which can promote agency, meaning, and purpose.[3]
• Increasing social connection and exposure to nature through green and social prescribing. These have multiple mental and physical health benefits, and engaging in nature-based solutions such as restoration can empower patients and increase community resilience to climate change.[6] For example, PaRx, Canada’s national nature prescription program, includes subsidized transportation and outdoor venue access.[7]

When someone is unable to regulate their emotions, has impairments in functioning, engages in risky behaviors, or has thoughts of suicide, this goes beyond eco-distress. Clinicians should treat new or worsening symptoms of mood, anxiety, substance use, or other mental disorders as they typically would, in addition to offering the climate-specific interventions above.

Education and training for health professionals to integrate climate-aware mental health care into practice should be a priority.[3] Additionally, meaningful systems-level action on climate change by governments and corporations is urgently needed to address the climate mental health emergency.
—Ilona Hale, MD, FCFP
Council on Health Promotion Member
—Ou Jia (Emilie) Wang
Medical Student, Faculty of Medicine, UBC
—Melissa Lem, MD, CCFP, FCFP
Clinical Assistant Professor, Faculty of Medicine, UBC
—Rachel Grimminck, MD, FRCPC, DABPN, CGP
Clinical Assistant Professor, Faculty of Medicine, UBC
Clinical Assistant Professor, Department of Psychiatry, University of Calgary

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This article is the opinion of the authors and not necessarily the Council on Health Promotion or Doctors of BC. This article has not been peer reviewed by the BCMJ Editorial Board.

[15]

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License [15].

References

1.    Imperial College London. Climate cares centre. Accessed 4 May 2025. www.imperial.ac.uk/climate-cares/ [16].

2.    Heinz A, Brandt L. Climate change and mental health: Direct, indirect, and intersectional effects. Lancet Reg Health Eur 2024;43:100969. https://doi.org/10.1016/j.lanepe.2024.100969 [17].

3.    Lawrance EL, Thompson R, Newberry Le Vay J, et al. The impact of climate change on mental health and emotional wellbeing: A narrative review of current evidence, and its implications. Int Rev Psychiatry 2022;34:443-498. https://doi.org/10.1080/09540261.2022.2128725 [18].

4.    Kumar P, Brander L, Kumar M, Cuijpers P. Planetary health and mental health nexus: Benefit of environmental management. Ann Glob Health 2023;89:49. https://doi.org/10.5334/aogh.4079 [19].

5.    Climate Mental Health Network. Climate emotions wheel. Accessed 4 May 2025. www.climatementalhealth.net/wheel [20].

6.    Ivers R, Astell-Burt T. Nature Rx: Nature prescribing in general practice. Aust J Gen Pract 2023;52:183-186. https://doi.org/10.31128/AJGP-01-23-6671 [21].

7.    Lesser I, Thomson C, Lem M. Green exercise as an opportunity to promote equity in physical activity engagement across diverse populations. J Phys Act Health 2024;21:533-535. https://doi.org/10.1123/jpah.2024-0091 [22].