Editing IPCC:AR6/WGII/Chapter-7 (section)

==== 7.2.5.1 Observed Impacts on Mental Disorders ====

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''A wide range of climatic events and conditions have observed and detrimental impacts on mental health'' ( ''very high confidence'' ) ''.'' The pathways through which climatic events affect mental health are varied, complex and inter-connected with other non-climatic influences that create vulnerability (Figure 7.6). The climatic exposure may be direct, such as experiencing an extreme weather event or prolonged high temperatures, or indirect, such as mental health consequences of undernutrition or displacement. Exposure may also be vicarious, with people experiencing decreased mental health associated with observing the impact of climate change on others or simply by learning about climate change. Non-climatic moderating influences range from an individual’s personality and pre-existing conditions, to social support, and to structural inequities ( [[#Gariepy--2016|Gariepy et al., 2016]] ; [[#Hrabok--2020|Hrabok et al., 2020]] ; [[#Nagy--2018|Nagy et al., 2018]] ; [[#Silva--2016b|Silva et al., 2016b]] ). Depending on these background and contextual factors, similar climatic events may result in a range of potential mental health outcomes, including anxiety, depression, acute traumatic stress, PTSD, suicide, substance abuse and sleep problems, with conditions ranging from being mild in nature to those that require hospitalisation ( [[#Berry--2010|Berry et al., 2010]] ; [[#Cianconi--2020|Cianconi et al., 2020]] ; [[#Clayton--2017|Clayton et al., 2017]] ; [[#Ruszkiewicz--2019|Ruszkiewicz et al., 2019]] ; [[#Bromet--2017|Bromet et al., 2017]] ; Lowe, 2019). The line between mental health and more general well-being is permeable, but in this section we refer to diagnosable mental disorders—conditions that disrupt or impair normal functioning through impacts on mood, thinking or behaviour.

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[[File:b9680ca351db5c67f3df6a80181b0f78 IPCC_AR6_WGII_Figure_7_006.png]]

'''Figure 7.6 |''' '''Climate change impacts on mental health and key adaptation responses.''' PTSD: Post traumatic stress disorder.

''There is an observable association between high temperatures and mental health decrements'' ( ''high confidence'' ) '', with an additional possible influence of increased precipitation'' ( ''medium agreement, medium evidence'' ). Heat-associated mental health outcomes include suicide ( [[#Williams--2015a|Williams et al., 2015a]] ; [[#Carleton--2017|Carleton, 2017]] ; [[#Burke--2018|Burke et al., 2018]] ; [[#Kim--2019b|Kim et al., 2019b]] ; [[#Thompson--2018|Thompson et al., 2018]] ; [[#Schneider--2020|Schneider et al., 2020]] ; [[#Cheng--2021|Cheng et al., 2021]] ; [[#Baylis--2018|Baylis et al., 2018]] ; [[#Obradovich--2018|Obradovich et al., 2018]] ); psychiatric hospital admissions and emergency room visits for mental disorders ( [[#Hansen--2008|Hansen et al., 2008]] ; [[#Wang--2014|Wang et al., 2014]] ; [[#Chan--2018|Chan et al., 2018]] ; [[#Mullins--2019|Mullins and White, 2019]] ; [[#Yoo--2021|Yoo et al., 2021]] ); experiences of anxiety, depression and acute stress ( [[#Obradovich--2018|Obradovich et al., 2018]] ; [[#Mullins--2019|Mullins and White, 2019]] ); and self-reported mental health ( [[#Li--2020|Li et al., 2020]] ). In Canada, [[#Wang--2014|Wang et al. (2014)]] found an association between mean heat exposure of 28°C and greater hospital admissions within 0 to 4 days for mood and behavioural disorders (including schizophrenia, mood and neurotic disorders). A US study found mental health problems increased by 0.5% when average temperatures exceed 30°C, compared to averages between 25°C and 30°C; a 1°C warming over five years was associated with a 2% increase in mental health problems ( [[#Obradovich--2018|Obradovich et al., 2018]] ). Another study found a 1°C rise in monthly average temperatures over several decades was associated with a 2.1% rise in suicide rates in Mexico and a 0.7% rise in suicide rates in the USA ( [[#Burke--2018|Burke et al., 2018]] ). A systematic review of published research using a variety of methodologies from 19 countries ( [[#Thompson--2018|Thompson et al., 2018]] ) found an increased risk of suicide associated with a 1°C rise in ambient temperature.

''Discrete climate hazards including storms ( [[#Kessler--2008|Kessler et al., 2008]] ; [[#Boscarino--2013|Boscarino et al., 2013]] ; [[#Boscarino--2017|Boscarino et al., 2017]] ; [[#Obradovich--2018|Obradovich et al., 2018]] ), floods ( [[#Baryshnikova--2019|Baryshnikova and Pham, 2019]] ), heatwaves, wildfires and drought ( [[#Hanigan--2012|Hanigan et al., 2012]] ; [[#Carleton--2017|Carleton, 2017]] ; [[#Zhong--2018|Zhong et al., 2018]] ; [[#Charlson--2021|Charlson et al., 2021]] ) have significant negative consequences for mental health'' ( ''very high confidence'' ). A large body of research identifies the impacts of extreme weather events on PTSD, anxiety and depression; much of the research has been done in the USA and the UK, but a growing number of studies find evidence for similar impacts on mental health in other countries, including Spain ( [[#Foudi--2017|Foudi et al., 2017]] ), Brazil ( [[#Alpino--2016|Alpino et al., 2016]] ), Chile ( [[#Navarro--2016|Navarro et al., 2016]] ), Small Island Developing States (Kelman et al., 2021) and Vietnam ( [[#Pollack--2016|Pollack et al., 2016]] ). Approximately 20–30% of those who live through a hurricane develop depression and/or PTSD within the first few months following the event ( [[#Obradovich--2018|Obradovich et al., 2018]] ; [[#Schwartz--2015|Schwartz et al., 2015]] ; [[#Whaley--2009|Whaley, 2009]] ), with similar rates for people who have experienced flooding ( [[#Waite--2017|Waite et al., 2017]] ; [[#Fernandez--2015|Fernandez et al., 2015]] ). Studies conducted in South America and Asia indicate an increase in PTSD and depressive disorders after extreme weather events ( [[#Rataj--2016|Rataj et al., 2016]] ). Evidence is lacking for African countries ( [[#Otto--2017|Otto et al., 2017]] ). Children and adolescents are particularly vulnerable to post-traumatic stress after extreme weather events ( [[#Brown--2017|Brown et al., 2017]] ; [[#Hellden--2021|Hellden et al., 2021]] ; [[#Kousky--2016|Kousky, 2016]] ), and increased susceptibility to mental health problems may linger into adulthood ( [[#Maclean--2016|Maclean et al., 2016]] ).

''Wildfires have observed negative impacts on mental health'' ( ''high confidence'' ) ''.'' This is due to the trauma of the immediate experience and/or subsequent displacement and evacuation ( [[#Dodd--2018|Dodd et al., 2018]] ; [[#Brown--2019|Brown et al., 2019]] ; [[#Psarros--2017|Psarros et al., 2017]] ; [[#Silveira--2021b|Silveira et al., 2021b]] ). Sub-clinical outcomes, such as increases in anxiety, sleeplessness or substance abuse are reported in response to wildfires and extreme weather events, with impacts being pronounced among those who experience greater losses or are more directly exposed to the event; this may include first responders.

''Mental health impacts can emerge as result of climate impacts on economic, social and food systems'' ( ''high confidence'' ) ''.'' For example, malnutrition among children has been associated with a variety of mental health problems ( [[#Adhvaryu--2019|Adhvaryu et al., 2019]] ; [[#Hock--2018|Hock et al., 2018]] ; [[#Yan--2018|Yan et al., 2018]] ), as has food insecurity among adults ( [[#Lund--2018|Lund et al., 2018]] ). The economic impacts of droughts have been associated with increases in suicide, particularly among farmers ( [[#Carleton--2017|Carleton, 2017]] ; [[#Edwards--2015|Edwards et al., 2015]] ; [[#Vins--2015|Vins et al., 2015]] ); those whose occupations are ''likely'' to be affected by climate change report that it is a source of stress that is linked to substance abuse and suicidal ideation ( [[#Kabir--2018|Kabir, 2018]] ). Studies of Indigenous Peoples often describe food insecurity or reduced access to traditional foods as a link between climate change and reduced mental health ( [[#Middleton--2020b|Middleton et al., 2020b]] ). The loss of family members, for example due to an extreme weather event, increases the risk of mental illness ( [[#Keyes--2014|Keyes et al., 2014]] ). Individuals in low- and middle-income countries may be more severely impacted due to lesser access to mental health services and lower financial resources to help cope with impacts compared with high-income countries ( [[#Abramson--2015|Abramson et al., 2015]] ).

''Anxiety about the potential risks of climate change and awareness of climate change itself can affect mental health even in the absence of direct impacts'' ( ''low confidence'' ) ''.'' There is a need for more evidence about the prevalence or severity of climate change-related anxiety, sometimes called ecoanxiety, but national surveys in the USA, Europe and Australia show that people express high levels of concern and perceived harm associated with climate change ( [[#Steentjes--2017|Steentjes et al., 2017]] ; [[#Clayton--2020|Clayton and Karazsia, 2020]] ; [[#Cunsolo--2018|Cunsolo and Ellis, 2018]] ; [[#Helm--2018|Helm et al., 2018]] ; [[#Leiserowitz--2017|Leiserowitz et al., 2017]] ; [[#Reser--2012|Reser et al., 2012]] ; [[#Steentjes--2017|Steentjes et al., 2017]] ). In a US sample, perceived ecological stress, defined as personal stress associated with environmental problems, predicted depressive symptoms ( [[#Helm--2018|Helm et al., 2018]] ); in a sample of Filipinos, climate anxiety was correlated with lower mental health ( [[#Reyes--2021|Reyes et al., 2021]] ) and a non-random study in 25 countries showed positive correlations between negative emotions about climate change and self-rated mental health ( [[#Ogunbode--2021|Ogunbode et al., 2021]] ). However, an earlier study found no correlation between climate change worry and mental health issues ( [[#Berry--2015|Berry and Peel, 2015]] ). Because the perceived threat of climate change is based on subjective perceptions of risk and coping ability as well as on experiences and knowledge ( [[#Bradley--2014|Bradley et al., 2014]] ), even people who have not been directly affected may be stressed by a perception of looming danger ( [[#Clayton--2020|Clayton and Karazsia, 2020]] ). Not surprisingly, those who have directly experienced some of the effects of climate change may be more likely to show such responses. Indigenous Peoples, whose culture and well-being tend to be strongly linked to local environments, may experience mental health effects associated with changes in environmental risks; studies suggest connections to an increase in depression, substance abuse or suicide in some Indigenous Peoples ( [[#Canu--2017|Canu et al., 2017]] ; [[#Cunsolo%20Willox--2013|Cunsolo Willox et al., 2013]] ; [[#Middleton--2020b|Middleton et al., 2020b]] ; [[#Jaakkola--2018|Jaakkola et al., 2018]] ).

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