Climate “Psychopathology”
The Intersection of Mental and Physical Health in the Climate Emergency
Abstract
Abstract. Climate change is now widely recognized as the greatest threat faced by humanity for thousands of years and is known to affect the social and environmental determinants of health; including access to clean air, safe drinking water, sufficient food, and secure shelter (WHO, 2018). Anthropogenic climate change has already resulted in warming and precipitation trends that claim 150,000 lives annually, and a recent report from the WHO forecasts that between 2030 and 2050 climate change will cause an additional 250,000 additional deaths per year (WHO, 2018). The interaction between climate change, mental health, and physical health is not yet well understood. This review addresses the question of how climate change is affecting mental health and will demonstrate that climate psychopathologies really matter in the face of the climate emergency.
Overview of the Impacts of Climate Change
Climate change is now widely recognized as the greatest threat faced by humanity for thousands of years. It is the defining issue of our time, and we find ourselves at a pivotal moment (United Nations, n.d.). Human-induced environmental changes include global warming due to changes in the composition of the atmosphere, primarily due to emissions of greenhouse gasses (particularly carbon dioxide and methane) (Ruddiman, 2013); species extinctions some 100 to 1,000 times higher than background levels due to land-use conversion as well as targeted hunting and harvesting (Lewis & Maslin, 2015); land surface transformation (human mining activities alone move more sediment than all the world’s rivers combined) (Monatersky, 2015); deforestation; rising sea levels; erosion of the ozone layer; acidification of lakes, streams, rivers, and the oceans; as well as unprecedented new evolutionary pressures (due to the development of new products like antibiotics, pesticides, novel genetically engineered organisms, the transportation of species to new habitats, intensive harvesting, as well as through the selective pressure of higher air temperatures as a result of greenhouse gas emissions) (Lewis & Maslin, 2015; Ruddiman, 2013).
Human effects on the environment have reached levels severe enough that Earth may now be in a new geological epoch, “The Anthropocene” (Crutzen & Stoermer, 2000; Lewis & Maslin, 2015; Ruddiman, 2013). Scholars have suggested that plastic pollution – which is already being deposited into the fossil record, forming “technofossils” – may be used to mark the start of this new era; leading some to suggest that this period in Earth’s geological history may become known as “the plastic age” (Thompson et al., 2009; Zalasiewicz et al., 2016). This new era is defined by the fact that human activity is said to be the dominant influence on the environment, the climate, and on Earth’s ecology (Lewis & Maslin, 2015; Ruddiman, 2013).
Human beings are thus grappling with a new norm, where we find ourselves forced to accept that we live in an increasingly hostile and dangerous environment, irrefutably made so by human activity. We observe – with increasing frequency – climate change-induced natural disasters occurring with ever-increasing severity. Every year sees successive record-breaking temperatures, ice melts, forced displacements, and other frightening harbingers of what is yet to come. How do we respond to this crisis psychologically, and should so-called climate “psychopathology” be a priority in the face of the climate emergency?
Climate Change, Health, and Mental Health
Climate change is known to affect the social and environmental determinants of health; including access to clean air, safe drinking water, sufficient food, and secure shelter (WHO, 2018). Anthropogenic climate change has already resulted in warming and precipitation trends that claim 150,000 lives annually, and a recent report from the WHO forecasts that between 2030 and 2050 climate change will cause an additional 250,000 additional deaths per year (WHO, 2018).
A robust evidence base of literature now exists which provides details on the different and interactive ways in which climate change affects physical health (such as through altered vector transmission of infections, emergency situations following freak weather events, and through new and emerging environmental challenges such as altered UV radiation (WHO & WMO, 2012), but little is known about how climate change affects mental health (Hayes et al., 2018).
The available literature exploring the relationships between observed variations in meteorological variables and health is steadily increasing, for example, the association between heatwaves and excess mortality is an area that has received increasing research attention (McMichael et al., 2006; Page et al., 2012). So far, most research in this field has focussed on the effects of thermal stress, extreme weather events, and infectious diseases as well as modeling future food yields and hunger prevalence (McMichael et al., 2006). Climate change is therefore known to contribute to the global burden of disease and toward premature deaths; these effects are projected to progressively increase across all countries, and all regions (Confalonieri et al., 2007). However, the evidence base around the mental health impacts of climate change remains sparse.
Climate Change and Mental Health
There are many risks to mental health that manifest themselves over the course of an individual’s lifetime, some of which are summarized in Figure 1 (Kieling et al., 2011). Figure 1 identifies a large number of hypothesized threats to well-being which could theoretically be related directly to climate impacts (particularly in relation to individual, family, and community settings), namely, poor nutrition, physical ill-health, trauma, debt and poverty, bereavement, job insecurities, and poor housing and living conditions (Kieling et al., 2011).
Climate impacts could therefore be set to act as a universal catalyst for mental illness globally, by increasing the frequency and durability of risks to mental health across every life stage, every social setting, and every scale – from individuals to entire cultures: resulting from the increased likelihood of struggles with poverty, famine, drought, and disaster survival with accompanying bereavement, as well as chronic stress and anxiety associated with the ever-present threats which climate change brings.
There is strong evidence to suggest that the most robust predictor of mental illness in adulthood is psychiatric symptoms or disorder during childhood and adolescence (Fryers & Brugha, 2013; Reef, Diamantopoulou, et al., 2010; Reef, van Meurs, et al., 2010; Reef et al., 2009, 2011). Indeed, this continuity of psychopathology is observed across the life span, with anxious and depressed problems in childhood being one of the strongest predictors of adult psychopathology (Reef et al., 2009). Not only is there evidence of enduring psychopathology across the lifespan; there is further evidence suggesting that being affected with a mental health disorder increases the risk of developing another, thus comorbidity within psychiatric disorders is high (Plana-Ripoll et al., 2019). A number of systematic reviews have been conducted which address the question of the long-term impacts of disaster events on mental health (Morina et al., 2014; Steinert et al., 2015). Chronic impacts following catastrophic events differ with regard to the specific types of psychopathology (e.g., depression versus post-traumatic stress disorder), but what is generally agreed is that individuals who experience severe trauma related to natural or technological disasters are at risk for adverse psychological outcomes in the years following these events (Cherry et al., 2015). Studies addressing the long-term mental health impacts of other catastrophes – such as war (note that increasing frequencies of violent conflicts are additionally associated with climate change) – consistently demonstrate the persistent negative impact of such events on children and young people into their adulthood, as well as the traumatic and enduring effects for those who are adults at the time of exposure (Gade & Wenger, 2011; McFarlane, 2015; Singhal, 2019).
Climate justice highlights the disproportionate impact which climate change has on those most vulnerable to its effects, who are typically the poorest and most marginalized members of society (as well as being those least culpable for the emissions that cause climate change) (Ingle & Mikulewicz, 2020). There is thus a double inequality where those least resilient and least able to adapt to climate impacts are additionally the most vulnerable to impacts caused by climate breakdown. Those with pre-existing mental health disorders represent one such vulnerable group. For countries within the World Health Organization (WHO) European Region; mental disorders are already the single biggest contributor to the non-fatal disease burden (WHO, 2019), and at present estimates suggest that there are more than 970 million people worldwide living with a mental health or substance use disorder (Ritchie & Roser, 2019). Thus, more than 12% of the global population is at increased risk of the psychological impacts of climate change as a result of a pre-existing mental illness – demonstrably linked to an increased vulnerability to the development of subsequent psychiatric disorders. Indeed, it is likely that many more people worldwide will experience mental distress or illness as a result of climate change, due to the ubiquitous and insidious nature of climate effects. However, careful consideration should be given before pathologizing what could represent adaptive responses to living in an increasingly dangerous and threatening world. Little is known about the “new” climate-related mental health experiences, headline-grabbing names of which are appearing with increasing frequency throughout the news and social media. Thus, due diligence should be exercised in seeking an understanding of the nature and structure of these cognitive experiences before dismissing them – and those who are experiencing them – as “disordered.”
At present, published data characterizing the mental health impacts of climate change is sparse. However, despite this paucity of available research, three classes of impact have been identified (Albrecht et al., 2007; Costello et al., 2009; Doherty & Clayton, 2011; Page & Howard, 2010). These include direct impacts, which are mental health injuries as a result of the acute or traumatic effects of emergency events; indirect impacts, which represent threats to well-being due to the observed impacts of climate change, as well as the effects of living in a state of constant existential threat and uncertainty; and psychosocial impacts, which relate to the community and social impacts of climate change, often the result of lost livelihoods and conflicts over increasingly scarce resources (Albrecht et al., 2007; Costello et al., 2009; Doherty & Clayton, 2011; Page & Howard, 2010).
Direct, Indirect, and Psychosocial Impacts
Direct Impacts
Acute and direct impacts of climate change on mental health are those injuries associated with more frequent (and more powerful) weather events, natural disasters, and adjustment to degraded or disrupted physical environments; the extreme wildfires in Australia at the end of 2019 and into this new decade representing one such devastating example (Albrecht et al., 2007; Costello et al., 2009; Doherty & Clayton, 2011; Page & Howard, 2010). In fact, the severe, chronic drought in Australia over the last 10 years has allowed physicians and researchers there to be pioneers in documenting the relationship between climate change, weather events, and direct impacts on mental health (Bourque & Willox, 2014). They have found that the drought has been associated with chronic psychological distress, generalized anxiety, depression, and an increased incidence of suicide (specifically among farmers in Australia) (Bourque & Willox, 2014). Note that farming is an occupation in which there is already such a high incidence of suicide globally that it is considered a “universal phenomenon” (Behere & Bhise, 2009, p. 242).
Despite cultural variations between countries and individuals, communities show some common patterns of psychosocial responses to disasters (Weiss et al., 2003), the most common being acute post-traumatic stress disorder, as well as a range of other stress-related problems such as complicated grief, depression, anxiety disorders, somatoform disorders, and drug and alcohol abuse (Fritze et al., 2008).
Other extreme weather events like typhoons, floods, hurricanes, and major storms have offered an opportunity to study climate impacts on mental health. For example, following severe flooding in England in 2000: exposed individuals experienced a four-time higher risk of psychological distress, which was – in turn – associated with a significant excess of physical illness among both children and adults affected (Reacher et al., 2004). The link between physical and mental well-being will be addressed later in this review, but note that the reciprocal relationship between these two metrics of health will increase the severity and duration of climate-related impacts on well-being, potentially leading to lifelong impairment in some instances.
Young people exposed to high levels of trauma following Hurricanes Katrina and Gustav experienced post-traumatic stress disorder (PTSD) and depression for up to 3 years after the event (Weems & Banks, 2015), highlighting the often chronic nature of severe mental health impacts associated with climate change. Specifically, a longitudinal study by Abramson et al. found that in 2010 (more than 4 years post-disaster), 40.8% of parents in Louisiana and 49.1 % of parents in Mississippi reported that their children were experiencing emotional and/or behavioral problems that developed after experiencing the disaster (2010). The cumulative prevalence rate of diagnosed mental health conditions (such as anxiety, depression, or behavioral disorder) 4 years post-disaster was high, at more than 37 % (Abramson et al., 2010). Lambert and Lawson (2012) found evidence of post-traumatic outcomes in professional counselors who serviced those affected by Hurricanes Katrina and Rita, as well as “compassion fatigue” in those who had been treating evacuees. Thus, even those not displaced or harmed directly from the disaster event can find themselves vicariously traumatized as a result of their own experiences in the wake of such an event.
Indirect Impacts
New terms are emerging rapidly describing some of the indirect psychological effects of climate change; eco-anxiety, ecophobia, solastalgia, eco-paralysis, environmental- or eco-grief, and eco-overwhelm representing some of the most common (Albrecht et al., 2007; Gifford & Gifford, 2016; Kevorkian, 2004; Rabinowitz & Poljak, 2003; Sobel, 1996). This offers a clue to the pervasiveness of these issues, but – as yet – very little is understood about these “disorders”: do they represent contemporary mental illnesses and if so, are they phenotypically distinct or would they fall within the same spectrum of the disorder as existing conditions (like panic disorder or generalized anxiety disorder)?
Eco-anxiety, for example, describes the worry experienced as a result of witnessing the slow and (seemingly) irrevocable manifestation of the impacts of climate change, leading to fear, concern, and despair for the individual’s own future, that of their children, and even for later generations (Albrecht, 2011). Ecophobia, according to Sobel (1996, p. 27), is a fear of ecological problems and the natural world such as fear of oil spills, rainforest destruction, whale hunting, acid rain, and the spread of vector-borne diseases, among other examples (Kelsey & Armstrong, 2011); in contrast, a solastalgia is a form of mental or existential distress caused by environmental change (usually in reference to global climate change) (Albrecht et al., 2007; Pollard, 2007). The term combines the Latin word solacium (meaning comfort) and the Greek root algia (meaning pain) to describe the homesickness that can be felt while one is still at home, but when the environment is changed irreparably (Kelsey & Armstrong, 2011). Similarly, environmental grief is a term to explain the emotional response to the loss of ecosystems (Kevorkian, 2004).
Eco-anxiety has become something of a buzz-word, used with increasing frequency in news and social media, despite the fact that – as yet – there are no formal diagnostic criteria available to diagnose the condition. Given that so little is currently understood about climate-related mental health disorders – we are a distance away from having validated, reliable measures that can be used to detect these “new” disorders; let alone understanding how best to effectively treat and manage them, or to project the anticipated additional burden which these issues may place on mental health care providers globally. Eco-anxiety may not represent psychopathology at all; indeed, perhaps it is an adaptive response to life in an increasingly volatile environment. Undoubtedly, this increasingly pervasive psychological experience is one that can affect the quality of life of those experiencing it and certainly requires urgent further research to characterize.
One worrying conclusion which can be drawn, however, is that these indirect mental health impacts are likely to be experienced by the greatest proportion of people around the world, as they relate to the psychological impacts of observing the impacts of climate change; the effects of which are undoubtedly increasing in magnitude and severity on an almost daily basis. The potential psychological harm of these effects is perhaps best summarized by this alarming statistic (again, from researchers in Australia), who observed that 25% of children surveyed honestly believe the world will end before they get older (Tucci et al., 2007). Similar results were found in a study with children in Germany (Albert et al., 2010), hinting at a real time-bomb of mental health problems for an entire generation. This will inevitably have wide-reaching, negative repercussions in many metrics beyond simply health and well-being.
Growing up with the ever-present threats posed by climate change has been likened to the experiences of children during the Cold War when nuclear war appeared imminent (through accident or pre-emptive strike): school children reacted with despair and loss of motivation (Tucci et al., 2007). There is a legacy impact on mental health associated with living with the imminent threat of war or nuclear Armageddon: with post-traumatic stress disorder and depression commonly noted outcomes (El-Deeb, 2017; Poikolainen et al., 2004). Parallels to climate change are drawn easily, as both involve a clear and direct existential threat. However, although both climate change and the threat of nuclear war involve an imminent threat not just to the survival of a particular individual, communities, or societies, but to the human species (and perhaps life on the planet as a whole); the significant difference between the threats of nuclear war and climate change is the potentially greater range of ways in which citizens have the capacity to take action individually and collectively against climate change (Tucci et al., 2007).
Psychosocial Impacts
Mental health outcomes after disaster events like Hurricane Katrina have been related both to exposure to the event, and to subsequent displacement, unstable housing, and lack of access to support services and employment (Larrance et al., 2007), indicating some of the psychosocial impacts on mental health. Further, families are vulnerable to an elevated level of child abuse following a disaster, possibly due to increased parental stress and decreased social support (Keenan et al., 2004). The potential psychosocial impacts of climate change are of complexity beyond the scope of this review, however, notable examples include the complex inter-relation between heat and increased interpersonal violence, as well as violent suicides (Anderson & DeLisi, 2011; Page et al., 2007; Töro et al., 2009); conflicts over increasingly scarce resources (Reuveny, 2008); mass migrations and dislocations (Agyeman et al., 2009); rising levels of pollution associated with increased incidences of mental health issues including depression (Gladka et al., 2018; Khafaie et al., 2019); and chronic environmental stress, loss of livelihoods, loss of property and even loss of cultural identity (Anderson & DeLisi, 2011; Ford et al., 2014; Fritze et al., 2008; Heyward, 2014; Maldonado et al., 2013).
From what little data is currently available on the mental health impacts of climate change, research clearly suggests that anxiety and mood disorders (at all degrees of severity) are a commonly cited consequence of all three forms of impact (direct, indirect, and psychosocial), along with often chronic post-traumatic symptoms, as well as increased incidences of substance abuse, interpersonal conflict, and suicide. Clearly this matters from a humanitarian point of view, but what relationship does mental health have with physical well-being in these increasingly volatile times?
The Relationship Between Mental and Physical Health
Apart from the clear humanitarian case for understanding and treating the mental health impacts of climate change: the relationship between mental and physical ill-health provides a concerning picture of the wide-reaching and often permanent health implications that early life trauma and mental illness often pose.
There is a long history of research within the field of neuropsychology demonstrating how detrimental early life traumatic experiences can be on adult brain development (Bazak et al., 2009; McEwen, 2003; Perry et al., 1995). For example, pre-natal trauma (a result of excessive levels of the stress hormone cortisol in the mother), or even chronic trauma or mental illness (such as depression and PTSD) during childhood or adolescence can lead to structural abnormalities in brain regions such as the hippocampus and frontolimbic circuitry, resulting in decreases in memory capacity, deficiencies in emotional functioning, as well as abnormalities in threat processing and an increased vulnerability of recurrence of mental illness (Herringa, 2017; Weir et al., 2013). Early life stress can have a profound and permanent impact on the brain architecture of the individual, with research in animal models demonstrating that stress can have detrimental effects on the development of neuroendocrine, neuroanatomical, and neurobiological functions in the brain (Gómez-González & Escobar, 2009). Similarly concerning; there is further evidence from animal models that traumatic events in early life can impact adult neurogenesis, resulting in a decreased ability for the brain to form new neurons in adulthood (Lemaire et al., 2006; Rizzi et al., 2007). Comparable results have been observed for human children, where adverse early life experiences are correlated with increased vulnerabilities to the development of psychopathologies, age-related cognitive decline, and permanently reduced adult hippocampal neurogenesis, associated with deficiencies in learning, memory, and stress regulation (Herringa, 2017; Korosi et al., 2012).
Psychiatric disorders have been linked to increased risks of somatic illnesses and even premature death (Månsson et al., 2019). For example, individuals with severe mental illnesses like schizophrenia, bipolar disorder, and major depression (the last of which has been demonstrated to be related to climate impacts) appear to be at a greater risk of cardiovascular disease (Correll et al., 2017): likewise, a relationship between high levels of mental distress and an increased risk of dying from cancer has also been observed (Batty et al., 2017). Serious mental illness can reduce life expectancy by 10–20 years, a loss that is equivalent – or worse – than that for heavy smoking (Chesney et al., 2014). Indeed, mood and anxiety disorders have been associated with telomere attrition; a hallmark of cellular aging (Månsson et al., 2019). Thus, psychiatric illness and early trauma can have a demonstrable, detrimental effect on health and well-being even at a cellular level.
Climate change, particularly the direct impacts of such – including extreme disaster events like floods, forest fires, hurricanes, typhoons, and droughts – is continuously delivering extreme environmental stressors into the lives of many millions, thus is could certainly represent a serious and consistent source of prenatal and early life trauma, likely resulting in negative neuropsychological outcomes for a great proportion of those affected. Similarly, it is clear to see how the climate emergency and the indirect and psychosocial mental distress associated with it will contribute to an increase in both mental health burden on healthcare systems, but also on the physical health needs of many around the world as a result of the reciprocal relationship between mental and physical health.
Climate impacts will be an ongoing issue for many generations to come, particularly in light of the fact of inertia in climate systems leading to a delay between cause and effect, thus impacts are set to get considerably worse before they get better (IPCC, 2001; Meehl et al., 2005). The mental health impacts of climate change are already devastating for many, but existing indications of how mental and physical health intersect suggests that climate change represents the greatest threat to health and well-being in recorded human history. Thus, the mental health impacts of climate change are an urgent, enduring threat to health, even in the face of the other devastations levied by the climate emergency.
Urgent further research is therefore required in order to characterize the nature of climate-related cognitive experiences like eco-anxiety (are they mental health disorders or adaptive responses?), as well as to explore the potential detrimental impacts which living in a constant state of climate-induced stress may be having on cognitive and neurobiological development, physical health, and mental health for individuals around the world. Healthcare systems will need to adapt to cope with unprecedented new demands brought about by climate impacts; thus, developing an understanding of what the additional burdens will be for health and social care across the lifespan will allow for effective forecasting, mitigation, and adaptation of health and social care systems to cope with increasing demand as the effects of climate breakdown march on.
Harriet E. Thompson (PhD) is a postdoctoral researcher in climate psychology at The Centre for Climate Justice. Harriet is recognized by the British Psychological Society as one of the UK’s pioneering researchers investigating the effects of climate change on mental health. She has worked in clinical research for over 10 years and holds a PhD in experimental clinical neuropsychology.
References
(2010). Children as bellwethers of recovery: Dysfunctional systems and the effects of parents, households, and neighborhoods on serious emotional disturbance in children after Hurricane Katrina. Disaster Medicine and Public Health Preparedness, 4(S1), S17–S27. https://doi.org/10.1001/dmp.2010.7
(2009). Close to the edge, down by the river? Joining up managed retreat and place attachment in a climate changed world. Environment and Planning A, 41, 509–513. https://doi.org/10.1068/a41301
(2010). Shell Jugendstudie. Jugend 2010
[Youth study] . Shell. https://nbn-resolving.org/urn:nbn:de:0168-ssoar-385922(2011).
Chronic environmental change: Emerging “psychoterratic” syndromes . In I. WeissbeckerEd., Climate change and human well-being: Global challenges and opportunities (pp. 43–56). Springer. https://doi.org/10.1007/978-1-4419-9742-5_3(2007). Solastalgia: The distress caused by environmental change. Australasian Psychiatry, 15(1), S95–S98. https://doi.org/10.1080/10398560701701288
(2011).
Implications of global climate change for violence in developed and developing countries . In J. ForgasA. KruglanskiK. WilliamsEds., The psychology of social conflict and aggression (pp. 249–265). Psychology Press.(2017). Psychological distress in relation to site specific cancer mortality: pooling of unpublished data from 16 prospective cohort studies. British Medical Journal, 356, j108. https://doi.org/10.1136/bmj.j108
(2009). Pre-pubertal stress exposure affects adult behavioural response in association with changes in circulating corticosterone and brain-derived neurotrophic factor. Psychoneuroendocrinology, 34, 844–858. https://doi.org/10.1016/j.psyneuen.2008.12.018
(2009). Farmers’ suicide: Across culture. Indian Journal of Psychiatry, 51(4), 242–243. https://doi.org/10.4103/0019-5545.58286
(2014). Climate change: The next challenge for public mental health? International Review of Psychiatry, 26(4), 415–422. https://doi.org/10.3109/09540261.2014.925851
(2015). Long-term psychological outcomes in older adults after disaster: Relationships to religiosity and social support. Aging & Mental Health, 19(5), 430–443. https://doi.org/10.1080/13607863.2014.941325
(2014). Risks of all-cause and suicide mortality in mental disorders: A meta-review. World Psychiatry, 13(2), 153–160. https://doi.org/10.1002/wps.20128
(2007).
Human health. Climate Change 2007: Impacts, Adaptation and Vulnerability. Contribution of Working Group II to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change . In M. L. ParryO. F. CanzianiJ. P. PalutikofP. J. van der LindenC. E. HansonEds., Contribution of Working Group II to the fourth assessment report of the Intergovernmental Panel on Climate Change, 2007 (pp. 391–431). Cambridge University Press. https://www.researchgate.net/publication/327395828_Human_health_Climate_Change_2007_Impacts_Adaptation_and_Vulnerability_Contribution_of_Working_Group_II_to_the_Fourth_Assessment_Report_of_the_Intergovernmental_Panel_on_Climate_Change_ML_Parry_OF_Canz(2017). Prevalence, incidence and mortality from cardiovascular disease in patients with pooled and specific severe mental illness: A large-scale meta-analysis of 3,211,768 patients and 113,383,368 controls. World Psychiatry, 16(2), 163–180. https://doi.org/10.1002/wps.20420
(2009). Managing the health effects of climate change; Lancet and University College London Institute for Global Health Commission. Lancet, 16(373), 1693–1733. https://doi.org/10.1016/S0140-6736(09)60935-1
(2000). The anthropocene. IGCP Newsletter, 41, 12–14.
(2011). The psychological impacts of global climate change. American Psychologist, 66(4), 265–276. http://www.igbp.net/download/18.316f18321323470177580001401/1376383088452/NL41.pdf
(2017). The experience and prevalence of PTSD in Palestinian adults living in the Gaza strip, Brunel University.
(2014). Adapting to the effects of climate change on inuit health. American Journal of Public Health, 104(Supplement 3), e9–e17. https://doi.org/10.2105/AJPH.2013.301724
(2008). Hope, despair and transformation: Climate change and the promotion of mental health and wellbeing. International Journal of Mental Health Systems, 2, Article 13. https://doi.org/10.1186/1752-4458-2-13
(2013). Childhood determinants of adult psychiatric disorder. Clinical Practice & Epidemiology in Mental Health, 9, 1–50. 10.2174/1745017901309010001
(2011). Combat exposure and mental health: the long-term effects among US Vietnam and Gulf war veterans. Health Economics, 20(4), 401–416. https://doi.org/10.1002/hec.1594
(2016). The largely unacknowledged impact of climate change on mental health. Bulletin of the Atomic Scientists, 72(5), 292–297. https://doi.org/10.1080/00963402.2016.1216505
(2018). Impact of air pollution on depression and suicide. International Journal of Occupational Medicine and Environmental Health, 31(6), 711–721. https://doi.org/10.13075/ijomeh.1896.01277
(2009). Altered functional development of the blood-brain barrier after early life stress in the rat. Brain Research Bulletin, 79, 376–387. https://doi.org/10.1016/j.brainresbull.2009.05.012
(2018). Climate change and mental health: Risks, impacts and priority actions. International Journal of Mental Health Systems, 12, Article 28. https://doi.org/10.1186/s13033-018-0210-6
(2017). Trauma, PTSD and the developing brain. Current Psychiatry Reports, 19(10), Article 69. https://doi.org/10.1007/s11920-017-0825-3
(2014).
Climate change as cultural injustice . In T. BrooksEd., New waves in global justice. New waves in philosophy. Palgrave Macmillan. https://doi.org/10.1057/9781137286406_8(2020). Mental health and climate change: Tackling invisible injustice. The Lancet Planetary Health, 4, e128–e130. https://doi.org/10.1016/S2542-5196(20)30081-4
. (2001). Climate change 2001: IPCC third assessment report. IPCC Secretariat: Cambridge University Press.
(2004). Increased incidence of inflicted traumatic brain injury in children after a natural disaster. American Journal of Preventative Medicine, 26(3), 189–193. https://doi.org/10.1016/j.amepre.2003.10.023
(2011).
Finding hope in a world of environmental catastrophe . In A. E. J. WalsP. B. CorcoranEds., Learning for sustainability in times of accelerating change (pp. 187–200). Wageningen Academic Publishing. https://doi.org/10.3920/978-90-8686-757-8(2004). Environmental grief: Hope and healing (Doctoral dissertation). Union Institute and University. http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.561.289&rep=rep1&type=pdf
(2019). Extreme pollution, climate change, and depression. Environmental Science and Pollution Research, 26(22), 22103–22105. https://doi.org/10.1007/s11356-019-05727-5
(2011). Global mental health 2: Child and adolescent mental health worldwide: evidence for action. The Lancet, 378(9801), 1515–1525. https://doi.org/10.1016/S0140-6736(11)60827-1
(2012). Early-life stress mediated modulation of adult neurogenesis and behaviour. Behavioural Brain Research, 227(2), 400–409. https://doi.org/10.1016/j.bbr.2011.07.037
(2012). Resilience of professional counselors following hurricanes Katrina and Rita. Journal of Counselling and Development, 91(3), 261–268. https://doi.org/10.1002/j.1556-6676.2013.00094.x
(2007). Health status among internally displaced persons in Louisiana and Mississippi travel trailer parks. Annals of Emergency Medicine, 49(5), 590–601. https://doi.org/10.1016/j.annemergmed.2006.12.004
(2006). Postnatal stimulation of the pups counteracts prenatal stress-induced deficits in hippocampal neurogenesis. Biological Psychiatry, 59, 786–792. https://doi.org/10.1016/j.biopsych.2005.11.009
(2015). Defining the anthropocene. Nature, 519, 171–180. https://doi.org/10.1038/nature14258
(2013). The impact of climate change on tribal communities in the US: Displacement, relocation, and human rights. Climatic Change, 120, 601–614. https://doi.org/10.1007/s10584-013-0746-z
(2019). Improvement in indices of cellular protection after psychological treatment for social anxiety disorder. Translational Psychiatry, 9(1), Article 340. https://doi.org/10.1038/s41398-019-0668-2
(2003). Early life influences on life-long patterns of behaviour and health. Mental Retardation and Developmental Disabilities Research Reviews, 9, 149–154. https://doi.org/10.1002/mrdd.10074
(2015). The impact of war on mental health: Lest we forget. World Psychiarty, 14(3), 351–353. https://doi.org/10.1002/wps.20253
(2006). Climate change and human health: Present and future risks. The Lancet, 367, 859–869. https://doi.org/10.1016/S0140-6736(06)68079-3
(2005). How much more global warming and sea level rise? Science, 307(5716), 1769–1772. https://doi.org/10.1126/science.1106663
(2015). Anthropocene: The human age. Nature News, 519, 144–147. https://doi.org/10.1038/519144a
(2014). Remission from post-traumatic stress disorder in adults: A systematic review and meta-analysis of long term outcome studies. Clinical Psychology Review, 34(3), 249–255. https://doi.org/10.1016/j.cpr.2014.03.002
(2007). Relationship between daily suicide counts and temperature in England and Wales. British Journal of Psychiatry, 191, 106–112. https://doi.org/10.1192/bjp.bp.106.031948
(2012). Temperature-related deaths in people with psychosis, dementia and substance misuse. The British Journal of Psychiatry, 200(6), 485–490. https://doi.org/10.1192/bjp.bp.111.100404
(2010). The impact of climate change on mental health (but will mental health be discussed at Copenhagen?). Psychological Medicine, 40, 177–180. https://doi.org/10.1017/s0033291709992169
(1995). Childhood trauma, the neurobiology of adaptation, and “use-dependent” development of the brain: How “states” become “traits”. Infant Mental Health Journal, 16(4), 271–291.
(2019). Exploring comorbidity within mental disorders among a Danish national population. JAMA Psychiatry, 76(3), 259–270. https://doi.org/10.1001/jamapsychiatry.2018.3658
(2004). Fear of nuclear war increases the risk of common mental disorders among young adults: A five-year follow-up study. BMC Public Health, 4, Article 42. https://doi.org/10.1186/1471-2458-4-42
(2007). Solastalgia: The distress caused by environmental change. Australasian Psychiatry, 15, S95–S98. https://doi.org/10.1080/10398560701701288
(2003). Host – environment medicine: A primary care model for the age of genomics. Journal of General Internal Medicine, 18, 222–227. https://doi.org/10.1046/j.1525-1497.2003.11101.x
. (2004). Health impacts of flooding in Lewes: A comparison of reported gastrointestinal and other illness and mental health in flooded and non-flooded households. Communicable Disease and Public Health, 7(1), 39–46.
(2009). Child to adult continuities of psychopathology: A 24-year follow-up. Acta Psychiatrica Scandinavia, 120(3), 230–238. https://doi.org/10.1111/j.1600-0447.2009.01422.x
(2010). Predicting adult emotional and behavioral problems from externalizing problem trajectories in a 24-year longitudinal study. European Child & Adolescent Psychiatry, 19, 577–585. https://doi.org/10.1007/s00787-010-0088-6
(2011). Developmental trajectories of child to adolescent externalizing behavior and adult DSM-IV disorder: Results of a 24-year longitudinal study. Social Psychiatry and Psychiatric Epidemiology, 46(12), 1233–1241. https://doi.org/10.1007/s00127-010-0297-9
(2010). Children’s problems predict adults’ DSM-IV disorders across 24 years. Journal of the American Academy of Child & Adolescent Psychiatry, 49(11), 1117–1124. https://doi.org/10.1016/j.jaac.2010.08.002
(2008). Ecomigration and violent conflict: Case studies and public policy implications. Human Ecology, 36, 1–13. https://doi.org/10.1007/s10745-007-9142-5
(2019). Mental Health. https://ourworldindata.org/mental-health
(2007). Neonatal isolation impairs neurogenesis in the dentate gyrus of the guinea pig. Hippocampus, 17, 78–91. https://doi.org/10.1002/hipo.20247
(2013). The anthropocene. Annual Review of Earth and Planetary Sciences, 41, 45–68. https://doi.org/10.1146/annurev-earth-050212-123944
(2019). Early life shocks and mental health: The long-term effect of war in Vietnam. Journal of Development Economics, 141, Article 102244. https://doi.org/10.1016/j.jdeveco.2018.06.002
(1996). Beyond ecophobia: Reclaiming the heart in nature education, Orion Society.
(2015). The course of PTSD in naturalistic long-term studies: High variability of outcomes. A systematic review. Nordic Journal of Psychiatry, 69(7), 483–496. https://doi.org/10.3109/08039488.2015.1005023
(2009). Plastics, the environment and human health: Current consensus and future trends. Philosophical Transactions of the Royal Society, 364, 2153–2166. https://doi.org/10.1098/rstb.2009.0053
(2009). Relationship between suicidal cases and meteorological conditions. Journal of Forensic and Legal Medicine, 16(5), 277–279. https://doi.org/10.1016/j.jflm.2008.12.015
(2007). Children’s fears, hopes and heroes: Modern childhood in Australia. Australian Childhood Foundation.
. (n.d.). Global issues: Climate change. https://www.un.org/en/sections/issues-depth/climate-change/
(2015).
Severe stress and anxiety disorders in adolescence: The long-term effects of disasters . In K. Cherry (Ed.). Traumatic Stress and long-term recovery (pp. 177–194). Springer. https://doi.org/10.1007/978-3-319-18866-9_10(2013). Developmental risk I: Depression and the developing brain. Child and Adolescent Psychiatric Clinics of North America, 21(2), 237–259. https://doi.org/10.1016/j.chc.2012.01.004
(2003). Mental health in the aftermath of disasters: Consensus and controversy. The Journal of Nervous and Mental Disease, 191(9), 611–615. https://doi.org/10.1097/01.nmd.0000087188.96516.a3
. (2018, February). Climate change and health (fact sheet). https://www.who.int/news-room/fact-sheets/detail/climate-change-and-health
. (2019). Monitoring mental health systems and services in the WHO European Region: Mental Health Atlas, 2017. WHO. http://www.euro.who.int/__data/assets/pdf_file/0009/396765/EMH-Atlas-6.pdf?ua=1
. (2012). Atlas of health and climate. WHO Press. https://www.who.int/globalchange/publications/atlas/en/
(2016). The geological cycle of plastics and their use as a stratigraphic indicator of the anthropocene. Anthropocene, 13, 4–17. https://doi.org/10.1016/j.ancene.2016.01.002
