The Climate Emergency Calls for a New Approach to Mental Health

Yves here. I don’t mean to sound churlish, but devastation is a regular feature of human experience. It’s not hard to make a list. The firebombings of World War II. The Black Plague. The Mongol conquests. The US naplaming much of Laos. One can argue that the purpose of major religions is to reconcile humans to the inevitability of suffering and death. So the focus on mental health costs of climate disasters, in your humble blogger’s opinion, is a reflection of poor social health going into these crises.

Yes, first responders and other rescue personnel too often see searing images and need help to blunt the trauma. Individuals who’ve lost a spouse, children, parents have a hole in their lives and would likely benefit from solace and support. But some are also suffering material crises, like the loss of a livelihood, savings, shelter. Being depressed and anxious is an entirely rational response to desperation. It’s hard to see how this type of victim recovers psychologically without getting some material support.

And before you contend, “Unlike past disasters, climate change is a potential end of civilization/large scale dieoff event,” that’s how some past crises (again the Black Plague, the droughts that led to the collapse of the Mayan civilization) looked to victims at the time. Smaller scale disaster look cataclysmic if they destroy the world you know.

Mind you, I’m not saying the mental health initiative described below isn’t important. What I am saying is its necessity is due in large measure to the way neoliberalism has weakened community and social ties and increased economic anxiety.

By Bob Doppelt, coordinator of the International Transformational Resilience Coalition (ITRC), a network of mental health, social service, climate, and other professionals working to build universal capacity for mental wellness and resilience for the climate emergency. Originally published at Undark

It was 80 degrees outside in Oregon’s Southern Willamette Valley, the record drought continued, and a red flag warning had been issued to alert residents to beware of wildfires. No, it was not autumn, when wildfire season has historically occurred in the region. It was April 16, when it should have still been cool and pouring rain outside. The surprising wildfire warning seemed to have everyone on edge, fearful about what might happen to them, their families, and neighbors then and later in the year.

Just the past September, the historic Holiday Farm wildfire had completely incinerated the small town of Blue River and destroyed at least 430 homes and over 20 commercial sites in the McKenzie River Valley. The numerous wildfires burning throughout the state at the time made Oregon’s air quality the worst in the world, triggering “very unhealthy” air quality alerts. Residents were urged to stay indoors to prevent respiratory problems.

Afterward, a number of residents living in or close to the McKenzie Valley reported severe anxiety, depression, and other mental health problems. Research suggests that as many as 30 percent of first responders, like those who fought the Oregon wildfires, develop behavioral health issues, including post-traumatic stress disorder, or PTSD. Ordinary civilians were also greatly distressed. “It’s kind of hard to have good mental health days when your world is, literally, on fire,” one Oregon resident told NBC News.

The frightening events occurring in Oregon mirror the disruptions to the global climate system, regional weather patterns, and ecological systems happeningacross the United States and worldwide.

On Earth Day, a week after the red flag warning in Oregon, President Joe Biden boldly committed the U.S. to slashing greenhouse gas emissions by 50 percent of 2005 levels by 2030. Although much needed, the pledge is coming very late in the game and, even if successful, will not prevent serious impacts to the planet and society. Therefore, I and the six cosignatories of this letter — all of us mental health professionals — urge the U.S., as it aggressively cuts emissions, to make an equally bold commitment to build population-level, or universal capacity for mental wellness and resilience with respect to the impacts of the climate emergency. This will require expanding our mental health system to more actively engage community members both in preventing large-scale traumas and in healing from them when they do occur. Both will be necessary to avoid the devastating mental health and psychosocial problems that climate change will engender.

The Covid-19 pandemic offers just a tiny preview of some of the mental health and psychosocial consequences of the climate emergency. Like the pandemic, climate change will cause cascading disruptions in the ecological, social, and economic systems people rely on for food, water, jobs, incomes, shelter, health, safety, and other basic needs. No one will be immune from the incessant pileups of the often-toxic stresses that will result.

Those stresses will be compounded by more frequent, extreme, and prolonged storms, wildfires, heatwaves, floods, droughts, and other disasters. Extreme climate conditions already impact more than 47 million Americans every year, and many of those who are directly affected may be severely traumatized as a result. Last year Oak Ridge National Laboratory, a science and technology research center sponsored by the Department of Energy, projected that the number of Americans impacted by these conditions could double by 2050, implying that a third or more of the population will be stricken every year.

Left unaddressed, the combination of cascading disruptions to essential systems and acute disasters generated by rising temperatures will produce individual and collective psychological, emotional, and behavioral traumas at levels never before seen in our nation.

Individual and collective traumas feed on themselves. As the traumatic impacts of the current pandemic have shown, they can distort perceptions and jumble the truth — and they can resurface and aggravate unresolved past traumas like historic racism and economic inequality. They can also produce dangerous polarization among people, trigger violence, and reduce society’s ability to resolve problems.

Time is of the essence to prepare every U.S. resident for the protracted mega-emergency speeding our way. If we remain ill-equipped, the resulting individual and collective traumas will threaten everyone’s health, safety, and wellbeing. Further, they will make it all but impossible to enact the changes required to slash emissions and reduce temperatures to manageable levels.

Direct human service and single-person psychological treatment programs — while they will remain important — were set up for different conditions and cannot address the scope and scale of the individual and collective traumas that lie ahead. To prevent and heal large-scale traumas, we must expand the mental health system to place an equal emphasis on a public health and prevention science approach.

A public health approach prioritizes preventing health and social problems, not merely treating them after they appear. It does so by enhancing and augmenting individual and collective wellness and resilience skills, social support networks, and other strengths and resources known as “protective factors,” which buffer people from the forces that generate traumas. It also recognizes that most individual, family, and community mental health problems result from numerous interrelated factors that require multisystemic responses — not a few siloed interventions focused on individuals or families who are deemed to be high-risk, or who show symptoms of psychopathology.

The growing interdisciplinary field of prevention science expands on the public health approach by showing that many mental health and psychosocial problems are avoidable and that public health initiatives can enhance wellness and resilience.

There is a growing consensus that the most effective way to prevent and heal individual and collective traumas is to engage a wide and diverse array of respected local community leaders and organizations, with a special emphasis on marginalized groups, in designing and implementing actions that build the capacity for mental wellness and resilience among all residents.

Many such initiatives already exist throughout the U.S. They are usually led by trained residents, and not mental health professionals. (Mental health professionals participate and support the community initiatives and assist people who, even after engaging in those community-based initiatives, still cannot function or remain at risk of harming themselves or others.) Community-based initiatives use evidence-based, historical, and culturally-tailored approaches to build and strengthen protective factors that prevent and heal traumas.

Even as the Biden administration aggressively aims to reduce emissions, it is imperative that it — as well as states, cities, and organizations focused on mental health — swiftly act to scale up existing community-based initiatives and galvanize many additional ones to preempt and heal the mental health and psychosocial issues that climate change will bring. Too much is at stake to ignore the problem.


Additional signatories:

Dr. David Shern, senior associate, Department of Mental Health at Johns Hopkins University and vice board chair of the Campaign for Trauma-Informed Policy and Practice

Dr. David Pollack, M.D., professor for public policy in the departments of Psychiatry, Family Medicine, and Public Health and Preventive Medicine at Oregon Health and Science University, and board member of the Climate Psychiatry Alliance

Dr. Lise Van Susteren, M.D., psychiatrist in private practice and a co-founder of the Climate Psychiatry Alliance and the Climate Psychology Alliance

Dr. Mandy Davis, associate professor of practice, Portland State University School of Social Work, and director of Trauma Informed Oregon

Elaine Miller-Karas, co-founder, the Trauma Resource Institute

Jesse Kohler, executive director, Campaign for Trauma-Informed Policy and Practice

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  1. Verifyfirst

    “What I remember most of those times is that poverty creates desperation, and desperation creates violence.”
    ― Studs Terkel, Hard Times: An Oral History of the Great Depression

    1. Adam Eran

      And you might add, police, when faced with desperate people, feel endangered enough to shoot or abuse them.

  2. WaltD

    I’m prone to anxiety to begin with, but reading about the looming heatwave in the PNW has really sent my anxiety running this morning. I have three young kids, and mostly just try not to think about what the world will be like in the future.

  3. steve

    “One can argue that the purpose of major religions is to reconcile humans to the inevitability of suffering and death.”

    Considering they have caused a disproportionate amount of suffering and death I suppose they are well positioned in their pontifications.

    “Even as the Biden administration aggressively aims to reduce emissions…” OK. Whats the harm in a little Biden cheerleading at this stage.

  4. vw

    I’m going to sound more churlish than Yves here (someone has to be). But at this point in my life, I 100% reject the framing of this article. “We need more mental health experts”? No, this is just job-seeking. “Mental health experts” as a group aren’t going to provide one lick of value or help to us regular people as we face down the climate crisis. At best, they’ll provide the sympathetic listening ear we used to be able to access through this old-fashioned thing called “a friend”. But unlike a friend, they’ll bill the insurance at $$$ an hour for the privilege.

    Yves makes a great point about how most suffering is related to modern economic conditions – I agree. Here’s a question. Is it a mental illness to be upset about your business going bankrupt? Or that the foundation of money itself seems to be shifting under our feet and making it impossible to plan even over the medium term? Or, heck, let’s go further – is it a mental illness to be wracked with grief for a dead spouse? A mental illness? If we were to look broadly, which would likely be more helpful to the sufferer in the long run for either of these cases – a counselor, who bills at $$$? Or a priest? (Replace with the proper name of the religious leader for any given faith.)

    My broader point here, is that the climate emergency is not really a problem which can be solved by anyone who is billing the insurance $$$/hour. Obviously, this is true in that it doesn’t directly contribute to any physical solutions, but it’s also true because the solutions–any which are on offer–are not going to be individual. We need either a broad societal consensus on concrete actions to be taken to prevent/mitigate the damage, or a broad societal spiritual consensus that can give us meaning as we stumble through the misery of the world burning around us, for reasons that are entirely our fault. Global warming is too big. The individual can’t get a grasp of it. Functionally, it’s going to come across in our personal lives no differently than “God is smiting the wicked, and you too are wicked.”

    Right now, I can cry about that to either a friend or a priest (or equivalent) and be comforted as much as any individual can comfort another. So why do I need someone billing my insurance at $$$/hour, again?

    Sorry for the rant – just had an overwhelming urge to ball up the referenced article and kick it into the sun. Let all the rent-seeking members of that “coalition” plant home gardens and learn to love rice and beans… just like the rest of us.

    1. Dirk77

      Allow me to less cheery than Yves or you. It’s predicted to be 113 F in Portland OR on Sunday. In June. As Yves says, the people of the world have a bigger problem than any mental trauma they might experience. I’ve mentioned before on this blog that, watching how humans are, if you think there needs to be a solution, it is culling the population, starting with the biggest polluters and working your way down. Perhaps the people of Burundi will be spared. I don’t mean to be a French communist, making statements and not expecting anyone to take them seriously – until the Khmer Rouge did. Yet, given all the other ideas floating around, do you seriously expect things to end well? Perhaps you can regard this as a realistic baseline and try to do better.

      1. steve

        The author, without directly saying so, is speaking of the possibly of civilizational collapse and lets just say that wouldn’t be an optimal outcome. As to his proposed approach to mitigating the dissolution of society, and we are starting pretty far along in the unraveling, I have no idea what “prevention science approach” or “”protective factors,””(rare quotequote w/ coma) means. But I do wish him luck, there will be plenty of misery, suffering and anger to go around, and it will be hell.

  5. LAS

    I regularly think that so many social problems are medicalized b/c that’s the only area of social supports the federal gov has not yet defunded. For instance, advocates are trying to get rent/food to poor and homeless persons through Medicaid b/c there is no more AFDC (welfare) since 1996. We’re asking medicine to work on the social determinants of health when we should point the finger smack straight on governance and policy makers.

    The problem with funding social supports/services through the medical complex is that it makes things more expensive. So much of that funding is consumed in the administration, by the most highly paid doctors and hospital administrators, making services inefficient and too limited for the needs of the nation.

    No one wants to say this is what’s happening, but IMO, this is what’s wrong with how we’re solving the problems the American people suffer. The government is not being responsible to the people the way it should. For the benefit of a few rich protagonists, the reasonable human development and protections the nation needs are blocked and prevented from happening.

    1. CanCyn

      I agree 100%!! We need to house and feed people and help them find decent employment. This would de-stress so many. As someone who worked in the community college system for many years, I watched administrators chase whatever funding dollars were available to them and mental health services were increasingly where the money was. It seems that there is always money available for some kind of mental health training. Ask for money to replace decrepit furniture or some other operational need and it is a no go. Give your employees the latest mental health info seminar? The money is there. Buy little signs indicating your dept is a ‘safe space’ for students? Here you are. The examples are endless.
      So many people in so many places are expected to be able to support their clients’ and their employees’ mental health… a seminar here and a seminar there and we’re all mental health experts. Meanwhile what people (in my line of work, people = students) need are the basics – food, shelter and decent jobs.
      The climate disaster is coming regardless and we all have a right to be stressed by it. For many it doesn’t have to mean barely getting by right now.
      As always, it is political will, not ability, that is stopping good things from happening for folks who need it. I keep thinking about FDR’s “Make me do it” request to the people. I guess part of the problem is that faith in government as a actor for good is so eroded that no one will even ask. It doesn’t occur to them that government can be a force for good.

  6. Sawdust

    I’m reminded of the joke that psychoanalysis has been around for a hundred years and everything’s worse.

    1. Petter

      I still have my copy of Walker Percy’s Lost in the Cosmos:The Last Self Help Book
      The Strange Case of the Self, your Self, the Ghost which Haunts the Cosmos
      How you can survive in the Cosmos about which you know more and more while knowing less and less about yourself, this despite 10,000 self help books, 100,000 therapists and 100,000,000 fundamentalist Christians
      Why is that of all the billions and billions of strange objects in the Cosmos –novas, quasars, pulsars, back holes-
      you are beyond doubt the strangest
      Why is it possible to learn more in ten minutes about the Crab Nebula in Taurus, which is 6,000 light years away, than you presently know about yourself, even though you’ve been stuck with yourself all your life.
      As to the subject at hand – psychologists are ready and willing to help (for a small fee, I assume). Here’s a cut and paste from one group’s website (not linked).
      Eco-Emotions and Climate Anxiety: A climate psychologist is here to help.

      We provide support for individuals and groups in overcoming climate anxiety. This may involve:
      Overcoming anxiety or depression related to climate change
      Identifying goals in order to have an impact
      Challenging feeling overwhelmed and that climate change is too big for you to make a difference
      Keeping focussed on solutions
      Processing thoughts and ideas around climate change that are negatively impacting you
      Taking action (small and large) to affect climate change
      Support if you have been directly impacted upon by the consequences of climate change (floods, natural disasters etc).

  7. lordkoos

    I like to say, if you aren’t depressed, you aren’t paying attention. I don’t think many people on the planet have any idea what it’s going to be like in 30 years, perhaps excepting those who have been victims of recent wars .

  8. HotFlash

    vw June 25, 2021 at 11:54 am

    If we were to look broadly, which would likely be more helpful to the sufferer in the long run for either of these cases – a counselor, who bills at $$$? Or a priest? (Replace with the proper name of the religious leader for any given faith.)

    That priest or other may not bill $$$$, but s/he is usually fed, clothed and housed at the expense of the congregation. Sometimes with perks. So whaat sortof thingdo we have here? Free-at-the-point-of care single-payer counseling? A private/public partnership? A grift?

    I have had occasion in my life to talk the ear off a professional therapist, and was grateful that I didn’t have to bore my friends to death with it. But that was for Big Stuff, regular things my friends put up with me about, and I am grateful for the NC community as well. I feel relatively sane here : ) eg, I do not talk to my friends about Ivermectin, and there are only a few I talk to about my despair that TPTB will do anything about our global climate ruination.

  9. vw

    I hear your point, and I too have had occasion to hire an online therapist when I needed a sympathetic ear that I wasn’t related/married to. (It might not have been necessary if modern life wasn’t so hostile to maintaining friendships as an adult, but in a pinch, it did the trick.) The framing of the “priest” and their funding, though, slightly misses what I was trying to say.

    A priest (etc) has – ironically – more tools at their disposal for psychological comfort than a psychologist does. They can speak directly to the sufferer about matters of the spirit, about God(s), about death, and about how best to approach life and its eternal disappointments. If their tradition has been around longer than the day before yesterday, they have access to incredible works of literature gathered across the generations that can inform or boost their own wisdom, i.e. the Bible or the Bhagavad Gita. Psychologists are bound to materialist views, and recommending any spiritual path contradicts the profession’s ethics (if I am understanding correctly). So they are stuck with the language and techniques of self-help. Not that these don’t work – they can work quite well for many issues – but they falter when put up against something so vast and impersonal as global warming is going to be. How long will positive thinking or exposure therapy work to “fix” stunted fields and dry riverbeds? Or the forest you loved as a child burning to ashes?

    Global warming and its associated anxiety/grief is a lot closer to worrying about salvation, or Fate (at least until it becomes an incredibly tangible and practical issue – at which point there will be no time for a couch, or anything but survival). The mental health profession itself, though great for helping an individual through their individual problems, is unfit to deal with something on this level. Only some sort of spiritual understanding or guidance is going to get the populace through this. And in your example above, well, the people are paying the priest for… this! To provide them this service, exactly. To guide and support worshippers through the hardest trials of life. If the faith isn’t providing what’s needed, the tithers – at least in this country – are free to go elsewhere for the service. It’s cheaper (financially) than going out-of-network, at least.

    I hear you about ivermectin, too, and about the despair one feels when they look with both eyes open at the ruinous, feckless behavior of our current elites. I can’t talk about this with the people in my life, either. In a world where it looks like that speaking one’s mind will be greeted with harsher and harsher consequences, I have turned to a spiritual practice myself. I hope to transform myself in time into the equivalent of a babushka in communist Russia – allowed to go to church and worship every Sunday, after even the priests had been shipped off to the gulag, because no one in society could deny them their devotion. If not in practice… in spirit. It’s something no one and nothing can take away – maybe even the only thing that qualifies.

  10. Tom Bradford

    While the organisation the author represents claims the word “International” in its title it is, as many such, guilty of seeing the world and the US as co-extensive, and hence the symptoms and diagnosis appropriate to the US are equally appropriate to the world as a whole.

    I would refer you to “The World Happiness Index”, as commented on in:

    This surely is a direct reflection of the author’s arguments – the depression and anxiety in a nation triggered by its population’s perception of the ‘climate emergency’ are going to be a huge drag on its ‘happiness’; status. And where is the US in this index? In the middle.

    For many of the countries at the bottom of the table ‘the climate emergency’ is hardly a factor. Many if not most of their populations likely have little understanding of the scientific debates and reasoning underlying the forecasts, and anyway their day-to-day survival today provides more than enough worry without being concerned about what might happen a decade or two down the track – and no pontificating about your mental health is going to help when your physical health is at immediate risk.

    So what about the many countries above the US on the happiness index? Look at them. Especially the top ten. What do they have in common? I suggest it is social cohesion. Is it a co-incidence these are all countries who have responded well to Covid?

    These are countries where the populations have confidence that if push comes to shove, whether it’s a pandemic, climate change or any other disaster on a national scale the nation – and its society – will hold together. Will work together. Will look after each other.

    This is the answer, not having better access to psychiatrist’s couches on an individual basis to shore up our personal mental strength to deal with existential threat. In fractured, individualistic societies like the US and others in the middle of the happiness index the fear is that if disaster hits you’re on your own. But the answer isn’t a new approach to mental health. It’s a new approach to the society you live in.

  11. WalterM

    Well, Naked Capitalism just made me crazy enough to post about the climate on faecbook (basically, “something bad will happen soon”). People will say sympathetic things. I’ll talk to my therapist.

    My daughter is going to take some action directed at getting the attention of an important leader in a few days. She’s asked me not to participate, but I wish her well. She’s a hard little something-or-other, and if anybody can move things in the right direction, it might be her.

    I read the article twice, and I got very little out of it. I suppose mental health care could help us keep struggling when we want to give up. I suspect struggle is the thing to do, even when there doesn’t seem to be much hope.

  12. Keith Newman

    I’m with the churlish here. As with other commenters I see a search for more hours to bill by the authors. Global warming is the topic “du jour” but how about the stress of living on a low insecure income, no health care, no childcare, despair leading to drug addiction and death? Etc. How about the US destruction of Syria turning 13 million people, one half of the population, into refugees. I can barely imagine the mental health problems they have. ETC.

  13. JBird4049

    I wouldn’t be to blasé about how COVID, the drought, the economy, the police and so on is affecting people; the “weight” of all this reminds me of the oppressive emotional background during the Cold War; James Burke in one of his shows noted that the world could end while you were having a long afternoon picnic deep in the countryside. A relaxing day ending by seeing that you didn’t have a city anymore.

    This was the background hum for over forty years and just how heavy, how destructive it was, I only noticed after the Cold War ended. It was as if I had lost a hundred pounds that I didn’t even knew I had. The relief was profound. This does help to explain why so many people are focused on the vaccines. It is an emotional support, an apparently reachable goal that will, they think, set them free.

    You couldn’t run or hide from, or stop any nuclear war. It was going to happen, or not, whatever you decided to do. A war that might destroy the planetary civilization. A war in which the living might actually envy the dead regardless of your class or how “lucky” you might have been. So just how do you deal with that emotional toll? Yes, we do have some greater agency today, than we had then. You never know, but the majority of the human should not die horrible deaths over a few days or weeks as well. However, the size of the various problems and their likely endings are just horrifying. We might collectively pull that metaphorical rabbit out of the hat, but I wouldn’t count on it.

    So no, I will not mock or denigrate the emotional pain or the weight of despair anyone might be dealing with. Anyone with the awareness of a turnip is aware, at some level, that it might get much worse for them, no matter how off they are, due to the whole mess we are in. And just like in the Cold War, most of us don’t have anywhere, really, to run too.

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