Jyoti Mishra, PhD MBA, Associate Professor, Psychiatry, University of California San Diego (UCSD), Co-director, UC Climate Change & Mental Health Initiative

I begin these remarks with a reflection on my personal journey at the intersection of climate change and mental health. I have been personally motivated for climate action for most of my life, growing up in a family in India that always prioritized sustainability, zero waste and that everything broken can be fixed! In 2017-18, my six-year-old son joined climate action demonstration marches with me that stimulated even greater resolve to take action (Figure 1). One day, my son came home with a flyer for a penny-drive fundraiser to support those impacted by California’s worst wildfire in history that hit Butte County. The ‘Camp Fire’ of 2018 still remains California’s deadliest wildfire to-date with 50,000 evacuations and 150,000 acres of area burned and 85 human lives lost. Wildfires have only continued to increase in frequency and intensity since the ‘Camp Fire’ of 2018. What is most notable is that these fires primarily hit vulnerable communities that reside at the Wildland Urban Interface (WUI). These communities are often the ones that rank highest in poverty rates and additionally have low health outcome rankings, which means that climate change accelerated disasters such as the frequent wildfires are putting an added toll on our most impacted communities.

With collaborative community partnerships, we have investigated the chronic mental health impacts of climate change exacerbated California wildfires. Nearly one-year after the wildfire event, we found significant chronic impacts, observing 3X prevalence of post-traumatic stress disorder (PTSD), and 1.5-2X prevalence of depression and anxiety compared to prevalence rates in neighboring non-impacted regions [1]. We have also shown that individuals who are not directly impacted by the fires in terms of impacts on self/family/property, but just witness the fires occurring within their communities, i.e., indirectly exposed, also suffer a significant mental health toll (Figure 2). Such mental health impacts have been corroborated by other studies [2,3] and our results have also been cited by the Intergovernmental Panel on Climate Change (IPCC) Sixth Assessment Report [4] and by the US Fifth National Climate Assessment [5]. At this point, I’d like to emphasize that the dissemination of this knowledge to practicing clinicians is very important so that they may be aware of the mental health implications of climate change accelerated extremes, and be prepared to provide care to patients appropriately.

In further work, we have also shown that cognition and brain health can be chronically impacted by extreme climate events such as wildfires [6]. Specifically, we find that the ability to process cognitively interfering information, i.e., distractions, is impacted in individuals who have been directly or even indirectly exposed to the wildfire event relative to non-exposed controls (Figure 3). Overall, these objective cognitive outcomes dovetail with qualitative lived experience reports of individuals not being able to attentively focus on tasks and goals in their daily lives in the aftermath of the extreme climate event. Underlying the significant cognitive effects, we also find a hyper-aroused brain response in individuals who self-reported experiencing climate trauma from the wildfire event. Such a hyper-aroused brain response is also observed in PTSD and potentially suggests a hyper-alert brain that is constantly scanning for threats in the environment. Additional findings from our research show that the wildfire impact further influences long-term decision-making abilities. We find that individuals directly exposed to an extreme climate event have difficulty making choices that have greater expected value rewards in the long-term; instead they choose decisions that give small immediate rewards but not long-term large rewards. These serious impacts can greatly influence daily life decisions.

Overall, climate trauma is a relatively new term that has come to define the mental health impacts of climate change accelerated extreme events [7]. Climate trauma deeply impacts vulnerable communities and adds to the impact of existing stressors, as shown by studies of floods and wildfires occurring concurrently with the COVID-19 pandemic [3]. Climate trauma also impacts community health in terms of increased risk of suicide, violence and homicide within the community [8,9]. In its definition and psychological understanding, the term climate trauma suggests that we are not separate from the Earth, its ecosystems and climate. We as humans are both the problem and the providers of potential solutions. We humans are the traumatizers as well as the traumatized – what affects the planet reciprocally affects us. And most importantly, climate trauma represents a form of trauma that supersedes or intersects with all other trauma, illustrating how it is another layer of disadvantage for the communities that will be facing the worst of climate change, but have done the least cause it. In this sense addressing climate trauma is intertwined with the goals of climate justice.

Building community resilience is critical for addressing climate (mental health) trauma. The climate resilience framework aims for three essential pillars including (1) mitigation efforts to reduce future risks, (2) adaptation to ongoing climate change impacts, and (3) societal transformation. It is important to note that mitigation efforts such as providing access to clean air, energy, green environments has co-benefits for mental health and well-being. Similarly, adaptation efforts that provide refuge in the face of existing changes – heat and air quality warning systems, improved building design with green and blue infrastructure, passive cooling systems, as well as preparing shelters, infrastructure and resources for an upcoming extreme climate event – all bring mental health and well-being co-benefits [4]. Per the IPCC, societal transformation is a profound and often deliberate shift initiated by communities toward sustainability, facilitated by changes in individual and collective values and behaviors, and a fairer balance of political, cultural, and institutional power in society. For such societal transformation, climate education for the masses is essential as is greater social connection between our communities and building interdisciplinary coalitions bridging scientific, medical, technological and even religious and spiritual leadership as exemplified by the Vatican summit.

In our work in Californian communities affected by wildfires, we have also investigated the personal factors that contribute resiliency in the face of disasters (Figure 5). These include belief in personal resilience – the ability to bounce back from stressors, mindfulness – the ability to stay in the present moment, as well as physical fitness [1,10]. We have observed that individuals with these traits have reduced symptom severity of PTSD, depression and anxiety observed in the aftermath of a traumatic climate event. Furthermore, we find that those with close family ties and those who have a strong sense of community show greater well-being in the aftermath of the traumatic climate event. Thus, community-based infrastructure and resources that foster personal resiliency by providing opportunities for mindfulness skills development, physical activity as well as opportunities for community bonding can be vital for resiliency development. In this context, nature-based resiliency skills development can also emerge as an important avenue to boost mental health. In fact, in eco-therapy practice, individuals learn to connect with nature in a mindful way and can restore their personal associations with the environment that may have previously become traumatic due to the extreme climate event [11]. California communities are now adopting eco-therapeutic practices alongside eco-stewardship for both personal and environmental sustainability [12].

Finally, efforts to integrate mental health skills development within climate education are also very important for individuals to participate in sustained climate action and prevent individual burnout. As the co-lead of the University of California Climate Mental Health Initiative, we have recently launched coursework that integrates mindfulness practices as well as mental health education to develop personal resilience and thereby, transform the climate anxiety felt by our youth to collective climate action [13]. This year, hundreds of students across 8 University of California campuses participated in the course – they immersed themselves in the inner work of building personal resilience alongside the outer work of undertaking collective climate action projects. Empirically, we found that this Climate Resilience education significantly reduced climate anxiety in youth and further enhanced their self-efficacy for climate action. More of such scalable education models are needed. I am hopeful that the upcoming Climate Resilience regional summits, which will be a confluence of community leaders, researchers, governance, philanthropists and entrepreneurs, will include a focus on mental health and well-being of the people and the eco-system. Collaborative climate action projects emerging from these summits can focus on building a blueprint for resilience, engaging cities and counties from the ground-up.

In summary, climate change-driven disasters have real and chronic mental health impacts: PTSD, depression, anxiety as well as impacts on cognitive functions and brain health. In this context, developing plans for community mental health resiliency is critical. It is important to emphasize that climate mitigation and adaptation efforts bring co-benefits for mental health and well-being and should be appropriately assessed in this context. Finally, societal transformation initiatives must embed mental health focused interventions & education.

References

1. Silveira, S. et al. Chronic mental health sequelae of climate change extremes: A case study of the deadliest californian wildfire. Int. J. Environ. Res. Public Health 18, (2021).
2. Charlson, F. et al. Climate Change and Mental Health: A Scoping Review. Int. J. Environ. Res. Public Heal. 2021, Vol. 18, Page 4486 18, 4486 (2021).
3. To, P., Eboreime, E. & Agyapong, V.I.O. The Impact of Wildfires on Mental Health: A Scoping Review. Behav. Sci. 2021, Vol. 11, Page 126 11, 126 (2021).
4. IPCC Sixth Assessment Report. Climate Change 2022: Impacts, Adaptation and Vulnerability | Climate Change 2022: Impacts, Adaptation and Vulnerability. https://www.ipcc.ch/report/ar6/wg2/ (2022).
5. Fifth National Climate Assessment. https://nca2023.globalchange.gov/ (2023).
6. Grennan, G., Withers, M., Ramanathan, D. & Mishra, J. Differences in interference processing and frontal brain function with climate trauma from California’s deadliest wildfire. PLOS Clim. 2, e0000125 (2023).
7. Woodbury, Z. Climate Trauma: Toward a New Taxonomy of Trauma. Ecopsychology 11, 1–8 (2019).
8. Basu, R., Gavin, L., Pearson, D., Ebisu, K. & Malig, B. Examining the Association Between Apparent Temperature and Mental Health-Related Emergency Room Visits in California. Am. J. Epidemiol. 187, 726–735 (2018).
9. Burke, M. et al. Higher temperatures increase suicide rates in the United States and Mexico. Nat. Clim. Chang. 8, 723–729 (2018).
10. Kornbluh, M., Withers, M.C., Ades, J., Grennan, G. & Mishra, J. Identifying protective socio-ecological factors for college students in California’s deadliest wildfire. J. Am. Coll. Heal. 1–5 (2022) doi:10.1080/07448481.2022.2047706.
11. Mishra, J. Mindfulness and the Climate Crisis. Mind & Life Institute Insights https://www.mindandlife.org/insight/mindfulness-and-the-climate-crisis/ (2023).
12. Ecotherapy Program – Chico State. https://www.csuchico.edu/ecotherapy/
13. Epel, E. & Mishra, J. UC Climate Resilience Course: Transforming Climate Distress to Action. https://www.climateresilience.online/ (2024).