Where Is Mental Health in Global Climate Negotiations?

Locals in Shindhuli, Nepal, are resting under the tree to avoidexcessive heat. Hot days and heat wavesare becoming more frequent in recent years, and research says excessive heat impacts mental health. Credit: Tanka Dhakal/IPSby Tanka Dhakal (baku)Friday, November 22, 2024Inter Press Service

BAKU, Nov 22 (IPS) - The mental health impacts of climate change are not widely discussed, but increasing evidence shows how climate change is affecting mental health and raising the risk of new mental health challenges. Experts say that existing systems are not equipped to cope with the current and additional challenges related to health and mental health caused by climate change.

World leaders and experts are currently in Baku, Azerbaijan, to decide on the future roadmap for climate change adaptation and mitigation. However, a paper published in Nature Mental Health showed that only 49 mental health actors were identified among the participants at COP events from COP1 (1995) to COP28 (2023). This represents just 0.014 percent of the total number of participants and 0.99 percent of health community participants. Given this historically low representation, experts are urging the integration of mental health into global climate negotiations.

Dr. Alessandro Massazza, Honorary Research Fellow at the Center for Global Mental Health.

In an interview with Dr. Alessandro Massazza, Honorary Research Fellow at the Center for Global Mental Health, IPS inquired about the importance of mental health representation and how climate change is increasing vulnerabilities.

IPS: Where do you see climate change and mental health discussion on platforms like COP? Is it getting recognized?

Massazza: The discussion on the impacts of climate change and on mental health needs to be contextualized within the broader discussions on climate and health that are taking place at COP and at other events focusing on climate change. And in a way, we're seeing the climate change and health narrative becoming more prevalent in COP discussions.

Last year, at COP28 in Dubai, we saw the first declaration on climate change and health being announced and signed by more than 150 different countries. We saw the first health day taking place that COP28, and again, even now in Baku, we had a day focusing on health as part of human development day. I think we're also seeing increased mentions of climate change and health within negotiating tracks and negotiators highlighting how in their own respective countries, climate stresses are impacting the health of their populations, and I think that's ultimately because health is a really powerful argument for climate action as it highlights the human face and the lived experience of climate change. Within that broader discussion on climate and health, I think it's fair to say that mental health tends to receive little attention. I don't think that's unique to the Climate and Health discussion. I think within health, more broadly, often mental health, for a variety of different reasons, tends to not receive the attention that it deserves.

But to give an example, we just published a paper in Nature mental health in which we looked at the presence of mental health actors at COPs. And we were able to identify only 49 mental health actors that took part at any COPs, from COP1 to COP28, and that corresponds to 0.01 percent of the total number of participants at COP. If you then look at what that corresponds within the health community, that still corresponds to less than 1 percent of the health community participation. I think that kind of shows the lack of representation of mental health voices within COP, but it's improving.

I am seeing negotiators and stakeholders referring to physical and mental health when highlighting the impacts of climate change.

IPS: You touched on the historical background of mental health discussion within the climate space. I wonder why it is important to connect dots between climate change and mental health.

Massazza: One thing that I think is important, maybe to highlight, is the context in which climate change is happening within the mental health landscape globally. For example, based on data from the World Health Organization (WHO), we know that around 1 billion people around the world are already living with a diagnosable mental health problem, and we know that most people around the world are not able to access appropriate treatment for their condition.

The treatment gap for severe mental health problems in certain countries is as high as 90 percent, so that's a really staggering number, showing how most people really are not getting the care that they need and that they deserve. Inevitably, this means that mental health disorders are extremely costly to society, so the estimated annual cost of mental disorders across the world is estimated to be approximately 1 trillion US dollars.

Despite the cost of mental health problems, we see governments not spending far enough on mental health. So, if you look at the average expenditure of governments on mental health, you see that within the health budget, on average, only 2 percent of that health budget is spent on mental health, and often, most of this funding is spent on tertiary care, such as psychiatric hospitals or care that isn't really able to address the needs of people in the most appropriate way.

Having said that, I think this is to say that climate change, unfortunately, is not going to make any of this better, and climate change is likely going to act as a threat multiplier and is going to deepen some of these issues and potentially reverse some of the progress that we have made in improving and addressing mental health in the last decades.

The other side of the coin is that health, both physical and mental health, can be a really powerful argument for people working within the climate space to highlight the human face of climate change. And I think we see how often, when health is highlighted in the context of climate change, that can function as a really powerful source for people to understand how climate change is impacting their day-to-day lives.

IPS: Let's talk about the impact of extreme weather events, from heat waves to flash floods. All these extreme weather events are becoming more frequent; do these events directly impact or feed into the psychological health? Or is this making situations more vulnerable?

Massazza: We know that climate change is leading to more frequent, more intense, and more long-lasting extreme weather events such as floods and storms, and there are different ways in which these extreme weather events are like to impact mental health.

But to simplify, I guess one can think about two main pathways. One is a direct impact. When people live through extreme weather events like floods in Nepal and Spain, they may be exposed to potentially traumatic events and potentially traumatic events can increase the risk for certain mental health problems, such as post-traumatic stress disorder, depression, anxiety, and substance misuse

There is then an indirect way; we know that these extreme weather events are likely to worsen what in public health we call the social determinants of health. These are things like housing, livelihood, and economy, and people that are exposed to these types of events might lose their house, they might lose their job, their family dynamics might get disrupted, and all of these factors can negatively impact people's mental health.

To give a practical example from Azerbaijan, we collected some case studies from the northern region of Azerbaijan, which is a mountainous region heavily reliant on agriculture that, in recent years, has been exposed to flooding as well as to drought. And these climate stresses have meant that some people have had to sell their animals, which represent the main source of income. They had to relocate to other areas because of the damage of the flood, and all these stresses inevitably impacted people's mental health.

IPS: Is there any specific difference between how all these different events impact the mental health of the people?

Massazza: One specific type of extreme weather event that is attracting increasing amounts of attention, which is heat waves and extreme heat. And this is a type of exposure that is particularly interesting, and we are seeing increasing levels of evidence on how extreme heat is impacting mental health. We know that people living with certain mental health conditions tend to be at higher risk of death during heat waves. For example, people living with psychosis tend to be at higher risk of mortality in the context of extreme heat. We also see that people living with mental health problems might be at higher risk of hospital admissions during extreme weather events. And finally, the third outcome is suicide. We tend to see a positive association between extreme temperatures and heat waves and higher levels of suicide.

What we don't yet understand very well is, why are we seeing these associations?

People have been exposed to heat waves, to floods, and to droughts throughout the course of time. What's different because of climate change is the intensity, frequency, and cumulative nature of exposure, and that has profound implications for mental health.

So, it's important to think about the connections between physical and mental health in the context of climate change.

IPS: What is the role of a conference like the COP or any other gathering of leaders or experts when it comes to addressing climate change and mental health? Do you see any role for these conferences?

Massazza: I think climate change is really one of the defining threats to health that we are experiencing. So, every single decision that is made at COP is going to have health implications, both on physical and on mental health. That’s why COP and other climate decision-making processes have huge impacts and implications for our health in terms of mental health. When we look at the policy outcomes, mental health tends to be one of the least included health outcomes. If we take the example of the Nationally Determined Contributions that are being updated ahead of COP30 in Brazil, only 3% of NDCs mention mental health, and when you compare that to vector-borne diseases or heat-related illnesses that are mentioned by nearly 30% of NDCs, we really see how there's a big discrepancy between how much attention mental health gets versus physical health. Another example comes from adaptation policies, and there was a recent paper in the Lancet; out of 160 documents, zero of them mentioned children's mental health considerations. This obviously needs to change. And places like COP are a good way to create attention.

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© Inter Press Service (2024) — All Rights ReservedOriginal source: Inter Press Service