Introduction

In the context of our rapidly changing environment and climate, resilience defines our ability to bounce forward to a sustainable and regenerative way of living, and is urgently needed at scale. Three essential action pillars have been identified to achieve climate resilience, including 1) mitigation of current and future risks, 2) adaptation to ongoing climate change impacts, and 3) change in societal behaviors towards a more sustainable future or societal transformation1. These pillars are tightly inter-connected as we are in the midst of the climate crisis. Hence, mitigation and adaptation actions and policies need to be enacted in parallel, and societal transformation is important to engage the public and all our communities in effective mitigation and adaptation. The Intergovermental Panel on Climate Change (IPCC) formally defines societal transformation as “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”2. It follows that societal transformation requires both bottom-up public support and top-down political will and institutional policies to enact climate change solutions in a timely manner. Here, we emphasize that an important pathway for such transformation includes framing the climate crisis around mental health alongside physical health of individuals and communities. We acknowledge that there is already compelling evidence for the physical health impacts of climate change3,4,5, and propose that a stronger emphasis is needed on the often-neglected mental health impacts.

Mental health impacts of climate change

Planetary warming from rising CO2 emissions was predicted in the last century and accurately detected by the year 20006,7. The first quarter of this century has already witnessed large scale amplification of climate change-driven extreme weather events, including record-breaking heat waves, mega-droughts, million-acre fires, unprecedented floods, and severe storms8. Much evidence now unequivocally demonstrates that climate change is directly affecting human health: 5 billion people - more than 60% of the world’s population - have already been impacted when accounting for death, injury, homelessness and need for emergency assistance driven by environmental change4,9,10,11,12. Notably, high temperatures also drastically impact mental health, which is important to address because global health systems are particularly weak in providing mental health supports2,13.

Research shows that hazards accelerated by climate change have massively increased the prevalence of post-traumatic stress disorder (PTSD), depression and anxiety in exposed populations2,14,15,16. For instance, a case study we conducted after the deadliest Californian wildfire in history found that 30–40% of fire-exposed community members showed above clinical threshold symptoms for mental health distress even up to a year post-disaster (Fig. 1A)17. There is also large population evidence in California for increased psychotropic medication prescriptions for antidepressants, anxiolytics, and mood-stabilizing medications in the post-disaster period18.

Fig. 1: Example of serious mental health and related cognitive impacts of a climate change-driven extreme event.
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A Heightened prevalence of PTSD, anxiety and depression was observed in individuals impacted by the climate change accelerated deadliest wildfire in California to-date17. Directly fire-exposed individuals showed ~3X PTSD and ~1.5X anxiety and depression prevalence relative to non-exposed controls. Indirectly exposed individuals were those who witnessed the wildfire in the community but did not suffer personal loss; they also showed high symptom prevalence. B Wildfire-exposed individuals further showed ~20% reduced accuracy for processing interference (i.e., distracting information) relative to non-exposed controls, hence had impacted attention abilities due to heightened distractibility20. C Long-term decision-making was also significantly impacted in individuals directly exposed to the wildfire21. Error bars in (A) depict 95% confidence intervals. Swarm-box plots in (B, C) show median with lower and upper quartiles as bottom and top edges of the boxes, respectively; whiskers denote the data range and the scatter points show individual values. *p < 0.05, **p < 0.005 significance for comparisons of exposed vs. non-exposed samples.

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The complex mental health impacts of climate change driven extremes are now broadly described as climate trauma19. Notably, in a subsample of participants from our case study of the deadliest wildfire in California, we observed that fire-exposed individuals had ~20% reduced cognitive ability to process distracting information compared to non-exposed control individuals (Fig. 1B)20. These objective neuro-cognitive findings further aligned with the lived experience of impacted community members, who reported not being able to pay attention to goal-relevant information while constantly distracted by apparent environmental threats and stressors. This study additionally revealed a neurobiological correlate of climate trauma with hyper-aroused/ hyper-alert frontal brain activity in response to distractions in individuals directly exposed to the extreme climate event20.

More recently, we find that direct exposure to wildfires is also associated with deleterious impacts on long-term decision-making in individuals (Fig. 1C)21. Here, long-term decision-making refers to the preference towards decision choices that reflect long-term cumulative gains in the face of short-term losses. It is precisely this ability of foresightedness that is needed while the world implements climate solutions. Yet, as more and more of the human population is exposed to climate extremes, it is gravely concerning that these decision-making skills are being significantly altered by climate stress.

Many related studies have also shown impacts on neuro-cognitive performance driven by heat and air pollution. High temperatures have been evidenced to impact attention, memory, decision-making, and overall executive functioning22,23,24 with further daily life repercussions such as poor law enforcement25, impacted judiciary decisions26 and even higher suicide rates27,28. Air pollution also contributes to global warming; pollutants like methane and black carbon that are short-lived climate pollutants (SLCPs) are even more potent heat-trapping gases than carbon dioxide, thereby, contributing to global warming29. The impact of these pollutants on human cognition heighten the risk for Parkinson’s, Alzheimer’s and dementia30,31,32,33,34, and early life exposure to pollutants is linked to neurodevelopmental disorders, IQ loss and accelerated brain aging35,36,37.

Notably, while the visible nature of extreme climate events can dissipate within a few days, the impacts on mental health and cognition can be long-lasting. After the deadliest wildfire in the western United States, we observed significant mental health, cognitive and neurobiological impacts up to a year after the fires17,20,38. Other disaster studies have shown impacts of wildfires and floods on mental health, particularly PTSD lasting 3–6 years, in research from Canada, China, England, India and Korea16,39,40,41,42,43. Systematic analysis of slow-onset climate change (droughts, changing temperatures over time and local perceptions of ecosystem change) has also revealed significantly exacerbated symptoms of anxiety, depression and psychological distress in this context44.

From a cost analyses perspective, the additional societal costs of mental disorders due to changes in climate-related hazards, air pollution and inadequate access to green spaces is estimated at $47 billion annually in 2030, and projected to grow exponentially to $537 billion in 205045. Here, it is also essential to emphasize that climate mental health trauma extends beyond the Western/biomedical framework of clinical mental disorders; it is also recognized as a crisis of well-being especially experienced by the world’s Indigenous communities46,47,48. While Indigenous Peoples make up only ~5% of the world’s population, they effectively manage and protect ~80% of the Earth’s biodiversity, and the lands and natural resources hold deep cultural and spiritual significance within their societies. Therefore, climate change related over-exploitation of natural resources causes disproportionate suffering for Indigenous communities that intimately depend on the integrity of their ecosystems for survival and flourishing. Alongside Indigenous communities are climate vulnerable communities (CVCs) who will face the worst impacts of climate change despite having done the least to cause it1,2. These CVCs are home to 3.3 billion people who already deal with high levels of non-climate trauma driven by socio-economic disadvantages, including poor access to healthcare and energy resources. Climate trauma will disproportionately affect morbidity and mortality in these communities1,2,49, which is also referred to as the Climate Gap50. Thus, overall there is an urgent need to develop and implement targeted solutions that prioritize equity and environmental justice and thereby, close the Climate Gap and co-benefit both physical and mental health51,52,53,54,55,56.

Mental health integrated within the pillars of climate resilience

Key pillars of climate resilience require concurrent focus on (i) risk mitigation, (ii) adaptation and (iii) societal transformation1. Notably, given the regional heterogeneity in vulnerability risks, there are essentially different regional starting points for climate resilient development for different communities2,49. It has also been acknowledged that in the near-term, implementing transformational change could be disruptive to various economic and social systems, but in the long-term would generate benefits to human well-being and planetary health57,58. Thus, there is no single championed blueprint for societal transformation2, and inter-connected national, subnational and local climate action strategies all have key roles. Here, we first discuss the climate resilience pillars of mitigation and adaptation and how a mental health focus is relevant to these. We then take a deeper dive into pathways for advancing societal transformation with an emphasis on mental health. Overall, we call for adoption of a broader framework that integrates mental health as a priority alongside physical health55.

Enabling climate mitigation and adaptation actions with mental health co-benefits

Climate mitigation focuses on reducing and eventually eliminating fossil fuel use, as well as phasing out emissions of all heat trapping pollutants, including CO2 and SLCPs (methane, hydrofluorocarbons, black carbon soot) by 205059,60. Examples of mitigation technologies include those for carbon emissions treatment, waste-to-energy conversion, recycling and waste management, biofuels, renewable solar, wind and tidal energy, and eco-vehicles. These efforts can be facilitated by giving impetus to green finance especially in developing nations61,62; it is estimated that up to $3.75 trillion of such finance can be generated by taxing carbon emissions for its climate damages63. Implementing mitigation actions at scale would cut the rate of warming by half before 2050 saving over 5 million lives annually and producing profound physical and mental health co-benefits2,4. Examples of effective mitigation strategies with such co-benefits include California’s cap-and-trade program, which has reduced the state’s greenhouse gas emissions, improved air quality, and simultaneously benefitted environmental justice via targeted investments in CVCs64. State governments in the Global South are also leading the charge in mitigation solutions with co-benefits; for instance, the state of Gujarat in India launched the country’s first climate change department in 2009, and is focusing its resiliency building efforts on sustainable agriculture, renewable energy, and energy conservation while simultaneously protecting Indigenous tribal zones and prioritizing human physical and mental health65.

Despite ongoing mitigation efforts, climate change will likely get worse for at least the next 25 years due to the thermal inertia of oceans and glaciers, before the warming curve starts to bend66. Thus, adaptation to unavoidable climate risks necessitates the same priority as mitigation. Principally, the major constituency to focus on for adaptation will be the poorest 3 billion people, whose collective emissions are less than ten percent but are the most vulnerable to climate impacts because of where they live combined with limited access and affordability to energy, food, water, and healthcare67.

Adaptation involves reducing exposure to risks as well as reducing vulnerability to unavoidable risk exposures. Adaptation solutions have important co-benefits for mental health and well-being. Heat and air quality warning systems benefit risk preparedness; these alongside improved building designs with green and blue infrastructure and passive cooling systems that provide respite during temperature extremes, all reduce the likelihood of individuals succumbing to post-disaster trauma68,69,70,71,72,73. Wide communication of the understanding of heat and air pollution hazards, including impacts on mental health and neurological health33, can play a role in disaster preparedness and bring community awareness to seek out appropriate post-disaster health services74. Adaptation solutions thus, also include better access to public health systems for the most vulnerable and greater access to mass transit systems and post-disaster supports. Integral to mental health adaptation, we need improved surveillance and monitoring of mental health impacts after extreme weather events, mental health first aid training for care providers and first responders and climate change resilience planning at the community level. As successful examples, pre-planning of temporary shelters in China for prospective flooding significantly lowered rates of anxiety, depression and PTSD in the aftermath of flooding among those displaced who were able to access the planned resources75. Another key example comes from Australia, where after the bushfires in 2019–20, the federal government allocated funds to support mental health through free counseling for those affected, increased access to telehealth, extended hours for mental health services and had programs designed specifically for youth76. In the US, mental health interventions have been successfully applied in communities in the northeastern states after coastal flooding77. Further, for Indigenous people, it is very important to preserve connections to traditional culture and place to enhance well-being78 and build resilience to environmental change79. As an example, the reindeer herding Sámi in Scandinavia and Russia have described threats to core conditions for herding as ‘facing the limit of resilience’80. To address this, the Swedish Sámi parliament implemented a climate adaptation program wherein reindeer herding management plans strategically secured adequate winter grazing for the Sámi and reduced fragmentation of grazing areas. This strategy brought significant co-benefits by increasing the mental and spiritual well-being of the Sámi people while also decreasing their dependency on fossil fuels that were being used to transport reindeers to suitable pastures farther away81. Similarly, for the subarctic Indigenous community, domestic rainwater harvesting initiatives to promote household water security has been shown to concurrently improve mental health82. Overall, there is strong evidence that multi-sectorial initiatives focusing on improvements in education, quality of housing, safety and social protection supports are required as part of adaptation to enhance well-being and promote resilience to climate risks83,84.

Including a mental health & well-being framework to promote societal transformation

The societal transformation pillar of climate resilience is essential for the effective implementation of technologies and policies under the first two pillars (Fig. 2). Societal transformation focuses on building political and social capital to implement long-term mitigation and adaptation strategies at scale. Decades of climate inaction due in part to the lack of widespread public pressure and support has taught us that political capital is as important as financial capital85. Additionally, as long as unsustainable and inequitable economic growth holds prominence in the public mind, environmental destruction will continue unabated56,86.

Fig. 2: The pillars of climate resilience with societal transformation providing the central foundation.
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Societal transformation is essential to leverage people’s lived experiences of the climate crisis to generate mass support for climate action. Societal transformation is achievable with a four pronged action approach under its umbrella, including climate education for all, enhanced social connection, intentional coalition building and long-term policymaking that prioritize environmental sustainability towards enhancing physical and mental health and well-being of the global population.

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In today’s world, achieving societal transformation is challenging particularly because of the way that climate issues have become politicized87. In countries around the world, the rise of populist movements, increasing political polarization and sectarianism, and the spread of disinformation has created pockets of resistance to scientific solutions to the climate crisis88,89,90,91,92. Building the kind of broad public support to address the crisis thus requires identifying solutions that frame the crisis in ways that apolitically relate to the public. In this context, a health framework around the climate crisis that also emphasizes mental health is crucial, especially because mental health is essential for us to rebound after any setback or rather bounce forward post-disaster93.

Global public health research shows that framing climate change in terms of health and environment can bolster public support in high-emitting countries like China, USA, India, Germany and the UK. Notably, positive, health oriented framing garners support for climate policies even amongst climate skeptics94. Just as health challenges affect people across the ideological spectrum, data shows that in the United States, conservative and liberal communities alike are experiencing higher rates of mental health distress - depression, anxiety, and reduced well-being95,96,97,98. Thus, framing the climate narrative to recognize the interconnectedness of the climate crisis and the crisis of well-being that we are all experiencing as humans can help shape a unified and community-rooted approach to societal transformation. In support of this narrative, research shows that focusing on co-benefits of development (such as economic and scientific advancement) as well as benevolence (moral duty and caring towards the planet) can motivate the public to address climate change across ideological divides99. Yet, it has also been shown that non-climate frames can fail if individuals do not sufficiently relate to that specific framing100. Thus, the extant climate narrative needs intentional and careful reframing in key ways –

First, we need to broaden the focus of the narrative from eco-system and physical health to also emphasize mental health. Given the co-benefits of restoring eco-system health for the overall physical and mental health of the people, both climate policy as well as public health and mental health policy need to synergistically push for mutual win-win solutions13,101.

Secondly, we need to acknowledge the interconnected welfare of the entire global population in the Global South and the North. For instance, the Global South faces the disproportionately larger burden of illness and mortality due to climate change relative to the Global North56. Yet, climate accords aimed at supporting the Global South often face pushback from the Global North due to concerns about the financial burden of providing significant aid and the biased perception that developed countries are being unfairly held responsible for historical emissions. This leads to tension regarding who should bear the primary responsibility for climate action and funding mitigation efforts in the Global South and can perpetuate mitigation inequalities49,56. More inclusive, non-siloed ideology that emphasizes global well-being is urgently needed to tackle this problem. Notably, such equitable ideology has roots in Indigenous understandings86 as well as contemplative practices that have shown much evidence for mental health benefit102. Nurturing belief in common humanity further aligns with the ‘Inner Development Goals' framework, which emphasizes fostering the inter-relationships needed to live more sustainably and achieve long-term positive change103.

Third, a shift is needed in our mental framework from valuing short-term gains to long-term sustainable prosperity. This shift in decision-making is an important neuro-cognitive component of mental well-being104. In this context, our neuroscientific research finds that we leverage our brain’s memory systems when encoding for long-term rewards105,106. In turn, memory systems are capable of driving adaptive behavior, i.e., behavior that iteratively learns from past experiences and errors and chases what is most valued. As a society, assigning the greatest objective value to the long-term sustainability of the planet can help nudge individuals to be more willing to sacrifice short-term gains. Related neuroscientific research shows that mentalizing and perspective-taking predict intergenerational sustainable behavior, which refers to meeting the needs of the present generation without compromising the ability of future generations to meet their own needs107,108. Further, interventions that stimulate mentalizing significantly increase sustainable decision-making109; a mega-study spanning 63 nations showed that mentalizing the impact of one’s actions on future generations can be an effective approach to enhance climate policy support at a global scale110. Again, Indigenous communities have practiced intergenerational sustainable behavior for centuries now, demonstrating the way an entire community can train the brain to act with a long-term, sustainable focus111,112,113.

We acknowledge that shifting extant narratives is notoriously challenging. Overarching narratives like the climate narrative spring from a complex architecture of assumptions that people hold about the world114,115. These assumptions encode long-held human biases about equity and who deserves dignity, as well as beliefs about the possibilities (or even limitations) of interconnection, and the kind of agency individuals have to solve societal problems. Changing these narratives thus requires more than a messaging campaign116. Research shows that influencing human lived experience is a far more effective approach to dislodging pre-existing assumptions than information provision117, which has also been validated in the context of climate engagement118. Weaving a new climate narrative thus depends on reconfiguring the nature of the experiences people have in such a way that reshapes how they perceive themselves, the groups around them, and the institutions they inhabit. For instance, we can inculcate intergenerational sustainable behavior in our everyday lives and workplaces by mentalizing the impact of our actions on future generations, discussing our moral duty towards the planet, understanding the issues that people within a community deeply care about, which impact their future, and further, sustain engagement by involving people in co-design, co-creation and co-ownership of the change they’d like to see118. Such sustainable future thinking and practice has led to companies successfully adopting Environmental, Social, and Governance (ESG) sustainability goals118 and to creation of future design councils within communities that encourage people to think about future generations and thereby, design and plan community infrastructure that fosters sustainability and intergenerational justice119. This trait of ‘futurability’ refers to experiencing an increase in happiness and mental well-being because of deciding and acting toward foregoing current benefits to enrich future generations119.

In other words, societal transformation requires rebuilding systems that change the way individuals understand climate issues, the way groups of people connect with each other, and the relationship of people and communities to large-scale infrastructure, institutions and policies.

Here, we describe four key approaches to societal transformation that leverage a well-being framework to help mold people’s lived experiences of the climate crisis at the individual, collective, and institutional levels. We emphasize (1) climate literacy for the masses with a focus on health, mental health and well-being; (2) stronger social interconnection between communities; (3) intentional coalition-building amongst key knowledge stakeholders, and (4) long-term climate policymaking that achieves cross-partisan support (Fig. 2).

  1. 1.

    Climate education for all. Focusing on education can empower people of all ages with awareness of the interconnections between climate change and our physical and mental health120. Education is a way to build on the inherent learning capabilities in any community, and is a crucial asset that a community has to solve its own problems. Climate literacy also informs us about the need for climate action. Because knowledge alone does not drive action, experiential approaches to education make it more likely that climate education will dislodge pre-existing assumptions and reshape people’s understandings of climate121. Among effective examples of climate education at scale is the “Bending the Curve: Climate Change Solutions” multi-disciplinary undergraduate course created at the University of California (UC) that is taught on 10 campuses all across the state. The course has enrolled 500 students annually since its launch in 2017, and particularly focuses on solutions designed to bend the warming curve, and to accelerate resilience and climate justice for our planet’s most vulnerable people122. This focus is aligned with the principles of socio-cultural theory that climate education needs to leverage participation, relevance and inter-connectedness to support a collective response to crisis123. There are also now published studies demonstrating the positive impacts of climate education. Cordero et al.124 showed that climate change education is associated with reduction of individual carbon emissions by 2.86 tons of CO2 per year. In another study of a thousand adolescents, such education enhanced climate change knowledge that positively correlated with increased climate change concern and hope, which in turn predicted changes in pro-environmental behaviors125.

    Since greater awareness of climate change impacts can also be distressing, climate education needs to also integrate training in mental health skills to address eco-grief and eco-anxiety. This is particularly important for our youth, who suffer from tremendous climate distress and have not yet developed the life experiences that feed resilience98. Developing mindful behaviors has also been shown to significantly correlate with sustainable decision-making, ecologically responsible behavior and climate action126,127,128. Additionally, in our studies of wildfire impacts on mental health, we have found that mindfulness is a negative predictor of climate trauma, protecting exposed individuals from developing long-lasting symptoms of PTSD, anxiety and depression17,38. In this context, an education study showed that mindfulness and sustainability can be feasibly co-taught129. Within the UC system, we have recently designed and implemented specific climate resilience education with a particular focus on mental health and psychological well-being130. The UC Climate Resilience course curriculum disseminates knowledge and practical skills to transform personal climate distress into collective action. Group climate action projects are an essential component of this course that help mold individual experiences by learning to collectively plan, organize and solve local climate-related challenges. Notably, we find that such climate resilience education that integrates mental health resilience, significantly reduces climate anxiety and distress and enhances collective self-efficacy, i.e., the belief that together as a collective we can overcome big challenges and further, enhances willingness to participate in climate action131. Collective action in turn buffers mental health132. Here, we also acknowledge the Planetary Health Education framework because it considers integration of interconnection with nature, equity and social justice, movement building and systems change within climate education133. Overall, climate education can work at the individual level to reshape people’s understanding of climate in holistic, experiential ways, and further promote risk-preparedness, psychological resilience, collective action and thereby, societal transformation.

  2. 2.

    Social connection. Humans are naturally social beings, and the way we ingest and make meaning of information is necessarily social134. Yet, social connection in many contemporary societies has declined, leading to greater social isolation135,136 that is further linked to greater climate distress137. To develop new understandings of and narratives around climate, people need to be embedded in communities of belonging that create the psychological safety needed to make sense of the climate crisis as a crisis of well-being, and to become motivated to work with each other138,139,140. Such social connectedness and social support further reduce the risk for various mental health problems141,142, as we have also found in our post-disaster research38.

    We further posit that framing the climate crisis around mental health creates pathways for social connectedness that have previously been foreclosed. The politicization and polarization of issues like climate mean that a number of people are hesitant to address the issue within their social circles. A broad literature has shown that avoidance is a frequent strategy people deploy to avoid polarizing conversations within their social networks143,144,145,146. Framing and discussing the climate crisis around mental health, however, creates a pathway for opening up conversations amongst people who may be hesitant to tackle what is perceived to be an otherwise polarizing issue. In doing so, the mental health framework enables people to foster stronger social capital vis a vis the climate crisis.

    Additionally, building social connection is critical for people and communities planning for future disaster response, and, when needed, implementing disaster preparedness plans. Recent studies of disaster resilience have shown that strong social connections within the family and within communities can significantly protect well-being in the aftermath of climate disasters38,147,148. Rebuilding social connection thus weaves the fabric necessary for a thick, interconnected climate narrative to emerge that bridges people and communities. In non-urban regions of the world, where 45% of the population live, faith-based leaders and organizations (FBOs) can play a vital role in rebuilding community connections as they are already integral to sustainable community development149,150,151,152,153. Especially in non-urban areas, FBOs play a prominent role in providing for basic needs (food, clothing, shelter), social services as well as post-disaster supports, while meeting the spiritual needs of community members. Even in urban areas faith-based thrift stores, such as The Salvation Army, make affordable clothing accessible for community members. Communities also rely on FBOs for food pantries and food kitchens. In rural areas where there is capital scarcity, religious values and resources of FBOs have an unparalleled ability to foster social cohesion and supports. In turn, faith leaders play an important role in communicating the science of climate change through sermons, and leading by example by transitioning houses of worship to renewable infrastructure, divesting from fossil fuels, advocating for equity and climate justice, and deploying FBO infrastructure and nature-based solutions in disaster recovery. Indeed, FBOs are considered important cultural partners for achieving the United Nations (UN) Sustainable Development Goals globally in religious adherents, estimated at 80% of all humanity154.

  3. 3.

    Intentional coalition-building among key knowledge stakeholders. Cross-sectoral collaboration and communication is necessary to scaffold the change from the individual to institutions155. If individuals and communities develop new climate narratives, but social, political, and economic institutions do not, people can become disaffected from unresponsive societal institutions156, thus stymying the work of remaking the climate narrative. However, generating such cross-sectoral collaboration is challenging because each sector has its own ways of producing and articulating knowledge and its own incentives for what kind of work it values. Consider, for instance, people’s lived experiences of eco-anxiety and eco-grief. In personal communication, members of the public have related to the first author that some healthcare providers do not yet acknowledge their lived experiences of climate trauma, despite the growing scientific evidence linking climate change to mental health impacts. Therefore, scientists like us must work alongside the medical community to shape provider-patient conversations and make more care providers aware of new research findings, especially given the long time horizon over which climate trauma and grief emerge. As an example of such cross-sectoral collaboration, the American Medical Association that has nearly 300,000 clinician members across the United States now hosts a module on climate change and mental health on its online education hub that is accessible for accredited learning for clinicians157. Studies of previous climate disasters also show how cross-sectoral collaboration is crucial for future disaster planning and for protecting post-disaster mental health and well-being, as discussed under the adaptation pillar above.

    It is also important to acknowledge the crucial role of community led efforts in promoting mental health, well-being and climate resilience. There is a global shortage of clinical mental healthcare providers to serve community needs, and in this context community workers play a vital role in providing mental health supports13. For example, in wildfire afflicted regions in the western US, ecotherapy counselors are serving community members suffering from PTSD158. Ecotherapy or forest therapy integrates community mindfulness-in-nature practices that can serve as a way for people to cope with eco-grief and eco-trauma, and rekindle a positive human earth connection159. Such programs also integrate knowledge about Indigenous sustainability practices, and greater awareness of the native land & species, culture and history, with active participation in land stewardship. So the very communities that have suffered the most in the aftermath of climate change disasters are emerging as the ones with the most innovative community resiliency solutions, albeit many-a-times out of necessity due to absence of larger mental healthcare infrastructure. Such community initiatives can serve as models for other communities, helping to prevent eco-paralysis160.

    There are also successful examples emerging from sub-Saharan Africa where mental health needs leverage the support of community-based traditional and faith healers161. Similarly, in India, a community counselor based program for depression treatment has been implemented at scale and has shown sustained clinical and cost-effectiveness162,163. A recent scoping review describes 37 mental health and psychosocial interventions that have been implemented in the context of climate change ranging from individual-level psychotherapy to community-based activities, mental health media campaigns, and cash grants; however, the majority of these initiatives have not been evaluated for efficacy and remain at nascent stage164; importantly, there is a lack of publicly shared implementation information for these initiatives that would be key for scaleup.

    Effective cross-sectoral collaboration is rare because too many efforts seek to build knowledge-sharing networks that have no real power, often rendering nothing more than intermittently useful conduits for information. Sustained collaboration of the kind needed to scaffold individual and community change to institutional change requires the construction of intentionally designed coalitions that make explicit agreements about power and knowledge sharing in ways that speak to the interests of multiple stakeholders165,166. Building coalitions that generate long-term collaboration can reinforce the linkages between people’s individual, interpersonal, and societal experiences of a holistic climate narrative. Currently, less than 5% of global climate finance serves the health sector and only 2% of government budgets are devoted to mental health13,167. Building effective cross-sectoral coalitions that emphasize both physical and mental health can garner more targeted funding for impact at scale in the climate and health sector.

  4. 4.

    Long-term policymaking. Finally, remaking a climate narrative also necessitates reshaping the policies to reflect an integrated approach to climate, health, mental health and well-being. In this regard, the “Community Mental Wellness & Resilience Act,” that has been considered in the US Congress is a relevant step forward168. This policy seeks to authorize funding for community-led initiatives to prevent and heal the burgeoning mental health problems caused by climate change driven emergencies and disasters. Its focus on well-being may potentially make it less susceptible to the gridlock that has characterized other climate legislation.

    On a global scale, there is some historic precedent for long-term policymaking on climate and health. Public health effects have been the major drivers of global regulatory actions for cutting down air pollution and phasing out emissions of non-CO2 climate pollutants such as chlorofluorocarbon refrigerants (CFCs) because of their depletion of stratospheric ozone that protects us from harmful UV radiation. The Montreal Protocol to protect the Earth’s ozone layer is to-date the only UN environmental agreement to be ratified by every country in the world, and has successfully phased out 98% of ozone-depleting substances, saving nearly two million people from skin cancer every year169. This exemplar global health policy has a major climate co-benefit because CFCs can be up to 10,000 times more potent than CO2 in warming the climate170. Similarly, SLCPs including black carbon, methane, hydrofluorocarbons, are also coming under regional bans. Industrial bans on these pollutants alongside food waste management programs can additionally curb greenhouse gas emissions59,60. Importantly, these programs are simultaneously engaging communities in local action, such as city level composting infrastructure that engages every home in green waste management, and thereby contribute to societal transformation and promote well-being171. If adopted globally, this strategy could mitigate global warming by up to 0.6 °C, and help to prevent climate tipping points172.

Conclusion

As the climate crisis grows, we can no longer just rely on mitigation to protect people and ecosystems. We have to broaden the approach to integrate mitigation with adaptation and make people climate resilient, so we can survive the crisis and thrive in its aftermath. Climate resiliency efforts thus need to simultaneously focus on three pillars of mitigation, adaptation, and societal transformation. Although societal transformation has been a challenging area to identify solutions, developing a narrative that takes a holistic, integrated approach to understanding the intersection of climate, physical health, mental health and well-being represents a potentially compelling pathway to stimulate change. We need to emphasize mitigation and adaptation solutions and policies that have physical and mental health co-benefits for all and reduce the climate gap driven by inequities. Multisector partnerships and community-based approaches will be critical to reduce vulnerabilities and address mental health needs. A well-being focused climate narrative will require change strategies at the level of individuals, groups, cross-sectoral coalitions, and top-down institutions. Strengthening social connection and rebuilding community cohesion will be essential for climate resiliency. Supporting community led solutions that work in partnership with key knowledge and research stakeholders can further help to advance the evidence-base for effective solutions. Finally, climate education for all can help convert personal distress to collective action, and generate a movement, which realizes that the costs of inaction are much greater than taking sustainable action for planetary well-being.