United Nations University
Maastricht Economic and Social Research Institute on Innovation and Technology

第258回FASID BBLセミナー「気候変動とメンタルヘルス～エコ不安症とどう向き合うか～」
2024年1月24日（水）開催
第258回FASID BBLセミナー
2024年1月24日（水）開催

Sanae Okamoto, PhD
Psychology, Behavioural science,
Economics of Innovation Unit
Co-lead, UNU Climate Resilience Initiative
United Nations University UNU MERITAgenda1. Climate change impacts on health
2. How does climate change affet mental health?
3. Climate Injustice - Inequality and vulnerability
4. Casesa. Geographical insights and traditioanl or community approaches
I. South East Asia
II. Africa
b. Future generation
5. Global advocacy and climate negotiation
6. What can be done, next steps - Co-benefits of climate action for mental healthoutcomes2

1. Climate change impacts on healthLawrance, et al., 2021

Climate change impacts health both directly and indirectly, and is strongly
mediated by environmental, social and public health determinants.
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Climate change is directly contributing to humanitarian
emergencies from heatwaves, wildfires, floods, tropicalstorms and hurricanes and they are increasing in scale,frequency and intensity.
Between 2030 and 2050, climate change is expected to cause
approximately 250 000 additional deaths per year, fromundernutrition, malaria, diarrhoea and heat stress alone.
The direct damage costs to health (excluding costs in healthdetermining sectors such as agriculture and water andsanitation) is estimated to be between US$ 2–4 billion peryear by 2030.
Areas with weak health infrastructure – mostly in developing
countries – will be the least able to cope without assistance toprepare and respond.
Polluted air kills 5 million people each year

Reducing emissions of greenhouse gases through better transport, food and energy use
choices can result in very large gains for health, particularly through reduced air pollution.

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Image: WHO

The causes of climate change are rooted in human behaviourand hence human psychology
With action to tackle climate change requiring a reshaping of societal andindividual choices and lifestyles that minimise the emission ofgreenhouse gases.
It is important to understand the range of psychological responses –thoughts and feelings – that individuals and communities have in relation toclimate change in order to appropriately
engage communities in climate
adaptation and mitigation
efforts while supporting mental healthand emotional wellbeing.

How does climate change affet mental health?

Lawrance, et al., 2021

Multifaceted impacts of climate change on mental health“a state of mind characterized by emotional well-being, good behavioral
adjustment, relative freedom from anxiety and disabling symptoms, and acapacity to establish constructive relationships and cope with the ordinary
demands and stresses of life” (American Psychological Association ,2020)

Direct and indirect impacts of
CC:
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Post- and Pre-TraumaticStress Disorder
Depression
Disruption of psychosocial
well-being
Fear, anger, anxiety,helplessness, hopelessness
Alcohol, Susbstance abuse
New terms: Eco-Anxiety /Climate anxiety / Climate
grief / Eco-grief / Solastalgia,
etc.

9New terms describing impacts of climate change on mental health
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•
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Climate change anxiety is associated with the symptoms
of generalised anxiety disorder and is experienced by people, often
young, overwhelmed with anxiety and the feeling that they have nocontrol over the planet’s future.
Eco-grief is triggered by witnessing environmental degradation,
viewing media depictions or indirectly experiencing the climate
crisis.
‘Solastalgia’ is used to describe feelings of people whose native
lands or familiar environments are changing quickly and who haveexperienced a loss of sense of place.
These mental health conditions could occur through•acute events such as storms, floods, and wildfires;•long-term changes such as droughts and heat stress as well
as related food and water insecurities; and•long-lasting changes to landscapes and physicalenvironments caused by altered ecosystems and landscapes.

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Coffey, et al., 2021)

WHO, 2022

Climate Injustice - Inequality and vulnerability

Climate injustice
The climate impacts fallheavily on those
oppressed by historicand present social,economic, and politicalpower dynamics. (APA,
2020)
MH is not the result of
single events, but theresult of complex causal
chains that begins before
birth and changes acrossthe life-course
development

WHO, 2022

Predictions: Evidence for impacts on specific mental health outcomes
SuicideIncreased suicide rates with increasing temperatures have been reported globally, from low- to high- income settings.
• Approximately a 1% increase in the number of suicides for each 1°C temperature increase, once thetemperature passes a threshold that is unique to each location (Gao, 2t al., 2019).
• The exact relationship depends on contextual factors such as humidity or demographic variables (Inoue, et al., 2008).
• Rising temperatures will lead to 22,000 extra suicides (95% confidence interval 9,000 – 40,000) across theUnited States and Mexico alone by 2050 (e.g., Burke, et. al., 2018).
• Air pollution (e.g., Isabelle, et al., 2019) and extreme weather events such as a wildfire or hurricane (e.g., Brown, et al.,2018) can both contribute towards higher rates of suicide.
Increased new cases of mental health problems
Climate change increases the risk that people will experience prolonged distress that meets criteria for mental illness• Extreme weather events are associated with stressors and traumas (e.g. displacement, food insecurity, griefand loss) that may increase mental health burden and reduce wellbeing.
• Psychological trauma, including new cases, have been understandably observed following extreme weather events
including floods, hurricanes and bushfires (e.g., Australian Government report, 2020) but also in response to slower acting
climate events such as droughts (e.g., Vins, et al., 2015) and rising sea level (e.g., Asugeni, et al., 2015).
• Worsened mental health including new cases or worsened symptoms of PTSD, depression, anxiety and substanceabuse have been observed in citizens of all ages as well as healthcare professionals working in disaster relief(e.g., Kar, et al., 2006).

Predictions: Evidence for impacts on specific mental health outcomes
Displacement / migration• There could be as many as 200 million climate refugees by 2050 as a result of climate change and theassociated flooding, rising sea level, droughts and growing shortage of food and arable land (e.g., Myers, et al., 2002).
• People will increasingly be temporarily evacuated or locally displaced by climate-related disasters, such as those
who had to temporarily flee or permanently lost their homes in the Australian bushfires. All these forms ofdisplacement or migration come with mental health burdens (e.g., Shultz, et al., 2019).
Worse outcomes for people with mental illness
People who experience mental illness are more vulnerable to the effects of climate change on physical / mental health.
• People with pre-existing mental illness, particularly psychosis, dementia and substance abuse, have a two to
three times higher risk of death during heatwaves than people without （e.g., Cianconi, et al., 2020).
• Higher temperatures have been associated globally with increased risks of hospital admissions – including in theemergency department – for experiences diagnosed as bipolar disorder, schizophrenia, alcohol and substancemisuse, dementia, and self-harm (e.g., Almendra, et al., 2019).
o Due to side-effects of medications for mental illness, because they impair the body’s ability to regulate
temperature, leading to higher risk of severe physical symptoms (e.g., Martin-Latry, et al., 2007) particularly among theelderly (e.g., Dodgens, et al., 2016).
o There may be insufficient awareness of this risk among those on such medication or indeed among
healthcare and first aid practitioners (e.g., Mann, et al., 1978).
• High temperatures can lead to poorer sleep, altered blood flow and other physiological processes that
underlie cognition, which in turn can worsen the symptoms of mental illness and reduce mental wellbeing (Taylor, 2017).

Cases:Geographical insights - traditioanl or community
approaches
South East Asia (ref: Soo Chen Kwan, 2022, UNU-IIGH)

IPCC, 2022: Climate Change 2022: Impacts, Adaptation, and Vulnerability.

Climate change and impacts on human systems in Southeast Asia (SEA)
Climate projections• minimum temperature extremes (warmnights) very likely warmed faster compared tothe maximum temperature by 1.2 °C to 3.8 °C.
• Increases in annual mean rainfall over mostland areas but drier conditions during JJA.
Monsoon precipitation is projected to increase.
• Increase in meteorological droughts as aconsequence of an increasing frequency of
extreme El Niño.
• Increase intensity of tropical cyclones withdecreasing frequency and an increase in theamount of TC-associated precipitation is
projected.
Predicted conditions: displacements; water insecurity; food insecurity; cultural
disruption and livelihood change (indigenous people); increase in heat related
illnesses; infectious diseases; mental health issues – vulnerability in informal
settlements and the poor
(Modified from Kwan, 2022)

Cultural challenges of addressing mental health in SEA• Different cultural groups somaticize psychological illnesses• Filipinos do not differentiate between physical and mental disorders –disaster survivors seek out indigenous and folk healers for disturbed
behavior and somatic complaints that appear to have no medical
causes• In Cambodia, the term baksbat (broken courage) is used to describe
post trauma symptoms including feeling fearful, mute and deaf, andlacking trust in others (Chhim, 2012).

• The cultural value of shame, lack of knowledge, and presence ofstigma attached to persons with mental illness prevents themfrom seeking formal care.
•

Source: Nikkei.Asia

Survivors generally prefer seeking help from family and friends.

• Traditional beliefs with the existence of traditional healers(indigenous and folk healers)• Herbalists - Kru Khmer in Cambodia; arbolarios and manghihilots(magnetic healing using prayers and massages) in Filipino, especiallyin rural areas• Also popular in East Timor, Viet Nam, and Indonesia (up to 80%
before they consult a medical professional).
Hechanova et al. (2020). Cultural implications for the provision of disaster mental
health and psychosocial support in Southeast Asia. Resistance, Resilience, andRecovery from Disasters: Perspectives from Southeast Asia.

Source: https://krukhmer.com/(Modified from Kwan, 2022)

Cultural sensitivity of MHPSS interventions in SEA
MHPSS: Mental health and psychosocial support• Reduce the barrier of stigma• Campaign (e.g. renaming schizophrenia)• Offering services in less stigmatizing locations to reduce shame - digital services• MHPSS Interventions to incorporate cultural dimension (values, beliefs, practices)
for better outcomes.
• Community, and society interventions that promote social support andinterdependent coping efforts may be more important in SEA.
• Collaborative networks to avoid fragmentation• counsellors, psychotherapists, psychologists & psychiatrists• local healers (provide training to both sides for integration)• survivors’ natural counselors – families, incorporating the family
in treatment by providing psychoeducation to reduce stigma• disaster responders, community health workers, leaders, religious
workers• non-governmental organizations (NGOs) and universities

Ito et al. 2012. Lessons learned in developing community mental
health care in East and South East Asia. World Psychiatry
2012;11:186-190.
(Modified from Kwan, 2022)

Cases:Geographical insights - traditioanl or community
approaches
East Africa (ref: Kariuki Weru, 2022, UNU-EHS)

IPCC, 2022: Climate Change 2022: Impacts, Adaptation, and Vulnerability.

Clinical services in East Africa at a glance
Kenya:

Rwanda:DRC:≤ 1,500
psychiatric beds

2 psychiatrichospitals≈100
psychiatrists≤ 1,000
psychiatricbeds

0.06 MH* staff per
100,000

Tanzania:

Uganda:Ethiopia:≤ 1,000
psychiatricbeds

1 referral
psychiatrichospital

1 psychiatrichospital≤50 psychiatrists≤ 500
psychiatricbeds

No data for North Sudan, South Sudan and Burundi
Images sourced through Creative Commons License (CC)

(Jörns-Presentati et al., 2021)(Modified from Weru, 2022)

Regional Climatic Events in East Africa
Climate events

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Loss of life ; Lossof livelihoods ;Climate migration

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Tropical Cyclones ●● ● ● ● Flooding●●
Wildfires ●Drought ●Shrinking lakes ●Locust Swarms ●(Gebrechorkos, Hülsmann & Bernhofer, 2019)(Modified from Weru, 2022)

Progress nonetheless..

https://www.weforum.org/agenda/2021/08/4-facts-mental-health-africa/
https://www.afro.who.int/news/access-mental-health-and-psychosocialsupport-services-remains-unequal-children-andCases:Future generations – Youth and children
Youth’s perceptions, Perspectives from psychological development
and intervention

The lack of progress in global climate action contributing to distress,
especially among young people and children
As climate change-induced risks and events have been in news
headlines almost daily, many young people and children learn about
governments’ inertia on global climate action.
• A recent landmark study conducted in 10 different countries (Australia,
Brazil, Finland, France, India, Nigeria, Philippines, Portugal, UK, USA)with 10,000 young people (16-25 years old) revealed that more than
80% of respondents worried about climate change and more thanhalf were extremely and very worried with emotions with expressedas ‘sad’, ‘afraid’, ‘anxious’, and ‘angry’. (Hickman, et al., 2021)
o The respondents regard governments as
failing to address or act on the climate crisis in a
coherent, urgent way, expressing that they feelbetrayal and abandonment both individually andon behalf of future generation.
• Another study reported that young people arefactoring climate-anxiety into their decisions
on whether or not to have children, with 97%
saying they were concerned about the well-beingof children in the future. (Schneider-Myerson, et al., 2020)

Cases: Long-term and cross-generational impacts of climate change induced
events on mental health• MH is not the result of single events, but the result of complex
causal chains that begin before birth and changes acrossdevelopment• Most children with psychological problems including thoseliving in high-income countries, receive almost no treatment.
• Although climate change is now recognised as a catastrophic
harm to children’s health, with more than 88% of the current
burden of disease attributable to climate change occurring inchildren, very little attention has been given to the mental
health consequences of climate risks for children.
• Around 85 % of the world’s children (approx. 2.2 billion)
live in low- and middle-income countries that are mostvulnerable to CC, despite being least responsible for causing it,
and least empowered to participate in its solution.
Yet the UN has long recognised that “young people are not only victims ofclimate change, but they are also valuable contributors to climate action”.
We need to build an integrated climate service where all generations – from old toyoung – can discuss the mental health risks of climate change and address how to28
cope and build resilience among ourselves.

(e.g., WHO, 2022, Vergunst, 2022)

Developmental approach and children’s vulnerability
Healthy human psychological development is influenced
by physiological, genetic, cognitive, emotional, socialand environmental factors and the dynamic interplay
between them, and can be disrupted by environmental risks(e.g., disasters, water insecurities) at multi levels¡ Biological system (e.g., stress-induced changes in the

response-neural system, irregularity in DNA methylation)¡ Microsystem (e.g., increased family stress, reduced

quality of parenting)¡ Mesosystem (e.g., disruption of family / community social

disfunctioning / school closure)¡ Exosystem (e.g., intergroup conflict, reduced access tohealth system)¡ Macrosystem (e.g., social breakdown, forced migration)¡ Chronosystem (e.g., environmental change due to climatechanges)29(modified from Noffsinger, et al., 2012)

Long-term and cross-generational impactsof climate change: The damage begins
before birth and cascades acrossdevelopment with each unresolved
challenge setting traps for the next.

(Vergunst, 2022)

*early onset of mental
disorders is 14.5 years old(e.g., Vergunst, 2022)(Vergunst, 2022)

A long-term developmental perspective
recognizes the importance of early detection
and prevention of mental health vulnerability
to children’s psychological development.
The earlier the better!

Global advocacy and climate negotiation

Climate education will play a key role in fostering psychological resilienceamong future generations
Three, first-ever initiatives for youth:
1) the Youth Climate Champion,2) the International Youth Climate Delegate Program,3) and the Youth Stocktake à Climate Education
The COP28 Presidency urge improved global climate education,with 38 countries signing the UNESCO Greening Education
Partnership Declaration to incorporate climate education into their
Nationally Determined Contributions and National Adaptation Plans.

What role do you see education playing in fostering resilience among
future generations in the face of climate-related challenges?
• Building knowledge of climate change but also learning from each other what
we can do, such as pro-environmental behaviours or recognise how we feeland share these feelings at a safe space such as schools.
o It needs to be considered as a ‘new normal’ curriculum as teachers, parents
and caregivers may feel anxious as well. We need to empower these people
who will be guiding the next generation with the right knowledge andexplain what type of actions we can take.
• We should also teach children about climate facts in a way that does notscare themo Including collaborative experiential learning with
community-activities such as planting trees in the local
environment, visiting neighbouring nature, interacting with
scientists. This would support children to gain the rightknowledge of the role of nature for our healthy planet,
and a collective feeling.
o It would lead to the development of a community-levelsupport ecosystem.

What can be done, next steps?
- Co-benefits of climate action for mental health outcomesLawrance, et al., 2021

Psychology and climate change - Climate anxiety / climate denial
Human Evolution: Fight – Flight - Freeze response• Climate denial / dismissiveness often stems from a fear of change and what the climate
crisis will mean for our lives, livelihoods and lifestyles:o e.g., Because climate change can seem too enormous of a threat to tackle as anindividual, hostility is directed at those advocating for climate action.
• Fight – Flight - Freeze response whenever we’re faced with athreat.
o While some people respond to the climate crisis by fighting it(e.g., by engaging in climate activism)o some experience a freeze response (fear and inability to act)o some flee and avoid the problem altogether
Climate change public engagement efforts must start withthe recognition that people have different psychological,
cultural, and political reasons for acting / not acting
à How can we manage these response and empower people into climate action?
à Who are the social actors that can support the process?

(e.g., Cannon, 1932)

The role of school and climate education
The role of community and individuals
The role of communication and (social) media
Using advanced technologies (e.g., AI, Digitalization)
Tailored Interventions for Sustainability Transitions

Lawrance, et al., 2021

“Health is the personal experience of climatechange. It is the human face of climate change.”
Reem Ebrahim Al Hashimy, UAE minister of state for international cooperation“Without health, we have nothing.”
Mia Amor Mottley, Prime minister of Barbados

By Palácio do Planalto from Brasilia, Brasil 01.01.2023 - Cumprimentos dos chefes deEstado e de Governo, CC BY 2.0,
https://commons.wikimedia.org/w/index.php?curid=131446267
By PMO Barbados https://www.flickr.com/photos/pmobarbados/5164
8128885/, PDM-owner,https://commons.wikimedia.org/w/index.php?curi
d=112227489

Thank you!
okamoto@merit.unu.edu

参考文献一蘭（発表者のものにかぎる）
https://unu.edu/article/climate-changes-impact-mental-health-overlooked-andmisunderstood-heres-what-can-be-done
https://www.diplomaticourier.com/posts/mental-health-challenge-climate-change
https://unric.org/en/climate-change-its-impacts-on-mental-health/
https://www.japantimes.co.jp/commentary/2024/01/24/world/climat-changecop28-mental-health/
https://collections.unu.edu/eserv/UNU:9123/UNU-EHS_CRI_230518pdf.pdf
https://www.merit.unu.edu/unu-climate-resilience-researchers-pen-op-ed-incontext-by-thomson-reuters/
日本におけるメンタルヘルス対策
https://www.mhlw.go.jp/bunya/shougaihoken/health_link/index.html
気候変動市民会議
https://citizensassembly.jp/project/cd_kaken/jp-list