Ecological grief and anxiety: the start of a healthy response to climate change?
Authors: Ashlee Cunsolo, Sherilee L Harper, Kelton Minor, Katie Hayes, Kimberly G Williams, Courtney Howard
Journal: The Lancet Planetary Health (2020)

There is increasing global awareness that the next 10 years must be a period of extensive and rapid mitigation and adaptation to safeguard humanity from the worst harms of the climate crisis. An urgent need for action was recently underscored by three Intergovernmental Panel on Climate Change Special Reports: the Special Report on Global Warming of 1·5°C, the Special Report on Climate Change and Land, and the Special Report on the Ocean and Cryosphere in a Changing Climate. Similarly, the 2019 report of the Lancet Countdown on Health and Climate Change1Watts N Amann M Arnell N et al.The 2019 report of The Lancet Countdown on health and climate change: ensuring that the health of a child born today is not defined by a changing climate.Lancet. 2019; 394: 1836-1878Summary Full Text Full Text PDF PubMed Scopus (442) Google Scholar highlighted potentially catastrophic health risks for a child born today if an adequate response to climate change does not occur, including increased rates of food insecurity and undernutrition, of diarrhoeal and infectious diseases, and of complications from air pollution, and increased morbidity and mortality from exposure to extreme weather events (eg, heatwaves, flooding, wildfires, and hurricanes).1Watts N Amann M Arnell N et al.The 2019 report of The Lancet Countdown on health and climate change: ensuring that the health of a child born today is not defined by a changing climate.Lancet. 2019; 394: 1836-1878Summary Full Text Full Text PDF PubMed Scopus (442) Google Scholar Despite the overwhelming scientific evidence available and mounting public advocacy, at the 2019 UN Conference of the Parties negotiations, a small group of governments seemed to block meaningful progress, leading to inadequate outcomes. As the first Production Gap report made clear in 2019, governments still plan to produce approximately 120% more fossil fuels than would be consistent with limiting warming to 1·5°C. Increasingly, research and news outlets around the world are highlighting the ways in which climate change is degrading ecosystems and altering lives, livelihoods, and the socioeconomic and environmental systems on which humans rely. Empirical evidence showing both the acute and chronic mental health effects of climate change has also risen sharply in the past decade, and a breadth of studies have examined the mental health effects of climate-related hazards,2Obradovich N Migliorini R Paulus MP et al.Empirical evidence of mental health risks posed by climate change.Proc Natl Acad Sci USA. 2018; 115: 10953-10958Crossref PubMed Scopus (71) Google Scholar, 3Burke M González F Baylis P et al.Higher temperatures increase suicide rates in the United States and Mexico.Nat Clim Change. 2018; 8: 723-729Crossref Scopus (118) Google Scholar, 4Cunsolo Willox A Harper S Ford JD et al.Climate change and mental health: an exploratory case study from Rigolet, Nunatsiavut, Labrador.Clim Change. 2013; 121: 255-270Crossref Scopus (98) Google Scholar including post-traumatic stress disorder, depression, anxiety, the exacerbation of psychotic symptoms, and suicidal ideation and suicide completion.3Burke M González F Baylis P et al.Higher temperatures increase suicide rates in the United States and Mexico.Nat Clim Change. 2018; 8: 723-729Crossref Scopus (118) Google Scholar Alongside these mental health impacts, experiences of ecological anxiety (ie, apprehension and stress about anticipated threats to salient ecosystems) and ecological grief (ie, grief in relation to ecological loss) related to climate change are burgeoning.5Hayes K Poland B Addressing mental health in a changing climate: incorporating mental health indicators into climate change and health vulnerability and adaptation assessments.Int J Environ Res Public Health. 2018; 151806Crossref Scopus (31) Google Scholar, 6Cunsolo A Ellis N Ecological grief as a mental health response to climate change-related loss.Nat Clim Change. 2018; 8: 275-281Crossref Scopus (195) Google Scholar, 7Clayton S Maning C Krygsman K et al.Mental health and our changing climate: impacts, implications, and guidance. American Psychological Association and EcoAmerica, Washington, DC2017Google Scholar Although these are not fully understood psychological phenomena, research is emerging. For example, Cunsolo and Ellis6Cunsolo A Ellis N Ecological grief as a mental health response to climate change-related loss.Nat Clim Change. 2018; 8: 275-281Crossref Scopus (195) Google Scholar characterise ecological grief as falling into three main areas: grief associated with physical ecological losses, grief associated with the loss of environmental knowledge, and grief associated with anticipated future losses.6Cunsolo A Ellis N Ecological grief as a mental health response to climate change-related loss.Nat Clim Change. 2018; 8: 275-281Crossref Scopus (195) Google Scholar This emerging research coincides with spikes in online searches and worldwide media attention about "eco anxiety" and "climate anxiety" (appendix). Research also highlights the disproportionate and differential effects of ecological anxiety and grief on different groups. Peoples who rely most closely on the land and land-based activities for their livelihood and wellbeing (eg, Indigenous Peoples and farmers) are at the forefront of exposure to the climate crisis.6Cunsolo A Ellis N Ecological grief as a mental health response to climate change-related loss.Nat Clim Change. 2018; 8: 275-281Crossref Scopus (195) Google Scholar, 7Clayton S Maning C Krygsman K et al.Mental health and our changing climate: impacts, implications, and guidance. American Psychological Association and EcoAmerica, Washington, DC2017Google Scholar In March, 2020, a survey of 2000 young people aged 8–16 years commissioned by the British Broadcasting Corporation showed that 73% were worried about the state of the planet, 19% have had a bad dream about climate change, and 41% do not trust adults to tackle the challenges presented by climate change. Additionally, scholars such as Susan Clayton8Clayton S Mental health risk and resilience among climate scientists.Nat Clim Change. 2018; 8: 260-261Crossref Scopus (15) Google Scholar investigate the psychosocial impacts of working within climate science, finding that these professionals often experience burnout, anxiety, grief, and depression, with some choosing to leave the area of research. From a broader health perspective, national surveys in Canada, the USA,9Leiserowitz A Maibach E Rosenthal S et al.Climate change in the American mind: November 2019. Yale University and George Mason University, New Haven, CT2019Google Scholar and Greenland10Minor K Agneman G Davidsen N et al.Greenlandic perspectives on climate change 2018–2019: results from a National Survey. Kraks Fond Institute for Urban Research: University of Greenland and University of Copenhagen, 2019Google Scholar show that about half of adults in these countries report that climate change is harming people now or will in the future (appendix). In Greenland, for example, more than 75% of residents have personally experienced the effects of climate change, and 38% experience very to moderately strong emotional responses of fear when they think about climate change.10Minor K Agneman G Davidsen N et al.Greenlandic perspectives on climate change 2018–2019: results from a National Survey. Kraks Fond Institute for Urban Research: University of Greenland and University of Copenhagen, 2019Google Scholar Although ecological grief and anxiety are reasonable and functional responses to climate-related losses,6Cunsolo A Ellis N Ecological grief as a mental health response to climate change-related loss.Nat Clim Change. 2018; 8: 275-281Crossref Scopus (195) Google Scholar given the anticipated increases in population-level emotional distress, anxiety, and grief,2Obradovich N Migliorini R Paulus MP et al.Empirical evidence of mental health risks posed by climate change.Proc Natl Acad Sci USA. 2018; 115: 10953-10958Crossref PubMed Scopus (71) Google Scholar, 3Burke M González F Baylis P et al.Higher temperatures increase suicide rates in the United States and Mexico.Nat Clim Change. 2018; 8: 723-729Crossref Scopus (118) Google Scholar, 6Cunsolo A Ellis N Ecological grief as a mental health response to climate change-related loss.Nat Clim Change. 2018; 8: 275-281Crossref Scopus (195) Google Scholar, 8Clayton S Mental health risk and resilience among climate scientists.Nat Clim Change. 2018; 8: 260-261Crossref Scopus (15) Google Scholar an urgent response is needed from clinicians, public health practitioners, families, researchers, educators, and policy makers. Building on available evidence, there are many ways in which the emotional suffering associated with ecological change can be reduced, including the following six steps. First, training for health professionals on climate change and mental health should be increased. Given the acute increase in ecological grief and anxiety, techniques with the ability to scale rapidly need to be developed and disseminated to support health professionals, including toolkits, workshops, train-the-trainers approaches, communities of practice, and web-based teaching techniques. Second, enhanced clinical assessments and support are needed. For some people suffering from ecological grief and anxiety, clinical support might be required, particularly if their safety or functioning are affected. If, however, a person is functioning relatively well, anxiety and grief due to changes in the natural world—although unpleasant and at times painful—can also be understood as emotions that might assist people in making productive and positive change, including dedicating energy towards the implementation of climate solutions, if appropriately supported.6Cunsolo A Ellis N Ecological grief as a mental health response to climate change-related loss.Nat Clim Change. 2018; 8: 275-281Crossref Scopus (195) Google Scholar Third, already-proven individual and group therapy strategies should be harnessed. Given that many people feel lonely, isolated, or ashamed within their ecological grief and anxiety, the well known benefits of peer interactions and interpersonal group therapy could be drawn upon. Such strategies are successful in supporting other types of emotional distress by bringing people together.8Clayton S Mental health risk and resilience among climate scientists.Nat Clim Change. 2018; 8: 260-261Crossref Scopus (15) Google Scholar Building on the strengths of group therapy, there are many examples of networks that have been created to support climate-related mental wellness (eg, the Good Grief Network). Fourth, "social prescribing" and exerting effort towards solutions could be increased. Symptoms of ecological grief and anxiety might be alleviated through work to reduce the underlying threat and through social prescribing of activities that support and enhance environmental, physical, and mental health. Examples include prescriptions for active travel and commuting or spending time in nature (eg, shinrin-yoku or forest bathing). Additionally, work that is community-based can support social connectedness while facilitating the implementation of initiatives that themselves have benefits for mental health, such as increasing the amount of trees in urban spaces, improving the infrastructure for active commuting, and reducing air pollution through a shift to clean energy.7Clayton S Maning C Krygsman K et al.Mental health and our changing climate: impacts, implications, and guidance. American Psychological Association and EcoAmerica, Washington, DC2017Google Scholar Fifth, there must be a focus on families. Given the degree of distress in children and youth,7Clayton S Maning C Krygsman K et al.Mental health and our changing climate: impacts, implications, and guidance. American Psychological Association and EcoAmerica, Washington, DC2017Google Scholar it is important to consider a healthy family-oriented response to a shared external threat, including acknowledging the challenge, encouraging parental insight into young peoples' responses, providing time for empathetic communication with children and youth, validating their feelings of fear and disillusionment, and jointly mobilising hope through meaningful goal-directed activities.7Clayton S Maning C Krygsman K et al.Mental health and our changing climate: impacts, implications, and guidance. American Psychological Association and EcoAmerica, Washington, DC2017Google Scholar Finally, a health equity approach is key. It is important to acknowledge that mental health care access can be impeded by inadequate mental health-care infrastructure in certain areas, culturally relevant care, and practitioner familiarity with climate-related anxiety and grief, as well as an overburdened mental health care system and disparities in underlying determinants of health. Furthermore, evidence indicates that often those who experience the most acute forms of ecological grief and anxiety are also often those with less access to mental health resources.6Cunsolo A Ellis N Ecological grief as a mental health response to climate change-related loss.Nat Clim Change. 2018; 8: 275-281Crossref Scopus (195) Google Scholar Therefore, a health equity approach to resources and response is essential to building the resilience of mental health systems. The next 10 years are a crucial decade for the world. Ecological grief and anxiety over current losses or anticipated future change are a sign of relationship with, or connection to, the natural world. What is needed are accessible and safe spaces to explore these difficult emotional reactions, the political will to ensure that important strategies and supports are funded, and the research required to strengthen and support approaches of healing and resilience. Recognising that emotions are often what leads people to act, it is possible that feelings of ecological anxiety and grief, although uncomfortable, are in fact the crucible through which humanity must pass to harness the energy and conviction that are needed for the lifesaving changes now required. We declare no competing interests. Download .pdf (.59 MB) Help with pdf files Supplementary appendix