Scores to Settle: What does climate change have to do with mental health and young people?

How can a systemic approach to addressing climate change and inequality guide our understanding of the impact of climate change on mental health? Banner image: Shutterstock/Diganta Talukdar

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This article is part of a series in which OECD experts and thought leaders  from around the world and all parts of society  address the COVID-19 crisis, discussing and developing solutions now and for the future. Aiming to foster the fruitful exchange of expertise and perspectives across fields to help us rise to this critical challenge, opinions expressed do not necessarily represent the views of the OECD.

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As part of an OECD Forum series, the virtual event Working it Out: Mental Health & Employment will take place on 4 November 2021, 14:30–16:00 CET—register now!

As part of an OECD Forum series, the virtual event Working it Out: Mental Health & Employment will take place on 4 November 2021, 14:30–16:00 CET—register now!

One of the worst things about persistently high rates of mental illness is that they are largely preventable. Calling for thousands of extra clinicians and more effective drugs won’t fix it, though they are needed. Instead, the tap must be turned off at the source, otherwise we are forever mopping up. Despite the world’s phenomenal wealth, technology, governance know-how and so on, we haven’t managed to do this yet. And so we keep mopping the best we can which, in some places, is hardly at all.

To be fair, mental illness can be intransigent partly because it emanates from distant sources that can be hard to find and deal with. It winds its way along complex chains of causality, many elements of which are outside easy control. Certain individual characteristics heighten vulnerability to mental illness—such as being introverted or having particular genes—but the big causal hitters tend to be socially mediated factors. Put simply, bad things happen as a result of where you land in life (like being born into poverty, violence or a lack of educational opportunity) and get tangled up with personal characteristics that have pejorative social meaning.

It’s the way of the world that some people grow up and live as “less than”. Sometimes they know this through others’ open words and actions. More often, it happens indirectly and can be all the worse for it. Either way, the message is clearly sent and received. And since this “less than” group includes all women as well as a large array of other categories, it happens that most people have been taught that they were born worth-less: they have the “wrong” skin colour, gender, religion, age, sexuality, citizenship status, language, place of origin, culture and so on. You could be forgiven for thinking that very few people could possibly fit the “right” mould.

Anyone reflecting on this state of affairs knows by logic and by feeling that this is unnecessary and deeply offensive. But the fact remains that relations between and within nations are structured in ways that load the dice in favour of the few at the top of the tree and (especially) against those grubbing for a living at the bottom. It’s wonderfully comfy at the top, of course, though it’s fashionable in some rich and powerful circles to rail against the unfairness of it all as they hide their fortunes in offshore bank accounts. But they don’t really care, do they? If they did, they would change the rules—rules they set. But the time of those toiling below is cheap, and their bodies expendable.

Down the bottom, where the living is harshest, people know in ways you can’t learn in books that the world doesn’t really care. This fact is in itself distressing, overwhelming, terrifying. So why wouldn’t this shape mental health, make people depressed, anxious or traumatised? Open them to doing whatever it takes to soothe the pain? Little wonder that mental illnesses spring up like weeds in the wastelands of the wretched and the dispossessed. It’s a miracle that so many people manage to survive such circumstances at all, let alone forge fulfilling lives, as many do.

This unjust and needless inequality is the big tap that must be turned off. It’s the thing that enslaves a huge chunk of humanity under the yoke of greed, selfishness and the simple but lethal “not really caring” about those trodden underfoot and left behind.

But what does all this have to do with climate change? The answer is simple, though the solutions are not: the very dynamics that provoke mental illness are the same as those that have given us climate change. The world is overheating not because of a blip of physics or a little misunderstanding (“Oops!”). It’s happening because of a relatively tiny yet immensely powerful group’s exploitation of the planet without regard for the costs, even the financial ones (which are now phenomenal by any standards). There is no financial, technological, logical, moral or other sound reason for the destruction of our beautiful world. Like affronts such as racism, poverty and the subjugation of women—that should all be classified as crimes against humanity—global heating is the vile by-product of false entitlement, unrestrained greed and the refusal to share power and resources. Make no mistake, prosperity can be good, but it only if it’s shared. It isn’t.

Read more on the Forum Network: Why write about climate change for World Mental Health Day?, by Susan Clayton, Whitmore-Williams Professor of Psychology, College of Wooster

That this continues even as swathes of the world burn, are submerged or wither, is a terrible wrong. The injustice, the criminality of it, hand-in-hand with the evident physical effects of global warming, are helping fuel a worldwide increase in feelings of fury, desperation and helplessness. These are mighty risk factors for mental illness. They are also, of course, potential drivers of radical change. But back to that in a moment.

That the situation is dire and the need urgent should be obvious to all; but it’s particularly keenly felt among the young. It’s their future, after all, that’s going up in smoke. Many are angry, desperate and aghast, at once incredulous at what adults have done (are doing!) and powerless to make them stop. Little wonder some feel they have a score to settle  or find that living with this bind is draining their happiness.

Let’s remember that, unlike physical illness, mental illness is primarily an affliction of youth. Fourteen is the peak age of first onset of illness, a time when brains are still immature and the tough hide of life experience yet tender. Global heating is already disrupting normal child psychological development and we can expect increasing rates of harm if it continues unabated.

In addition to a dangerously warming planet, we’re well into year two of the COVID-19 pandemic. It’s a disaster of mythical proportions that has disproportionately affected young people and, especially, young women. And, of course, those other “wrong” categories of person, particularly the women within them.

Yet the COVID-19 pandemic may be a once-in-a-lifetime chance to stop fiddling at the fringes of climate change and deal with it properly. Despite a mightily patchy performance, the world has shown itself capable of concerted and dramatic action to address an urgent global threat to humanity. Climate change requires exactly the same kind of action and now the world knows how to do it. People will accept difficult policies if needed.

The necessary effort must include young people, not as the recipients of patronage but as full members of the team, including in leadership and executive roles. Young people—mainly young women—have already demonstrated strong, clear and ethical leadership; innovation and creativity; courage in the face of near-insurmountable odds; and sheer determination and hard work. They are motivated and know how to mobilise. Civil society, clinicians, researchers and, vitally, respected international organisations have a great role to play in supporting young people’s efforts: with the advantage of not being beholden to one single master nor dependent on a sole source of funding, they often have more room to move than do politicians. They can help young people by demanding change and galvanising political pressure which, in turn, helps politicians to shift their rhetoric and actions.

Lifting the veil on the system can be a formidable step in the right direction, as the embarrassment of riches revealed in the recently liberated Pandora Papers has reminded us. To address climate change, mental health and their relationship effectively, it’s vital to attack the systems that create and maintain them. Endpoints such as surging psychiatric morbidity and devastated natural environments matter enormously, of course. But solving problems like mental health and global heating depend on successfully addressing their causal factors and the interactions among them. This is what a systemic approach seeks to do.

Read more on the Forum Network: Summer’s End by Frances MacGuire, Policy Manager, Lancet Countdown 

Promises are not enough and behavioural change is needed in so many areas: the world of politics, how we make and use energy, greening and reconfiguring health systems towards a greater focus on health promotion and early intervention, building connected, capable communities and the legal frameworks that support all of these. Extremes of unequal power and wealth can only be defeated by collective action; the United Nations’ Common Agenda, with its “breakdown or breakthrough” message, provides motivation and a template.

It can be hard to get people to download the updates for their opinions and consequent actions. In these cases, enforcing compliance with (new or improved) laws can change behaviour and, over time, shift values and attitudes. Despite the conspicuous anomaly provided by some public figures, most people are uncomfortable doing things that manifestly go against their stated beliefs. We can see that today in the widespread view that people shouldn’t keep slaves (at least, not in leg-irons) or send small children up to clean chimneys, practices that were once commonplace.

Young people are ready, willing and able to initiate reforms and help fix the climate change mess. They are keen to do so as an integral part of recovering from the pandemic. They must be enabled to do it their way, a green way. Their mental health would benefit immeasurably from being supported to contribute, both in the doing of it and in the end result.

To obtain these benefits, some vested interests (people, actually) must step aside. Stemming the tide of mental illness, just like mitigating climate change, begins and ends with regulating the worst excesses of inhumanity. Just a decade or so from irreversible disaster, this means nothing short of a radical overthrowing of aspects of the established order. Along with a fair go and a healthy planet, revolution is the birth right of the young.

Watch this video to learn more about the OECD's approach to addressing the negative mental health effects of the COVID-19 pandemic.

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Intergenerational Solidarity Health Green Recovery Sustainable Development Goals Tackling COVID-19

Helen Berry PhD

Honorary Professor of Climate Change and Mental Health, University of Sydney

Helen is the inaugural Honorary Professor of Climate Change and Mental Health at the University of Sydney. She is a widely-cited psychiatric epidemiologist and expert in how climate change, disasters and social and physical place influence mental health and wellbeing. She advises on national and international research programs and is a lead member of the MJA-Lancet (Australian) Countdown scientific team. She has developed multiple population screening measures including the Australian Community Participation Questionnaire, the Brief Weather Disaster Trauma Exposure and Impact Screen and others which are included in population health and intervention studies around the world. Helen has been supported by competitive research funding and has led influential research-policy initiatives. She also holds an honorary appointment at Macquarie University.