International Journal of Public Health

, Volume 55, Issue 2, pp 123–132 | Cite as

Climate change and mental health: a causal pathways framework

  • Helen Louise BerryEmail author
  • Kathryn Bowen
  • Tord Kjellstrom
Original Article



Climate change will bring more frequent, long lasting and severe adverse weather events and these changes will affect mental health. We propose an explanatory framework to enhance consideration of how these effects may operate and to encourage debate about this important aspect of the health impacts of climate change.


Literature review.


Climate change may affect mental health directly by exposing people to trauma. It may also affect mental health indirectly, by affecting (1) physical health (for example, extreme heat exposure causes heat exhaustion in vulnerable people, and associated mental health consequences) and (2) community wellbeing. Within community, wellbeing is a sub-process in which climate change erodes physical environments which, in turn, damage social environments. Vulnerable people and places, especially in low-income countries, will be particularly badly affected.


Different aspects of climate change may affect mental health through direct and indirect pathways, leading to serious mental health problems, possibly including increased suicide mortality. We propose that it is helpful to integrate these pathways in an explanatory framework, which may assist in developing public health policy, practice and research.


Climate change Mental health Public health Adaptation 



This research was supported by The Australian National University general facilities and not by any specific research grant.

Conflict of interest statement

The authors have no conflicts of interest to declare.


  1. Agriculture Food Organization (2008) The State of Food and Agriculture 2008. Food and Agriculture Organization, RomeGoogle Scholar
  2. Ahern MM, Kovats RS, Wilkinson P, Few R, Matthies F (2005) Global health impacts of floods: epidemiologic evidence. Epidemiol Rev 27:36–46CrossRefPubMedGoogle Scholar
  3. Alston M, Kent J (2004) Social impacts of drought: a report to NSW agriculture. Centre for Rural Social Research, Charles Sturt University, WaggaGoogle Scholar
  4. Anderson CA, Anderson KB (1998) Temperature and aggression: paradox, controversy, and a (fairly) clear picture. In: Geen R, Donnerstein E (eds) Human aggression: theories, research and implications for policy. Academic Press, San Diego, pp 247–298.
  5. Australian Bureau of Statistics (2004) Year Book Australia, 2004 Economic impact of drought in 2002–2003Google Scholar
  6. Beaudoin CE (2007) News, social capital and health in the context of Katrina. J Health Care Poor Underserved 18:418CrossRefPubMedGoogle Scholar
  7. Berry HL (2007) “Crowded suburbs” and “killer cities”: a brief review of the relationship between the urban environment and mental health. NSW Public Health Bull 18:222–227CrossRefGoogle Scholar
  8. Berry HL (2009) Social capital and mental health among Indigenous Australians, New Australians and Other Australians living in a coastal region. Aust J Adv Mental Health 8Google Scholar
  9. Berry HL, Welsh JA (2009) Social capital and health in Australia: an overview from the household income and labour dynamics in Australia survey. Soc Sci Med. doi: 10.1016/j.socscimed.2009.10.012
  10. Berry HL, George E, Rodgers B, Butterworth P, Caldwell TM (2007a) Intergenerational transmission of reliance on income support: psychosocial factors and their measurement. In: Australian Government Department of Families, Housing, Community Services and Indigenous Affairs (ed) Social Policy Research Paper No. 31, Commonwealth of Australia, CanberraGoogle Scholar
  11. Berry HL, Rodgers B, Dear KBG (2007b) Preliminary development and validation of an Australian community participation questionnaire: types of participation and associations with distress in a coastal community. Soc Sci Med 64:1719–1737CrossRefPubMedGoogle Scholar
  12. Berry HL, Kelly BJ, Hanigan IC, Coates JH, McMichael AJ, Welsh JA, Kjellstrom T (2008) Rural mental health impacts of climate change. The Australian National University, CanberraGoogle Scholar
  13. Besser LM, Dannenberg AL (2005) Walking to public transit: steps to meet physical activity recommendations. Am J Prev Med 29:273–280CrossRefPubMedGoogle Scholar
  14. Blashki GA, Berry HL, Kidd MJ (2009) Primary care responses to climate change. In: Moss J (ed) Climate change and social justice. Melbourne University Press, Melbourne, pp 144–167Google Scholar
  15. Bouchama A, Dehbi M, Mohamed G, Matthies F, Shoukri M, Menne B (2007) Prognostic factors in heatwave-related deaths: a meta-analysis. Arch Intern Med 167:E1–E7CrossRefGoogle Scholar
  16. Brearley HC (1929) Homicide in South Carolina: a regional study. Soc Forces 8:218–221CrossRefGoogle Scholar
  17. Bridger RS (2003) Introduction to ergonomics, 2nd edn. Taylor & Francis, LondonGoogle Scholar
  18. Brugha TS, Cragg D (1990) The list of threatening experiences—the reliability and validity of a brief life events questionnaire. Acta Psychiatr Scand 82:77–81CrossRefPubMedGoogle Scholar
  19. Campbell T, Campbell A (2007) Emerging disease burdens among the poor in cities in the developing world. J Urban Health 84:i54–i64CrossRefPubMedGoogle Scholar
  20. Carroll N, Fritjers P, Shields MA (2009) Quantifying the costs of drought: new evidence from life satisfaction data. J Popul Econ 22:445–461CrossRefGoogle Scholar
  21. Cheatwood D (1995) The effects of weather on homicide. J Quant Criminol 11:51–70CrossRefGoogle Scholar
  22. Coelho A, Adair J, Mocellin J (2004) Psychological responses to drought in Northeast Brazil. Interamerican J Psychol 38:95–103Google Scholar
  23. Cohn E, Rotton J, Peterson A, Tarr D (2004) Temperature, city size, and the southern subculture of violence: support for social escape/avoidance (SEA) theory. J Appl Soc Psychol 34:1652–1674CrossRefGoogle Scholar
  24. Commission on Social Determinants of Health (2008) Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. World Health Organization, GenevaGoogle Scholar
  25. Conger RD, Conger KJ, Elder GH, Lorenz FO, Simons RL, Whitbeck LB (1992) A family process model of economic hardship and adjustment of early adolescent boys. Child Dev 63:526–541CrossRefPubMedGoogle Scholar
  26. Costello A, Abbas M et al (2009) Managing the health effects of climate change. UCL Institute for Global Health and Lancet Commission. Lancet 373:1693–1733CrossRefPubMedGoogle Scholar
  27. Currie G, Richardson T, Smyth P, Vella-Brodrick D, Hine J, Lucas K, Stanley J, Morris J, Kinnear R, Stanley J (2009) Investigating links between transport disadvantage, social exclusion and well-being in Melbourne–Preliminary results. Transp Policy 16:97–105CrossRefGoogle Scholar
  28. De Silva MJ, McKenzie K, Harpham T, Huttly SRA (2005) Social capital and mental illness: a systematic review. J Epidemiol Commun Health 59:619–627CrossRefGoogle Scholar
  29. Dohrenwend BR (1990) Socioeconomic status (SES) and psychiatric disorders: Are the issues still compelling? Soc Psychiatry Psychiatr Epidemiol 25:41–47PubMedGoogle Scholar
  30. Drought Policy Review Expert Social Panel (2008) It’s about people: changing perspectives on dryness: a report to government by an expert social panel on dryness. Commonwealth of Australia, CanberraGoogle Scholar
  31. Faris RE, Dunham HW (1939) Mental disorders in urban areas: an ecological study of schizophrenia and other psychoses. The University of Chicago Press, ChicagoGoogle Scholar
  32. Frank LD, Andresen MA, Schmid TL (2004) Obesity relationships with community design, physical activity, and time spent in cars. Am J Prev Med 27:87–96CrossRefPubMedGoogle Scholar
  33. Freedy JR, Saladin ME, Kilpatrick DG, Resnick HS, Saunders BE (1994) Understanding acute psychological distress following natural disaster. J Trauma Stress 7:257–273CrossRefPubMedGoogle Scholar
  34. Friel S, Marmot M, McMichael AJ, Kjellstrom T, Vagero D (2008) Global health equity and climate stabilisation: a common agenda. Lancet 372:1677–1683CrossRefPubMedGoogle Scholar
  35. Fritze JG, Blashki GA, Burke S, Wiseman J (2008) Hope, despair and transformation: climate change and the promotion of mental health and wellbeing. Int J Ment Health Syst 2:13CrossRefPubMedGoogle Scholar
  36. Global Humanitarian Forum (2009) The anatomy of a silent crisis. Global Humanitarian Forum, GenevaGoogle Scholar
  37. Gullone E (2000) The biophilia hypothesis and life in the 21st century: increasing mental health or increasing pathology. J Happiness Stud 1:293–321CrossRefGoogle Scholar
  38. Habitat UN (2006) The state of the world’s cities—the millennium development goals and urban sustainability. United Nations Habitat Organization, NairobiGoogle Scholar
  39. Hanson A, Bi P, Nitschke M, Ryan P, Pisaniello D, Tucker G (2008) The effect of heat waves on mental health in a temperate Australian city. Environ Health Perspect 116:1369–1375CrossRefGoogle Scholar
  40. Haq S, Kovats S, Reid H, Satterthwaite D (2007) Reducing risks to cities from disasters and climate change. Environ Urban 19:3–15CrossRefGoogle Scholar
  41. Harrington JM (1994) Shift work and health: a critical review of the literature on working hours. Ann Acad Med Singapore 23:699–705PubMedGoogle Scholar
  42. Herrman H (2001) The need for mental health promotion. Aust N Z J Psychiatry 35:709–715CrossRefPubMedGoogle Scholar
  43. Hickie I (2002) Responding to the Australian experience of depression. Promotion of the direct voice of consumers is critical for reducing stigma. Med J Aust 176:S61–S62PubMedGoogle Scholar
  44. Higginbotham N, Connor L, Albrecht G, Freeman S, Agho K (2007) Validation of the environmental distress scale. EcoHealth 3:245–254CrossRefGoogle Scholar
  45. Hollingshead AB (1958) Social class and mental illness. Wiley, New YorkCrossRefGoogle Scholar
  46. Horton R (2007) Launching a new movement for mental health. Lancet 370:806CrossRefPubMedGoogle Scholar
  47. Horwitz AV, Wakefield JC (2007) The loss of sadness: how psychiatry transformed normal sorrow into depressive disorder. Oxford University Press, New YorkGoogle Scholar
  48. Horwitz P, Lindsay M, O’Connor M (2001) Biodiversity, endemism, sense of place, and public health: inter-relationships for australian inland aquatic systems. Ecosyst Health 7:253–265CrossRefGoogle Scholar
  49. Howarth E, Hoffman MS (1984) A multidimensional approach to the relationship between mood and weather. Br J Psychol 75:15–23PubMedGoogle Scholar
  50. Intergovernmental Panel on Climate Change (2007) Climate change 2007. Synthesis Report. Cambridge University Press, CambridgeGoogle Scholar
  51. Jorm AF, Griffiths KM, Christensen H, Medway J (2002) Research priorities in mental health, part 1: an evaluation of the current research effort against the criteria of disease burden and health system costs. Aust N Z J Psychiatry 36:322–326CrossRefPubMedGoogle Scholar
  52. Judd F, Jackson H, Komiti A, Murray G, Hodgins G, Fraser C (2002) High prevalence disorders in urban and rural communities. Aust N Z J Psychiatry 36:104–113CrossRefPubMedGoogle Scholar
  53. Katz IR (1996) On the inseparability of mental and physical health in aged persons: lessons from depression and medical comorbidity. Am J Geriatr Psychiatry 4:1–16Google Scholar
  54. Kerslake DM (1972) The stress of hot environments. Cambridge University Press, CambridgeGoogle Scholar
  55. Kjellstrom T (2009a) Climate change exposures, chronic diseases and mental health in urban populations - a threat to health security, particularly for the poor and disadvantaged. World Health Organization Centre for Health and Development, KobeGoogle Scholar
  56. Kjellstrom T (2009b) Climate change, direct heat exposure, health and well-being in low and middle income countries. Global Health Action 2:1–3Google Scholar
  57. Kjellstrom T, Hogstedt C (2009) Global trends of work-related injuries and diseases. In: Elgstrand K, Pettersson I (eds) OSH and development. Royal Institute of Technology, StockholmGoogle Scholar
  58. Kjellstrom T, Holmer I, Lemke B (2009d) Workplace heat stress and health - an increasing challenge for low and middle income countries during climate change. Global Health Action (in press)Google Scholar
  59. Kovats RS, Hajat S (2008) Heat stress and public health: a critical review. Annu Rev Public Health 29:41–55CrossRefPubMedGoogle Scholar
  60. Leighton AH (1965) Poverty and social change. Sci Am 212:21–27CrossRefGoogle Scholar
  61. Leithead CS, Lind AR (1964) Heat stress and heat disorders. Cassell, LondonGoogle Scholar
  62. Maes M, Demeyer F, Thompson P, Peeters D, Cosyns P (1994) Synchronized annual rhythms in violent suicide rate, ambient-temperature and the light-dark span. Acta Psychiatr Scand 90:391–396CrossRefPubMedGoogle Scholar
  63. Magnusson A (2000) An overview of epidemiological studies on seasonal affective disorder. Acta Psychiatr Scand 101:176–184CrossRefPubMedGoogle Scholar
  64. Mathers CD, Loncar D (2006) Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med 3Google Scholar
  65. McMichael AJ (1993) Planetary overload. Cambridge University Press, CambridgeGoogle Scholar
  66. McMichael AJ (2003) Global climate change and health: an old story writ large. In: McMichael AJ, Campbell-Lendrum D, Ebi K (eds) Climate change and health: risk and responses. World Health Organization, Geneva, pp 1–17Google Scholar
  67. McMichael AJ, Campbell-Lendrum D, Kovats S (2004) Climate Change. In: Ezzati M, Lopez AD, Rodgers A, Mathers C (eds) Comparative quantification of health risks: global and regional burden of disease due to selected major risk factors. World Health Organization, Geneva, pp 1543–1650Google Scholar
  68. McMichael AJ, Kjellstrom T, Smith KR (2006a) Environmental Health. In: Merson M, Black R, Mills AJ (eds) International public health, 2nd edn. Aspen Publishers, Gaithersburg, pp 394–444Google Scholar
  69. McMichael T, Woodruff RE, Hales S (2006b) Climate change and human health: present and future risks. Lancet 367:859–869CrossRefPubMedGoogle Scholar
  70. McMichael AJ, McMichael C, Berry H, Bowen KJ (2009) Climate change, displacement and health. In: McAdam J (ed) Climate change and displacement: multidisciplinary perspectives. Hart Publishing Oxford, OxfordGoogle Scholar
  71. Miller G, Chen E, Cole SW (2009) Health psychology: developing biologically plausible models linking the social world and physical health. Annu Rev Psychol 60:501–524CrossRefPubMedGoogle Scholar
  72. Nicholls N, Collins D (2006) Observed climate change in Australia over the past century. Energy Environ 17:1–12CrossRefGoogle Scholar
  73. Nitschke M, Tucker GR, Bi P (2007) Morbidity and mortality during heatwaves in metropolitan Adelaide. Med J Aust 187:662–665PubMedGoogle Scholar
  74. Norris F, Friedman M, Watson P, Byrne C, Diaz E, Kaniasty K (2002) 60,000 disaster victims speak: part I. An empirical review of the empirical literature, 1981–2001 Psychiatry 3:65Google Scholar
  75. Parsons K (2003) Human thermal environment. The effects of hot, moderate and cold temperatures on human health, comfort and performance, 2nd edn. CRC Press, New YorkGoogle Scholar
  76. Prince M, Patel V, Saxena S, Maj M, Maselko J, Phillips MR, Rahman A (2007) No health without mental health. Lancet 370:859–877CrossRefPubMedGoogle Scholar
  77. Ramsey JD (1995) Task performance in heat: a review. Ergonomics 38:154–165CrossRefPubMedGoogle Scholar
  78. Ramsey JD, Burford CL, Beshir MY, Jensen RL (1983) Effects of workplace thermal conditions on safe working behavior. J Safety Res 14:105–114CrossRefGoogle Scholar
  79. Rose JB, Daeschner S, Easterling DR, Curriero FC, Lele S, Patz JA (2000) Climate and waterborne disease outbreaks. J Am Water Works Assoc 92:77–87Google Scholar
  80. Salcioglu E, Basoglu M, Livanou M (2007) Post-traumatic stress disorder and comorbid depression among survivors of the 1999 earthquake in Turkey. Disasters 31:115–129CrossRefPubMedGoogle Scholar
  81. Salick J, Byg A (2007) Indigenous peoples and climate change. Tyndall Centre for Climate Change Research, OxfordGoogle Scholar
  82. Sartorius N (2003) Social capital and mental health. Curr Opin Psychiatr 16:S101–S105CrossRefGoogle Scholar
  83. Sartorius N (2007) Stigma and mental health. Lancet 370:810–811CrossRefPubMedGoogle Scholar
  84. Schrier RW, Hano J, Keller HI, Finkel RM, Gilliland PF, Cirksena WJ, Teschan PE (1970) Renal, metabolic, and circulatory responses to heat and exercise. Ann Intern Med 73:213–223PubMedGoogle Scholar
  85. Smith KB, Humphreys JS, Wilson MGA (2008) Addressing the health disadvantage of rural populations: how does epidemiological evidence inform rural health policies and research? Aust J Rural Health 16:56–66CrossRefPubMedGoogle Scholar
  86. Srole LJ (1962) Mental health in the metropolis. New YorkGoogle Scholar
  87. Stehlik D, Lawrence G, Gray I (2000) Gender and drought: experiences of Australian women in the drought of the 1990s. Disasters 24:38–53CrossRefPubMedGoogle Scholar
  88. Thornicroft G (2007) Most people with mental illness are not treated. Lancet 370:807–808CrossRefPubMedGoogle Scholar
  89. Whitley R, McKenzie K (2005) Social capital and psychiatry: review of the literature. Harv Rev Psychiatry 13:71–84CrossRefPubMedGoogle Scholar
  90. Wickrama KAS, Wickrama T (2008) Family context of mental health risk II: more findings from a pilot study in Sri Lanka with tsunami affected mothers. Soc Sci Med 66:994–1007CrossRefPubMedGoogle Scholar
  91. Wilson EO (1984) Biophilia. Harvard University Press, MassachusettsGoogle Scholar
  92. World Health Organization (1948) World Health Organization Constitution. GenevaGoogle Scholar
  93. World Health Organization (2008a) Integrating mental health into primary health care: a global perspective. World Health Organization, GenevaGoogle Scholar
  94. World Health Organization (2008b) Our cities, our health, our future. Acting on social determinants for health equity in urban settings. In: Kjellstrom T (ed) World Health Organization, Centre for Health Development, Kobe, JapanGoogle Scholar
  95. World Health Organization (2009) WHO factfile for mental health. Accessed September 2009Google Scholar

Copyright information

© Birkhäuser Verlag, Basel/Switzerland 2009

Authors and Affiliations

  • Helen Louise Berry
    • 1
    • 2
    • 3
    Email author
  • Kathryn Bowen
    • 1
  • Tord Kjellstrom
    • 1
  1. 1.National Centre for Epidemiology and Population Health, College of Medicine, Biology and EnvironmentThe Australian National UniversityCanberraAustralia
  2. 2.Centre for Rural and Remote Mental Health, School of Medicine and Public HealthThe University of NewcastleNewcastleAustralia
  3. 3.Centre for Research and Action in Public HealthUniversity of CanberraCanberraAustralia

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