BJPsych Bulletin is delighted to announce Dr Daniel Romeu as the winner of the 2020 Praxis Editorial Award competition. Read his complementary blog post on his winning article: “Is the climate a mental health crisis?“.

It is difficult to escape the inconvenient truth of climate change. Although we have known about it for several decades, the scale of the issue has led to the common but dangerous mentality that individual efforts are futile. We have become complacent and perhaps a little desensitised.

As a psychiatrist in training who has worried about the planet and its future since childhood, I began to ask myself questions that linked my career to the issue at hand. How will the Earth look in thirty years? What impact will that have on my future patients? How can the medical profession take action? This led me to turn to the evidence and find answers.

Climate change is already influencing physical, social and economic systems around the globe, all of which shape psychological wellbeing. In this editorial, I summarise some of the key consequences of climate change on mental health and illness.

There is a growing body of knowledge indicating that global mental health is beginning to -and will continue to – suffer at the hands of climate change. Post-traumatic stress disorder, substance misuse, mood disorders and suicide, among other mental health presentations, are expected to become more common and severe. The reasons behind this are numerous and complex. Some are related to extreme weather events, global warming, environmental degradation and further infectious disease outbreaks. Others relate to disruption of infrastructure and additional strain on healthcare systems.

We can also see that diagnostic terms used in psychiatry are responding to changes in the environment. The literature describes the first “climate change delusion” and the emergence of new terms, including “ecoanxiety” and “headline stress disorder”. The idea that terminology changes according to human responses to the environment is not new – Seasonal Affective Disorder is a recent example.

Climate change is therefore an issue that every psychiatrist should be concerned about. Fortunately, there is also ample information and inspiration for those wishing to tackle the issue.

The ‘CARM’ approach nicely summarises what we can do as mental healthcare professionals to help with the issue of climate change – Collaborate, Advocate, Research and Mitigate. It is essential that we collaborate with policy makers and healthcare organisations to raise awareness, and to identify populations which will ensure their needs are advocated. We must also prioritise the undertaking of further research in this field. Finally, it is imperative to mitigate one’s own contributions to climate change. 

As doctors, the carbon footprint from our clinical practice is ten times greater than that from our personal lives. This puts us in a powerful position. By shifting our focus to illness prevention and social prescribing, among other strategies recommended by the Royal College of Psychiatrists’ Sustainability Committee, we can make a real difference.

Climate change is already shaping the role of psychiatry. I hope that clinicians reading this article consider the opportunity, ability and responsibility they have to define the impact that it has, and will continue to have, on their patients.

Read the 2020 Praxis Editorial Award winning article here

Dr Romeu’s article will also appear in a special BJPsych Bulletin edition on climate and mental health due in August 2021.