The climate crisis is a health crisis; it demands the urgent attention and action of healthcare professionals and organisations. In this issue of the BJPsych Bulletin, we consider what the destructive effects of the climate and ecological crisis entail for the mental health of populations, and what the response of psychiatrists, both individual and collective, must be. We also highlight the opportunities and benefits a more sustainable and preventative approach could offer individuals, communities and the planet.

This editorial is co-written by a developmental psychologist and a young climate activist. We start by showing how the climate crisis is imposing a heavy psychological burden on children and youth, both from experiencing climate-related disasters and from the knowledge that worse is to come. We then describe the global movement of youth demanding urgent climate action. We conclude that health professionals can support young people in many ways, but particularly by supporting their capacity to take action, raising awareness about the impact of the climate crisis on youth mental and physical health, and taking action themselves to work for a secure climate future.

There is scientific consensus that anthropogenic climate change is real and that it provides an existential threat to humanity and the planet. In this article, we focus on climate change conspiracy theories and the impact of such beliefs on mental health. We discuss the psychiatric disorders that might be relevant to conspiracy belief endorsement and we present the underlying psychological mechanisms. We note that there is little to no literature to associate beliefs about climate change with serious mental health conditions. However, we anticipate that such beliefs may manifest pathologically in psychiatric presentations as climate change becomes increasingly at the forefront of the global agenda.

This paper focuses on climate anxiety and its role in the psychology of climate change, compared with responses to the COVID-19 global pandemic. Four psychological hypotheses for why we do not act on climate change will be reviewed, and the role of anxiety for each, as well as potential solutions. Different types of climate anxiety both inside and outside the clinic will be explored, along with associated defence mechanisms and treatment.

This article explores how ‘wicked problems’ such as climate change might force psychiatry to rethink some of its fundamental ideas and ways of working, including clinical boundaries, understandings of psychopathology and ways of organising. We use ethnographic evidence to explore how mental health service ‘survivor’ activists are already rethinking some of these issues by therapeutically orienting themselves towards social problems and collective understandings of well-being, rejecting ‘treatment as usual’ approaches to distress. In this way we provide an example of the potential of activists to help psychiatry negotiate the climate crisis.

Climate change is already having unequal effects on the mental health of individuals and communities and will increasingly compound pre-existing mental health inequalities globally. Psychiatrists have a vital part to play in improving both awareness and scientific understanding of structural mechanisms that perpetuate these inequalities, and in responding to global calls for action to promote climate justice and resilience, which are central foundations for good mental and physical health.

The past 20 years have seen the disappearance and degradation of biodiversity on earth at unprecedented rates. This phenomenon shares similar drivers to those behind climate change yet requires its own solutions. The twin catastrophes of climate change and biodiversity loss demonstrate how our health is bound up in the vitality of this planet. There has been an increasing effort on the part of healthcare professionals to appreciate this relationship, as evidenced by the growing influence of planetary health as a discipline. However, the health impacts of biodiversity loss have been less focused on than those brought on by climate change. Psychiatry's appreciation of the interface between environments and our health, alongside the evidence for the connection between nature and mental health specifically, prompt psychiatrists to ensure that the institution of healthcare throws its influence equally behind solutions to climate change as well as biodiversity loss.

The Earth's climate is in a complex state of change as a result of human activity. The interface between climate change and physical health has received significant attention, but its effects on mental health and illness are less understood. This article provides an insight into the psychiatric sequelae of climate change, suggests strategies that psychiatrists can use to take action, and argues that it is their responsibility to do so.