Extreme heat and poor air quality are threatening childrens’ mental health. How can psychologists help?

Extreme heat, poor air quality, and other events related to climate change are harming young people’s mental health, finds a report released in October 2023 by APA and ecoAmerica. Those mental health consequences begin even before a child is born, the report says. 

Prenatal exposure to weather disasters, high temperatures, air pollution, and maternal anxiety can raise a child’s risk of a variety of behavioral and developmental issues, including anxiety, depression, ADHD, developmental delays, low self-control, and psychiatric disorders.

“The report documents psychological harms that are happening right now to the children and youth in our country,” said Dennis Stolle, JD, PhD, APA’s senior director of applied psychology. “These are not issues that we can wait and resolve later. As a society, we must act now.”

Sweltering heat waves and temperatures well over historical averages are becoming the new normal as the toll of climate change mounts. And more heat is likely to be a reality moving forward. A recent study found that the planet has a 66% chance of exceeding the 1.5 degree Celsius warming limit set by the 2015 Paris Agreement by between 2027 and 2032 (Dvorak, M. T., et al, Nature Climate Change, Vol. 12, 2022opens in new window).

Already vulnerable populations are likely to be the hardest hit. In the United States, districts historically affected by redlining—the practice of refusing home loans or insurance to neighborhoods based on race—are hotter than districts in the same cities not affected by redlining by up to 12.6 degrees F (Hoffman, et al., Climate, 2020opens in new window). Building practices that don’t encourage ventilation can exacerbate the urban heat effect, according to a recent study conducted in Guangzhou, China (Luo, F., et al, Frontiers in Environmental Science, 2023opens in new window).

Extreme heat is already a well-known threat to physical health, but mental health may be just as vulnerable as these heat waves become more common. A large body of research shows that extreme heat leads to worsening symptoms and more emergency department visits for people with mental health disorders. Among the general population, heat is linked to greater anger and negative mood and even an increase in violent behavior. People’s metacognition about heat waves may also contribute to climate anxiety or feelings of hopelessness about the planet’s future.

[Related: How does climate change affect mental health] 

“Psychologists have to be ready to help patients understand and cope and grieve through the climate anxieties while also finding inspiration in what comes next,” said Joseph Taliercio, PhD, a clinical psychologist and coordinator of research at Cognitive & Behavioral Consultants in New York who does advocacy work and outreach on heat and eco-anxiety. “Let’s figure out how to motivate change for those patients and make meaning out of the grief.”

It’s well-established that heat affects mental health. A recent systematic review and meta-analysis led by Jingwen Liu of the University of Adelaide School of Public Health found a 2.2% increase in mental health–related mortality and 0.9% increase in mental health morbidity per every 1.8 degree Fahrenheit rise in ambient temperature (Environment International, Vol. 153, 2021opens in new window).

[Related: How heat affects the mind]

The effects appear across mental health conditions. For instance, one large U.S. study of mental health–related emergency department visits found that there was an 8% increase in rates of visits on the hottest days of the summer compared with the coolest days, with the increases ranging from 5% to 11% across specific disorders and symptoms, including substance use, anxiety disorders, schizophrenia and related disorders, child-onset behavioral disorders, and self-harm (JAMA Psychiatry, Vol. 79, No. 4, 2022opens in new window). A study of ambient temperatures and suicide in the United States and Mexico further found that suicide rates rise 0.7% in U.S. counties and 2.1% in Mexican cities and towns for every 1.8 degree F increase in temperature (Burke, M., et al. Nature Climate Change, Vol. 8, 2018opens in new window).

“Extreme heat is an external stressor that is exacerbating people’s existing poor mental health,” said study lead author Amruta Nori-Sarma, PhD, an assistant professor of environmental health at the Boston University School of Public Health.

Some psychotropic medications can also affect people’s heat tolerance, making them more vulnerable to heat exhaustion or heat stroke. These include SSRIs, SNRIs, TCAS, and some antipsychotic medications. General physicians prescribing these medications may not always warn their patients about these side effects, Taliercio says.

Heat can also have unpleasant effects on the general population, regardless of other health conditions. The same 2018 study that found increased suicide rates with higher temperatures also found a rise in depressive social media posts on Twitter, indicating a general deterioration in mood.

Multiple studies, ranging from the individual level to the societal level, have also linked heat with aggression, according to a recent review (Nature Climate Change, Vol. 5, 2019opens in new window). “We can think of being in an uncomfortably hot environment as essentially making people more irritable,” said Craig Anderson, PhD, a psychologist at Iowa State University and one of the co-authors of that review.

Heat can have direct effects on mood and cognition, making people more likely to perceive others’ behavior as aggressive, he says. A recent National Bureau of Economic Research working paper led by economists at the University of California, Berkeley found that people in an uncomfortably hot room were more likely to behave destructively in an economic game that asked them to destroy another player’s winnings, with no particular benefit to themselves (Almås, I., et al., 2023opens in new window).

There are also indirect effects of heat on violence, Anderson says, including disruptions caused by drought and famine, leading to climate refugees making involuntary relocations. These disruptions may yield generational effects by depriving children of nutrition, safety, and stability, all factors known to impact lifetime violent behavior.

Mental health clinicians can help their patients recognize their heat-related vulnerabilities, including medication side effects or sleep disruptions caused by hot temperatures. Normalize the fact that heat causes feelings of tiredness and mental fogginess, Taliercio advises. Organizations such as the Climate Psychology Allianceopens in new window have resources and trainings for psychologists geared toward helping patients cope with eco-distress. One example is running a Climate Caféopens in new window, a gathering led by a trained facilitator where people can safely express their fears and concerns around climate change.

Extreme heat will make life difficult for many people, adding new barriers to attaining a psychologically and physically healthy life. But in many cases, says Anderson, the psychological research has already shown the path toward pushing back against environmental factors that negatively affect human development: Early childhood education, prenatal resources, investments in quality of life. The challenge is translating that science into political action, he says.

“I’m both optimistic and pessimistic,” he says. “Optimistic in that we know how to deal with a lot of this from a psychological standpoint. The pessimistic aspect, though, is that we as a society are not doing enough to deal with the magnitude of this crisis.”