Summary of the DCP's 2024 Guidance Document, "Clinical psychology and planetary health: changing course in the storm"

Holistic psychology emphasizes that “individuals are biological, psychological, and sociocultural totalities that cannot be fully explained in terms of individual components or characteristics” (American Psychological Association, 2018).

“The link between the CEE and biological health, mental health, and issues relating to social justice and equality, diversity and inclusion, is undeniable; it is an inherently biopsychosocial issue.”

🧬 Biological Impacts

Food and Nutrition

• “The CEE poses risks to food quality and supply worldwide” (Furtak & Wolińska, 2023).
• “Nutrition has a substantial impact on mental health,” influencing “the experience of mental health disorders and psychological wellbeing” (Offor et al., 2021).
• “The gut microbiome is implicated in the development of a breadth of mental health and neurophysiological conditions” and “affects the efficacy of therapies for these conditions” (Shoubridge et al., 2022).

Access to Natural Spaces

• “Extreme weather events disrupt ecosystems which in turn may impact access to natural spaces” (Upadhyay, 2020).
• Nature exposure “was found to be associated with beneficial changes in physiological systems implicated in the experience of mental health difficulties, including blood pressure, sleep, cognitive function, brain activity, and physical activity” (Jimenez et al., 2021).
• “Nature exposure decreased physiological markers of stress in 100% of studies” reviewed (Shuda et al., 2020).

💚 Psychological Impacts

Extreme Weather Events

• “Exposure to flood or storm damage predicted prevalence of mental health disorders in England” (Graham et al., 2019).
• Flooding impacts “water insecurity,” which negatively affects “psychological wellbeing and levels of distress” (Mushavi et al., 2020).
• “Food insecurity has been shown to be related to levels of mental health symptoms” (Pourmotabbed et al., 2020).

Climate Action

• “Collective action may buffer the relationship between climate change anxiety and mental health” (Schwartz et al., 2023).
• “Pro-environmental behaviour, including getting involved in conservation work and making greener consumer choices, is associated with higher subjective wellbeing internationally” (Capstick et al., 2022).

“Volunteering for the environment proffers an array of psychological benefits, such as social inclusion, education, and employment” (Patrick et al., 2022).

Nature Exposure, Mental Health, and Spirituality

• “Exposure to green and blue spaces has a positive association with psychological wellbeing” (Callaghan et al., 2021; White et al., 2021).
• “Higher levels of nature connectedness are associated with better psychological wellbeing and reduced levels of mental distress” (Nisbet et al., 2020).
• “Spirituality and nature connectedness mediate the relationship between nature exposure and psychological wellbeing” (Sahak et al., 2024).

👩🏾‍🦱👩🏻‍🦳👨🏼‍🦰 Sociocultural Impacts

Disproportionate Impacts

• “The health risks posed by climate change disproportionately impact certain groups: women, children and older adults, minoritised individuals, those with lower socioeconomic status, migrants or displaced people, and those with physical health conditions” (World Health Organization, 2023).
• “30 million people were internally displaced as a result of weather-related disasters in 2020 alone” (IDMC, 2021).

“Older adults are particularly affected by food and water insecurity and subsequent malnutrition” (Diamantis et al., 2023).

Working Contexts

• “Preliminary research has identified that discrepancies between individual values and perceived power to act in the workplace accompany high levels of worry about climate change” (Latter et al., 2024).
• “Engaging in climate action at work may have a beneficial psychological effect by allowing one to act in line with personal values” (Shackell, 2022).

📣 Call to Action

Clinical psychologists can:

• Advocate for “infrastructure that promotes active travel, such as walking or cycling, and provides amenities within walking distance, which is associated with better mental health” (De Nazelle et al., 2011).
• Promote the conservation of green and blue spaces, as “frequency of visits to natural settings is positively associated with mental health even when controlling for socio-demographic factors, season, and country” (White et al., 2022).

“Clinical psychologists can examine the contributing and consequent factors related to the CEE at both individual and systemic levels.”

Children and young people (CYP) are some of the worst affected by the climate and ecological emergency (CEE), which “multiplies the threats that already exist for vulnerable groups” (McMichael, 2013). The impacts include:

• “88% of the disease burden from climate change falls on children below five years of age” (Sheffield & Landrigan, 2011).
• “Higher emotional impacts compared with older generations” (Poortinga et al., 2023).

“As CYP progress through critical stages of maturation that are pivotal to their future wellbeing, this section considers the various impacts of the CEE through the lens of child development.”

🌱 Developmental Implications of the CEE

• Prenatal Period:

  • “Heatwaves are known to increase risk of obstetric complications, as well as preterm births and stillbirths” (Barreca & Schaller, 2020; Bekkar et al., 2020).
  • “Prenatal maternal stress during extreme weather events can negatively affect cognitive and behavioural development” (Evans, 2019).

• Early and Middle Childhood:

  • “Secure social bonds are important for psychological and emotional development, but extreme weather events can disrupt these bonds and lead to problems with attachment” (Clemens et al., 2022).
  • Psychological issues include “disrupted sleep, depression, and anxiety disorders such as PTSD” (Simpson et al., 2011).

• Adolescence:

  • “84% [of adolescents] were at least moderately worried about the ecological crisis, and 45% reported feeling negatively affected in their daily life and functioning” (Hickman et al., 2021).
  • Adolescents may experience “moral injury” due to “frustration over a lack of political action against climate change, as well as shame and guilt about one’s personal contribution to the problem” (Vercammen et al., 2023).

“When adolescents attempt to talk to adults about their concerns, they often feel dismissed or ignored” (Hickman et al., 2021).

🌟 Implications for Clinical Psychologists

• Reframing Climate Distress:

  • “It is important not to pathologise distress in relation to the CEE, which reflects an awareness of a real problem and an emotionally healthy response” (Marks & Hickman, 2023).
  • “Therapists need to be aware of their own emotional responses to the CEE in order to serve as useful containers for clients’ emotions” (Hickman, 2024).

• Supportive Interventions:

  • “A psychoeducational approach that reframes distress linked to the CEE as indicative of the care that CYP feel for others and the world, could be useful” (Hickman, 2024).
  • Use “group- or community-based approaches” such as schools-based workshops combining emotional engagement with “telling realistic but hopeful stories about possible futures” (Marks et al., 2023).

“Part of climate distress involves a feeling of interpersonal betrayal from adults and those in power, requiring a response that validates and contains these feelings” (Hickman et al., 2021).

📣 Call to Action

Clinical psychologists can:

• “Develop models of climate distress to enhance the understanding of CYP and their parents about emotional responses to climate and ecological change” (Pihkala, 2022).
• Support CYP to “build capacity to stay in touch with these feelings without being overwhelmed by them” (Gislason et al., 2021).
• Use “strengths-based narratives, community action, and participatory approaches through group/collective action to build mental health resilience” (Ojala, 2021).

“Awakening to the realities of environmental change leads to a potential for shock and trauma, which could be the optimal time for targeted support.”

Older adults are significantly impacted by the climate and ecological emergency (CEE), facing both physical and mental health challenges. This section highlights:

• “The threat to these populations from the CEE.”
• Points for clinicians and services to consider when working with older adults.

“Older adults are among those who will be affected first, most intensely, or will be among the more sensitive to extreme weather events.”

🌱 Environmental Beliefs

• “Age has little bearing on climate change scepticism” (Hornsey et al., 2016).
• Older adults “are more likely to believe that humans are already experiencing the effects of climate change,” possibly due to their longer exposure to environmental changes.

“The generational gap in climate-related beliefs and risk perceptions narrowed between 2020 and 2022, although a significant gap remained in which older adults reported less emotional engagement with the issue.”

🩺 Physical Health Implications

• “Heat-related deaths in over 65s have increased globally by more than 50% in the previous two decades” (Watts et al., 2020).
• “An older person is more likely to have diminished ability to regulate their body temperature, which can lead to increases in blood pressure and heart rate” (Kenny et al., 2010).
• Higher temperatures “exacerbate symptoms of dementia,” making older adults less able to respond to temperature changes (Zammit et al., 2021).

“Ageing immune systems are naturally less able to fight off infections” (Haynes, 2020), compounding the risks from vector-borne illnesses like malaria.

🧠 Mental Health Implications

Loneliness and lack of social support are “known contributors to mental health issues in older populations” (Lauder et al., 2004).

• “The loss of homes, possessions, and community ties can be particularly distressing for older individuals, leading to long-term psychological impacts” (Seritan, 2023).
• Socioeconomic disadvantage “is associated with more severe depression and anxiety following extreme weather events” (Clayton et al., 2017).

“Social support and culture are intertwined and contribute to the resilience of older adults” (Almazan et al., 2019).

This profound sense of powerlessness is echoed by many older individuals who feel increasingly isolated and unable to protect themselves from the growing threats posed by the climate crisis. Many are left to face these challenges alone, with limited access to resources or support networks that could help mitigate the impacts of climate change.

Older adults are particularly vulnerable to the emotional and psychological toll that the CEE takes. Nigel, another Expert by Experience, reflects on the growing emotional burden many carry, and the frustration of feeling powerless to influence change:

“Above all, it is the powerlessness and lack of agency that strikes such a chord.”

For many older adults, the climate crisis is not just an abstract concern but a lived reality. Drawing from his Irish heritage, Joe highlights how historical climate events, such as Ireland’s 19th-century famine, underscore the deep connection between planetary health and human suffering:

“The spread of potato blight that caused the famine was aided by a string of wet summers in Ireland, illustrating how changes in climate can have disastrous effects on agriculture.” (Joe Keaney).

The fear of future climate impacts is also closely linked to this history, and it exacerbates the emotional toll on older adults who have witnessed dramatic shifts in the environment over their lifetimes. Addressing the mental health needs of older adults in the context of climate change requires a comprehensive approach that incorporates both the physical and emotional dimensions of the crisis.

🌟 Implications for Clinical Psychologists

Addressing Physical and Mental Health Ramifications

• “Implementing targeted interventions to reinforce the resilience of older adults, developing age-sensitive climate adaptations, and engendering community buy-in are crucial” (Chang et al., 2022).
• Support older adults in “proactively regulating their body temperature and recognising the physical symptoms that might warrant more immediate attention in extreme weather conditions.”

Advocating for Services

• “Clinicians who work with older adults living in areas more prone to certain weather-related adverse events, such as flooding, can contribute to risk assessments” (Kriebel-Gasparro, 2022).
• Emphasize falls prevention and community rehabilitation to reduce reliance on wasteful medical procedures like joint replacements, which are “highly ‘wasteful’ procedures based on materials sent to landfill” (Prakash et al., 2023).

“Hospitals, nursing, and residential homes also need to consider robust temperature regulation.”

🌍 Call to Action

Clinical psychologists can:

• Advocate for “multi-faceted approaches involving public health, social care, and environmental agencies.”
• Promote interventions that address physical and psychological trauma from displacement caused by extreme weather events.

“As a global community, there may in time be the need to have more open conversations about how services and procedures are delivered in order to preserve our planet.”

People with intellectual disabilities (ID) face unique challenges in the context of the climate and ecological emergency (CEE). Exclusion from conversations and decision-making processes can lead to:

• Policies that are detrimental to their needs, described as “eco-ableism” (Cram et al., 2022).
• A lack of accessible information about climate change and its implications.

“Climate change policies must be co-created with people with ID to avoid additional harm and exclusion.”

🌱 Intellectual Disability in the Context of the CEE

• “Climate change” and “pollution” were identified as key concerns by participants with ID in a project exploring changes they wished to see in the world (Renel et al., 2020).
• Society’s tendency to “protect” individuals with ID can inadvertently exclude them from vital conversations and decisions about climate action, risking policies that “are made on behalf of rather than with these individuals.”

“Those with milder impairments may struggle to connect with the CEE due to…the higher rates of adversities, stigma, and marginalisation they endure” (Collins et al., 2022; Morgan, 2023).

🌟 Implications for Clinical Psychologists

Advocating for Inclusion

• “Disability-inclusive climate action groups are carrying out work to promote the voice of those in society who are most likely to be adversely affected” (e.g., Disability Rights UK at COP27).

Supporting Education and Communication

• Collaborate with speech and language therapists to create “accessible information to support people’s understanding of the CEE in ways that are sensitive to the emotional impacts.”

Ethical Considerations

• Engage in “a bold reimagining of care provision that privileges inclusion, interdependence, and rights over consumerism, independence, and choice” (Bell & Clegg; Burton & Kagan, 2006; Fyson & Cromby, 2013).
• Acknowledge complexities around “mental capacity, best interests, and a culture of service provision embedded in neoliberal ideology.”

📣 Call to Action

Clinical psychologists can:

• Advocate for “a just transition as society mitigates and adapts to the CEE.”
• Empower individuals with ID to engage in disability-inclusive climate action while ensuring their inclusion in broader decision-making processes.
• Ensure that service provision, including reducing reliance on driving, balances environmental goals with “equity of access” for individuals with ID.

“There is arguably a role for clinical psychologists to engage in a bold reimagining of care provision…to contribute towards an ideological shift away from neoliberalist ideologies linked to the acceleration of ecological collapse” (Weintrobe, 2021).

Clinical health psychology “integrates scientific knowledge with clinical skills to treat and manage health and illness” and typically involves “working within physical health multi-disciplinary teams.” (Richardson et al., 2023).

“In 2021, the World Health Organization declared the climate crisis to be the single greatest threat facing humanity.” (Wise, 2021).

“Over 200 health journals have joined to call on world leaders and health professionals to urgently recognise that climate change and biodiversity loss are one indivisible health emergency.” (Wise, 2021).

🧬 Direct Impacts on Health

“Climate change can be detrimental to health due to an increased severity and frequency of extreme weather events such as flooding, heatwaves, wildfires, storms, and drought.” (UKHSA, 2023).

“Increasing air pollution can cause acute and chronic harm, affecting nearly every organ.” (Schraufnagel et al., 2019a, 2019b).

• “Heatwaves have already caused excess deaths in England and Wales.” (Office for National Statistics, 2022).

• “Photosensitizing medications, including antipsychotics and antidepressants, can make people particularly vulnerable to increasing UV levels.” (Hofmann & Weber, 2021).

🌱 Indirect Impacts on Health

• “The spread of disease is becoming more likely as humans continue to change natural ecosystems.” (Ryan et al., 2019).

• “With poorer diets, malnutrition and greater food insecurity come widespread impacts on health and development.” (Medical Research Council, 2017).

“Extreme weather can cause disruptions to supply chains, and healthcare services can be stretched by climate change events.” (Stokel-Walker, 2022).

🌟 Planetary Health and Health Services

“Planetary health and human health are reciprocally connected, with implications for the operation of health services.” (MacNeill et al., 2021).

• “Environmental challenges, such as heatwaves and droughts, increase physical and mental health morbidity and place strain on health services and the workforce on which they rely.” (Berry et al., 2018).

• “Health services contribute to emissions, to the detriment of planetary health.” (MacNeill et al., 2021).

🌟 Implications for Clinical Psychologists

“Psychologists working in physical health have an important role, alongside other health professionals, in developing interventions that involve mitigation and adaptations to climate harms.” (World Economic Forum, 2024).

“We must also factor this knowledge into the development, planning, and delivery of services and clinical interventions, integrating environmental perspectives into high-quality, patient-centred care.” (NHS England, n.d.).

• Promote “co-benefit interventions” such as plant-based diets and active travel, which “improve human health and reduce greenhouse gas emissions.” (Willett et al., 2019; Celis Morales et al., 2017).

• Support “digital technologies” to reduce travel-related pollution and enhance accessibility. (Watts et al., 2018).

“By minimising the burdens of chronic disease, we can reduce the requirements for tertiary care and medication usage, which carry heavy carbon footprints.” (MacNeill et al., 2021).

• Expand the scope of practice beyond one-to-one treatments by drawing on community psychology approaches and addressing systemic inequalities. (Li et al., 2022).

📣 Call to Action

Clinical psychologists must “develop an understanding of the widespread impacts of climate changes on the health of their clients,” and “educate others and work with colleagues, patients, and healthcare communities to reduce the contribution of the health and care system to the climate crisis.” (UK Government, 2022).

The BPS Code of Ethics and Conduct (2021) acknowledges a duty to protect human welfare “both within the societies in which members live and work, and beyond them” (p. 3).

“Recognising that climate and ecological change pose significant threats to human rights – such as access to food, water, health, and sanitation – this section delves into the social justice dimensions of the CEE.” (Office of the United Nations High Commissioner for Human Rights, 2016).

🌱 Inequalities in Climate Responsibility

• The Global North was responsible for 92% of carbon dioxide emissions that were in excess of the planetary boundary of 350 ppm. (Hickel, 2020).
• The richest 1% have produced twice as much carbon emissions as the bottom half of the global population since the 1990s. (Khalfan et al., 2023).

“Rich countries have both the greatest historical responsibility for the CEE and the greatest ability to fund the required response to the CEE but have consistently failed to adequately finance climate action.” (Khalfan et al., 2023).

📊 Social and Marginalised Groups

• “People in lower income groups are hardest hit by the CEE.” (Khalfan et al., 2023).
• “Women and girls face a higher burden of threats, such as gender-based violence, in the face of extreme weather events.” (Doherty, Rao & Radney, 2023).
• “LGBTQ+ populations are vulnerable to the broad consequences of climate change, such as threats to emotional wellbeing, connection to community, and homelessness.” (Whitley & Bowers, 2023).
• “Individuals with mental health diagnoses are 2-3 times more likely to die in a heatwave.” (Meadows et al., 2023).
• “Disabled people face worsened inequity of access to resources amid the CEE” and are often excluded from climate policy. (Kett et al., 2021).

“The connection between the CEE and inequality is undeniable, casting it not merely as an environmental dilemma but a profound issue of social injustice.” (Barnwell & Wood, 2022).

Ψ The Role of Psychology in Addressing the Climate Crisis

Psychology has a critical role to play in addressing the climate crisis, particularly as it intersects with mental health, social justice, and systemic inequality. However, Nigel (Expert by Experience) notes that climate change remains inadequately integrated into mainstream psychological practice. This inertia must be addressed if the profession is to remain relevant and proactive in responding to climate impacts.

“This topic should be part of the mainstream of psychology… yet climate change remains stuck on the fringes of psychology.” (Nigel Reed).

Psychologists, as experts in emotional and psychological resilience, can contribute to climate action by addressing the mental health impacts of climate change, which disproportionately affect vulnerable populations, including those already marginalized by society. Yet, despite the clear need, the integration of climate awareness into psychological practice has been slow, and this must change.

🌟 Inspiring Leadership and Action

Nigel underscores the need for inspiring leadership within the field of psychology to combat climate change. He points to individuals who have led the way in connecting psychology with planetary health, yet the field at large has been hesitant to fully embrace this crucial issue. This leadership must not be reliant on individual efforts but must be embedded in the profession as a whole.

“It seems to be so dependent on enthusiastic individuals and not embedded in mainstream thinking.” (Nigel Reed).

Psychologists must take an active role in advocating for climate action and integrating environmental concerns into their practice, research, and teaching. As Nigel puts it, it’s crucial for the profession to ask itself difficult questions about how climate change is currently being addressed—and what needs to change.

“Perhaps one thing psychologists should ask themselves is how much do we need to know about climate change to better do our jobs now and… prepare the profession for a possibly very uncertain and very difficult future?” (Nigel Reed)

🌟 Future Generations

“The CEE places a disproportionate burden on younger generations and the unborn, who will experience the worst impacts whilst being responsible for fewer emissions than preceding generations.” (Hickman et al., 2022).

🌱 Implications for Psychologists

Psychologists can:

• Work in solidarity with nations in the Global South to tackle the CEE. (Barnwell & Wood, 2022).
• Provide supportive spaces for meaning-making and communal action. (Whomsley, 2021).
• Argue from a human rights perspective to prevent injustices. (Hagenaars et al., 2020).
• Actively include groups most affected by the CEE in decision-making. (Fernandes-Jesus et al., 2020).

“If our profession is serious about addressing colonialism and structural inequality, then this also necessitates deep and meaningful engagement with the CEE.” (Barnwell & Wood, 2022).

🌿 Georgia King: The Trainee Voice

“Two years: two years of training complete, two years since the ivory-billed woodpecker went extinct… two years of further inadequate government action, two years of trying to change the status quo, two years of witnessing shifting practices. A lot can happen in two years.”

Clinical psychology training offers a mixture of expectations, experiences, and realities. While there has been progress in embedding planetary health into syllabuses, this journey is often hindered by “dominant narratives of individualisation residing within the medical model” (Walker & Hewitt-Johns, 2021).

🌍 Equality and Systemic Theory

Encouraging systemic theory and social justice orientations, some training courses are fostering understanding of “macro forces underlying mental health” (Bronfenbrenner, 1992). However, challenges remain as many courses remain “rooted in an individualistic medical model approach” (King, 2024).

“Planetary health is about the interconnected health of humans, non-humans, and the Earth’s life-supporting systems.” (Myers & Frumkin, 2020).

🌟 Opportunities for Psychologists

Clinical psychology is uniquely positioned to address the climate and ecological emergency (CEE). Drawing on attachment theory, we recognise the significance of relational safety for children:

“This is not something that any adult can now guarantee for children, since either immediate threats or distal impacts are aspects of life from which they cannot escape.” (Edgington, 2023).

As a result, the CEE is a “mental health emergency in which psychologists not only have a duty to understand but also to respond” (UKHSA, 2023).

✨ Moving Forward

Training courses must continue to evolve, ensuring that planetary health is “a core part of training and not just a privilege limited to those who have extra capacity.” Psychologists are called to integrate planetary health into research, teaching, and practice, as outlined in professional codes of conduct (BPS, 2023; DCP, 2023).

🌿 Adaptive Leadership

Leadership in the context of the climate and ecological emergency (CEE) must transcend traditional approaches.

“Leadership of adaptation does not shy away from difficult realities through denial or passive hope and optimism, but allows for a range of emotional responses, including grief for what has been lost and courage to work toward change.” (Gosling, 2021).

Clinical psychologists are uniquely equipped to lead adaptively, bringing their reflective and self-aware skills to the forefront:

“Self-awareness… is a requirement for an honest confrontation with our own difficult emotions and an antidote to a reliance on denial- and avoidance-based ways of coping.” (BPS, 2019).

🌟 Broad Principles for Engagement

1. Think Systems

“Whatever action is taken within interconnected systems could generate unintended consequences.”

2. Bring Psychological Understanding
Leaders must address psychological barriers and promote clarity amidst uncertainty:

“Threatening and uncertain times may tend to promote more authoritarian leadership styles… [and] splitting and polarisation between positions such as blind optimism, denial and despair.” (Gosling, 2021).

Effective leadership requires:

“The capacity to uncover and understand people’s emotions and respond with clarity, conviction, and calm presence.” (Gosling, 2021).

3. Keep Purpose in Mind

“We must keep the intention of the work clear and remind people consistently of the situation we are in and the need to act.” (Gosling, 2021).

4. Seed Ideas
Change is an organic process, not an imposition:

“Let us adopt the practice of sowing seeds – ideas and inspirations – that might, in their own time, germinate in the minds and hearts of those around us.”

🌱 Specific Actions

Psychologists can lead by reducing psychological distress, fostering wellbeing, and addressing social justice in the context of the CEE:

“Helping others steer a course… without being unwittingly pulled into positions of salvation or doomism will be paramount.” (Gosling, 2021).

The focus remains on evidence-based actions and ethical practices, rooted in connection, interdependence, and sustainability.