International Review of Psychiatry

ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/iirp20

Climate change and mental health within the

African context

Monika dos Santos

To cite this article: Monika dos Santos (2022) Climate change and mental health
within the African context, International Review of Psychiatry, 34:5, 510-512, DOI:
10.1080/09540261.2022.2093626

To link to this article: https://doi.org/10.1080/09540261.2022.2093626

Published online: 27 Sep 2022.

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INTERNATIONAL REVIEW OF PSYCHIATRY
2022, VOL. 34, NO. 5, 510–512
https://doi.org/10.1080/09540261.2022.2093626

COMMENTARY

Climate change and mental health within the African context

Monika dos Santos
Department of Psychology, University of South Africa, Pretoria, South Africa

ABSTRACT ARTICLE HISTORY

Africa is ecologically sensitive, with vulnerable communities which are at particular risk of the Received 8 February 2022
associations and impacts of climate change. Serious climatic events can result in traumatic Accepted 21 June 2022
stress, developing into chronic psychopathological and psychiatric patterns. Nonetheless, there
KEYWORDS
remains a lack of psychiatric studies on mental disorders associated with climate change within
Climate change; mental
the African context. There is a need in Africa for robust complex adaptive integrated research health; public health; Africa;
concerning climate change impacts and associations on and with mental health and healthcare health systems
systems, policy and practice, so that relevant interventions may be implemented and strengthening
strengthened.

Introduction associated occurrences can also be delayed and can

Nations in the Global South, including those in
Africa, have contributed considerably less than their
Northern counterparts in terms of the production of
greenhouse gases, which in turn significantly contrib-
ute to climate change; yet they endure the most severe
of climate effects (dos Santos, 2021). Africa is thus
exceedingly vulnerable to the effects of climate change
which endanger the region’s adeptness to tackle its
development challenges. Most people and commun-
ities in sub-Saharan Africa are regarded to be
‘ecologically sensitive’, facing vulnerabilities due to a
related reliance on the land and other environmental
reserves, as well as due to exposure to environmental
threats. The localized effects in Africa of global cli-
mate change are intensifying these impacts.
Associated climate-hazards may result in anxiety,
depression, post-traumatic stress disorder and suicide
(Myers et al., 2011), yet empirical research is lacking
in the area.
The impacts of climate change on psychiatric
and psychosocial functioning
The impacts of climate change on mental health can
be explicit or implicit, and either short or long-term.
Serious events can operate via means comparable to
that of traumatic stress, resulting in well-documented
psychopathological patterns. Furthermore, the result
of exposure to life-threatening or protracted climate-
include psychological disorders such as posttraumatic
stress disorder. Nonetheless, there remains a distinct
lack of psychiatric studies on mental disorders associ-
ated with climate change. It is worth taking into
account that the link (though not necessary scientific-
ally robust in nature at this point) between climatic
aftermaths and mental disorders has only recently
been described and coined through the introduction
of new terms, for example, ecoanxiety, ecoguilt, ecop-
sychology, ecological grief, solastalgia (solastalgia is a
neologism which describes a form of emotional or
existential distress caused by environmental change)
and biospheric concern (Cianconi et al., 2020).
Difficult questions also need to be asked, and thor-
oughly researched, about human psychological and
physiological factors which could be driving climate
change; however, I will not focus on this aspect
within the context of this commentary.
Climate-induced hazards may also result in effects
such as dislocation and loss of income (as a result of
droughts in rural areas, for example), which may, in
turn, increase the prevalence of mental health condi-
tions (Myers et al., 2011). Furthermore, individuals
with pre-existing mental health or health conditions
may be more exposed and defenceless to these
changes. A correlation between falling temperatures
and extreme heat exposure, for example, can lead to
heightened aggression and other associated mental
health consequences in vulnerable populations. This

CONTACT Monika dos Santos dsantmml@unisa.ac.za Department of Psychology, University of South Africa, Pretoria, South Africa
ß 2022 Institute of Psychiatry and Johns Hopkins University

may suggest that if temperatures significantly diverge
from localized averages, there may be an association
with heightened mental health concerns (Berry et al.,
2010). Other examples of mental disorders that may
surge in frequency subsequent to a cataclysmic or
life-endangering event include trauma, post-traumatic
stress disorder, anxiety and depression, chronic dis-
tress and solastalgia (Godsmark et al., 2019).
A recent expert report by Barnwell (2021) outlines
the potential consequences of climate change on psy-
chological and mental health within the South African
context, though can be extrapolated to the broader
African, and perhaps even global context. Climate
change consequences highlighted in the report include
natural disasters (droughts, wildfires, flooding); water
insecurity; temperature, heat and sun exposure; air
pollution; associated health conditions; financial inse-
curity; food insecurity; institutional betrayal; interper-
sonal violence and identity disruptions and loss.
These climate consequences result in numerous psy-
chological experiences and harms, some of which
have already been mentioned in this commentary,
such as psychological and mental health treatment
impacts including the exacerbation of common men-
tal illness and mental health hospital admission;
depression; anxiety; post-traumatic stress; paranoia;
somatization; substance use; self-harm behaviour; sui-
cide; childhood developmental delays; accelerated
neurocognitive decline; dementia; cognitive impair-
ment and general trauma. Psychosocial and work-
related harms can include the disruption of commu-
nity identity; social stigma; marginalization; decreased
work productivity; humiliation; shame; loss of self-
efficacy; and disruptions to emotional bonds to place
and ancestral bonds.
Syndemic related relationships
Within the African setting, many imposing challenges,
such as the increasing disease burden of HIV/AIDS,
water and food insecurity, the impact of economic
globalization, the ramifications of colonization, result-
ant inequality and economic and geopolitical stresses
– ultimately converge with climate change. However,
an existing evidence base for some associations, such
as HIV/AIDS for example, upon which to base a risk
assessment remains inadequate. A study by Talman
et al. (2013) highlights a potential syndemic relation-
ship between the HIV/AIDS epidemic and environ-
mental degradation. While a study by Egondi et al.
(2012) suggests a correlation between HIV/AIDS-
related deaths and climate variables, it fails, however,
INTERNATIONAL REVIEW OF PSYCHIATRY 511
to outline the potential relationship in any detail. It
can, however, be inferred that an already immune-
compromised system due to HIV/AIDS can lead to
other more direct climate change, and psychiatric and
health associations. Furthermore, in South Africa
HIV/AIDS and psychiatric disorder co-morbidity
have been shown both to aggravate the delayed diag-
nosis and treatment of psychiatric disorders and to
negatively impact adherence to ARVs, thus making
populations even more vulnerable to the syndemic
impacts of climate change. Focussed, inexpensive and
evidence-based integrated strategies to reach these
populations are thus critical, for example, to
strengthen healthcare systems and services (dos
Santos & Wolvaardt, 2016).
Health-system strengthening, telemedicine
and policy advancement
According to the World Health Organization (2021),
COP26 special report on climate change and health,
health, and social justice needs to be placed at the
heart of climate talks. The mental health sector should
play a priority in climate change initiatives; however,
it is evident that there is a lack of scientific evidence
regarding the effects of climate change on mental
health, and on the health system in general, within
the African context (Myers et al., 2011). Based on the
few studies that are available within the African con-
text, it is evident that the health system, in general, is
ill-prepared for the added pressure that climate
change will cause (dos Santos et al., 2019). However,
a collective and technological perspective aligned to
the fourth industrial revolution can help to strengthen
healthcare systems’ resilience thinking within the
African context (dos Santos, 2021). We have recently
seen (particularly during the Covid-19 epidemic) how
approaches such as telemedicine can be successfully
implemented across many sub-Saharan African coun-
tries, providing vulnerable populations with access to
both mental health and health experts, which would
have otherwise been absent (Dodoo et al., 2022; dos
Santos et al. 2019). However, to execute telemedicine
properly, the technology for such connections is
required, which is not always the case in rural areas
(dos Santos et al. 2022).
Conclusions
The intricacies and associations between climate
change and mental health within the African context
highlighted in this commentary affirm the necessity
512 M. DOS SANTOS
for complex adaptive integrated research concerning
climate change impacts on mental health (and health
in general), and the advancement and adoption of
holistic healthcare and climate mitigation and adapta-
tion strategies which centre on strengthening mental
health and healthcare systems. Policy makers also
need to be pre-emptive in sourcing and enhancing
processes and practices to render mental health disas-
ter preparedness interventions and mental healthcare
services equipped for climate change (dos Santos
et al., 2019, 2022).
Disclosure statement
None.
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