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Similar to teaching during Covid, the discussion (and endless op-eds from non-educators) focused on the wrong root cause. Learning loss, anxiety, trauma, and disengagement was not due to students being masked or unmasked, in person or on Zoom. The issue was that no matter when, where, or how, students were being asked to learn during a global crisis.

Climate emergencies are similar and I fear schools, parents, and educators are not prepared for the mental health toll trauma from lived climate crises will have on students' ability to focus and learn. Educators collectively spend more time with youth than parents and caretakers throughout an academic year. It is crucial for the health of young people that teachers are trained to be more socio-emotionally aware of eco-anxiety and all of its manifestations.

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I do not want teachers to act as therapists when they are not trained as such, but, as everything must change if we wish to transform society to stay under 1.5 degrees of warming, this must include what and how students are taught. I would like to focus my paper this semester on climate anxiety in youth, particularly in secondary education (the field I work in).

As a means of improving health and health equity, I hope for schools to play a larger role in updating their curriculum and trauma-informed practices to include best practices for teaching about and supporting students through emotions about the climate crisis.

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According the the World Health Organization (WHO) (1948), “Health is a state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity.” The intersection of climate change and health is taking off as a field, recognizing the ways the climate crisis will decrease health and wellbeing around the world. I am most interested in the social determinants of health, the non-medical factors, conditions, and setting, as well as the systems that shape peoples' lives, work, and communities.

The World Health Organization (WHO) estimates an increase of 250,000 excess deaths per year between 2030 and 2050 due to climate change (Hayes et al., 2018). Often overlooked in the aftermath of climate-related disasters, weather events, and disease outbreaks are the mental health impacts of exposure to a crisis situation. Exposure to climate impacts can be direct or indirect, running along a spectrum. Likewise, mental health presents in a range of ways, From mild to severe, contextual to chronic (Dooley et al., 2021).

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"Environmental threats provoke strong feelings in many students, but some may deny being concerned, express disinterest, or even make jokes. These reactions can be provoked by a variety of factors, such as inadequate knowledge about climate change, a desire to avoid experiencing negative feelings, or conflicts with beliefs that have been learned at home."

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Climate Psychology Alliance North America

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The human-driven processes and impacts of climate change are disrupting young people's lives and are putting their homes, institutions, and physical and mental health at risk. While young people may not always talk about these experiences in school or act outwardly distressed, their feelings about climate change are still making their way into the classroom. What can educators do to help young people navigate these difficult emotions?

The Educator's Guide to Climate Emotions, written by a team of teachers, researchers, and mental health clinicians in consultation with youth climate leaders and climate psychology professionals, offers a variety of approaches for working with climate emotions in educational settings.

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This guide will help K-12 Educators address the emotional needs of their students as they learn about climate change and climate justice.

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Because physical health, mental health, and community health are interrelated, the solutions must also look for opportunities for overlapping care across these areas. Learning and education, public discussions about the health impacts of climate change, and working on practical action and solutions are some examples of overlapping strategies (Clayton et. al, 2017).

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Disasters from climate change can of course cause stress, trauma, and physical and material harm. “The potential for psychological trauma following a disaster likely depends on the scale of the catastrophe and level of exposure.”

For those highly impacted this can lead to PTSD, depression, and anxiety” (Dooley et al., 2021).

Impacts can be short or long term and range from youth stress to parental stress to migration stress (Dooley et al., 2021). I am particularly interested in the ways climate-related mental health symptoms impact students in school. Whether it’s displacement because a school has been destroyed or difficulties concentrating in a disaster or post-disaster setting, I would like to know how schools, teachers, counselors and curriculum, particularly at the secondary level, can appropriately meet the needs of students.

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Emma Lawrance, a researcher and fellow at the Institute of Global Health Innovation at Imperial College London, explains that the climate change and mental health field is quickly growing, but "it remains disconnected, unequal and siloed, with limited investment in this critical area of work for humanity." She goes on to say that, "often, connection is at the heart of the solution — connecting across disciplines, sectors, countries and cultures, to act on the connections between the health of our minds and planet" (Nature Editorial Board, 2024).

While working to increase interdisciplinary work, the field must also focus on climate justice by listening to the needs, concerns, and lived experiences of those who live in climate settings disproportionately impacted by the stress and trauma of living through climate disasters in the present (Denckla, 2024)

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A 16 year old student at a high school in New Orleans said, "I feel like generally there’s a lot of hopelessness among people my age. When talking about it, people are just kind of like, ‘Well, whatever." We're not even gonna have a planet in 50 years, so it doesn’t even matter" (Kamenetz, 2024). Currently, climate education and ESD teach students about the problems, but not a full range of solutions, and definitely not ways to cope with strong fear, anxiety, and grief around how much has been and will be lost, nor is education addressing how to cope with feelings around institutional abandonment. "This is an existential human crisis that I think teachers are not prepared to address...Just to address climate change in the context of science [isn’t] addressing the social-emotional and social science aspect of this crisis" (Kamenetz, 2024).

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An EdWeek survey conducted in October 2023 presented teenagers in the U.S. a list of 11 emotions to descibe how they feel when they think about climate change. The top answers were “Anxious,” followed closely by “afraid” and “helpless" (Kamenetz, 2024).

Many adults are still telling young people that they are the hope, they will be the saviors of our planet, when students who have learned about and experienced impacts of this crisis know the scale and scope are too big and the timeline is too short to wait any longer. Many times anxiety and a sense of unease comes from a lack of action. These types of statements often feel dismissive of their emotions when, in fact, "climate anxiety isn’t a clinical mental disorder; rather, the growing consensus in the field is that it’s a natural response to a real and existential threat" (Kamenetz, 2024).

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Climate mental health — making connections (Nature Editorial, 2024)

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Climate mental health — making connections (Nature Editorial, 2024)

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presents both commentary and research that conceptually advances understanding of the mental health effect of the ongoing and escalating climate crisis

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The changing patterns of climate, both directly and indirectly shaping extreme weather events, are costly phenomena. A recent estimate1 placed the global economic toll at US $143 billion annually. Evaluating the cost of extreme weather events from climate change, such as heatwaves, wildfires or hurricanes, often focuses on more direct or concrete measures, such as damage to infrastructure or loss of life. Increasingly, however, academic research papers and governmental reports have expanded to include the implications for physical and mental health in costs of disasters. The reverberations of these events are distributed across communities and experienced by individuals beyond those who are immediately affected.

Understanding the mental health effects associated with climate change has prompted the advent of new research disciplines. These include 'eco-distress'2 and 'eco-anxiety,'3 terms for describing feelings and emotions in response to climate change that may range from healthy and constructive psychological responses to chronic fear about cataclysmic environmental events. Climate psychiatry considers more specifically an increasing frequency of psychiatric conditions associated with disasters, including post-traumatic stress disorder, depression and anxiety, but it also focuses on some of the more immediate and proximal consequences of changing climate, such as rising temperatures and potential complications with psychotropic medications. Bringing these strands of research together, climate mental health serves as a means to describe and to include how individuals respond to the emerging threats of global climate change. This issue of Nature Mental Health presents both commentary and research that conceptually advances understanding of the mental health effect of the ongoing and escalating climate crisis.

Climate mental health as a discipline is in its infancy but draws on long-standing bodies of work in climate science and mental health. There is much work yet to be done to integrate and harmonize these component fields in terms of methodology, data collection and outcomes, as well as to prioritize mental health within the framework of climate policy and action. As Emma Lawrance, a researcher and fellow at the Institute of Global Health Innovation at Imperial College London, describes, "Climate change is multiplying risks to mental health. Conversely, action for a safer climate via mitigation and adaptation strategies is an unmissable opportunity to foster the conditions for a world where no one is held back by mental health problems. While the climate change and mental health field is rapidly emerging to understand and respond to these needs, it remains disconnected, unequal and siloed, with limited investment in this critical area of work for humanity. The task for researchers and funders is to listen to the needs of those experiencing the mental health challenges of a changing climate and learn from stories of resilience and solutions. So often, connection is at the heart of the solution - connecting across disciplines, sectors, countries and cultures, to act on the connections between the health of our minds and planet."

Toward this goal, a Comment by Lawrance et al. introduces the Wellcome-funded initiative ' Connecting Climate Minds '. The project brings together climate science and policy experts with mental health and global health researchers from around the world to align climate and mental health agendas for translation into national policy, setting the stage for future research in this area and opportunities to incorporate populations who may be most vulnerable, including Indigenous people and people experiencing mental health challenges.

Looking forward is a key element in carving out the field of climate mental health, but there is also an array of work underway. In a Q&A, Melissa Marselle discusses her journey and exploration of environmental psychology as well as the building of an evidence base around the mental health benefits of interacting with the natural environment. Climate change can disrupt biodiversity, limiting the restorative potential of blue (oceans and lakes) and green spaces (parks and forests).

Beneficial contact with nature is a positive conceptualization of interaction with environments, but the converse (the negative effect of experiencing climate disaster) is also crucial to acknowledge. In a Perspective, Minnis et al. describe the 'bio-exposome,' an integrative model of intercellular processes, stress physiology and the exposome - that is, everything that one is exposed to - as a means to better investigate and understand the mechanisms linking childhood adversity and negative mental health outcomes. As part of the exposome, climate associated disasters pose threats to human development through upheaval such as food insecurity and forced migration.

Young people are one of humanity's greatest assets but also one of its most vulnerable to the climate crisis. Although there is a burgeoning literature connecting climate change and adverse youth mental health, there is little data on this linkage in young people in country contexts that are most affected by climate disasters such as Small Island Developing Nations. This month's issue includes a research paper from Maharaj and colleagues demonstrating that climate distress mediated the relationship between mental health difficulties related to climate change and anxiety in a survey of Caribbean youth, adding to evidence demonstrating adverse mental health outcomes associated with climate change.

A systematic review by Burrows et al. gives us insight into the current landscape of both qualitative and quantitative research delving into the long-term effects of chronic climate change on mental health outcomes. Much of the work on climate-related mental health outcomes has come from studying the effects of acute climate disasters; however, this analysis focusing on chronic climactic exposures finds consistent associations with elevated suicide risk, increased psychological distress and diminished well-being.

At the outset of building the field of climate mental health, there are two prime messages conveyed. The first is that there is still a scarcity of high-quality data that empirically links aspects of climate change, especially chronic climate change, and specific adverse mental health outcomes. And a second message that bears on the first, which is that to adequately approach these gaps, it is imperative that the open research questions are considered through a multidisciplinary lens. Bringing climate scientists, mental health researchers and representation of the communities affected presents the best chance we have for mitigating the costs of the climate crisis. Connecting climate minds may be the connection to hope for a healthier future.

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Climate mental health - making connections - Nature Mental Health

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As the world grapples with the repercussions of climate change, the consequences for physical and mental health have become more salient. Climate mental health unifies multidisciplinary approaches, including climate science, psychiatry and psychology, to inform and shape public policy and action to mitigate the negative effects of climate change on mental health.

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Investigating the Mental Health Impacts of Climate Change in Youth: Design and Implementation of the International Changing Worlds Study

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Investigating the Mental Health Impacts of Climate Change in Youth: Design and Implementation of the International Changing Worlds Study

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“The project was conceived within the planetary health paradigm, aimed at characterizing and quantifying the impacts of human-mediated environmental systems changes on youth mental health and wellbeing.”

"Capturing and understanding global differences and nuances in young people’s psychological and behavioural responses to climate change is vitally important for informingmappropriate mental health support and climate policies that work within the sociocultural context"

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1. Introduction

The literature detailing the (mental) health and wellbeing impacts of climate change is rapidly growing, as highlighted in a number of recent evidence reviews [ 1, 2, 3, 4, 5, 6, 7, 8, 9]. The proliferation of academic papers also reflects increasing interest from the practitioner and lived experience advocates who wish to understand the nature, prevalence, and outcomes of psychological responses to the climate crisis to better support clients and entire communities who are affected in various ways and to catalyse action [ 10, 11, 12]. A number of studies, including some large international surveys [ 13, 14], have catalogued climate concerns, emotions, and the impacts on the lives and behaviours of people worldwide, with a particular interest in young people. These studies highlight that while some experiences are universal, there are contextual and cultural factors that shape or modulate responses to climate-related experiences. Ogunbode et al. [ 14], for instance, note that while climate change anxiety is negatively associated with wellbeing in almost all countries studied, there is more contextual variation in the links between climate anxiety, pro-environmental behaviour, and activism.

Capturing and understanding global differences and nuances in young people's psychological and behavioural responses to climate change is vitally important for informing appropriate mental health support and climate policies that work within the sociocultural context [ 3]. The idiosyncrasies of individual studies and the diversity of metrics to capture climate-related subjective experiences raise challenges for comparison and standardisation and make it difficult to draw conclusions about what substantive differences in the local climate psychology are and what is linked to incidental differences in assumptions, methodology, or specifics of the metrics employed. There is a clear need for collaborative investigations in which researchers working in different parts of the world, in partnership with their local communities, can share knowledge and methodologies and create contextually modified but conceptually uniform studies that allow us to compare and contrast insights derived.

This paper reports on the process of developing a coalition of researchers working on climate psychology and mental health in different sociocultural settings, namely, the UK, USA, Philippines, India, and three Caribbean countries. We detail how each group worked in partnership with local young people to amend and implement a survey with which to understand the thoughts and feelings of young people in response to climate change in the context of other (locally relevant) health and social crises (particularly the COVID-19 pandemic). Our aim is to share the principles we used to govern the research, the conceptual and practical challenges we have faced so far, and the observed strengths and limitations of our approach. From this, we derive some interim recommendations to set a firm direction towards creating an effective global community of practice in climate change and mental health research.

2. Climate Cares and the "Changing Worlds" Approach

The Changing Worlds study was initiated by Climate Cares, a collaboration between the Institute of Global Health Innovation and the Grantham Institute, both based at Imperial College London ( https://www.imperial.ac.uk/global-health-innovation/what-we-do/research/mental-health/climate-cares (accessed on 20 March 2023)). The initiative brings together an interdisciplinary team of researchers, designers, policy-makers, and educators aiming to understand and support mental health during the current climate and ecological crises, supported by a globally representative advisory board of experts in psychology and psychotherapy, climate and health policy, planetary health, environmental epidemiology, public health, and science communication, among the wide range of relevant disciplines. Climate Cares' vision is to equip individuals, communities, and healthcare systems with the knowledge, tools, and resources to be resilient to the mental health impacts of climate change and enable action that simultaneously benefits human health and wellbeing and the planet. Climate Cares does this through a programme of research, education and awareness raising, policy advocacy, and intervention design.

The original "Changing Worlds" survey was the first empirical research study conducted by Climate Cares and was developed in the UK in 2020, when there were no published data on the nature, prevalence, and severity of the mental health impacts of climate awareness in young people, the range of psychological responses they were experiencing, and the interactions with agency and behaviours. The study team included experts in environmental psychology, public health, mental health, neuroscience, climate and environmental science, and science communication. Additional input was sought from mental health practitioners and clinicians, and, crucially, from a young persons' advisory group (YPAG) specifically recruited for this study. In what follows, we briefly outline the development of the Changing Worlds study in the UK ( Section 2.1) and describe the development of the research partnerships and international implementation of the study ( Section 2.2 and Section 2.3) and the dissemination of the findings ( Section 3). Finally, we reflect on the challenges we faced and resolved and highlight prospects for the path forward in this field of research ( Section 4).

2.1. Conceptualisation and Operationalisation of the Changing Worlds Study UK

2.1.1. Rationale

The aim of the UK Changing Worlds study was to assess young people's psychological responses relating to the perception of climate change, primarily using quantitative metrics. We also included open-ended questions to potentially gather new insights into how climate change awareness influenced young people's thoughts, feelings, behaviours, and hopes and plans for the future in ways that were not captured by existing scales and questionnaires. At the time, there were no available data on the nature, prevalence, and severity of psychological responses to the climate crisis, though young people appeared-at least anecdotally-to be a particularly vulnerable group to mental health challenges and distress arising from climate crisis awareness. As the COVID-19 pandemic emerged as a major global health crisis at the time of the study, the decision was made to compare and contrast how young people in our UK sample responded to the two issues. Notably, the study was conducted during the first year of the pandemic, when public health interventions (e.g., lockdowns and requirements to isolate, wear masks, social distancing) in the UK were in full force. We screened for mental health and wellbeing indicators and collected basic demographic data. For each identified issue (i.e., the climate crisis and the COVID-19 pandemic), we asked about specific positive and negative impacts, as well as an assessment of the overall perceived impact severity. We measured psychological distress and emotions linked to the specific issue, their mental health status, and the self-reported extent to which this affected respondents' daily functioning and subjective wellbeing. Finally, we asked young people about their sense of agency in addressing each issue and about their actual engagement in pro-environmental and climate action. Established concepts were measured using previously published scales available at the time (e.g., "climate distress" was measured with Reser et al.'s [ 15] scale). Scales developed for one issue were adapted with minimal rephrasing to be comparable for the other issue, and this was achieved with the support of the YPAG (see below for further detail). Complementing the quantitative survey elements, a small number of open-ended questions were included. This was intended to provide richer insights into the subjective experience of climate distress, respondents' motivations for acting on it, and reflections on the impact of climate change in their lives, including their hopes and fears for the future. It was anticipated that the free-text responses would be thematically analysed to detect novel patterns or conceptual directions which would aid in setting and prioritising future research questions.

2.1.2. Conducting Research with Young People

While children, adolescents, and young adults are all considered to be particularly vulnerable groups, for the Changing Worlds study, we chose to focus on the older adolescent/young adult group (16-24 years) for conceptual and practical reasons. The first reason is that the adolescent and early adult years are also key periods of vulnerability for the development of mental health conditions [ 16]. The dual challenge of a global pandemic and the ongoing climate crisis was presumed to be a particularly significant factor for people at this sensitive developmental stage. More practically, working with young children requires additional ethical and logistical considerations, and gaining access to participants would have required collaborating directly with schools or other community groups. Under pandemic restrictions, this would have been extremely difficult. Adolescents and young adults, on the other hand, are highly technology literate and have a strong online presence, making them an easily accessible group who would also be able to independently decide whether or not to take part in the study, without the need to engage a gatekeeper. For the UK study, this meant we could include young people aged 16 and over. As common law in the UK presumes minors between 16 and 18 years of age are usually competent to give consent to medical treatment, they are also generally assumed to be competent to consent to participation in research without the need for parental or guardian consent. Further design considerations were directed by local ethical guidelines (e.g., those set out by the UK's Economic and Social Research Council) which highlight that "researchers should ensure that risk and harm in research is minimised and that adequate protection of children and young people is ensured. They should also consider the ethics implications of silencing and excluding children from research about their views, experiences, and participation" ( https://www.ukri.org/councils/esrc/guidance-for-applicants/research-ethics-guidance/research-with-children-and-young-people/ (accessed on 20 March 2023)). Climate Cares supports the principle that young people, who are disproportionately burdened by the climate crisis, should be afforded a voice in the matter. This includes providing opportunities to exercise agency with respect to research that is relevant to them, while also accounting for young people's capabilities and vulnerabilities, including their mental and physical health. We provided participant information materials in accessible language to ensure that those interested in taking part understood the procedures and the consequences of their participation, and that they were able to give prior informed consent without the need for additional parental/guardian consent. We also provided a broad range of freely accessible resources, online information, and helplines whereby young people can access support for mental health concerns. The study proposal was approved by the relevant research ethics committee at Imperial College London, which evaluated the risk level as appropriate for the study population, given the safeguards that were in place.

We recognised that when it comes to mental health and wellbeing, young people are experts in their own experiences and that it was vitally important to not just collect information from them but to engage young people directly in the design of the study. The YPAG, which consisted of a diverse group of ten young UK residents of different ethnicities and ages living in different parts of the country, provided feedback on the content and presentation (e.g., length, wording) of the survey and was also consulted on the design of the questions. For instance, the YPAG helped to create a list of the perceived positive and negative impacts of climate change based on a previously published questionnaire about the possible positive and negative impacts of the COVID-19 pandemic on the lives of young people. This was to ensure that the survey captured the impacts most relevant to the target sample and addressed their needs and concerns. The YPAG consultations were held over a series of online (Zoom) meetings, and participants were reimbursed for their time in line with UK Standards for Public Involvement in Research.

2.1.3. Sampling and Distribution

In the UK, our initial approach was to reach out to youth via targeted participation calls on websites, existing mailing lists, and social media linked to youth groups (e.g., religious, community groups), Universities, schools, mental health charities, and other organisations within the researchers' professional networks, as well as some snowball sampling. These participants were entered into a draw to win high street gift cards. Small rewards or raffles such as these are considered appropriate compensation without introducing undue inducement. We were deliberate in approaching a broad range of youth-focused groups to distribute information about the survey, so that not only young people already engaged in climate-related activities would be recruited. While our recruitment drive was moderately successful, to reach our target sample, we additionally distributed the survey using a paid survey panel service (Prolific). We set no participation restrictions other than the age, residency criteria, and self-assessed English language proficiency. These participants received immediate monetary compensation using the remuneration standard set by the company. Online research panel services have become well-used recruitment tools, especially in social research. They are now widely available, and many give researchers access to a broad demographic range of participants in countries such as the UK, the USA, Canada, and various European nations. There are limitations to their use as the quality of respondents has been called into question, and the majority of panellists do reside in a minority of countries. Nevertheless, for the UK study, this approach proved fruitful compared to the community sample, which saw a relatively high drop-out rate in the early stages of the survey (e.g., people clicked on the survey link, but did not complete the questions), which is common in web-based research [ 17].

2.2. The "Changing Worlds" Research Partnerships

2.2.1. Principles of Collaboration and Interdisciplinarity

We established partnerships between the UK Climate Cares team and several researchers/research groups involved in Planetary Health, located in the USA, the Caribbean (Trinidad and Tobago, Guyana, and Barbados), India, and the Philippines. These partnerships were initially facilitated through the professional networks of the Climate Cares team and largely based on verbal rather than formalised agreements. The guiding principle was a common interest in building a richer global understanding of young people's responses to the climate crisis. The partner organisations each agreed to develop a localised version of the Changing Worlds study according to their interest and needs, in a way that preserved reasonable equivalence across settings. Each lead researcher recruited a local network of researchers and practitioners with relevant skills and knowledge, recognising the need for interdisciplinarity as this type of research crosses boundaries between public health, climate change studies, environmental psychology, psychiatry, epidemiology, human geography, and possibly other disciplines. They also recruited local Young Persons' Advisory Groups to ensure materials and methods met local understandings and needs. The composition of the research teams at each site, therefore, varied, depending on available local resources and capacity. The UK team formed the central connection, facilitating interaction among the various site teams, which then allowed for greater access to the broad expertise required to successfully implement, interpret, and widely disseminate the research outputs and outcomes.

2.2.2. Funding and Project Management

Each of the site teams secured independent funding or allocated internal funding for the implementation of the project at that specific location. This decentralised funding approach was a necessity as we did not have access to sustained and sufficient external research funds for a multi-site investigation. As the mental health impacts of the climate crisis is an emerging field of research, there has been very limited relevant external grant opportunities to date, challenging the resourcing and pace of such research. As each site team managed their resources independently, the different studies operated on their own timelines. The resulting staggered implementation had certain benefits as it allowed the site teams to exchange lessons learned at varying project stages so that issues or challenges could be avoided or resolved more quickly. For instance, documentation prepared for, and approved by local Internal Review Boards was shared with other teams to facilitate ethical approvals.

In line with the independent funding arrangement, each site team was responsible for the local project management. Throughout the project cycle, the UK team provided a supporting role and offered additional capacity and human resources where requested, e.g., to aid with data analyses and manuscript preparation and to assist in study design and set up, as well as providing materials such as YPAG recruitment resources that could be locally amended. The extent of this support varied depending on the needs and resourcing of the site teams. For instance, the UK team was an equal partner in the USA study and a consulting/advisory partner in the India study. The site teams provided in-depth contextual and operational knowledge to successfully design and distribute the surveys and interpret the findings with reference to the relevant international and regional literature. We held regular web-based meetings between the UK team and the individual site teams, as well as (less frequent) multi-team meetings to share project updates.

2.3. Local Adaptations of the 'Changing Worlds' Methodology

Table 1 provides a summary of the study characteristics across the five different settings, highlighting survey design decisions, stakeholder involvement, recruitment strategies, sample characteristics, operational factors, outputs, and/or dissemination plans for future outputs. Each study received local ethical approval (at the time of writing, the Philippines study team was in the process of obtaining ethical approval from their IRB, and data collection had not yet started); at all sites, respondents gave prior informed consent; only participants able to give consent themselves were recruited for the studies. The age range varied by site, as local consent regulations with regard to minors (<18 years of age) imposed different restrictions on recruitment.

2.3.1. Survey Design and Content

The UK Climate Cares team shared the original survey instrument with the site teams. The survey was then tailored through discussions with locally recruited YPAGs. At most sites, the YPAG participants were selected from a larger pool of respondents to an open call for Expressions of Interest, or through more targeted advertisement of the opportunity to relevant youth organisations such as student groups and youth climate or social justice advocacy groups. Although we did not consistently apply formal selection criteria, we generally aimed to achieve reasonably gender balance within each YPAG and sought to include participants from different geographic regions (e.g., urban/rural), cultural/ethnic backgrounds, and socioeconomic groups, as relevant to the country. We also asked prospective YPAG members to indicate their availability and motivations for participation to identify individuals that were sufficiently engaged to ensure a productive YPAG process. The India site team employed an existing adolescent expert advisory group that had been set up for a separate study. Additional changes to the survey were based on local researchers' contextual knowledge and relevant academic and grey literature sources. These local adaptations largely fell into three categories, namely: (1) amendments to the emphasis on crises in addition to climate, for example, whether to include questions about the COVID-19 pandemic or other locally pertinent challenges (e.g., post-election political developments in the Philippines); (2) alterations (including additions or deletions) to ensure cultural relevance, such as what emotions made sense to the local young people; (3) wording or language changes to be equivalent but presented in a different language/culture. The first category included the addition of questions addressing pertinent social issues that intersect with climate change and public health crises, while the second included the omission of items considered inappropriate or likely to be interpreted in a manner inconsistent with the intended purpose of the original survey. For instance, we were interested in the kinds of emotions young people associated with climate change (and the COVID-19 pandemic), but after review by the experts and YPAG from the George Institute India, it was decided to omit certain emotion words from the list in the survey implemented there. These included, for instance, guilt and disgust, as these were words not typically associated with climate change or else they lacked a local translation that made sense in the context of climate change responses for the young slum dwellers targeted in the Indian version of the study. The USA YPAG, on the other hand, advocated for the inclusion of additional climate-related emotion words, including "cynical", "numb", and "manipulated", which reflected their local experiences. In the Caribbean Region, the local YPAG conducted a pilot amongst peers to test the readability and contextual relevance of survey items, and only minimal changes were suggested. Where relevant, the survey was translated into local languages to ensure that the participants' comprehension of the questions was not hindered by language barriers, and back translations were conducted to ensure linguistic equivalence (for details, see Table 1).

2.3.2. Sampling, Recruitment and Data Collection

The sampling and recruitment methodology was tailored to tap into locally available resources. Because regulatory and normative considerations were not uniform across countries, we adjusted procedures as needed. For example, in most sites, we limited participation to research volunteers between the ages of 18 and 24 as the regulatory frameworks for research with minors differed from the UK, making the inclusion of 16-18 year-olds impractical. Due to the success of the panel service approach in the UK, we used a similar service provided by the survey company Qualtrics in the USA where we had the funding to do so. This allowed us to set specific selection criteria and to create a sample that mirrored the ethnicity, age, and gender breakdown according to the USA census. We were also able to over-sample from geographic regions that had recently experienced climate-related extreme weather events or were subject to other (e.g., chronic) climate change phenomena such as drought or air pollution. We identified such regions at the county level as reported in the Federal Emergency Management Agency (FEMA) National Risk Index for Natural Hazards, the National Lung Association State of the Air Report, and the Centers for Disease Control (CDC)/Agency for Toxic Substances and Disease Register (ATSDR) Social Vulnerability Index. These additional restrictions significantly increased the cost of recruitment but also substantially reduced the data collection time. At other sites, e.g., in India, the research team had access to a database linked to a previous study comprising 9905 households, who agreed to be contacted for further research. The project sites were purposely and pragmatically selected because they were urban slums located close to the research team's offices in the cities of Faridabad and Hyderabad. This allowed the team to easily recruit from a unique population. An internet-based survey was not feasible; instead, trained field investigators collected the survey data in person. In the Caribbean countries and the Philippines, social media is very popular among the target demographic and mobile phone access is very common. This facilitated the recruitment of participants through social media marketing, including via the use of relevant local influencers known to many young people and data collection through a mobile-friendly online survey.

2.3.3. Data Analysis and Data-Sharing across International Borders

To facilitate data processing and assist with statistical analyses, the UK team made their data analysis plans, pre-publication drafts, and preprints of manuscripts available to the other site teams. In principle, Climate Cares will, as a collective, ensure that all publications resulting from its work are open-access to maximise the impact and ensure equitable access to the findings [ 20]. In a crisis discipline, such as the emerging nexus of climate change and mental health, ensuring that newly emerging evidence is freely accessible will benefit both scientific progress and the integration of evidence in policy and practice. Furthermore, we advocate for the adoption of a wider range of open science practices (e.g., preregistration of hypotheses, making research data and materials freely available, and publication on preprint servers). However, we recognise that there are different norms around research practices globally. For instance, while we anticipated that we would freely share the collected data among research teams to aid in data processing and interpretation, there were institutional policy barriers relating to the ethical implications of the international transfer of research data or even access to the data for researchers in other countries. Some of the information collected, while anonymised, is theoretically re-identifiable while a subject number database is held somewhere in the world (pseudonymised), thus requiring a high level of oversight and data security practices to ensure that the participants' rights and privacy are protected. Countries and institutions have different risk assessments around this process, and this will impact the transfer of personal data for research purposes. Recent developments in data protection regulations, such as the General Data Protection Regulation (GDPR; which governs the exchange of personal data for EU and UK researchers), require researchers to expend additional resources in order to confirm that other parties provide equivalent standards of protection for legitimate data transfers. This burden of responsibility, and the lack of training with respect to the various legal bases for data sharing, may make researchers hesitant to engage in data-sharing agreements in international research collaborations, especially when potentially sensitive data (e.g., health data) is collected [ 21]. We can only stress that prospective collaborators discuss their data sharing requirements early in the research partnership formation. Questions about who will own and control the data and how decisions will be made about potential future secondary data analyses should be included in these discussions. Most institutions will have the required expertise and capacity within their legal team and/or research office to facilitate these discussions and provide templates. Nevertheless, research agreements can take time to develop. It is therefore an important consideration in resource and timeline planning to avoid obstructions in the research process further down the line.

3. Dissemination of the Findings

Our decision to publish separate academic outputs for each of the sites was motivated by the staggered implementation of the different projects and our desire to share our observations in the most expedient manner. In line with this, as noted, where this was institutionally supported or even promoted, we published preprints of our manuscripts and provided open access to the survey tools and the data. Separate publications also allowed each site team to fully explore the nuance and detail captured in their survey results, including the qualitative analysis of free-text responses to provide rich contextualisation to the findings and to enhance the local policy relevance of the outputs.

To maximise our impact with the communities, institutions, and decision-makers that this research serves, Climate Cares and its various partners maintain an active profile on social media with which to disseminate key findings and project milestones such as publications. We also coordinate stakeholder engagement events and participate in scholarly meetings and discussions. Examples of engagement activities are provided in Table 1.

This initial approach-giving site teams precedence in terms of publishing their findings-does not rule out the possibility of a future publication reporting on the survey measures that were directly comparable, and exploring how differences in demographic and sociocultural factors affect the outcome variables. For instance, one research question of interest is whether the association between climate distress and mental health indicators is identical across the different settings. Informal discussions among the teams suggest that this may not be the case, but this requires further analytical validation. Additionally, we are interested in comparing the relative burden of worry about climate change in relation to other everyday worries (such as work, finances, relationships, school), which we anticipate will vary depending on the economic, political, and social context, as well as the experience of direct (physical) climate impacts.

To provide an interim summary and comparison of the key findings, we organised a side event at the 2022 Planetary Health Alliance Meeting, which was attended either in-person or virtually by members of each of the site teams. Copies of the talks and slides are available from the authors upon request, and a video recording of the full session is publicly available ( https://youtu.be/tyW7YiE61uk (accessed on 1 August 2023)). It is outside of the scope of this report to provide an in-depth comparison of the survey results or a quantitative analysis of the between-site differences. However, the high-level observations, summarised in Figure 1, serve to illustrate how our approach allowed us to uncover context-specific patterns within common thematic areas such as climate distress, emotions associated with climate change and the pandemic, and agency or action-taking. While this requires further validation, preliminary qualitative evaluation of the key findings suggests that the experience of climate distress is shaped by sociocultural and temporal variables (i.e., the timing of the survey). In the UK, for instance, while climate "distress" was relatively elevated, it had little effect on participants' day-to-day wellbeing compared to how their thoughts and feelings around the pandemic affected their everyday functioning. In India, young people appeared equally distressed about both issues and rated the effects on their day-to-day functioning as similar too. We hypothesise that this difference in perspective might be linked to the scarcity of physical climate impacts in the UK, and the timing of the survey in the midst of pandemic lockdowns in the UK. The distress scale we used measures general concern around climate change in a rather abstract way and can represent vicarious rather than direct personal experience. The distinction between this kind of abstract "distress" and more severe psychological impacts is supported by the findings from the US survey, where we additionally included an eco-anxiety measure. As in the UK, the overall US sample showed moderate-to-high climate distress, yet few reported symptoms such as rumination or affective disturbances that interfere with normal functioning. However, the US survey allowed us to explore how this might change when people are exposed to physical climate impacts. Young people reporting personal experience of events which they associated with climate change showed elevated scores on almost all outcome measures, including eco-anxiety. In India, both climate change and pandemic distress appeared to interfere with mental health, which may be because the specific sample (youth living in urban slums) may have less access to support systems, increasing the risk for poor outcomes in the context of any kind of public health crisis. We noted that anxiety and mental health concerns were common among Caribbean youth as well, and this was linked to perceptions of (limited) socioeconomic opportunity, a finding that seemed to be unique to that setting. At all sites, we noted differences in the types of emotions young people associated strongly with climate change versus the pandemic. Interestingly, positive emotions such as engagement and interest were common for climate change. While guilt was also noted at several study sites, pre-testing of the survey showed that this was not understood as a climate-related emotion in India. On the basis of our initial observations, further examination of cultural differences in the affective characterisation of climate change impacts seems warranted. Another important theme we explored was how feelings and thoughts around climate change might shape agency (the sense that one can effect change) and action taking (e.g., adopting pro-environmental behaviours). Distress about climate change (in the UK) and even experience of direct climate impacts (in the US) was linked with a greater sense of agency, suggesting that active hope can be maintained alongside, or even because of, engagement with the reality of climate change. UK youth who were more distressed tended to report more pro-environmental behaviours (i.e., increased distress was linked to taking actions that conserve or protect natural resources or avoid GHG emissions). In India, despite perceptions of agency being high, actual engagement in climate action was low. To understand which factors act as facilitators and barriers on youth action-taking, more in-depth qualitative research may be needed.

4. Limitations and Recommendations

4.1. Working through Challenges as a Team

As is the case with any collaboration, but particularly in a decentralised partnership with multiple site teams, a priori and joint decision-making about the assignment of roles and responsibilities is crucial. For those working in a crisis discipline, the inclination to respond expeditiously to perceived research gaps and needs in the communities we serve may cause us to miss some of those pivotal planning steps. We did not always start with an explicit assessment of each site team's goals, available resources, and capacity, which complicated the setting of realistic timelines. With the additional challenge of working on limited budgets, this meant that the Changing Worlds study was at times under-resourced, resulting in delayed deliverables (e.g., academic papers) and evidence implementation. Even when pressed for time, we would advocate for conducting a SWOT (strengths, weaknesses, opportunities, and threats) analysis [ 22] to help prioritise resource-sharing and capacity-building activities across the teams. This does not have to be a formal or time-consuming process, but recording this in some form is advisable as this will promote accountability. We note the importance of considering this as a reciprocal process that recognises the unique skills, knowledge, and resources of each partner, rather than a unidirectional exercise where the lead organisation assumes a position of power and control over resources [ 23].

An additional challenge in international research collaborations involving north-south knowledge-sharing is the significant structural biases in academia which reflect global power relations rooted in colonial legacies. These entrenched patterns affect how we produce and value knowledge, which, when driven by academics in the global North, often fails to fairly recognise the interests of the academics and stakeholders in the global South, thus reinforcing structural inequalities. In the case of the Changing Worlds study, the initial research idea did emerge from UK-based researchers, and we were aware of the potential for actual or perceived inequity when establishing international partnerships. However, there were a number of safeguards to promote just and equitable collaboration. The practices we adopted largely map onto the key domains outlined by Faure et al. [ 23]. Several aspects addressed in previous sections include control over funding and information export, support for capacity building with bidirectional knowledge sharing, and data ownership. Additional factors that support equity include fair attribution of intellectual contributions, as expected under the principles of research integrity. Authorship of resulting manuscripts was never assumed a priori and determined only on the basis of actual contributions to each specific research output. The local teams made decisions on authorship and were prioritised in the author order. In hindsight, there were also domains where improvements could be made. As mentioned, we did not create formal research agreements. Explicit documentation of respective responsibilities can be a critical tool in securing fair processes and outcomes for all involved. Instead of formal arrangements, collaborations were and continue to be based on trust and respect at the interpersonal level, which is also a crucial building block to supportive and effective research partnerships. However, constructive professional relationships between individuals or small teams may still not mitigate the asymmetrical power dynamics that are rooted in institutional distrust (e.g., prejudiced attitudes towards the capacity and skills of organisations in the Global South). To ensure that the mutual commitments and contributions towards the research partnerships were recognised, we featured the collaboration on Climate Cares' social media channels and the institutional website. We also made efforts to disseminate the research findings in joint presentations, most notably as a side event at the Planetary Health Alliance meeting in Boston, 2022. This allowed us to articulate and celebrate each team's achievements, as well as the collaborative successes. The various teams continue to collaborate on an ad hoc basis as opportunities arise and to meet resourcing needs to complete scheduled outputs, while some continuing collaborations have also emerged that are connected to a coherent (albeit not formally articulated) research programme. Establishing more formal agreements may become pertinent if shared competitive funding is obtained to support the next stages of the Changing Worlds research program.

Finally, we acknowledge that there is tension between the goal of delivering culturally appropriate and contextually relevant survey research and the goal, for analytical reasons, of achieving comparability in the quantitative metrics. While we maintained significant overlap between the survey instruments in the Changing Worlds study, there were some additions, omissions, and variations in the measures included by the different site teams. Thus, when interpreting between-site differences on key outcome variables, we must take into account these site-specific methodological variations. It may not always be possible to firmly distinguish between a true effect of sociocultural context and a spurious effect due to differences in survey delivery, which is a limitation that must be acknowledged. Moreover, some of our primary measures, such as the Climate Distress Scale and the Climate Agency Scale, still require further psychometric validation, including cross-cultural testing. The uncertain reliability and validity of these metrics across time and space adds an element of noise and thus warrants caution in interpreting similarities and differences in our findings across the study sites. Some of the newer climate anxiety measures (e.g., the Climate Change Anxiety Scale [ 24] and the Hogg Eco-anxiety Scale [ 25]) have since been used in different countries [ 14, 26, 27, 28, 29, 30, 31]. These measures show promise in terms of capturing and comparing climate change-related anxiety across samples, although further clarification of their psychometric properties is still required [ 32]. Our findings suggest that different scales (e.g., climate distress scale, eco-anxiety scale) capture related but nevertheless distinct experiences, including cognitive, behavioural, physical, and emotional aspects. More work is needed not only to understand how the various metrics relate to each other but, more fundamentally, to clarify the conceptual underpinnings of these constructs [ 33, 34]. Much of the existing conceptual and psychometric validation work remains restricted to developed countries. There is a need for global collaboration among methodological and subject matter experts in order to determine the appropriateness and comparability of existing measures and-possibly-to develop novel measures that can provide adequate and meaningful cross-cultural data on climate-related psychological responses. These endeavours are costly and time-consuming, requiring substantive international funding. Given the urgency and potentially escalating nature of the problem, we need more sustained funding to not simply develop metrics to capture the impacts but also to use those outputs to inform and evaluate (mental health) interventions.

4.2. Lessons Learned

One evident lesson that emerged from each of the study sites was the importance of working with local young people to deliver research outcomes. When the Changing Worlds project originated in 2020, evidence of the psychological impact of climate change had started to emerge only anecdotally. While practitioners and researchers expressed particular concern for the mental health of young people, a strong empirical basis was still lacking. We also noted that despite the growing movement of young climate activists, youth tend to remain excluded from decision-making on climate change and are overlooked as agents of change [ 35]. We strongly believe it is important to recognise that young people are the experts in their lived experience, and that they should-at the very least-be included or consulted in the design stages of research into climate anxiety. We were able to recruit exceptionally motivated, diverse groups of young people to provide input on the survey design and delivery at each site. This step was invaluable in contextualising each instance of the survey and ensuring that locally meaningful, actionable insights can be derived. We also recognise that there are intersecting layers of vulnerability that affect young people in different parts of the world and in different socioeconomic settings. Because of the direct input from young people, we were able to capture not only the extent of climate-related worry and anxiety but also how this was experienced in relation to timely and contextually relevant stressors (e.g., COVID-19, economic recession, political instability) that may have a multiplicative effect on youth wellbeing. In the future, if the project is sustainably resourced, we would also consider creating opportunities to meet and share learnings between the different youth advisory groups to support cross-cultural exchanges and capacity building around the social justice aspects of climate change.

The Changing Worlds studies were designed to address specific research questions around the occurrence of climate-related psychological responses and the relationship with mental health, but also to allow the exploration of emerging patterns of emotions, impacts, and behaviours. Thus, in addition to generating comparative data, the site teams were also able to identify specific local knowledge gaps, research opportunities, and resource requirements. The UK survey, being the first in the series, showed that climate distress was more pronounced than pandemic-related distress, which was remarkable at the height of the pandemic and in a setting where few people had direct experience with climate impacts. Climate change seems to loom large in the minds of young people, even in the face of other global crises. The USA data highlighted how direct experience of climate-related hazards (or the perception thereof) can heighten many aspects of young people's psychological response to climate change. While our study was the largest in the USA to date, the observed behavioural pattern requires further validation in a nationally representative sample in order to gauge the true prevalence of these more intense responses and whether certain climate events are more likely to engender perspective changes among youth. Among Caribbean youth, generalised anxiety levels were fairly high and life satisfaction was rated as moderate. Distress around the pandemic and climate change appeared to contribute to anxiety symptoms. In the context of projected climate impacts in the region, urgent research is needed in order to understand the intersecting vulnerabilities that may result in poor wellbeing outcomes under increased climate-related pressures. In India, the investigations revealed a need for more awareness-raising on climate change and its impacts, as this was notably limited among young people living in slums, especially in places that were not directly affected by climate change. The team's observations also indicated that young people needed more opportunities and platforms from which to take action in order to allow them to tap into their sense of agency to support climate adaptation efforts and to protect their communities. In the Philippines, the study development stage and consultation with youth representatives made it clear that stress and anxiety about the outcome of the 2022 national election could potentially compound anxiety around climate change and worry about their futures. The upcoming survey provides a unique opportunity to generate insights into potentially intersecting sources of mental health and wellbeing impacts among Filipino youth, centred around feelings of grief and injustice which are shared aspects of climate, pandemic, and political stress. Our efforts notwithstanding, much more research is needed in order to understand the nature and scope of the effect of climate change on youth globally, and efforts to amplify the voices of those most vulnerable to climate threat are crucial. Ongoing research should focus on the meaningful and active involvement of young people in order to ensure that the insights we gather are actionable and support positive wellbeing outcomes and involvement in climate action.

4.3. Envisioning a New Path Forward

While this study succeeded in bringing together expertise across regions to deliver novel insights into the ways in which youth are navigating their "changing worlds", this is only a small step towards understanding how youth mental health is affected by climate change and what can or should be undertaken to support resilience among this population. The emerging responsive space exploring climate change and mental health remains siloed, disconnected, and unjust, as health and climate inequities go unaddressed. Recognising this, the Wellcome Trust has recently funded an innovative project that aims to catalyse research and action at this exact intersection ( https://www.connectingclimateminds.org (accessed on 17 July 2023)). Ambitiously scoped, the project will cultivate a more connected, supported, and engaged community of practice on a global scale in order to create a research and action agenda. Young people are one of the identified vulnerable groups and key stakeholders that will be actively engaged in the regional and global dialogues that will set the research agenda. The authors of this paper are all involved in various roles with this important work, which extends and scales up the efforts to create an evidence base that incorporates lived experiences and that truly recognises and responds to community needs. The effective working relationships forged through the "Changing Worlds" study have been a crucial component in progressing the Connecting Climate Minds initiative, highlighting the value of building international collaborative relationships, and they will play an important role in seeing it through to completion.

In addition, the team behind the Changing Worlds study also co-designed a guided journal for young people using participatory design principles. The resulting journal was implemented in a physical journal booklet with daily reflection and writing activities that encourage the diarist to explore their thoughts and feelings around climate change, to identify self-care routines, and to find specific actions they can take. With a dearth of validated interventions for people experiencing climate distress, the UK team conducted a small pilot study to obtain initial feedback from a target population and ascertain the feasibility of larger-scale intervention studies with this journal. A similar pilot study is currently underway in the Caribbean, led by the same team that delivered the Changing Worlds study in this region and supported by the UK team. Additional intervention studies are planned in Australia and the Philippines in 2024.

These examples highlight how understanding and responding to the mental health and wellbeing implications of the climate crisis on global youth is best achieved not just through collaborations between research teams, but with meaningful public engagement. Wherever possible, we should centre lived experience and implement participatory methodologies. Achieving these goals will require substantive resources to be mobilised, including further investment from committed funders who recognise the importance of relationship and trust building as crucial steps in achieving actionable outcomes that truly meet the needs of the communities affected by climate change.

5. Conclusions

The Changing Worlds study aimed to explore psychological responses to climate change, the experience of climate distress, the mental health impacts of climate change, and the perception of agency among youth in parts of the world that have been differentially affected by climate change. The work was sensitive to the premise that different sociocultural norms might affect how concern about climate change is perceived and expressed, and explored the distinct combinations of economic and political pressures that were at play during a global pandemic. This research collaboration between relatively independently functioning site teams struck a balance between producing comparative data and allowing for site-specific amendments that met local needs, interests, and logistical constraints. The products of this research collaboration have highlighted how distress around climate change is common among youth, with impacts on their decision making capacity and mental health, and also how local challenges shape young people's psychological responses to the climate crisis. This paper summarised the teams' experiences and the lessons we learned in the process. We call for the research community to continue engaging in interdisciplinary and international research that also actively involves young people; their voices are critical in producing actionable evidence for incorporating health and wellbeing outcomes as essential components of global, regional, and local climate policies.

Author Contributions

A.V. wrote the first draft of this manuscript and created the graphs and tables; S.K.Y. and M.D. created the data summaries for the India study; S.M., M.H.C. and N.G. created data summaries for the Caribbean study; R.G., J.J.B.A. and C.A.P. created the data summaries for the Philippines study; B.W., A.V. and E.L.L. created the data summaries for the USA study; E.L.L. project managed the Changing World Study. All authors have read and agreed to the published version of the manuscript.

Funding

UK team: The study was supported by the Institute for Global Health Innovation. E.L.L. was supported by the Lenore England Innovation Fund at the Institute of Global Health Innovation. USA team: B.W. was supported by postdoctoral funding from the Stanford Center for Innovation in Global Health and the Stanford Woods Institute for the Environment, Stanford University. Additional project funding was provided by the Billion Minds Institute. Caribbean team: The study was funded by The University of the West Indies Grant Number Campus Research and Publication Fund-CRP.3.MAR21.08. India team: S.K.Y. is supported by the Adolescents' Resilience and Treatment Needs for Mental health in Indian Slums (ARTEMIS) project funded by the UK Research and Innovation/Medical Research Council (UKRI/MRC), Grant no: MR/S023224/1, and M.D. is supported partly under the Systematic Medical Appraisal, Referral, and Treatment for Common Mental Disorders in India-SMART Mental Health project funded by NHMRC (Grant No: APP1143911) and partly by the International Study of Discrimination and Stigma Outcomes (Indigo) funded by MRC, Grant no: MR/R023697/1.

Data Availability Statement

Data from the UK survey are freely available online ( https://osf.io/mgu6x). Survey data from the other study sites may be requested from the authors. At the time of writing no data had been collected for the Philippines study site.

Acknowledgments

We would like to thank the members of the various YPAG's for their invaluable contributions to the survey development. We also acknowledge the skilled contributions of the field staff in India who conducted the interviews. Quinta Seon, who was a Queen Elizabeth Fellow from McGill University at UWI, provided support with data analysis for the Caribbean study.

Conflicts of Interest

The authors have no conflict of interest to declare.

References

1. Hayes, K.; Blashki, G.; Wiseman, J.; Burke, S.; Reifels, L. Climate change and mental health: Risks, impacts and priority actions. Int. J. Ment. Health Syst. 2018, 12, 28. [Google Scholar] [CrossRef] [PubMed] [Green Version]

2. Reser, J.P.; Bradley, G.L.; Ellul, M.C. Public risk perceptions, understandings and responses to climate change. In Applied Studies in Climate Adaptation; Palutikof, J.P., Boulter, S.L., Barnett, J., Rissik, D., Eds.; Wiley: Hoboken, NJ, USA, 2012; pp. 43-50. [Google Scholar]

3. Kuppuswamy, B. Manual of Socioeconomic Status (Urban), 1st ed.; Manasayan: Delhi, India, 1981; pp. 66-72. [Google Scholar]

Figure 1. Summary of key findings from the completed "Changing Worlds" surveys in the UK, India, the Caribbean (Barbados, Guyana, and Trinidad and Tobago), and the USA. Data from the survey in the Philippines are not yet available.

Table 1. Summary of the Changing Worlds study characteristics.

Study dates/status

2020-2021
Complete

2021
Complete

2021-2022
Complete (The survey was rolled out across Guyana, Trinidad and Tobago, and Barbados with IRB approval from the University of the West Indies St. Augustine and Cave Hill, the University of Guyana, and the Pan-American Health Organization (PAHO). PAHO has been spearheading a separate ethical approval process for a separate roll-out of the survey in Jamaica, which is anticipated in the latter part of 2023.)

2023

2021-2022
Complete

Co-creation and stakeholder involvement in study design

Pre-existing adolescent expert advisory group (AEAG) that was part of another research study entitled "Adolescents' Resilience and Treatment Needs for Mental Health in Indian Slums (ARTEMIS)"

Ambassadors were recruited from students at The University of the West Indies Cave Hill Campus (Barbados), St. Augustine Campus (Trinidad and Tobago), and The University of Guyana, or students in the Environmental or Medical Science Programmes at The University of the West Indies and The University of Trinidad and Tobago, or young people involved in climate change NGO's in the Caribbean;
The original survey was piloted with small sample (N = 30) and feedback was used to make changes to/contextualise the survey content.

The young person's advisory group (YPAG) was recruited through nominations and referrals by major youth advocacy networks and organisations, consisting of eight young people representing different advocacy networks (e.g., mental health, climate change, social justice), regions of the country, and specific populations, including Indigenous representation.
The YPAG was consulted on content, wording, translation into the Filipino language, formatting, and dissemination strategy. The YPAG also piloted the survey and gave feedback on length, questions, and factors that could contribute to attrition.

Young person's advisory group (YPAG), which consisted of nine racially/ethnically and geographically diverse young people from across the USA. They were recruited through youth advocacy networks and social media.
The YPAG was consulted on content (e.g., list of emotions), wording, and formatting. The YPAG piloted the survey and gave feedback on length, questions, and factors that could contribute to attrition.

Survey topics

Climate change;
COVID-19.

Climate change;
COVID-19.

Climate change;
COVID-19.

Climate change;
COVID-19;
Politics and election stress.

Primary focus on climate change; COVID-19.

Survey content and local variations

▪

Added several emotions to the emotion rating question based on input from the YPAG, including "cynical", "numb", "manipulated", "hate", and "exhausted", as this reflected their individual experience in the USA context, e.g., hate was felt towards climate deniers, cynicism was felt in relation to system change inertia;

▪

Questions about participating in activism made no specific reference to any changes since the pandemic because the USA survey did not undertake a period of extensive lock-down or COVID-restrictions;

▪

The agency question "I believe climate change is inevitable no matter what we try to do to stop it" was rephrased as "I feel the threat of climate change cannot be reduced, no matter what actions are taken now" based on YPAG feedback. The question was interpreted in different ways, i.e., as either referring to beliefs about climate change being a hoax, or that the influence of fossil fuel companies is so powerful that "we" (as activists) cannot make change. This interpretation seemed unique to the USA context where the fossil fuel lobby and denialism have historically been and continue to be powerful forces in the debate on climate change and climate action.

▪

Addition of several scales and questions:

-

Perception of having already being directly impacted by climate change (yes/no);

-

Experience with specific extreme weather events/climate-linked events;

-

-

Psychological Adaptation Scale;

-

Meaning-focused Coping Scale;

-

Effect of climate change on future plans, including family planning, financial decisions, where to live and travel;

-

Trust in the political system.

Survey tool

Available on OSF: https://osf.io/9ewtn (accessed on 1 August 2023)

Available upon request

Available upon request

Available upon request

Available on OSF: https://osf.io/vr9xy (accessed on 3 July 2023)

Recruitment and sampling strategy

Participants were recontacted from a pre-existing census project database [ 19]

Paid research panel service (Qualtrics) with sampling to mirror the ethnicity breakdown and gender parity according to the most recent census, as well as targeted oversampling from geographic regions subject to (recent) extreme weather events and air pollution.

Sample size and characteristics

Manuscript DOIs

https://doi.org/10.1016/s2542-5196(22)00172-3
https://doi.org/10.31219/osf.io/e3tpu (accessed on 1 August 2023)

https://doi.org/10.1016/j.lansea.2023.100191 (accessed on 1 August 2023)

-

-

https://doi.org/10.21203/rs.3.rs-2698675/v1 (accessed on 1 August 2023)

Data availability

https://osf.io/mgu6x (accessed on 3 July 2023)

Contact authors

Contact authors

Contact authors

Contact authors

Other dissemination channels

The study findings were shared during a symposium held at the 9th World Congress of Asian Psychiatry (WCAP 2022) from 16-18 September 2022.

The National Health Research Conference of Trinidad and Tobago 2022.

-

Joint dissemination of findings

Network of Environmental Social Scientists seminar November 2022- https://www.nessaustralia.org/coping-with-eco-anxiety-in-a-pandemic/ (accessed on 1 August 2023)
PHA 2022 Side Event- https://youtu.be/tyW7YiE61uk (accessed on 1 August 2023)

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# data[].attributes.attachment_link.title
Investigating the Mental Health Impacts of Climate Change in Youth: Design and Implementation of the International Changing Worlds Study

# data[].attributes.attachment_link.description
As climate change continues unabated, research is increasingly focused on capturing and quantifying the lesser-known psychological responses and mental health implications of this humanitarian and environmental crisis. There has been a particular interest in the experiences of young people, who are more vulnerable for a range of reasons, including their developmental stage, the high rates of mental health conditions among this population, and their relative lack of agency to address climate threats.

# data[].attributes.headline
Planetary Health and Mental Health Nexus (Kumar et al., 2023) 

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Planetary Health and Mental Health Nexus (Kumar et al., 2023) 

# data[].attributes.body
The ways in which mental health may be affected by climate change via four distinct pathways: 1. discrete events like natural disasters 2. gradual changes, such as rising sea levels and higher temperature, 3. existing physical and social systems, e.g., economic and migration changes, 4. perception of climate change aka eco-anxiety.

State of knowledge on planetary crisis and mental health

# data[].attributes.headline
The climate change lessons teachers are missing (Kamenetz, 2024)

# data[].attributes.subject
The climate change lessons teachers are missing (Kamenetz, 2024)

# data[].attributes.body
-"Have compassion for that and get curious about really trying to understand the granularity of what that climate anxiety feels like—how it can make a young person feel futureless and abandoned by older generations, which is profound psychological distress that can tear away at the social underpinnings of wellbeing," Wray said"

# data[].attributes.attachment_link.title
The climate change lessons teachers are missing

# data[].attributes.attachment_link.description
What teachers need most are clear strategies that allow them to plug climate change lessons into existing curricula

# data[].attributes.headline
Supporting young people with climate anxiety: mitigation, adaptation, and resilience (Hurley, 2022)

# data[].attributes.subject
Supporting young people with climate anxiety: mitigation, adaptation, and resilience (Hurley, 2022)

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"It is completely unfair to ask a generation of young people to

develop enhanced psychological stamina to face climate change. But because of decades of inaction on the

part of previous generations, they are being asked to do so. We owe it to children and young people to

prioritise mitigation of climate change at its source, while at the same time investing in evidence-based tools to support their mental wellbeing in the face of this ongoing crisis."

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Mental Health and Our Changing Climate: Impacts, Implications, and Guidance (Clayton et al., 2017) 

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Mental Health and Our Changing Climate: Impacts, Implications, and Guidance (Clayton et al., 2017) 

# data[].attributes.headline
Understanding the mental health consequences of chronic climate change. Interview with Christy Denckla, assistant professor of social and behavioral sciences at Harvard T.H. Chan School of Public Health, 2024

# data[].attributes.subject
Understanding the mental health consequences of chronic climate change. Interview with Christy Denckla, assistant professor of social and behavioral sciences at Harvard T.H. Chan School of Public Health, 2024

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Gaps in research knowledge: "Only a fraction of the research around climate change and mental health is being conducted in the very settings that are absorbing a disproportionate burden of the adverse effects. We urgently need to document the effects of climate change on these populations, including adolescents and children, indigenous communities, displaced migrants, economically marginalized groups, and nations and regions on the frontline of the climate crisis, such as Africa and countries most vulnerable to climate extremes."

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January 18, 2024 - Christy Denckla, assistant professor of social and behavioral sciences at Harvard T.H. Chan School of Public Health, studies how adversity affects people's mental health and well-being throughout their lives. In a paper recently published in Nature Mental Health, she reviewed the body of evidence around the mental health consequences of chronic, slow-onset climate change.
Q: You identified some significant gaps in what we know about how climate change affects mental health. What do you see as the most urgent research priorities?
A: We already know a lot about the mental health effects of climate-related disasters like hurricanes and wildfires. Now, the most urgent research priority is to understand the mechanisms through which slower-moving aspects of climate change such as temperature variability, ecosystem shifts, and changes in precipitation affect mental health. This is the first step toward understanding when and where we need to intervene with prevention, health care, and policy responses.

Only a fraction of the research around climate change and mental health is being conducted in the very settings that are absorbing a disproportionate burden of the adverse effects. We urgently need to document the effects of climate change on these populations, including adolescents and children, indigenous communities, displaced migrants, economically marginalized groups, and nations and regions on the frontline of the climate crisis, such as Africa and countries most vulnerable to climate extremes.
Q: You suggest that future studies in this area should move beyond a trauma-based understanding of how climate change affects mental health. Can you explain?
A: Chronic, slower-onset stressors tend not to be immediately life-threatening and, therefore, have different effects on mental health relative to acute events. The effects of chronic stressors accumulate over time.

With regards to climate change, we need to reframe its adverse impacts as resulting not just from a singular traumatic event but from compounded stressors that affect individuals, families, communities, and societies. This is a relatively recent challenge and an area that is still developing. An example is understanding the causal influence of ecosystem changes on mental health, including melting sea ice or more frequent and prolonged droughts that unfold over years or decades. These changes unfold across connected systems, including changes to cultural practices (for example, local resource harvesting), communities' sense of self and place, food security, or access to health care.

To help us gain insight into the many intersecting ways that chronic climate change may affect people's mental health, we can design studies that use interview or narrative data to capture lived experiences. Also promising are studies that model complex and large datasets integrating mental health, geography, and features of the natural environment such as ambient air temperature.
Q: Are you planning any such studies?
A: We are planning a study that employs smartphone-based data collection to measure how people's moods and wellbeing are affected by local environmental conditions including urban heat islands, access to green space, or population density. We want to look at the complex links between environmental exposures and individual experiences, and to ultimately help find population-level solutions to mitigate the adverse effects of climate change on mental health.
Photos: Woman with water: iStock / Cheryl Ramalho; Denckla: Harvard Chan School

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Understanding the mental health consequences of chronic climate change

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Research is needed to understand the mechanisms through which slower-moving aspects of climate change such as temperature variability, ecosystem shifts, and changes in precipitation affect mental h...

# data[].attributes.headline
Roadblocks to quality education in a time of climate change (Kwauk, 2020)

# data[].attributes.subject
Roadblocks to quality education in a time of climate change (Kwauk, 2020)

# data[].attributes.body
"Studies show that effective climate change education exposes youth both to climate science (e.g., factual, declarative knowledge about climate and environmental science) and to ethical, political, affective, and participatory discussions about local barriers to effective sustainable practices or human and non-human system interactions, for example. Effective climate change education also entails constructivist, action-oriented, transdisciplinary, and engaging pedagogies that include critical reflection about local climate change impact, opportunities to apply learning through project-based problem- and solution-identification."

# data[].attributes.headline
Mental health and the global climate crisis (Corvalan et al., 2022)

# data[].attributes.subject
Mental health and the global climate crisis (Corvalan et al., 2022)

# data[].attributes.headline
Using Case Based Teaching of Climate Change Socio Environmental Mental Health (Haase, 2022)

# data[].attributes.subject
Using Case Based Teaching of Climate Change Socio Environmental Mental Health (Haase, 2022)

# data[].attributes.headline
Climate change and mental health: risks, impacts and priority actions (Hayes et al., 2018)

# data[].attributes.subject
Climate change and mental health: risks, impacts and priority actions (Hayes et al., 2018)

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doi: 10.1186/s13033-018-0210-6.

Affiliations

¹ 1Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada.

² 2Nossal Institute for Global Health, University of Melbourne, Carlton, VIC Australia.

³ 3Melbourne Sustainable Society Institute, University of Melbourne, Carlton, VIC Australia.

⁴ 4Australian Psychological Society, Level 11, 257 Collins St, Melbourne, VIC Australia.

⁵ 5Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC Australia.

Free PMC article

Free PMC article

doi: 10.1186/s13033-018-0210-6.

Affiliations

¹ 1Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada.

² 2Nossal Institute for Global Health, University of Melbourne, Carlton, VIC Australia.

³ 3Melbourne Sustainable Society Institute, University of Melbourne, Carlton, VIC Australia.

⁴ 4Australian Psychological Society, Level 11, 257 Collins St, Melbourne, VIC Australia.

⁵ 5Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC Australia.

Abstract

Background: This article provides an overview of the current and projected climate change risks and impacts to mental health and provides recommendations for priority actions to address the mental health consequences of climate change.

Discussion and conclusion: The authors argue the following three points: firstly, while attribution of mental health outcomes to specific climate change risks remains challenging, there are a number of opportunities available to advance the field of mental health and climate change with more empirical research in this domain; secondly, the risks and impacts of climate change on mental health are already rapidly accelerating, resulting in a number of direct, indirect, and overarching effects that disproportionally affect those who are most marginalized; and, thirdly, interventions to address climate change and mental health need to be coordinated and rooted in active hope in order to tackle the problem in a holistic manner. This discussion paper concludes with recommendations for priority actions to address the mental health consequences of climate change.

Keywords: Adaptation; Attribution; Climate change; Mental health; Mitigation.

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national center for biotechnology information

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Climate change and mental health: risks, impacts and priority actions - PubMed

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The authors argue the following three points: firstly, while attribution of mental health outcomes to specific climate change risks remains challenging, there are a number of opportunities available to advance the field of mental health and climate change with more empirical research in this domain; ...

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Climate change and mental health: risks, impacts and priority actions (2018)

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Climate change and mental health: risks, impacts and priority actions (2018)

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A Teachers’ Guide for Managing Climate Anxiety in the Classroom (2024)

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A Teachers’ Guide for Managing Climate Anxiety in the Classroom (2024)

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Signs of a changing climate, such as record-breaking heat and more severe weather, have become difficult to ignore-and they're causing many students to feel anxious, afraid, and a range of other negative emotions.

Yet teachers get little support on how to help students process these complicated feelings about climate change. Often, they barely have had professional development on how to teach about climate change in general, which research shows can make them reluctant to broach the subject.

Experts say climate change should be taught in an age-appropriate way at all grade levels and in all subjects, and that teachers must create space for students' feelings about the issue, too. To help, a team of teachers, researchers, and mental health clinicians who are part of the Climate Psychology Alliance of North America wrote the " Educators' Guide to Climate Emotions," released Thursday.

The guide includes teaching resources and shares tips for how teachers can recognize and respond to common climate emotions, including anger, frustration, guilt, and powerlessness. Teachers, the guide says, should teach how humans are already responding to climate change, and what students can do themselves, to instill a sense of possibility-and they should bring in other members of the school community for support during these tough conversations.

The co-authors of the guide-Carolyn McGrath, a visual arts teacher at Hopewell Valley Central High School in Pennington, N.J., and Kate Schapira, a senior lecturer in nonfiction writing at Brown University-spoke with Education Week about how teachers can tackle climate emotions in the classroom. The interview has been edited for length and clarity.

How are climate emotions dealt with in schools today?

McGrath: It feels like we're in the early stages of climate education rolling out in multiple states nationwide, in a way that's different than it's happened in the past. I think the seriousness of the issue and the urgency is much more omnipresent.

We all agreed in our group that as climate education was being embraced more widely, it was really important that the emotional and psychological components did not get lost. It's not just teaching, A+B = C; we're teaching about existential issues, and you can't separate that from the emotional impact.

What climate anxiety or other climate emotions means is going to vary really widely depending on who it is that's having them-not just how old is that person, or how marginalized is that person, but also, what has happened in that person's life? This could be a situation where a science teacher is teaching climate science, and a kid has, for the first time, a recognition that the world is changing in this very dramatic and, to some extent, unprecedented way.

It could also be a situation where a classroom holds students who had to leave their home because of a wildfire or a drought or a flood. One of the things that we wanted the guide to do was to offer teachers some tools and some illumination of those conditions.

The guide talks about how teachers have to walk the line between not dismissing students' concerns while also maintaining a sense of optimism. What does that balance look like?

McGrath: Climate optimism and doom-ism ... are positioned as dualities, as opposites. Some of what we're trying to do is encourage a holding of both-that things are bad, things are getting worse in some ways, and we have the potential to make difference.

[For] teenagers, it's all or nothing-either everything's going to be fine, or everything is terrible. I think teachers can really model for students how to hold that duality at the same time. It's very difficult. You don't want to overwhelm students with too much ... because then they can shut down. And if you're Pollyannaish, they can call you out and know that you're not being truthful because they're experiencing it, and they can see it with their own eyes what's happening. It's a real balancing act.

Schapira: One of the people who advised us on the guide, Britt Wray, wrote a book called Generation Dread. In the chapter on parenting, one of the things she says is that kids want to hear from the grownups in their lives that this is going to be hard, and we'll get through it together.

And while that's not the exact message that's appropriate for a classroom, ... it is something that I think a teacher can truthfully say about people, about a community that they're a part of, about being a member of various human communities. You don't want to write checks you can't deliver; you don't want to make promises that you can't keep. But there are truthful things that you can say to students about what's going on and how they can be part of engaging with [climate action in ways] that are age-appropriate.

Offer them a reminder of their own agency. Especially as they grow, small kids don't have very much agency. But you can build that sense through things that you do in the classroom. [Remind them]: "You are a person who can handle things. You are a person who can compromise with other people. You are a person who can make decisions. And you are a person who can still find enjoyment and excitement in learning about the world."

What is your advice to teachers who want to tackle climate change but are nervous to dive in?

Schapira: We have so many resources on this guide about exactly that. [The National Oceanic and Atmospheric Administration] has amazing resources. NASA has amazing resources for different aspects of the topic-very clear, made for educational purposes. Because they're made for teachers to use with students, including younger students, they're also at a very absorbable and legible level for teachers. You don't have to be a climate scientist at all to understand this stuff.

I think exploring those materials, with the intention of using them in your own classroom will also give you an introduction to those topics, even if you didn't feel comfortable with them to begin with.

McGrath: I'm an art teacher. I think the science aspect of climate change is a hurdle for a lot of non-science teachers, and for some science teachers, too. It's like, is that too complicated for me to teach? Do I need to know a lot before I can work with the students? And that's not the case.

We started out the guide saying, every teacher really should have some very basic understanding of climate science. It doesn't need to be intimidating. There are so many endpoints, and there's so many resources. SubjectToClimate, [a nonprofit that provides free teaching materials on climate change], is incredible. They have resources for different subject areas, different disciplines, different age levels.

It is unfortunate that climate education is ahead of where teachers are. Teachers have not been given the skills yet. So what I'm seeing on the ground is a lot of teachers diving in on their own or seeking out professional development opportunities.

I imagine that talking about climate emotions with students can stir up some hard feelings among teachers. How can teachers take care of themselves?

Schapira: Talk to a [mental health] professional if you are able to, talk to the people who love you and support you. If you are not able to talk to a professional or even if you are, be open and real with people about how this is affecting you. Consider contemplative practices or creative practices that can help people process emotion. And see if there's room in your life for a little advocacy and action.

Many teachers don't [have the capacity for climate action]-many teachers are so unbelievably overclocked and overworked that this just doesn't feel like a possibility for them. And we do understand that, but there is a fair amount of research out there that says that if you engage in positive climate action with other people in your community, you feel less bad. It feels less heavy, it feels less intolerable. You know that you're pushing on it in some direction, so you feel less helpless. And you're doing that with other people, so you feel more connected.

McGrath: I think that it is asking a lot of teachers to [be] a wellness teacher now, to teach your students about how climate change is impacting human health and mental well-being. Teachers are asked to do so many different things.

A real concern for us with the guide was that not only is climate change education a lot for non-science teachers, incorporating these social-emotional elements is, also. We're not expecting teachers to be therapists. It's not group therapy. It's an extension of the kind of social-emotional learning that teachers are already incorporating, and have for years incorporated into their classes. It's just a different way of looking at it.

Carolyn, can you share an example of addressing and supporting students' climate emotions from your own classroom?

McGrath: [High school] students are not very forthcoming with any type of emotion. We talked about this in the guide-there are so many reasons why a student is not going to raise their hand and say, "The sky is orange," like it was last June [because of wildfires], "and it's freaking me out."

I think it's important that we integrate ways that students can express how they're feeling without necessarily making them feel more vulnerable than they're comfortable with, and ideally, getting to a point of conversation. Starting steps are always things like, can you put it into art? Can you write about it? Is it something that you could talk [about] one on one ... as opposed to broadcasting to the whole class?

When the skies were quite dark and orange, last June, I asked students, "How do you feel about this?" A few students were able to talk about it, but then I passed out little slips of paper, and I said, "[Write in] just a few words what's going on for you. Outdoor activities were canceled-I've never seen anything like this in my lifetime. I assume you've never experienced this before."

It wasn't part of our lesson. We didn't spend the whole day talking about it. But I felt that it was important to acknowledge that it was scary and different and strange. A teacher can model that ... it's totally normal that when things are this abnormal to have strong feelings. I still have [students' responses] in my desk, and it was a full range-from "I don't care" or "I'm angry because I want to be doing my sport" to "I'm very terrified and don't know what's going on."

Because of the way the climate is changing, teachers are being asked to expand the way that they care for young people even more. We recognize that that's a challenge, and we hope that the guide can act as a bolster of support to teachers-because whether you actively engage in this work or whether you don't, it's still happening. And it's still impacting your students. Whether you want to or not, it's impacting everybody's teaching.

# data[].attributes.attachment_link.title
A Teachers' Guide for Managing Climate Anxiety in the Classroom

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Experts share research-backed tips for teachers on how to respond to students' complicated feelings about climate change.

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Climate change, mental health services, a better education system: what marginalised young people told us needs to be fixed (Kelly, Goring & Brown, 2022)

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Climate change, mental health services, a better education system: what marginalised young people told us needs to be fixed (Kelly, Goring & Brown, 2022)

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"My biggest hope is that they figure out how to deal with climate change. Oh, no, I take that back. They know how to deal with climate change. I hope that they do it."

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In youth policy and service delivery the idea of youth voice and participation is an uncontested "good thing". But which youth voices? Who is heard and who is left out?

Our recent research in Melbourne's inner northern suburbs and in the Geelong region has grappled with this question.

We have interviewed more than 80 young people since the start of the pandemic, in an effort to better understand the concerns of many disengaged, marginalised and disadvantaged young people in these areas.

We wanted to find out:

what challenges have they faced?

why do some young people seem to be able to get a say, while others don't?

how can these young people become active stakeholders in their own futures?

what might change these dynamics?

Crucially, we asked young people to share their views in a format they felt comfortable with - by speaking directly to their webcams or phone cameras. Common themes that emerged included:

the need for secure work now and in the future

the need for better mental health services

a sense of pressure around school

a sense of not being heard

concern about climate change and the future of the planet.

Read more: Uncapping of university places has not failed disadvantaged students

What we did

Many of the young people we heard from live with health and well-being challenges, neuro-diversity, and disengagement from traditional education, training and employment pathways. Financial struggles were common.

We asked young people to speak directly to their communities, and to a wider audience by filming their contribution on their camera phone or on a webcam. This allowed for a more natural flow of ideas from our interviewees. We published many of the videos on YouTube and Instagram.

Our generous interviewees spoke openly about the connections between their health and well-being, and the hopes, aspirations and anxieties they feel about the future - around education, work, relationships, and the planet.

What young people told us

Take, for example, Ruby, aged 16. She lives with her family in Geelong, is looking for work, and studies Victorian Certificate of Applied Learning (an alternative to Year 11 and 12 at school) at her local TAFE. She told us:

[...] they kind of like just say, to people that have anxiety or depression, to like, 'just breathe'. And I think for a lot of us that just doesn't work. I think we just need some better listeners and I think we need some people who genuinely care.

Emilie, aged 24, lives in a sharehouse in Geelong. She studies social work and is uncertain about the future.

I want to be hopeful for the future, but honestly, I don't know if I exactly am. In some ways, I feel that the government focuses on what the voters are gonna want to get them in for the next election.

Ruth, who was in Year 12 and living in the inner Melbourne suburb of Fitzroy, spoke about her life and her hopes for the future:

Dickheads in politics - less of them please.

I'd like to be in a relationship with someone who makes me really happy. Who treats me in a really genuinely wonderful way. And who brings me joy. And maybe cake as well.

During 2020, Astrid, now 20 years old, was living in social housing in Fitzroy with her mum and her kitten. She faces a number of challenges due to her dyslexia. She told us:

I hope, my biggest hope is that they figure out how to deal with climate change. Oh, no, I take that back. They know how to deal with climate change. I hope that they do it.

I also hope that the people who are running the community make note of the fact that young people want more involvement in it. And a place where they feel that they can be themselves.

Why do some young people seem to be on the margins?

Too often, the youth voices highlighted in public discourse and media narratives are the well-heeled, often privately educated beneficiaries of a system that serves wealthy people well while excluding those living with poverty or disability.

In an essay titled Can the Subaltern Speak? Indian scholar Gayatri Chakravorty Spivak explores the legacies of colonialism in "postcolonial" states (such as India) and "settler colonies" (such as Australia), as well as the forms of disadvantage experienced by indigeneous peoples in these contexts.

The "subaltern" groups are those people facing often multiple forms of disadvantage, who are denied access to processes that shape their oppression. They have no voice.

Our discussion with these young, marginalised people harks back to these ideas, and calls for close consideration of what young people from the margins demand: "better listeners" among the adults who shape their lives, and a reason to hope for the future.

As young Swedish climate activist Greta Thunberg put it:

We can no longer let the people in power decide what hope is. Hope is not blah, blah, blah. Hope is telling the truth. Hope is taking action. And hope always comes from the people.

# data[].attributes.attachment_link.title
Climate change, mental health services, a better education system: what marginalised young people told us needs to be fixed

# data[].attributes.attachment_link.description
We have interviewed more than 80 young people since the start of the pandemic, in an effort to better understand the concerns of many disengaged, marginalised and disadvantaged young people.

# data[].attributes.headline
Disempowering emotions: The role of educational experiences in social responses to climate change (Jones & Davidson, 2021)

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Disempowering emotions: The role of educational experiences in social responses to climate change (Jones & Davidson, 2021)

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responses to climate change

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Facing Anxiety in Climate Change Education: From Therapeutic Practice to Hopeful Transgressive Learning (Ojala, 2017)

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Facing Anxiety in Climate Change Education: From Therapeutic Practice to Hopeful Transgressive Learning (Ojala, 2017)

# data[].attributes.headline
The art of medicine: Will global health survive its decolonisation? (Abimbola & Madhukar, 2020)

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The art of medicine: Will global health survive its decolonisation? (Abimbola & Madhukar, 2020)

# data[].attributes.body
"The supremacy that manifests in global health is not
peculiar to global health. Entrenched in the fibre of past
and present social and political systems, supremacy re-
creates the inequities that global health seeks to undo."

"The imaginative leap that allows a global health practitioner to consider their position or an issue from varying viewpoints requires respect and humility. Empathy is not enough. The desire to make the world a better place, however genuine and heartfelt, is not enough. Respect and humility are vaccines against supremacy."

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Health in the framework of sustainable development (SDSN, 2014)

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Health in the framework of sustainable development (SDSN, 2014)

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why health is central to SD

"Action on Determinants Through Multisectoral Initiatives: The TG recognizes that the agenda for the unfinished burden of disease and emerging health conditions cannot be addressed without the concerted engagement of a diversity of stakeholders, including government, civil society, academia, the media, and private industry. Further, health needs to become a priority for actors outside the health sector, and sectors must work together to accomplish health objectives." (p. 9, 14)

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Unintended Consequences: Unknowable and Unavoidable, or Knowable and Unforgivable? (Suckling et al., 2021)

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Unintended Consequences: Unknowable and Unavoidable, or Knowable and Unforgivable? (Suckling et al., 2021)

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"How can we minimize unintended consequences?"