İklim Değişikliği Hindistan'da Ruh Sağlığı Sorunlarını Artırıyor

Özet (abstract)

Climate change has emerged as a key factor influencing mental health. Intergovernmental Panel on Climate Change, a United Nations body dedicated to studying various aspects of climate change, in its Sixth Assessment Report, reckoned with a very high level of confidence that climate change would increase mental health challenges, including anxiety and stress. Furthermore, it concluded that climate change risks would manifest in an expedited manner than previously expected. The World Health Organization also recognized this challenge and, in 2022, released a policy brief highlighting the links between climate change and mental health and provided recommendations on strategies to mitigate the mental health impacts of the climate crisis.[1] The idea of climate has evolved from being a static spatial concept to a dynamic global one, with the focus shifting from how climate affects humans to how human activities affect the climate. Climate change refers to persistent alteration in weather parameters, particularly temperature and precipitation, over large areas and long periods. It is widely regarded as a major global issue, primarily attributed to anthropogenic influences on climate systems of the Earth.[2] Empirical observations over the past few decades indicate a rise of approximately 0.5°C in the mean global temperature, largely driven by human-induced greenhouse gas emissions. Projections for the year 2100 suggest a further increase ranging between 2.4°C and 5.8°C.[3,4] Such ongoing warming is expected to lead to severe environmental consequences, including accelerated polar ice melt, coastal inundation, irregular precipitation, and more frequent floods and droughts. These adverse climate events are likely to have major social, economic, and environmental impacts worldwide, with developing countries and vulnerable population groups expected to suffer disproportionately. Climate change is often regarded as a “threat multiplier,” as it intensifies existing challenges, such as mass displacement, poverty, and resource scarcity, while also creating new global risks for people and ecosystems. India is highly susceptible to climate-induced disasters. It ranked sixth among countries most affected by climate change and natural disasters between 1993 and 2022.[5] In recent decades, the frequency of extreme weather events across the Indian subcontinent has shown a noticeable upward trend, resulting in substantial morbidity and mortality. Between 1970 and 2025, India experienced a total of 642 disasters, out of which 600 events resulted in at least one recorded fatality.[6] These events collectively led to 1.94 lakh deaths, averaging approximately 20 fatalities per event. Floods were responsible for the highest mortality share (35.7%), followed by storms (27.1%). Heat waves and cold waves contributed 6.2% and 2.5%, respectively.[6] In the past three decades, India has recorded over 400 extreme weather events, resulting in about 80,000 deaths and economic losses exceeding USD 180 billion.[5] The internal displacements caused by natural disasters in 2024 alone were 5.4 million.[7] In 2025, India experienced a sharp increase in extreme weather events, indicating an escalation of climate instability. Continuous heavy rains, floods, and landslides in the first 8 months caused nearly 1000 deaths.[8] The Southwest Monsoon brought 108% of the usual rainfall, resulting in excess but uneven precipitation, flash floods, and prolonged inundation. In addition, Cyclone Montha in October and early cold waves in November further highlighted the irregularities in the weather. A growing body of research in recent years has explored how climate change influences public health; however, its effects on mental health are yet to be adequately understood.[9-11] Climate change influences mental health in multiple ways. Extreme weather events can directly cause stress, trauma, grief, and loss. A recent systematic review found that survivors often experience disorders like posttraumatic stress disorder, anxiety, depression, and adjustment disorders. Also reported were the presence of fear, sleep impairment, and cognitive impairment.[12] Loss of livelihood, displacement, and disruption of social and community networks may lead to economic insecurity, loss of family and community support systems, reduced resilience, and increased vulnerability to mental illness. Gradual climatic changes, such as rising temperatures, water scarcity, and crop failure, may create ongoing uncertainty and worry about survival, contributing to chronic stress, hopelessness, and despair. Besides, people with preexisting psychiatric disorders may experience relapses or worsening symptoms due to disrupted healthcare, displacement, or environmental stress. Vulnerable populations, including women, children, the elderly, people with disabilities, indigenous groups, less educated and low-income families, may be particularly vulnerable, as it amplifies existing geographical, economic, and gender-based inequalities, thus creating a cycle of vulnerability. To address the challenges posed by climate change events and disasters, the Disaster Management Act, 2005 (DMA, 2005) provides a comprehensive institutional framework for the effective management of disaster situations. It led to the creation of disaster management authorities at various levels of the government, including the central, state, and district levels. Subsequently, the National Policy on Disaster Management (NPDM, 2009) was adopted to guide decisions and actions aimed at meeting the objectives. The National Disaster Management Plan 2019 outlines the framework and strategic direction for government agencies to manage disasters across all phases of the disaster management cycle, in alignment with the DMA, 2005, and the NPDM, 2009. It aims to implement the disaster management plan in a flexible and scalable manner, while also clarifying the responsibilities of stakeholders involved. The National Guidelines on “Psychosocial Support and Mental Health Services in Disasters” (PSSMHS, 2009) emphasized rebuilding the lives of communities affected by disasters through coordinated efforts in response, relief, and rehabilitation. The delivery of PSSMHS is aligned with broader healthcare efforts, including the general health programmes, the National Mental Health Programme, the District Mental Health Programme, and district health plans. The guidelines further highlight the importance of capacity building, training, strengthening service delivery, promoting research and documentation, and ensuring ongoing monitoring and evaluation at different levels of governance for effective implementation of PSSMHS initiatives. In order to specifically address the issue of climate change and health, the Ministry of Health and Family Welfare launched the National Program for Climate Change and Human Health (NPCCHH) in 2019. The NPCCHH’s “Health Action Plan for Climate Change and Mental Health” outlines strategies to address mental health challenges arising from climate-related stressors and disasters. It establishes the institutional framework for developing and implementing national response mechanisms and emphasizes collaboration between sectors such as health, environment, disaster management, and social services. The plan serves as a guiding framework for States and Union Territories to design their own mental health action plans to mitigate the effects of climate change on mental well-being. In addition, the National Disaster Management Authority (NDMA), the apex body responsible for formulating national policies, plans, and guidelines for effective disaster management in India, has, in collaboration with various national institutes and agencies, developed a series of training modules focused on psychosocial support and mental healthcare services.[13] These modules aim to equip primary healthcare physicians and other service providers with the skills to provide psychological first aid, recognize and manage mental health issues, and provide psychosocial support and care to disaster-affected individuals, including the vulnerable groups. In addition, NDMA coordinates efforts across ministries and states, oversees implementation, and ensures preparedness through capacity-building initiatives. It also supervises the National Institute of Disaster Management (NIDM), which serves as the country’s premier institute for developing human resources, capacity building of government and partner organizations, training, and policy advocacy to enhance disaster resilience across the country. NIDM, through the Child-Centered Disaster Risk Reduction approach, focuses on identifying, assessing, and reducing the impacts of disasters on children’s lives, well-being, livelihoods, and access to essential services.[14] Although India has robust policies and programs to address health challenges, the implementation of mental health measures during disasters continues to remain below the mark. Challenges remain most notably in the domains of preparedness, follow-up care, and long-term mental health support. Despite all the emphasis put on coordination in different sectors, departments, and levels of governance in the government policies, it is found to be lacking on the ground, resulting in a lack of availability and accessibility of services to the person with mental health issues. This also happens because survivors face multiple issues simultaneously in climatic disaster situations, and often other issues, such as physical injuries and the availability of food and shelter, take priority due to a lack of integrated services. Many regions in India are particularly vulnerable to extreme climate events, yet advance preparation for managing mental health crises in these areas is still inadequate. It also happens that in the immediate aftermath of a crisis, there is often a surge of assistance from the government and non-governmental organizations (NGOs); however, the absence of long-term rehabilitation planning and poor coordination of these efforts hampers them. As a result, the survivors are frequently left without sustained support just weeks or months after the disaster. Many survivors do not seek ongoing treatment, leading to relapses and increased morbidity. Structural issues, including a shortage of professionals with disaster-specific training and limited community awareness, further hinder recovery. Mental health is an integral part of the climate change discourse, particularly in a country like India, where the stakes are high. As we face a challenge as huge as climate change, it is crucial to prioritize mental well-being alongside environmental action. India’s postdisaster mental health strategy needs to transition from clinic-based care to a community-oriented psychosocial support model. Expanding the use of digital platforms such as the National Tele-Mental Health Programme (Tele-MANAS) can significantly enhance accessibility. Effective collaboration among government agencies, NGOs, and international organizations is essential to extend mental health services to vulnerable regions. Moreover, focusing on community resilience, mental health literacy, and strengthening immediate and long-term disaster response can empower populations to better adapt to the psychological impacts of climate-related and disaster-induced stressors.

Yazarların özeti; kaynağından alınmıştır. Indian Journal of Social Psychiatry, 2025 · DOI ↗