“Mental Health & Climate Change” is a monthly column by Elizabeth Bechard, Moms Clean Air Force Senior Policy Analyst, in which she explores how families are coping with our warming world.
Three years ago, about a week after completing the manuscript for my book on parenting and climate change, my life as a parent imploded.
Virtually overnight, one of my children developed severe psychiatric symptoms that were eventually diagnosed as pediatric acute-onset neuropsychiatric syndrome, also known as PANS. PANS is thought to be caused by a misdirected immune response that attacks the brain, initiated by an environmental or infectious trigger. Its sister illness, PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections), is triggered by the bacteria that cause strep throat.
For us, on top of the trauma of watching our child suddenly unravel in harrowing and unthinkable ways, PANS meant a deep dive into how the mental health care system in America works for families in crisis—or rather, doesn’t. It meant weeks of frustratingly futile trips to the pediatrician, desperate emails to therapists, panicked calls to a local mobile crisis line, and several trips to the emergency room.
Our pediatrician suggested we find a therapist, but no therapists would take us. Some told us their practices were full; others had monthslong waiting lists. Some told us our child, just five years old at the time, was too young for their practice. And others told us our child’s symptoms were too severe for them to handle. You should probably go to the emergency room, they said. We can’t help you.
The mobile crisis line offered no support. Each time we called, they were too busy with other cases to come to us. Once, they suggested we call the police on our child to scare them into submission, as if this was a suggestion they made often. You should go to the emergency room, they said. We can’t help you.
As our crisis escalated, we did go to the emergency room, because there was nowhere else to go. The doctors there were dismissive of any suggestion that an environmental exposure or infection had triggered my child’s symptoms and suggested we focus on better parenting techniques. Months later, we received unexpected, multi-thousand-dollar bills in the mail: the insurance company refused to cover any of the charges from the emergency room visits. I spent weeks on the phone trying to untangle why the charges weren’t covered, to no avail. We have no idea why this isn’t covered, the insurance company told me, but there’s nothing we can do to help you.
The irony that I’d spent the previous nine months immersed in writing and thinking about the intersection between the environment, mental health, and families for my book was not lost on me as we went through this experience—a cruel cosmic joke, if ever there was one. Though our bout with PANS wasn’t directly related to climate change, I knew all too well that climate change is exacerbating an already-worrisome youth mental health crisis in numerous ways.
If this is how our society handles children’s mental health crises now, I kept thinking, we will be completely and utterly screwed as the climate crisis gets worse.
The need for mental health care will only increase as climate change worsens
Bob Doppelt, founder of the International Transformational Resilience Coalition, has written and taught extensively about the need for a radical transformation of our mental health care system in light of the escalating climate crisis. As climate change brings more stress and trauma to families and communities, our collective need for mental health support will dramatically increase. There will be more children in crisis, for multiple reasons.
“To prevent the traumas, and heal those that occur,” Doppelt says, “we must swiftly expand how mental health [challenges] are addressed by engaging communities in using a public health approach to build population-level mental wellness and resilience for relentless stresses and adversities.”
The environmental triggers for mental health challenges may also increase in a changing climate. Currently, as we discovered firsthand, these triggers are poorly understood. Though PANS and PANDAS are relatively rare, their triggers are not—and some of them, like Lyme disease and mold, are becoming more common in a warming world. Particle pollution, a primary component of wildfire smoke, has been linked to increased psychiatric hospitalizations, emergency department visits, and risk of suicide. Part of the transformation of our mental health care system must be a better understanding of how infectious and environmental triggers can impact our brains so that patients can receive proper treatment and support, and so that exposure to these triggers can be minimized whenever possible.
A public health approach to mental health
Doppelt advocates for a public health approach to mental health that focuses on strengthening protective factors like social support systems, enhanced local resources, and collective and individual resilience skills. These protective factors can be developed as a kind of social infrastructure called “resilience coordinating networks” and can include initiatives to build community literacy around mental health, community trauma healing groups, and other activities to build social connection and resilience.
We were profoundly lucky to have friends and family who supported us through PANS when the health care system didn’t. We had protective factors and layers of socioeconomic privilege that many do not. But there are numerous things that could have made our experience far less traumatic than it was. We needed more people in our orbit who understood the potential environmental and infectious triggers for mental health conditions. We needed more trauma-literate neighbors and providers. We needed better resources for respite care. And we needed better options for acute mental health support for our child than frightening emergency rooms, ineffective mobile crisis lines, or monthslong waiting lists for therapy.
As the climate crisis continues to intensify, a whole lot more of us are going to need better mental health options for our children and ourselves. But I’m deeply encouraged by Doppelt’s work and by growing awareness of the potential environmental triggers for mental illness. I’m inspired by everyone I meet who is working toward transforming our mental health care system into an infrastructure built on networks of collective care.
Doppelt says often that communities can be medicine. Learning how to better support our families, friends, and neighbors in moments of crisis may be one of the most important climate actions we can take.
Moms Clean Air Force supports the Community Mental Wellness and Resilience Act (CMWRA), a bipartisan bill built on the ideas in Bob Doppelt’s work that would fund community-led initiatives that use a public health approach to mental health in light of the increasing stress of extreme weather.
Learn more about Moms’ work on mental health.
TELL CONGRESS: SUPPORT MENTAL WELLNESS RESOURCES FOR COMMUNITIES HIT BY CLIMATE DISASTER