The mental health consequences of climate change are vast, as extreme weather events, air pollution, and higher ambient temperatures can lead to devastating situations that cause extreme stress and other psychological conditions on affected populations.  

With new funding from the National Institute of Environmental Health Sciences (NIEHS), a School of Public Health researcher is aiming to identify the specific factors that increase vulnerability to the psychological effects of exposure to extreme heat.  

Amruta Nori-Sarma, assistant professor of environmental health sciences, has received a two-year, $466,000 grant from NIEHS to examine these mental health impacts in depth, and determine how clinical and policy interventions can better support mental health during days of extreme heat.

For the project, Nori-Sarma and a team of researchers from SPH and Boston Medical Center will utilize data from the Boston Emergency Services Team (BEST), which provides crisis evaluation and treatment services throughout the Greater Boston area under the leadership of Boston Medical Center and the Massachusetts Behavioral Health Partnership. Individuals in crisis who receive these services may have difficulty accessing other types of mental healthcare because they are uninsured or have public insurance. From this data, the team will examine psychiatric emergency services utilization, as well as interviews with clinicians providing psychiatric care, to determine the social, behavioral, and environmental factors that influence vulnerability to these adverse mental health impacts of extreme heat, particularly among patients in low socioeconomic status groups. 

“There is an urgent need to better understand the mental health effects of climate-related extreme weather, especially among the most vulnerable populations,” says Nori-Sarma. “The BEST data, in combination with discussions with clinicians working with these vulnerable patients, will provide us with more detailed information about the mental health effects of extreme heat exposures. We hope to also gain novel insights into the types of interventions that can be most impactful to mitigate the harms that these patients experience from extreme heat.”

“Complex social and clinical needs, such as high rates of homelessness or psychotropic medications that may interfere with thermoregulation, make our clients particularly vulnerable to climate change, particularly extreme heat events,” says coinvestigator Rachel Oblath, director of methodology and assistant professor of psychiatry at BU Chobanian & Avedisian School of Medicine, and who is part of BEST. “We hope the research will raise awareness of this issue and inform prevention and intervention efforts.”

This project builds upon previous research that Nori-Sarma has led that shows links between extreme heat and adverse mental health. A 2022 study published in JAMA Psychiatry found that summer days with higher-than-normal temperatures were associated with increased rates of emergency department visits for mental health-related conditions in the US, particularly substance use, anxiety and stress disorders, and mood disorders. In a 2021 study published in The BMJ, Nori-Sarma and colleagues found that complications from extreme heat were more pronounced among young and middle-aged US adults than older adults.

This work also aligns with SPH’s commitment to building knowledge, awareness, and evidence-based interventions to both climate change and mental health with the launch of the school’s Center for Climate and Health in 2022, as well as the Center for Trauma and Mental Health last year. Nori-Sarma co-directs the BUSPH-Harvard Chan School CAFÉ, the nation’s first and only Research Coordinating Center dedicated to accelerating research and translation on the health impacts of climate change, which also launched last year.

From February 5-7, the center will host its inaugural CAFÉ Climate & Health Conference, a virtual event that will bring together leaders and scholars from all levels of government, as well as industry and community organizations. Kate Burrows, assistant professor of public health sciences at the University of Chicago and a coinvestigator of the NIH grant, will host a panel on climate change and mental health at the conference, which will include Nori-Sarma as a speaker.

Revisit the video below to hear Nori-Sarma explain the three-tiered concept of climate change resilience, with examples of action that can be taken at each level.