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    Climate Change and Mental Health

    Apr 20 2022

    Climate change poses a clear threat to public health, including mental health, and people with mental health disorders are disproportionately impacted. In this episode, psychiatrist Dr. Robin Cooper joins us to discuss how experiencing these types of events can cause significant stress and distress for many and what we can do to address our climate and mental health crisis.

    Dr. Robin Cooper, Distinguished Life Fellow of the American Psychiatric Association, has been in private practice psychiatry in San Francisco, California for nearly 40 years and is an Associate Clinical Professor in the Department of Psychiatry and Behavioral Sciences at the University of California San Francisco. She is the co-founder and President of Climate Psychiatry Alliance, a national group dedicated to understanding, advocating, and educating the profession and the public about the urgent risks of our climate crisis and its impacts on mental health.

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    Transcript of Audio

    Joy Lloyd-Montgomery: Hello, and welcome to Mentally Healthy Nation, a podcast from the American Psychiatric Association Foundation. I'm today's host Joy Lloyd-Montgomery. Whether through personal experience or from watching the news, we've seen the devastation that climate change has had around the world.

    Speaker 2: People are telling us this is the worst they've ever seen. Fires have burned more intensely, more ferociously. They seem to have a mind of their own.

    Speaker 3: Satellite imagery is showing that Arctic sea ice is at its lowest levels on record.

    Speaker 4: To Northern Siberia. It hit 100.4 degrees.

    Speaker 5: We are looking right now at the all time record heat for the month of June.

    Speaker 6: Catastrophic category four hurricane bearing down in the US.

    Speaker 7: We could be looking at a majority of the surrounding communities flooded with upwards of nine to 20 feet of water.

    Speaker 8: Two largest wildfires in Colorado history.

    Joy Lloyd-Montgomery: Climate change has also had a profound impact on our mental health.

    Speaker 9: When the storm hit and the flooding began, I was terrified. I have had panic attacks because of my climate anxiety and climate trauma.

    Speaker 10: It would be impossible to overstate the impact that climate change unchecked will have on our mental health.

    Speaker 11: I was about maybe 15 or 16 when I realized that Katrina had an impact on my wellbeing as far as just being in totally new environments. I realized once I decided to go to Texas for college, I just had to move around a lot. I find a psychiatrist, I go to see him, I talk to him. He was just like, oh, you definitely have some PTSD. You're searching for some type of stability.

    Joy Lloyd-Montgomery: One of the psychiatrists dedicating her time to this issue is Dr. Robin Cooper. Dr. Cooper is the co-founder and president of Climate Psychiatry Alliance, a national group dedicated to understanding, advocating and educating the profession and the public about the urgent risks of our climate crisis and its impact on mental health. Welcome Dr. Cooper. Thank you so much for being here today.

    Dr. Robin Cooper: Thank you for having me. I'm really delighted to be invited to talk about something that is so close to where I spend most of my time and my concerns. I'm so delighted that you are paying attention to what I think is one of the most important issues that we face in our lives and in our profession.

    Joy Lloyd-Montgomery: Yes. Thank you. First, I want to take a few minutes to talk about the incredibly concerning report that was recently published by the IPCC. It made it pretty clear that the efforts governments and corporations have proposed to decrease greenhouse gas emissions aren't quite enough to stop global warming from exceeding that one and a half degrees Celsius mark, and that's even considering if they stick to these promises that they have put out to the public. So what are your thoughts on this? How are you feeling after reading this report?

    Dr. Robin Cooper: The IPCC report is so important and this latest one that you've just alluded to has been called a nightmare in scientific language; dry, scientific language, but the profound significance and all of the scientists who have spoken about this report that is so important have spoken over and over saying that we are on a really urgent timeframe to deal with the escalating global warmings and the impact on that, on being able to tackle this what I would call "wicked problem". And they have been very clear. They are sounding the alarm. It's just that we need to hear that and then use that in some effective way.

    Dr. Robin Cooper: That report came out shortly after the COP meetings, the international meetings in November. And that was equally concerning that all of the many nations that participated have not been able to robustly address really impacting the escalation of global warming. The IPCC report is really important because this particular report focused a good deal on health. It was the very first report that highlighted mental health impacts of climate change and identified mental health impacts as profoundly significant to what's happening for humans and the responses and what we're going to be facing going forward. It does embed in the report solutions and that's, of course, good. The question is, do we have the political will to implement solutions that we know are within our reach?

    Joy Lloyd-Montgomery: Were there particular solutions that really stood out to you?

    Dr. Robin Cooper: Well, they're really policies solutions identified across wide ranges of sectors because we're no longer in a situation where we're really going to stay within 1.5 degrees and only avoid increasing greenhouse gas emissions. We also have to know, we have to make policies that adapt to living in a world that is very different than what we had hoped for or anticipated. So it's both solutions about containing the escalation in greenhouse gas emissions, but what do we do to live in a world that is going to be hotter?

    Joy Lloyd-Montgomery: Well, that's making me a little anxious just hearing you say it.

    Dr. Robin Cooper: Well, but anxious as you hear that it should make you anxious and that's not a bad feeling. Anxiety says, hey, you hear that there's trouble, wake up and do something.

    Joy Lloyd-Montgomery: Right.

    Dr. Robin Cooper: The troubling feelings are also appropriate and can move us and they should.

    Joy Lloyd-Montgomery: It seems like a lot of people are feeling similarly. I know about half of Americans believe their mental health is currently affected by climate change. I'd love for you to talk about some ways that this tends to show up in addition to the anxiety that we just mentioned.

    Dr. Robin Cooper: These surveys indicating 50% or more, whatever, are only beginning to be seen because we're only starting to look at what I'd say is the prevalence of concern about climate change, and that's very good as we get a handle on this, but it is very clear that the emotional responses to what's happening on climate driven issues is escalating tremendously. I want to differentiate between the emotional, psychological impacts from acute disasters, disasters that are driven by climate change. And those are different than what we're talking about and this fear of kind of emotional distress as we wake up and see what is happening to the world that we're living in, and we are seeing more and more distress.

    Dr. Robin Cooper: The word eco-anxiety has become very popular or climate anxiety, but I want to really make it clear. It is not just worry anxiety. That's a big component. That's the part of the feelings that are distressing as we anticipate the future. Sometimes the experience is connected with a sense of dread and hopelessness and despair, but it is also a whole range of other feelings that are related to the experience of loss and grief and sadness, as we both experience the already damaged impact through our lives, but also the loss of potential that we have. We're really seeing that with youth, the loss of the potential and the expectations that they had about their lives. So the feelings connected to the awareness of climate changes and the increased attention to that, which needs to be there, has a wide scope of emotions connected to it.

    Joy Lloyd-Montgomery: You mentioned youth. Do some of these emotions tend to vary across generations in your experience?

    Dr. Robin Cooper: I'd say there are particular groups that are experiencing already a much more profound sense of these eco distress, big, big feelings as we're facing the big threats. Youth are definitely one of those. As I said earlier, we're only beginning to see survey data about the extent of this. One of the most important studies has come out of a collaborative study looking at 10,000 youth age 16 to 26, might be 18 to 26. I have to correct it on that, but 10,000 youth in 10 countries. And that's a big number. And the study, the survey, told us not surprisingly that youth are concerned, but the bigger surprises or the bigger concerns that came out of that is that these youth are reporting profound impacts in their everyday functioning. Their concerns about climate are impacting what they experience and do in their lives now.

    Dr. Robin Cooper: It also indicated a profound sense of disappointment and anger that their governmental entities have not done anything to protect their futures. And that I take, although the survey didn't specifically say that, I also think that they're angry and concerned that those of us who have been around longer than they have not protected their world for the future. It's a wake up call for us to impact our governments to move more robustly. But they're not the only groups that are profoundly concerned. Those people who live close to the land and whose lives have already been profoundly impacted are suffering enormously. We would be here for hours looking at the many communities, but just to point out, the Inuits in the Northern Arctic area are an indigenous group that already had profound loss because they live on the ice and their entire community is threatened and they're experiencing extraordinary grief and impacts on their mental health functioning and substance abuse increases and the kinds of things that we're seeing there.

    Dr. Robin Cooper: Other communities that live close to the land; farmers, fishermen, those who are already impacted, are suffering enormously. And there's also a suffering of the spiritual experience of being able to be connected with generations and hundreds of years of community life that has had the spiritual connection with living close to the land. And then other groups, climate scientists who are close to the data, those people who work on the IPCC reports, or those who understand in granular ways in their everyday life, climate journalists reporting on this and climate activists, those who are close, have profound, emotional experiences that are important to pay attention to.

    Joy Lloyd-Montgomery: Absolutely. I want to go back really quickly to when you were talking about some of these especially vulnerable communities like the Inuit. I thought it was beautiful that you mentioned and sad too the spiritual aspect of it. I don't know how often that is considered a part of the conversation. I went to Hawaii recently, and I was overwhelmed by how connected so many of them are with the land. And to think about what you said with these Inuit people being probably eventually displaced from their land that they've known and their cultural practices that are related to their environment, that being taken away from them is just incredibly tragic.

    Dr. Robin Cooper: Very tragic. And it's a profound assault on their psychic wellbeing. And that spirituality that is so connected with the land is I'm going to turn it around. It's one of the things that the many indigenous groups are bringing to those of us who live in our busy urban lives pulled here, there, and elsewhere, who are disconnected from that connection to the natural world. And that's something we can actually learn from, the indigenous wisdom that is brought to us from those who are feeling it in such a threatened way.

    Joy Lloyd-Montgomery: Absolutely. There's so much that we can learn from various groups across the world, but I mean, people who this was their land, not ours, and there's a lot of progress that can be made in the connection that we have. I don't know that I ever really felt particularly connected growing up, to be honest.

    Dr. Robin Cooper: We have become in our consumer driven society, in our urban settings, very, very disconnected with a connection that is internally felt. And there's a lot in this realm of climate wellbeing that says get in touch with nature and get out, which is extremely important because it's calming to our emotionally inflamed experience. But one of the things that I think it also brings to our attention is that this wicked problem about climate change is affecting all of us. And, of course, we're grappling now with COVID and coming out of COVID. Are we going to go into it? One of the things that that really woke us up to is how interconnected the entire world is. And that's important to know about climate change that this is happening everywhere. We are interconnected, it's affecting all of us.

    Joy Lloyd-Montgomery: Absolutely.

    Dr. Robin Cooper: And the solutions are also interconnected. That difficulty in holding that is climate change impacts are fragmented. They happen differently in different locations, in different time period. So there will be a disaster of a hurricane or a wildfire or drought experiences, and it takes a degree of cognitive sophistication to connect those and hold them over time and space. And that's a challenge because it allows us to experience these things in fragmented ways and then put them away, go back to our own time, our own lives, order something again on Amazon, make us feel good. And that's a problem in holding the reality of this over time and space.

    Joy Lloyd-Montgomery: Right. I want to get back to that point in a second, but when you mention these disasters like fires and droughts, what do people tend to experience? I mean, we see the devastation on the news, but I don't know if we really delve into how that is affecting people's mental health and wellbeing.

    Dr. Robin Cooper: So let me differentiate the drought from the wildfires or the hurricane.

    Joy Lloyd-Montgomery: Yes, please.

    Dr. Robin Cooper: And differentiating then the acute events that are climate driven from the slow moving indirect impacts on our world, but the issues of sea level rise and drought and the things that are more slow moving and sometimes hard to see. The disaster events are pretty well known. People have profound distress when they're faced with the threat to their lives, their communities, and the severity of loss from a major hurricane, a major flood, a wildfire. They're driven away from their homes. They're fearful that they could die. They experience the loss of those who have died or have been significantly wounded by these big events. Their communities sometimes are completely destroyed and they can't go back and live there. The economic impacts are massive. So we know that there are acute distress responses.

    Dr. Robin Cooper: And sometimes those also trigger heroism. And the media loves that. Loves to report on Joe who went out and saved someone. But our attention is limited there. And we also know that in those phases, people's sleep can be disrupted. They can have experiences of anxiety. Most people are fearful of being separated from their loved ones during that time, separation anxiety. Some people retreat to alcohol and drugs or more smoking ways to manage that acute distress. Burnout; the heroism, it is tiring. The longer term impacts, of course, we know can impact mood and depression and post-traumatic stress so that the impacts can be much delayed, particularly for people who experience disasters repeatedly.

    Dr. Robin Cooper: And my heart goes out to the people who live in the Louisiana Bayou, happens over and over. Or the displaced people from Katrina. The thing that woke us up. Many people moved to Houston and were hit again in the hurricanes in Houston or the wild fires in my Northern California area year after year.

    Dr. Robin Cooper: So those impacts of severe disasters are pretty well known. Not everybody has those emotional, those big scars. Many people recover, and there is some growth from the altruism that can come out of that. That's different than those slower moving insidious, continual kinds of impact on our environment. The droughts, sea level rise; those are more difficult to sometimes see. Severe drought though that we are seeing in many parts of the world, and it can switch off with floods. In Africa, there's severe droughts and then severe rainstorms that go back and forth. But droughts are particularly concerning. They impact the ability of farmers to make a living. They have a profound impact on food insecurity, on the availability of water. In California where I live we're at 12,000 years... no, 1,200 years of the most severe droughts. It's unfathomable to think that there may be a time when I turn on my faucet and there isn't water and the restrictions on that, the impact again, on agriculture, on the land, on whether the land will be livable. Those are very significant.

    Dr. Robin Cooper: And so what we've seen in certain areas of severe drought are farmers with increased suicide rates, particularly documented in Indian farmers in the Northern parts of India and in Australia. But I'm hearing it much more in the US. Ranchers in Montana who are in incredible distress. Montana has one of the highest rates of suicide, so it's a concern. And, again, that ability to feel that your home is a place that you can continue to be in. Same is true of sea level rise. Same is true with the other kinds of gradual impacts on the world we live in.

    Joy Lloyd-Montgomery: I didn't know about farmers struggling with suicide ideation. That's terrible. We've talked about various groups of people who are experiencing the effects of climate change on their mental health, but I'm curious, are there particular concerns for those with psychiatric conditions?

    Dr. Robin Cooper: Absolutely. Thank you for making sure that being a good psychiatrist I pay attention to the vulnerability of the mentally ill. There are particular populations that are vulnerable, and the mentally ill are definitely one of those populations. Let's just take severe mental illness. What we know is that there are periods during extreme heat, heat waves, which are becoming more frequent, more severe and more enduring, that that has particular impacts on mental health functions. But on those with preexisting mental illnesses, there is increased emergency room visits during extreme heat, increased hospitalizations. A recent report from China had increased hospitalizations for depression just due to extreme heat. Those with preexisting mental illnesses die at three times the rate of non mentally ill during periods of extreme heat.

    Dr. Robin Cooper: Now, we don't completely know the whys of all of that. There's some information that the illness of schizophrenia may have some intrinsic components of the disease that interfere with thermoregulation, the body's ability to stay cool enough, and that may be a driver. And that information predates our use of neuroleptics and medication. The medications we use for severely mentally ill impacts the ability of the body to sustain its core temperature and can be another threat. And then substance abusers also get into trouble during extreme heat.

    Dr. Robin Cooper: Now, there are particular things that we should think about in terms of features of severe mental illness that make it difficult to respond both to extreme heat, but to disasters. Apathy is a component of periods of severe mental illness and symptomatology. Impairments in motivation, in reality testing, in judgment, in executive functioning, the ability to perceive troubles and plan for it and execute responses are impaired. The attention to what's happening in the environment can be impaired, particularly with depressive periods. And so some of the inherent features of mental illness place our population that we're concerned about at particular risk to responding and to taking care of themselves during these periods of threat.

    Dr. Robin Cooper: So those who are marginally, but fragilely compensated to deal with the issues in their lives, can be tipped over. And, of course, the severely, mentally ill are dependent on an intact delivery system, the supports, and those are fragile. We're in a terrible situation in good times around access to care. And then the supply of medications can be interrupted. So there are lots of vulnerabilities. Some of the impacts of severe extreme heat, the heat waves that can kill people, they don't have to be that way. There can be important ways that we can educate our patients and our providers to help people cope and survive heat waves.

    Dr. Robin Cooper: I just want to draw your attention to a toolkit that I've worked with in collaboration with several other people on the Climate Psychiatry Alliance Website, climatepsychiatry.org/heattoolkits, and that's available to use with patients to be able to give them the tools to survive these extreme heat waves.

    Joy Lloyd-Montgomery: Thank you for mentioning the toolkit. We will make sure to link it in the episode description. So before I get to psychiatrists and their roles in educating their patients, I just want to touch on these other stressors and things that people may be dealing with in the social determinants of health, people who are living in more under-resourced areas or urban areas and the effects that the environment has on their health. I know we're talking about mental health, but physical health and mental health as you know obviously are very inextricably linked. I just wonder if you can elaborate a little bit more on how where you live may be impacting your health and mental health.

    Dr. Robin Cooper: First off, thank you very much for really clearly stating that the mental health impacts cannot be unraveled from the other physical impacts. These are all interconnected. We can only talk about one thing at a time, but these are all laced together. The social determinants of health, if there is any predictor of the severity of impacts on mental health and physical health of climate driven issues, it is race and poverty. Race and poverty over and over come out as major significant factors for those who suffer the most, who will suffer first and more significantly. Those of us with more wealth and resources have the capacity to protect ourselves more easily. It doesn't mean we won't be all affected. And that's true if we think domestically and internationally also. The global south in comparison to the more wealthy Northern countries are also suffering much greater.

    Dr. Robin Cooper: So you've brought up something about where people live and how they live. It's really important. Substandard housing or homelessness, unemployment, or sub employment poverty, access to food, the place where people live, we call that the built environment. If we talk about that built environment, and we look at inner city urban neighborhoods versus suburban wealthier neighborhoods, what do we see? Huge differences just in heat, 10 to 15 degree differences in communities with green spaces and urban canopy versus inner city with asphalt and concrete and substandard housing. That has profound impacts on communities of poverty and color.

    Dr. Robin Cooper: And there is no question in my mind that this goes back to some policies that have driven the disparities historically. Red lining is showing up to have an impact on these disparities that we're seeing now. Many communities have vulnerability maps that their departments of public health look at. If you look at those vulnerabilities for impacts, they match the maps of poverty and they match the maps of where more people of color live. It is absolutely true that climate change is an issue of disparities and equity and justice. And we have to hold that all the time, both as we look at the vulnerabilities, at the impacts, but also some of the policy solutions. So climate change I call a mega social determinant of health. It is a multiplier of all of those contributions that have those negative outcomes that we're seeing.

    Joy Lloyd-Montgomery: I like that term climate change is a mega social determinant of health. We'll make sure that we talk about it at the annual meeting.

    Dr. Robin Cooper: Yes.

    Joy Lloyd-Montgomery: We talked about some climate activists a little bit earlier and how that's even a way for some of us to channel our anxiety, but we know these individual efforts aren't enough. You were just talking about how governments and corporations need to do things. So for those of us who want to have a broader impact, how can we encourage governments and corporations to do more? How can we advocate for these issues?

    Dr. Robin Cooper: I hope more of us want to impact these big, big areas. I don't want to downplay how the ways we all make choices in our individual lives are important, but it is a distortion to think that that's enough. We're way, way beyond "I recycle". We have to think in broader ways because the impacts are significant. I think we kind of made that clear, but the solutions are embedded in bigger policies. And that's also really important because there's kind of sense that if an individual feels that they're responsible, well, actually we all live in this world and can't live in this world without contributions to the fossil fuel use. So the policies have to be the solutions. Policy engagement means involving oneself with politics. And I don't mean left, right, Republican, Democrat. I mean the creation of policies that make a difference to both reducing fossil fuel use and adapting to the world, but engaging with policies for our mental health professionals is... We're all so busy. How the hell do I do that? When? Who? How? I want to just say advocacy is one of the ways to do that, and that is a skill.

    Dr. Robin Cooper: We're not born knowing how to do that or where to find ways to do that. It is a skill. But we as mental health professionals can use our voices in support of the many policies. And there isn't one, it is interconnected with many, many issues, both at the local, at the community level, at the state level and nationally. We cannot do that without being participants in larger groups that we come together with to address some of the policies and legislative strategies. How do we use our professional organization to help us lead the way? Will APA, our professional organization, use its government relations and make this a priority and respond quickly and robustly and keep on top of the many legislative things that we can have an impact on?

    Dr. Robin Cooper: And how do we as our professional organization join with others in the sphere of healthcare delivery? The medical society consortium on climate and health is one of the places that we're a member. APA is a member. Climate Psychiatry, the group I'm with is a member. Building connections with bigger organizations because that's how we deliver, that's how we are more effective to use our voice in support of policies.

    Dr. Robin Cooper: I need to add that the American Psychiatric Association has taken a big step in the creation of the standing committee now on the committee on mental health and climate change. That's a really important recognition by the APA of the significance of this, and that committee has to be empowered and will continue to make sure that the APA moves forward in the activities around climate change and mental health. And we're very thankful for the APA leadership, particularly Jeffrey Geller when he was president for creating that important committee and raising the attention to climate change and mental health in the organization.

    Dr. Robin Cooper: Then there are many other ways that healthcare professionals can engage in agency action involvement with this. John Coverdale, one of the leaders in this field, has an acronym CAARE and we've expanded that CAARE to clinical. What do we do at the clinical level? What do we do at the administrative level? How do we impact all of the organizations that we're involved with to be more sustainable in our practices? That's true with the APA. We're considering what the carbon footprint is at going to our meetings and managing our practices and managing our operations.

    Dr. Robin Cooper: The advocacy is the second double A in that CAARE model, again, those organizations that I've spoken about. Also Healthcare Without Harm, which is another organization to help us to move to sustainable health practices. Research; how do we develop appropriate and useful research questions? Not just getting another publication, but research questions that we can come to and use them in that advocacy sphere. And then education; education from little kids all the way through professional education so that we have a climate-literate community and profession.

    Joy Lloyd-Montgomery: What a beautiful and helpful acronym. I want to talk about that last piece that you just mentioned in terms of education and even starting with our little kids. What are some ways that schools can educate young folks about climate change and environmental health, and how can we continue that throughout the course of our education?

    Dr. Robin Cooper: It's so important. And how can schools do that? You have opened a can of worms because regrettably climate has been politicized. Climate change has been politicized just as so many other issues that are so, so important in our society. Education and what schools should teach regrettably has politicized. So we have to be savvy to that, but we have to pay attention to being able to teach our young children and all of us through the whole developmental spectrum about the reality of what's happening.

    Dr. Robin Cooper: And there is actually a wonderful organization called Schools for Climate Action that works at multiple levels, engaging school boards, teachers, groups, teacher unions, to develop both policies and curriculum across the K to 12 spectrum for those schools and divides up the curriculum, thinks about the curriculum, the integration into schools in appropriately developmental ways. Because we don't talk to kindergartners or expose kindergartners in the same way as we do high school students who are already knowing what's happening in the world.

    Dr. Robin Cooper: There is I know on the schools for climate action some blueprints for environmental literacy that breaks it down. But what schools can do and what teachers can do with little ones is start to develop that connection with nature and that awe and being involved in that and environmental stewardship that is appropriate for little ones. We also need to know, we don't create climate worry or eco distress or anxiety for little ones. They pick it up and hear what's happening in the world. So we need to be attentive to that and address it appropriately. And being able to do that in the classroom and outside of the classroom is extremely important.

    Dr. Robin Cooper: Projects that relate to environmental stewardship are important for those younger groups and then always an ear to their emotional distress that comes up as these things are faced. And then as kids get into middle school, the curriculum has to change to be more attentive to how they think about scientific principles, how you assess it, what we know in age appropriate ways.

    Dr. Robin Cooper: And the same is true as it merges into the more sophisticated ways that high schoolers or college students are experiencing this and becoming more literate about that. We cannot shirk the science. We have to be able in our schools to present it in ways that is appropriate and not politicized. Holding deeply to this is important for our students to learn about and also learn what to do to make the world better because they have to be armed with solutions. I'm going to send to you charming but serious children's books, illustrated books, that are helpful for the little ones to be able to... and parents and educators to help kids face what is happening in our world in ways that are manageable for their feelings.

    Joy Lloyd-Montgomery: That would be fantastic. Thank you for sharing those resources. You mentioned that these kiddos pick up the distress from those around them. When we see that, which is something that we need to be attentive to, like you said, what are some ways that you think would be helpful for teachers or parents, what have you, to address that specific part of their distress that's related to climate change or for the older folks who like we said are experiencing maybe grief and anxiety, things like that as it relates to climate change?

    Dr. Robin Cooper: First off with kids, I want to know what you know. Tell me what your worries are. Tell me what your thoughts are. Stay with children with what they're thinking and don't expand and don't add more. Listen, respond to what they're bringing up. Always, always be truthful, but you don't have to load them up with all the truth. Do not say there's nothing to worry about. We can say there are big problems that we're facing and I will do my best to protect you. I will do everything I can to protect the world that you'll have, and we can do this together. So they're big troubles, but let's you and I find a way to make a difference together.

    Joy Lloyd-Montgomery: I love that.

    Dr. Robin Cooper: Why don't we join depending on what's appropriate developmentally that group that I know is cleaning up the beach with all the plastic. Lets you and I do that together. So finding very specific ways and always reminding children that we are here to protect them in the very best ways, and I/we will do our best to do that and that even though the troubles, the problems are big, we can do something.

    Dr. Robin Cooper: And the same is true for grownups. We don't talk that much, but we have agency and we need to be able who engender what is beginning to be spoken about as realistic hope, not false hope, not equating hope with optimism like things are going to come out wonderful.

    Joy Lloyd-Montgomery: Everything's going to be right.

    Dr. Robin Cooper: Oh, just fine.

    Joy Lloyd-Montgomery: Can't make that promise.

    Dr. Robin Cooper: No, no, but we can hold that there is reasonable hope. And what's being talked about now is that hope is a verb. It is something that we do, that genuine grounded hope, I'm reading you a quote, comes from rolling up our sleeves rather than watching other people do the work and that some of the ideas about realistic hope come from the healthcare world around managing big health threats like cancer. Having a realistic goal with a way to get there and a way to involve one's self and motivate one's self to act in that ways, and there is place for realistic hope because what we do now will have an impact on how damaged the world will be in the future.

    Dr. Robin Cooper: So we're not going to come out of this unscathed. We are already hurting, and we will, but the severity can be impacted by engagement and activism. And that not only goes toward... They say there's this thing, activism is the antidote to anxiety. Well, yes, partly. If you are mobilized in doing something, you can manage the big feelings of hopelessness and powerlessness in a better way. And it's a win-win because it also can have direct impacts on solutions that we need.

    Joy Lloyd-Montgomery: Before we go, Dr. Cooper, it's been such a fantastic conversation, but I want to give you the final words. So is there anything that you want to make sure that listeners walk away with from this episode?

    Dr. Robin Cooper: There are several things. In the mental health sphere, we have not had a significant enough voice, and it is our responsibility to carry that voice into the public sphere and into our profession. And there is a way for all of us who are so overloaded and so busy to have an impact on this profound threat to emotional wellbeing. And it's a matter of finding the place and finding the place that matches your own particular style. And then I'm going to put in a plug for joining the caucus at the American Psychiatric Association, the work that our colleagues in the American Academy of Community Psychiatrists are doing for my group, Climate Psychiatry Alliance. Join our group, you'll get the newsletter. We're a robust organization and other groups. This is for all of us to come together.

    Dr. Robin Cooper: The other thing I just want to put a plug for is I'm involved in a panel discussion that we'll be on using and jumping off of don't look up, the film, and we have a great panel that will expand on a number of the things that we've touched on today. And that's going to be on the 21st. I will send you the link for that to make it apparent. It should be a very exciting thing. We're telling people, bring your own popcorn. And that's a project and a panel discussion that's being coordinated out of the University of California, San Francisco, in conjunction with the many activities around Earth Day, which is appropriate that we're talking about this now because it's the day that recognizes the important connection and our need to be stewards to the world that we live in.

    Joy Lloyd-Montgomery: Well, Dr. Cooper, it's been a pleasure. We appreciate you joining us on our podcast Mentally Healthy Nation and teaching us a little bit about climate change and mental health and the disparities that exist in that intersection and some of the solutions that we can be a part of. Thank you so much.

    Dr. Robin Cooper: Thank you for having me.

    Joy Lloyd-Montgomery: Dr. Robin Cooper, distinguished life fellow of the American Psychiatric Association, the APA, has been in private practice psychiatry in San Francisco, California for nearly 40 years and is associate clinical professor in the Department of Psychiatry and Behavioral Sciences at University of California, San Francisco. Since learning about the threats of climate disruption over a decade ago, Dr. Cooper has focused most of her efforts on climate change with attention to both education and advocacy about the impacts on health and mental health. Dr. Cooper was co-author of the 2017 APA position paper on climate change and mental health, which articulated APA's commitment to this issue and set the stage for their ongoing engagement.

    Joy Lloyd-Montgomery: We want to thank our listeners for joining us today. For more information about the Climate Psychiatry Alliance, visit www.climatepsychiatry.org. To learn about the work being done at the APA Foundation, you can visit apafdn.org. If you enjoyed what you heard today, please share this episode with a friend, family member or colleague. I'm Joy Lloyd-Montgomery. Take care.

    Speaker 13: The views and opinions expressed in this podcast are those of the individual speakers in their personal capacity only and do not necessarily represent the views of the American Psychiatric Association Foundation or the views' official policy or position of the institutions and organizations with which the speakers are affiliated. The content of this podcast is provided for general information purposes only and does not offer medical or any other type of professional advice. If you are having a medical emergency, please contact your local emergency response number.