title: Climate change and mental health: a causal pathways framework.
abstract: OBJECTIVE
  Climate change will bring more frequent, long lasting and severe adverse weather events and these changes will affect mental health. We propose an explanatory framework to enhance consideration of how these effects may operate and to encourage debate about this important aspect of the health impacts of climate change.
  
  
  METHODS
  Literature review.
  
  
  RESULTS
  Climate change may affect mental health directly by exposing people to trauma. It may also affect mental health indirectly, by affecting (1) physical health (for example, extreme heat exposure causes heat exhaustion in vulnerable people, and associated mental health consequences) and (2) community wellbeing. Within community, wellbeing is a sub-process in which climate change erodes physical environments which, in turn, damage social environments. Vulnerable people and places, especially in low-income countries, will be particularly badly affected.
  
  
  CONCLUSIONS
  Different aspects of climate change may affect mental health through direct and indirect pathways, leading to serious mental health problems, possibly including increased suicide mortality. We propose that it is helpful to integrate these pathways in an explanatory framework, which may assist in developing public health policy, practice and research.
authors.affiliation: National Centre for Epidemiology and Population Health, College of Medicine, Biology and Environment, The Australian National University, Canberra, Australia. Helen.Berry@anu.edu.au
authors.forename: Helen Louise
authors.initials: HL
authors.lastname: Berry
authors.forename: Kathryn
authors.initials: K
authors.lastname: Bowen
authors.forename: Tord
authors.initials: T
authors.lastname: Kjellstrom
mesh_terms: D000223:Adaptation, Psychological; D057231:Climate Change; D006801:Humans; D001523:Mental Disorders / Q000209:etiology; D008603:Mental Health; D011634:Public Health