When a storm driven by climate change forces a family from its home, the impacts don't necessarily disappear once the waters recede and the damage is repaired. Though harder to spot, the impacts on people's mental health can be pervasive and enduring.
That is the thrust of a report released Wednesday by the American Psychological Association, Climate for Health, and ecoAmerica, called "Mental Health and Our Changing Climate: Impacts, Implications, and Guidance."
The report builds on previous work and examines the harm caused by the various manifestations of climate change, from extreme weather and wildfires to heat waves and the general "eco-anxiety" that comes from coping with the enormity of the climate crisis.
"We have this strange situation with climate change in our country that people don't talk about it much, and that means we don't have the opportunity to get prepared for it," said Susan Clayton, one of the report's authors. "That makes it scarier. It seems so amorphous."
The news about climate change can be so frightening, so overwhelming, that instead of shaking people into awareness, it can drive them toward denial. One study cited by the report found that people who received complex information about the threat of climate change felt more helpless and more likely to want to avoid hearing about it in the future.
"Talking about it makes it more manageable and concrete. It can also increase the political will to do something about it," said Clayton.
Climate change's potential impact on mental health isn't universal. Some groups, particularly children and the poor, can be particularly vulnerable.
The report pointed to the response to heat as an example.
By the end of the century, the average American will see between four and eight times as many days above 95 degrees as today, according to estimates cited in the report. Arizona could go from 116 days above 95 degrees to 205 by 2099.
When temperature rises, so does aggression, studies have shown. Heat can also muddle our minds, making it harder to settle disputes without violence.
"It's stressful to be hot, and that leads you to act out," said Clayton. "That has real social justice implications. Who can afford to have air conditioning, and who can't?"
Children are more sensitive to temperatures changes because their sweat glands are not fully developed, making them less able to cool themselves. They are also more prone to dehydration.
Climate impacts can also have longterm effects on their development. The report cited studies that found that children who have experienced a flood or a drought during key developmental periods are shorter, on average, as adults. Pregnant women exposed to heatwaves during their second and third trimesters have a higher chance of going into early labor and tend to have babies with lower birth weights.
And long after the events are over, children are more likely than adults to show severe distress, as well as higher rates of post-traumatic stress disorder.
Mona Sarfaty, the director of the Program for Climate and Health in the Center for Climate Change Communication at George Mason University, who was not a part of the study, said she has encountered this in her work on health care and climate change. After the severe flooding in Louisiana last August, when 30 percent of the state flooded and thousands of people were evacuated, many were fundamentally disoriented, she said. "There were children who became terrified every time it rained subsequently," she said.
With storms, drought and wildfires driven at least in part by climate change spreading to new areas of the country—like the fires in Tennessee and North Carolina last year—more people are being exposed to immediate climate hazards.
Sarfaty is the director of the Medical Society Consortium on Climate & Health, a new group that aims to help the public and policymakers understand how climate change is impacting health. The group represents more than half of the physicians in the country and includes 11 of the nation's leading medical societies.
The consortium recently released a study with similar goals to the mental health study. Both, Sarfaty said, can serve as tools for primary care physicians.
"Every physician needs to be thinking about the mental health impacts of climate change and know the vulnerabilities of their own community so they can help to strengthen people against the impacts," she said.
The mental health report outlined other ways to strengthen people, too.
Encouraging bicycling or walking, or choosing public transit over a car can help, according to the report. Physical activity has a direct connection to mental health, and using public transit fosters a sense of community.
Helping people find ways to prepare for and combat climate change in their own lives—like preparing for extreme events or building local resilience—can also make it easier to cope with the stress that comes from knowing the world is changing.
"We like to feel secure in our jobs, our finances, our relationships, our homes," said Clayton. "Climate change has a real potential to make us feel insecure in many of those things."