Introduction

IN autumn 2021, the world’s political leaders and thousands of delegates will fly to Glasgow for COP26, a conference self-characterised as uniquely urgent in the effort to keep global warming within liveable limits. It will, it says, be a chance to secure international agreements and mobilise global finance, to assess progress, motivate slackers and really drill down into the details of how to achieve a zero-carbon world. Only, we know how this goes now. More data, more speeches, more distant targets and planned interventions. And all the while, global greenhouse gas emissions climb towards a record high in 2023 (Harvey, 2021), propelled by three trillion dollars of G20 fossil fuel subsidies since the Paris agreement (Carrington, 2021). National and international governance is presumably not easy: electorates probably do in fact want cheap cars and holidays; fast and radical change probably does risk destabilising the economy and with it people’s lives. And yet it is difficult to escape the feeling that we have been profoundly failed over the past few decades – of course by the shadowy and entangled interests of big business and big politics, but also by widespread inertia and magical thinking among the generally well-meaning – as the chance to stop catastrophe has drifted by. Now the effects of this failure are plain to see, and still it is tempting to wonder whether the end of the world as we know it (and of so many, many little worlds) will ever be prioritised – or whether, between COVID and the culture wars, Brexit and Barnard Castle, we might just somehow never quite get round to it.

In recent research interviews – on psychological responses to climate change – many participants expressed a similar lack of hope:

This last quote, in particular, seems fitting in the month of the German floods, around which it was possible to detect a shift in media discourse – away from the usual questions of, first, whether this might be climate change, and, second, if it is, whether we ought to cut emissions; and towards new questions about a lack of preparedness and adaptation. These questions are probably overdue. But still their salience is depressing – ‘We’ve got no time. It’s already f**ked.’

In this paper I would like to present a few ideas about what clinical psychology (or clinical eco-psychology) should do about climate change, in a world at the tipping point. These ideas are informed by results from the third aim of my research, which was to explore how participants felt clinical psychology or mental health services could support people in distress about climate change. This is not a hypothetical consideration: CAMHS services have already observed a groundswell in distress related to climate change (Watts & Campbell, 2020), and many of my research participants described what felt like clinically significant-distress. Perhaps more importantly, however, I feel that my participants’ ideas have wider implications – both for how services might support people in more general distress, and for the question of how clinical psychologists concerned about climate change should look to engage with the issue. Above all, I want to argue for a pursuit of overlapping clinical and climate objectives through extensive ‘green prescribing’ – and specifically through the facilitation of localised, small-group, ecologically-protective projects.

Methods

Semi-structured interviews were conducted with 15 participants, who self-selected for the research on the basis of an emotional engagement with climate change. Participants were recruited predominantly through the social media pages of environmentalist groups, and also occasionally through word-of-mouth. Data was analysed using Braun and Clarke’s (2006; 2020) reflexive thematic analysis. Interviews were structured, and data analysed, with a view to addressing three research aims. Findings for two of these aims – first, to explore the experience of people’s distress about climate change and, second, to explore personal practices for alleviating this distress – will be reported in a separate paper. The third aim – the question of how services could support people distressed by climate change – will be considered here. For this reason, not all participants will be quoted in the below results, though all were important in shaping my general line of thought.

It should be noted that, though the research sought participants distressed by climate change, it did not seek participants who had been significantly affected by climate change in a direct, physical way (e.g. having lost their home or a relative in a flood). Such people would presumably have had a different story to tell.

Results

Participants were asked for their perspective on how psychology services might help people distressed by climate change. In a few cases, participants could base responses on personal experiences of seeking help, whether or not as a direct consequence of distress about climate change. Results will be structured here according to a process-content distinction, wherein ‘process’ refers to general concepts underpinning clinical support, and ‘content’ refers to more specific ideas about what this support might practically involve.

Process

Two themes were developed to capture findings less about the desired content or purpose of support from services, than about the spirit in which the support would need to be offered. The first of these centred around the idea that there could not (and should not) be any cure or fix for distress about climate change, and that any such distress should be conceptualised not as aberrant or unhealthy but as the sane response to insane circumstances (inspiring the theme’s name, ‘the anti-psychiatric perspective’).

In this way, participants suggested that, because distress about climate change is ‘logical and based in science’ (Katrina), mental health services would almost ‘have to bamboozle you into forgetting the seriousness of the problem in order for you to feel okay’ (Hannah). It seems possible that these sentiments reflect a general scepticism about the possibility of any psychological help for distress about climate change. They certainly indicate that any intervention – psychological or psychiatric – that merely dampens or distracts from the distress would spectacularly miss the point and discourage engagement.

A related theme (named ‘authenticity’) was developed to conceptualise the idea that effective psychological support would depend, firstly, on clinicians who were genuinely concerned and knowledgeable about climate change and, secondly, on a public who engaged with interventions ‘as naturally as possible’, as ‘a meaningful part of life’ (Benjamin).

Other participants spoke of the possibility of feeling ‘really angry’ (Gabrielle) if distress about climate change was met by a generic anti-anxiety or anti-depression response, and of the need for professionals to ‘understand what’s reasonable and what’s pessimistic [in relation to climate change]’ (Natasha), to prevent rational worries being misinterpreted as catastrophic thinking.

Bringing together the authenticity and anti-psychiatry themes, it can be seen that participants were somewhat sceptical about clinical psychology’s entrance into the area of climate change distress. It is indeed not clinical psychology’s usual territory, and our welcome may be thought contingent on a genuine concern for environmental issues and on a non-pathologising approach, which involves not just the diagnosis and treatment of distress, but the shared acknowledgement of an unfolding tragedy.

Content

There was some variety in participants’ ideas about the content or aim of support from services.

Some participants felt that there could be a role for psychology in helping people to manage (though not eradicate) distress about climate change. Catherine, for instance, suggested that services could offer exercises to help with physiological markers of anxiety, such as a ‘racing heart and [when you] can’t control your breathing’. Other participants suggested that services could encourage self-care and a reasonable balance between engagement with climate change and other interests or activities:

Participants’ main message, however, seemed to be that services could best support people by facilitating proactive engagement with climate change. To this end, participants suggested that social or community groups (‘forming relationships’), work in nature (‘nature therapy’), and ecologically-protective activities (‘eco-behavioural activation’) would all have value. Each of these ideas will be considered in turn.

Summary of results

Findings suggest some scepticism about the role of clinical psychology in supporting people in distress about climate change. Certainly, it seems evident that any support would have to come from a place of knowledge and genuine concern about climate change, and be delivered in a way that respects the reality and depth of the problem. Beyond the scepticism and the caveats, however, the findings do also clearly recommend a combination of group support, time in nature, and ecologically-protective activity as a fruitful avenue for intervention. Candidates for such interventions are not hard to imagine, and might include conservation, rewilding, or regenerative agricultural projects. Increasing access to these kinds of projects, especially in combination with the (Luke’s) cognitive reframe from global problem to local solution, would be a vital step in meeting the mental health needs of people distressed by climate change.

Final implications: What we need to do

Though this research was explicitly concerned with the support that services might offer people distressed by climate change, the results – and specifically the idea of small-group, nature-based, eco-behavioural interventions – can also be read as providing broad support to the ‘green prescribing’ movement. Green prescribing has become the generic term for interventions that use time in nature as a therapeutic tool. Evidence for the approach’s effectiveness is extensive and growing (Korpela et al., 2016; Poulsen, 2017; Song et al., 2016). Indeed, it seems reasonable to suggest that the benefits of time in nature – for cognitive (Berman et al., 2008; Schertz & Berman, 2019) and emotional (White et al., 2019) wellbeing – might represent the single most robust set of findings in all psychology. The content or cause of a person’s distress is, from this perspective, a secondary issue. Low mood, anxiety, a basic lack of purpose or connection: all would be amenable (though of course not in the case of every person) to the benefits of work with nature.

The government has already committed four million pounds to green prescribing schemes across the country (Defra Press Office, 2020) – small money, of course, but evidence that a confluence of clinical, political and ecological interests might be within reach. In this hopeful context, I would like to propose three fairly concrete steps for ecologically-concerned clinical psychologists. I believe that these steps represent the best opportunity for the profession to use the power it does actually have, within mental health services, to effect meaningful change. It is hoped that the result will be a useful increase to the range of interventions available in services, and a tiny step (but potentially many tiny steps) towards an environmental salvage mission. The steps are obvious:

This proposal is inspired by my participants. Like Luke, I want concrete action with a localised focus; like Michael and Hannah, I want real, tangible evidence of positive outcomes. Like so many of my participants, I want to leave behind the impotence of waiting for divine, political intervention and to start ‘solving problems from below without permission from above’ (Brown & Jones, 2021). I want to preserve just a single patch of beauty, and for many others – in chain reaction – to do the same, until, like bees, who think nothing of the global context to their minute exertions, we have pollinated the world.