Psychoanalytically, we could read the story of climate change as a sibling rivalry between the Global North and South in their relationship with Mother Earth. The northern sibling has set itself up as the more powerful child, omnipotent and aggressively attached to the mother. At the expense of the southern sibling, the North has dominated the system through acting out to exploitatively maintain and defend its own relevance, importance and adequacy. 

The North’s domination also comes at the expense of the entire system. It affects the nurturing mother’s health, while the overpowered southern offspring struggles with the mental and physical burden of impotence and negative self-identification, adding to Mother Earth’s pain at her inability to control her more aggressive child. Having no alternative to protect the earthly family system from complete destruction, she gives stern, consequential warnings that demand more mature behaviour from both her children – warnings in the form of the intensifying ecological disasters of climate change.

Psychoanalysis, however, is not the most effective psychological framework to understand and practically address the challenges posed by adaptation to climate change. Psychosocial psychology, which asserts that the external context and the intrapsychic influence each other, is more applicable. This framework is most relevant as it includes understanding the impact of the historical, as well as how the social, political and economic affect psychological and intrapsychic processes. Although likely to be resisted by practitioners following classical psychological approaches, in the context of climate adjustment, a psychosocial approach is the only one that can promote a just transition to climate change in a manner that accounts for individual and mental health challenges in their sociopolitical context. 

Climate change ushers in a watershed moment in the history of humanity. It is a global, complex, systemic predicament that presents the world with associated health problems that are diverse and far-reaching. Social, historical and political factors operating at different scales affect levels of vulnerability to environmental change. The colonial exploitation of sub-Saharan Africa has resulted in this region facing the challenges of climate change with particularly high levels of vulnerability. 

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South Africa is not immune from the sociopolitical consequences of its history and enters the climate change quandary with vulnerabilities that are deeply entrenched socially, economically, politically and psychologically. 

The psychological effects of apartheid have not been adequately researched and documented. However, apartheid imprinted a negative racialised identity on the black population and led to low levels of education, poor economic opportunities and poor social infrastructure. This has further affected the health status of black communities, including their mental health. Living under apartheid and its persistent continuities in contemporary society can be seen as a state of continuous traumatic stress. 

Psychological distress in South Africans has its roots in the social, economic and political. It has affected mental health, inter-group relations and issues of identity. Research suggests that race differences in psychological distress can be attributed to socioeconomic status, especially in relation to education and income. Others have suggested that racial prejudice and discrimination worsen psychological distress. The prevalence of mental illness in South Africa is high. The country’s health system has, however, been pitifully ineffective in providing care.

Socioeconomic vulnerability is a major contributing factor to the increasing incidence of mental illness. Half of South Africans currently live in poverty, and 44% are unemployed. The poor live in areas with poor infrastructure and higher susceptibility to pollution, poor water access and water quality, poor sanitation, malnutrition and other risk factors. 

This means that the health consequences are greater for the poor. Low socioeconomic status and poverty are positively related with suicide. Low levels of education are also dominant in the country. Continued institutional failure to provide the necessary social and economic support makes adaptation to climate events significantly more difficult.

Low educational levels and grant dependency also add to the difficulty. These factors make the population more vulnerable to psychological adversity and mental illness. It is thus clear that the upfront investment necessary to respond to climate change could amplify South Africa’s economic, infrastructural and therefore mental health challenges, particularly psychological trauma and stress responses. If not managed effectively, the transition to a low-carbon economy is likely to be accompanied by a significant increase in mental illness. 

Preparation for these changes offers an opportunity to alter the woeful state of mental health care and to utilise the complexity of the climate change challenge to begin to address mental health care in the context of broader social injustices. 

Climate change and mental health perspectives

Mental health advocates in the United States, Canada, the United Kingdom and Australia have adopted the term “climate anxiety” or “eco-anxiety” to describe psychological responses to climate change. These responses can include fear, anxiety, loss, grief, despair and guilt.

Presented to the world from an individualistic and bio-medicalised cultural perspective, climate anxiety undermines, and may even deny the need for, efforts to address climate injustice, which has its roots in the historical domination and exploitation of the Global South by the North. 

It shifts discussion of climate change and climate justice into a sphere of elitism and exclusivity. This positioning risks excluding race and its social and political consequences from climate activism. Already broadly witnessed in the media, such exclusion is also manifest, for example, in the recent barring of a young Ugandan climate change activist from the World Economic Forum. 

The climate anxiety focus also marginalises communities and individuals and denies the economic and social impact of racism. In addition, it further disempowers the process of adaptation to climate change. Instead, solutions to the effects of climate change are put in the hands of professional elites, at the expense of the voices of those most affected by climate change. The resulting strategies favour the community sectors with the means to more easily adapt. 

Examination of the effects of climate change on mental health in the Global South yields little information, given the lack of research on how the region is engaging on this issue. Research on the topic in South Africa is similarly limited. Google searches on or related to climate anxiety or eco-anxiety in South Africa produced few results. If we assume that internet search results are an indicator of relevance, this suggests that the challenges or the distress experienced by populations in South Africa are dissimilar to those of populations in the Global North.

Local social movements that address mental health challenges exclusively in relation to climate change are rare. In a recent webinar on mental health and climate change, the African Climate Alliance (ACA) highlighted the continual marginalisation of black communities, along with climate issues deepening the already prevalent inequality that these communities experience. The ACA’s contributions affirm that the South African populace is more vulnerable to the mental health harms of climate change because these occur in the context of a black majority already marginalised and carrying the burden of mental illness due to the trauma of injustice and the lack of infrastructure and resources. 

The severe historical trauma of systemic violence and racial discrimination, as well as an internalised negative racialised black identity, make South Africans more vulnerable to the expected impacts of climate change, including increased burden of disease, water and food insecurity, sun and heat exposure, energy crises, financial insecurity, interpersonal violence, natural disasters and mental health effects. 

Increased depression, sadness, anger, helplessness, hopelessness, fatigue, inability to experience pleasure, loss of energy, feelings of worthlessness, anxiety, panic, restlessness, suicidal ideation and suicides are all likely to overwhelm the South African population and the existing support systems. Given that women, children and youth are among South Africans most vulnerable to these mental health issues, the effects of climate change are potentially calamitous in increasing socioeconomic sustainability. 

Addressing the mental health effects of climate change as independent of the broader sociopolitical and psychosocial South African context would effectively deny the reality experienced by the country’s majority. It would likely lead to mental health interventions directed only at the best-resourced 25% of the estimated one-third of South Africans requiring mental health support, such as psychiatric consultation, medication, counselling, psychoeducation or psychotherapeutic treatment. Moreover, it could distract public attention from climate change realities, delay adaptation by leading to climate change denial and restrict the necessary contributions that all South Africans need to be aware of to contribute to a low-carbon economy. 

Furthermore, the South African response to the Covid-19 pandemic illustrates the importance of engaging communities on issues of change. The pandemic response has exposed systemic failures that have further diminished the ability to access mental health treatment. Anxiety about contracting Covid-19 has increased depressive symptoms, and studies of the first lockdown found that 33% of the population was depressed, 45% fearful and 29% acutely lonely. This experience reinforces the necessity for greater focus on understanding societies’ lived realities to support mental health in a just transition responding to climate change. 

Considerations in developing a framework for a just transition

The mental health consequences of a just transition in response to climate change are clearly complex, multifaceted and beyond the scope of this essay. It is, however, imperative that efforts integrate the ideas below into framework development from the outset. 

The sociopolitical dynamic is such that those who will be most affected by climate change have the least ability to bring about societal change. In the context of a post-apartheid South Africa that has been sorely disappointing in the delivery of a promised transformation that would benefit all its citizenry, the necessity of climate change adaptation offers an opportunity to re-engage transformation. 

A relevant societal transformation would need to be holistic and make an impact on the provision of all services to the people, including mental health services. Thus, the conceptualisation of the climate adaptation process needs to be the ideological, conceptual and intellectual container within which the issues of mental health care are housed, and it is the first step in such a transition. 

Relevant transformation requires that all voices be heard and needs addressed. Inclusion of all South Africans, but particularly vulnerable communities at the earliest stages of engaging in a just transition in response to climate change, is necessary to provide a platform for expression of community need, to integrate this requirement into conceptualisation and planning, and to begin the mammoth task of redressing systemic inequality through climate change adaptation. Effective climate adaptation interventions must address systemic issues in their totality. This may challenge existing power relations and require the re-imagining of an entire social system.

Psychologically, the long-standing effects of race and class segregation and social inequity have caused social fragmentation. This has resulted in a disconnect between people: from each other, from themselves and from the social forces impacting their lives (Pavel 2015). This fragmentation, and the accompanying confusion, disempowers those who endeavour to bring about social change. Communities in metropolitan regions have largely been accepted as the sites through which collaboration for change will be most effective. 

However, if climate change response initiatives are to be successful, vulnerable communities need to be empowered to take control of the climate issues which affect mental health in their communities. The factors above are significant for change in South Africa, where low educational levels are an important consideration in climate change adaptation. Adding to the complexity is the lack of information needed to understand a community’s awareness of climate change and its impact on the community’s environment. 

Thus, climate change intervention needs to consider the relevance of the issues to specific communities, along with the specific mental health issues present in that location. Empowering communities by giving them the autonomy to identify, plan and respond to the particular sociopolitical issues which underlie their mental health is a just and sustainable way to address the transformation required for effective climate change adaptation. 

Quantifying the extent of mental illness in South Africa is difficult and complex. There is also little local research to help us interpret the South African silence on climate change. The question of whether the silence results from denial, apathy or ignorance is as yet unanswered. In the context of climate change adaptation, moving forward from a place of knowledge is imperative. Research in this domain is essential; without it, mental health cannot be clearly and firmly located on the just transition road map. 

In the context of the marginalisation of South African communities, research methodologies need to counter the culture of extraction upon which mining and other industries have built their success. Industrial profitability has been derived largely without reciprocal care and replenishment of the environment from which materials have been extracted. A beneficial research methodology needs to model an alternate way of relating that considers the sustainability and sources of knowledge. 

In this vein, decolonising research methodologies are appropriate in setting community empowerment, advocacy and social change as primary objectives. Such research processes begin by assessing where communities currently are in their developmental processes and catalyse interventions for transition and adaptation. In terms of content, research on the power dynamics of resistance to climate adaptation needs is planned in partnership with the community, psychosocial psychologists and climate governors. This partnership could develop a programme that authentically marries the needs of all parties, while remaining aware of the losses that inevitably will be part of the transition. 

Community psychologists have a valuable role to play in this process as climate change activists: demystifying both psychology and climate change, communicating and translating environmental changes in relation to climate change, and serving as community process directors, researchers and mental health professionals to address the mental health challenges specific to the communities they work in. 

Climate change adaptation related to both technical and mental health indicators must be taught at all educational levels to empower more South Africans with the skills to identify and intervene in mental health issues at a community level. Social support is the strongest indicator of maintaining good mental health. Community organisations must therefore play a central role in providing such support to address mental health adaptation to climate change.

An intersectoral approach to managing mental health in the context of climate adaptation, including but not exclusive to government departments, would be most effective in addressing the mental health effects of climate change adaptation.

Increased global temperatures, droughts in Africa, and wildfires in North America and Australia have started to alert the world to the severity of climate change and the human suffering it brings. 

In South Africa, a just mental health transition to climate change is best achieved if it is understood systemically, takes into consideration the interplay of the sociopolitical and the psychological and is mindful of the society’s dynamic nature. Any adaptation measures, therefore, need to go beyond the technical, recognise the psychosocial impact and account for the psychological trauma that comes with climate change as we undertake a just transition to a low-carbon economy. DM/OBP

Read part one

Read part two

This essay series has been produced by the Presidential Climate Commission Secretariat and New Climate Economy, with support from the Danish Ministry of Foreign Affairs. The interpretations and findings set forth in the essays are the authors’ alone.