Written By: Ryan Parker, CGMH Research Analyst I
In a recent Think Global event hosted by the Duke Global Health Institute (DGHI), a panel of researchers from the Duke Global Mental Health topical working group on climate explored how climate change is affecting mental health, particularly in communities already living on the margins.
In her introduction, Dr. Chris Gray, a CGMH affiliate and Assistant Research Professor of Global Health, highlighted the dual nature of climate-related effects. While climate change can manifest in acute events such as floods and hurricanes—often followed by heightened rates of PTSD, depression, and anxiety—it also involves what has been described as “slow violence”: a gradual accumulation of environmental exposures that drive displacement and disrupt livelihoods over time.
The first panelist, Dr. Qudsia Shah, Senior Research Officer at the Aga Khan Centre’s Institute of Ismaili Studies, discussed these dynamics in Pakistan, where rapid melting of Himalayan glacial lakes—an essential water source for more than two billion people—has triggered increasingly frequent outburst floods. These events have strained local communities, contributing to displacement and livelihood anxiety, tension within families, increased reliance on opioids and other substances, and heightened vulnerability among those who rely on livestock and other animals.
Building on this perspective, Aaliya Aaliya, a PhD student in Earth and Climate Sciences at the Nicholas School of the Environment, shared findings from her work in Hassanabad, a village in the Hunza Valley of Pakistan. Following devastating floods and mudslides, she conducted a cross-sectional study showing that more than half of surveyed residents met criteria for PTSD, alongside elevated levels of depression and anxiety. Aaliya called on researchers, including those like herself who do not typically work in mental health, to consider who in their own communities and study settings may be most vulnerable to the psychological effects of climate change.
Offering a view from East Africa, Festus Lokato, a Project Officer at Africa Inland Church Health Ministries, described the escalating challenges faced by pastoralist communities around Lake Turkana, Kenya. Already vulnerable to poverty and displacement, pastoralists are confronting intensified water scarcity, growing conflict over diminishing resources, and worsening food and nutrition insecurity. Climate-related threats—from flooding to the spread of vector-borne diseases—compound these pressures. Lokato noted that forced migration and loss of livelihood have contributed to increased substance use, particularly among men whose social and economic roles have been destabilized by environmental change.
To offer an integrated view of the three presentations, Dr. Joao Ricardo Vissoci, CGMH affiliate and Associate Professor in Emergency Medicine, emphasized the shared patterns across the three contexts. “When mental health is impacted,” he noted, “it is impacted directly, but also indirectly by changes in livelihood.” Addressing the mental health consequences of climate change, he stated, will require bottom-up approaches that meaningfully engage communities and policymakers, support multisectoral solutions, and “embed mental health promotion in day-to-day activities.”
Across the panel, the message was clear: climate resilience and mental health resilience go hand-in-hand. As environmental pressures intensify, so too will the psychological burdens for those most vulnerable to a changing climate. At the Center for Global Mental Health, in partnership with the Climate and Global Health Initiative and the Duke Climate Commitment, we are committed to helping address those pressures.