"A valid mixture of anxiety, despair, rage, grief": Canadian clinician perspectives on climate-related extreme weather impacts and mental health

Siqi Xue , Dorsa Nouri Parto, Leanne M Lacap , Lisa D Hawke , Charlotte Munro , Samantha Wells, Madeha Umer, Martin Rotenberg , Muhammad Ishrat Husain, Sean A Kidd

Climate change has been increasingly recognized as a determinant of mental health, yet limited research has examined how mental health care systems and clinicians are perceiving and responding to the impacts. This study explores the experiences of clinicians supporting people with mental health conditions in relation to climate change and extreme weather events (EWEs).
We conducted a cross-sectional qualitative descriptive study using four virtual focus groups with 25 clinicians in Ontario, Canada, representing diverse professional backgrounds. Semi-structured discussions explored clinicians’ observations of climate-related impacts on patients, implications for clinical practice, and perspectives on individual- and system-level responses. Transcripts were analyzed using a codebook-based thematic analysis.
Clinicians reported a range of climate-related mental health impacts on patients, including climate anxiety, existential distress, suicidality, sleep disruption, and agitation during EWEs. Youth and women were perceived as particularly affected, with climate concerns shaping future outlooks and reproductive decision-making. Participants also described physical health vulnerabilities linked to medications, substance use, and social inequities. Clinicians experienced frustration and moral distress, and limited preparedness to address climate-related challenges.
Clinicians in Canada are already responding to the consequences of climate change within resource-constrained health care systems. Strengthening climate-informed training, addressing social determinants of vulnerability, and supporting clinician wellbeing and readiness are critical steps towards building climate-resilient mental health care.