Shifting spaces: Could tackling climate change in cities help solve the youth mental health crisis?

Young people are experiencing growing levels of distress, with research on adolescent mental health trends highlighting a significant surge in anxiety and depression since the 2010s. What are the causes of this shift and how can we tackle it?

The latest insights show a more nuanced analysis can inform interventions to reverse this shift. Those interventions can take place at all levels of society – within the home, with parents, with mental health workers and with policy-makers.

Speaking during the ‘Less Play, More Talk?’ session at the World Economic Forum’s Annual Meeting of the New Champions 2024 in Dalian, China, two leading mental health experts discussed how issues such as climate change and COVID are impacting young people’s mental youth and offered solutions.

Two major intersecting shifts are urbanization – with half a billion more city dwellers forecast over the next 15 years – and the need for action around declining adolescent mental health, said Pamela Collins, Professor and Chair at the Department of Mental Health at Johns Hopkins University.

As cities grow and urban conurbations bulge, so too does the number of people who are living with mental health disorders, she said. The majority of these conditions start in adolescence – a time when most are working out who they are in the world and their identity within the interconnected networks that surround them.

Cities, she explained, are transforming and becoming the principle place where young people grow up and form their impressions of the world and their place within it.

“Central to adolescent development and mental health are adolescents’ interactions with their environments, and right now, urbanization is one of the forces that is shaping environments around the world,” Collins explained.

Cities, of course, bring access to opportunities, healthcare and jobs, as well as social freedom. "But these can also be places of crowding, of density – things that actually increase people's stress and sense of overload,” she said.

Young people under the age of 25 are those most likely to move to cities for opportunities with experts estimating that, by the year 2050, 70% of the world's adolescents and children will live in these urban centres. With the access to opportunity also comes exposure to risk.

"Urbanization is also a cause of disparities which can expose people to adversities such as poverty and violence that also damage people’s mental health and well-being, leading to higher risk of anxiety, depression and psychosis," she said.

Young people face the twin fears of a lack of connections and concerns about the world they are inheriting, a world increasingly impacted by climate change, suggested Emma Lawrence, Lead, Mental Health and Lead, Climate Cares Centre at the Faculty of Medicine, Institute of Global Health Innovation, Imperial College London.

“We know from the evidence that young people need connection for healthy relationships,” she said.

“They need connection to hope, connection to the ability to regulate their own emotions and develop psychological resilience, but also connection to clean air, water and food security, education, healthcare, access to nature and ability to practice their culture free from discrimination and violence.”

A sense that things are getting worse, not better, that the world is worsening, rather than improving can be destabilizing for adolescents and damage their ability to access all of the things that adolescents need to thrive – basic resources, jobs or connections to other people. The lockdowns, she said, were an extreme example of this.

“So if you care about youth mental health… then you must care about climate change. It is a risk multiplier that is currently escalating - the likelihood that young people around the world are exposed to traumas and stresses - and it's destabilizing,” she explains.

Lawrence also highlighted the interconnectedness of mental health with their social and physical environment. “Young people who are exposed to air pollution, even from in utero, are more likely to experience anxiety, depression and psychosis. There's changes to their brain structure associated with social connection, with ADHD and with anxiety.

“If you're exposed to an extreme weather event, you can be disconnected from healthcare, from your schooling, and experience traumas and stressors that may have lifelong consequences,* she added.

A destabilizing present also feeds a fear of the future. "Many adolescents, particularly those already living with a changing climate, are also feeling anger, fear, grief about not only what's happening now, but what's to come,” she said.

But much can be done to address this issues, Collins said.

“At an individual level, young people need the skills to manage their own emotions, things that will allow them healthy emotional development - so recognizing and managing emotions - being able to deal with success and failure in responsible ways. They need skills for resilience,” she said.

“Secondly, a defining theme for any city that supports youth mental health is concern for young people's social fabric, and the city therefore needs to provide young people with the skills, the opportunities and the places for health and social relationships – relationships with peers, with families, across generations and within their communities.”

At an organizational level, cities should therefore reduce barriers for access to mental health care and support for young people. This includes both normalizing the use of mental health services and also ensuring that they are both affordable and accessible, she said.

Policy-makers should also work with urban space designers, educators and other partners to provide protections from issues such as discrimination, harassment and violence by creating safe spaces and environments for young people that support connections. Green spaces, for example, were invaluable during COVID not only for access to nature but also as a safe space for vital social interaction.

“[If] we want a world where no young person is held back by mental health problems, then we all need to advocate for bold and just climate action,” adds Lawrence.

With emissions still rising, many young people feel betrayed by what they see as an intergenerational injustice. The additional mental health burden due to climate hazards in access to green space and air pollution alone is forecast to cost $47 billion by 2030 and $537 billion two decades later.

“So if we can recognize this complexity and this interconnectedness… and that climate action is an opportunity multiplier for mental health, every one of us here in this room making decisions across sectors and across levels can contribute to a world that is better for our climate and our minds simultaneously.”

After all, it is the same skills that we need to invest in psychological resilience and social resilience for young people in a changing climate. “So if we implement things in cities like more green space and reduced air pollution, this will also protect developing brains,” she adds.

The International Monetary Fund has estimated that we spend about $7 trillion a year subsidizing the fossil fuel industry, observes Lawrence. “So the world has resources to create these kinds of healthier environments, and young people depend on the decisions of all of us.

“The cost of climate inaction on the mental health of young people is the greatest challenge humanity has ever faced,” she continues. “But it is our responsibility in this generation to seize the biggest opportunity that has ever existed for us to transform society in a way that's healthier for our minds as well as the planet.”