GoKawiilThe families of farmers are left bereft after relatives poison themselves with hazardous pesticides.Credit: Anshuman Poyrekar/Hindustan Times via Getty
Mental health is central to global health and sustainable development. It is shaped both by individual experiences and by access to services, and by broader societal and environmental factors. Laws, policies, governance systems and institutions influence how environmental hazards, damage, services and resources are distributed, affecting people’s livelihoods, safety, opportunities and quality of life1.
Children and adolescents are particularly vulnerable because exposures to environmental hazards can coincide with sensitive periods of development. Early exposure to mercury, lead and persistent organic pollutants can impair cognitive and behavioural development and increase the risk of mental-health conditions later in life.
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For adults and older people, exposure to heavy metals, air pollution, contaminated water and poor-quality environments can lower their sense of well-being and worsen depression and anxiety. For individuals who rely on natural resources and their communities, depletion of the animal and plant species they depend on and disruptions to traditional ways of life and livelihoods are associated with poor mental-health outcomes2.
Yet, global treaties, conventions and international-policy instruments treat mental health and the environment as separate domains. Mental health is rarely built into the reporting requirements, national implementation plans, financing criteria or accountability mechanisms of environmental conventions.
And environmental change is framed in treaties as a risk factor rather than as a core area of mental-health governance. For example, the 2013–30 agenda of the World Health Organization’s mental-health action plan recognizes that climate stability, healthy ecosystems, pollution control and sustainable land use shape the conditions in which people live, work and maintain their health3. But planning and monitoring systems for both domains remain disconnected. The Sustainable Development Goals (SDGs), too, lack indicators that integrate environmental and mental-health outcomes.
As a result, the implementation of environmental treaties is rarely considered to be part of measures that prevent mental-health conditions, and mental-health outcomes are seldom used to assess the success of environmental policies. What is needed is a practical bridge between these agendas: shared indicators, financing incentives, implementation guidance and accountability mechanisms that connect environmental governance to the prevention of mental-health conditions.
Here, we argue that environmental treaties such as the United Nations Framework Convention on Climate Change should be recognized as upstream policy instruments that shape mental health and psychosocial well-being before clinical intervention is needed4. The UN high-level political declaration recognizing the widespread burden of non-communicable diseases, including mental-health conditions, can become a basis for further action5.
To show the interconnected pathways, we propose, as a first step, a tiered policy framework that differentiates between environmental conventions according to their relevance for mental health and their readiness for indicator-based evaluation (see Supplementary information).
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