As global temperatures rise and heat waves become more frequent and intense due to climate change, governments around the world have increasingly implemented Heat-Health Action Plans (HHAPs) designed to mitigate the harmful effects of extreme heat on populations. These plans are intended to reduce heat-related morbidity and mortality, particularly addressing physical health outcomes such as heat stroke and cardiovascular events. However, a new comprehensive study conducted by researchers at Columbia University’s Mailman School of Public Health reveals a glaring oversight embedded within these strategies: the insufficient integration of mental health considerations and interventions. Despite growing evidence linking extreme heat to adverse mental health outcomes—including heightened anxiety, depression, and suicidality—most HHAPs either marginally acknowledge these impacts or fail to offer specific protective measures.
The impetus for this study stems from alarming estimates demonstrating that exposure to heatwaves worldwide has more than doubled since the 1980s. The accelerating pace of climate change exacerbates this trend, placing enormous strain on already vulnerable populations. Recognizing the critical intersection of environmental stressors and mental well-being, Columbia researchers undertook a systematic content analysis of 83 Heat-Health Action Plans across 24 countries, examining how mental health risks are currently framed and addressed within governmental policy frameworks.
Findings from the analysis reveal a dichotomy in recognition versus action. Approximately 76 percent of the plans broadly mention mental health as a concern linked to extreme heat. Yet only 31 percent explicitly identify the unique and nuanced mental health consequences induced by heat stress, including increased psychiatric emergencies and elevated suicide risks. More disturbing, a mere 22 percent of the plans articulate concrete, actionable interventions tailored to mitigate these specific mental health harms. This disconnect points to a significant public health gap, as evidence increasingly supports that heat exacerbates symptoms in individuals with pre-existing mental health disorders such as depression and schizophrenia, while also precipitating new mental health crises among the general population.
The study’s senior author, Dr. Robbie Parks, emphasizes this critical shortfall. Parks, an assistant professor in Columbia’s Department of Environmental Health Sciences, underscores that “emerging research establishes extreme heat as a potent but often overlooked risk factor for mental health deterioration.” Yet, according to Parks, existing heat adaptation policies largely fail to translate acknowledgment into effective strategies that shield vulnerable groups from these deleterious effects. This gap significantly undermines the overall efficacy of Heat-Health Action Plans and represents an urgent area for policy evolution.
Delving deeper into the content of existing HHAPs, the researchers noted a general tendency to focus on broad-based public messaging and physical health interventions, such as hydration and cooling centers, without addressing the underlying social and environmental drivers that amplify mental health risks. Key factors such as heat-induced displacement, economic stressors, and disruption of sleep patterns—each known to contribute substantially to mental distress—are often neglected. Moreover, at-risk populations, including homeless individuals and socially isolated community members, seldom receive targeted support or mention in these plans. Interventions that could foster social cohesion, such as community neighbor check-in systems during heat events, are notably scarce.
Geographically, the study found striking disparities. While HHAPs in higher-income countries show some level of mental health inclusion, low- and middle-income countries—which frequently bear the brunt of climate impacts—largely omit specific mental health protections. India emerges as a rare exception, standing alone among these nations in explicitly incorporating mental health considerations into its heat adaptation policies. This gap is especially concerning given the disproportionate heat exposure and resource limitations faced by populations in the Global South, amplifying vulnerability and health inequities.
Co-author Allison Stewart-Ruano, a doctoral candidate specializing in environmental health sciences, emphasizes the multifaceted nature of the challenge. Stewart-Ruano articulates that effective responses must be multi-tiered, leveraging clinical interventions and community-based efforts in tandem. For instance, ensuring access to cool, quiet sleeping environments can relieve heat-induced sleep disturbances linked to mood disorders, while training local networks to recognize and help vulnerable neighbors during heat crises can combat isolation and despair. Such integrative approaches, bridging medical and social spheres, are critical for building resilience.
This research arrives at a pivotal moment for climate and health policymaking. As heatwaves escalate both in frequency and severity, the mental health burdens they impose risk overwhelming healthcare infrastructures and exacerbating existing disparities. The study’s findings act as a clarion call for governments and public health agencies to rethink and redesign Heat-Health Action Plans. Incorporating targeted mental health interventions—rooted in a deep understanding of socio-environmental determinants—can transform these plans from purely physical health-focused initiatives to comprehensive strategies that truly safeguard overall well-being under climate stress.
Importantly, the collaborative nature of this research extends beyond Columbia University. Contributions from epidemiologists and climate-health experts at the London School of Hygiene and Tropical Medicine, Health Equity and Human Rights LLP, and WHO/WMO Joint Office for Climate and Health reinforce the global relevance and urgency of the issue. Such interdisciplinary and international cooperation underscores the complexity of heat-induced mental health impacts and the need for coordinated, evidence-driven policy solutions.
Additionally, funding support from multiple grants by the National Institutes of Health reflects the increasing prioritization of climate-related health research within the biomedical community. These investments enable the rigorous evaluation of existing policies and facilitate the development of innovative interventions that can be scaled globally. The study’s publication in the peer-reviewed journal Current Environmental Health Reports lends further credibility, positioning it as a vital resource for policymakers, clinicians, and environmental health practitioners eager to address this emerging crisis.
Looking ahead, the researchers recommend urgent integration of mental health risk assessments into heatwave surveillance and early warning systems. They advocate for inclusion of mental health professionals in the design and deployment of heat response measures, ensuring the social and psychological dimensions are not sidelined amidst the conventional focus on physiological risks. Emphasizing community engagement and equity will also be central to effectively reaching and supporting those most at risk during extreme heat events.
In conclusion, rising global temperatures are not only challenging our physical health but disproportionately threatening mental health worldwide. This new study exposes critical shortcomings in existing government Heat-Health Action Plans, revealing a widespread failure to operationalize mental health protections despite growing evidence. Bridging this divide demands proactive, multifactorial policy adjustments that address the clinical, social, and environmental facets of heat-related mental illness. Only through such comprehensive approaches can societies hope to maintain mental well-being amidst the intensifying heat waves of the 21st century.
Subject of Research: People
Article Title: A Critical Gap in Addressing Mental Health in Heat-Health Action Plans Worldwide
News Publication Date: 26-May-2025
Web References:
https://www.pnas.org/doi/10.1073/pnas.2024792118
http://dx.doi.org/10.1007/s40572-025-00486-7
References:
Parks, R. M., Stewart-Ruano, A., Spriggs, R., Keyes, K. M., Ornelas Van Horne, Y., Massazza, A., Czerniewska, A., Saez Reale, A., Shumake-Guillemot, J. (2025). A Critical Gap in Addressing Mental Health in Heat-Health Action Plans Worldwide. Current Environmental Health Reports. https://doi.org/10.1007/s40572-025-00486-7
Keywords: Climate change adaptation, Public health, Environmental health
