Climate Change, Disasters, and Mental Health of Adolescents in India

The commentary addresses how global climate change and associated disasters (e.g., cyclones, floods, droughts) affect mental health, with a focus on Indian adolescents. It highlights that while physical health impacts of climate change have been emphasized, frequent disaster events also precipitate anxiety-related responses and severe mental disorders, imposing substantial individual and societal burdens. India’s large, diverse, and disaster-prone geography, including ecologically fragile regions like the Sundarbans, makes adolescents—who are in a critical neurodevelopmental phase—particularly vulnerable. The piece aims to outline the interaction between climate change, disasters, and adolescent mental health in India and to motivate research and service innovations tailored to vulnerable regions.

India ranks among the most climate-vulnerable nations, with several states (e.g., Arunachal Pradesh, Assam, Bihar, Jharkhand, Meghalaya, Mizoram, Uttar Pradesh, Uttarakhand, West Bengal) identified as highly exposed due to climatic variability, agriculture dependence, and adaptive capacity constraints. The Sundarban delta is a hotspot for cyclones, storm surges, flooding, sea-level rise, and saline intrusion, leading to financial strain and psychological distress. The literature documents that disaster exposure increases risks for mental disorders, with consequences spanning functional disability, reduced productivity, stigma, and social isolation. Evidence indicates adolescents bear a disproportionate burden: WHO estimates suggest roughly two-fifths of 10–14-year-olds and about half of 15–19-year-olds experience anxiety disorders. Post-disaster studies report elevated PTSD and anxiety among adolescents, including 10.8% PTSD after the Andaman & Nicobar tsunami and, in cyclone-affected Odisha, 26.9% PTSD and 12% generalized anxiety disorder among school-going adolescents—rates higher than those observed among adults in India’s National Mental Health Survey 2016 (0.2% PTSD; 1.3% GAD). The commentary also notes community resilience in frequently affected areas and suggests that older adults may exhibit greater immediate post-disaster resilience due to life experience. Despite accumulating global and Indian evidence, the adolescent-specific evidence base remains relatively small, hampered by low mental health awareness and prioritization, limited skilled human resources, and a focus on mortality over morbidity in community settings.

As a viewpoint, the paper synthesizes existing literature and includes insights from a pilot study in the Canning I block of the Sundarbans, West Bengal. In the pilot, adolescents attending an Adolescent Clinic and key stakeholders (medical officers at the NCD clinic and clinic counselors) were interviewed to assess mental health morbidity, substance use, and resilience in the context of frequent disasters. Screening tools included the PHQ-9 for depression and the Brief Resilience Scale for resilience. Based on pilot learnings, the authors plan a large-scale, convergent mixed-methods study targeting adolescents aged 18–19 years to quantify common mental disorders and qualitatively identify gaps and barriers to accessing mental health services. The planned study aims to inform an integrated service delivery model for disaster-prone regions.

- Disasters linked to climate change adversely affect mental health, compounding physical, social, and economic impacts; adolescents are particularly vulnerable due to developmental sensitivity. - Epidemiological indicators: WHO estimates ~2/5 of 10–14-year-olds and ~1/2 of 15–19-year-olds experience anxiety disorders. Post-disaster adolescent PTSD prevalence reported at 10.8% (Andaman & Nicobar tsunami) and 26.9% PTSD with 12% GAD in cyclone-hit Odisha, exceeding adult Indian rates (PTSD 0.2%, GAD 1.3%). - Pilot study (Sundarbans, West Bengal): Using PHQ-9, over two-fifths of participating adolescents screened positive for mild depression; all participants showed normal resilience on the Brief Resilience Scale. - Communities repeatedly exposed to disasters may demonstrate preparedness and resilience; older adults may be more resilient immediately post-disaster due to greater life experience. - Structural and system-level gaps (limited skilled resources, low awareness, prioritization, and community recognition) constrain adolescent mental health assessment and care in disaster-prone settings.

The synthesis underscores that frequent climate-related disasters in India exacerbate adolescent mental health risks, aligning with evidence of elevated post-disaster PTSD and anxiety in youth. The findings highlight a dual narrative: heightened vulnerability during a critical developmental period and the potential for resilience within frequently affected communities. The pilot data from the Sundarbans point to meaningful levels of depressive symptoms despite normal resilience scores, suggesting subclinical or early-stage morbidity that warrants systematic screening and intervention. Addressing identified gaps—such as limited mental health literacy, scarcity of trained providers, and access barriers—can improve early detection and care. Tailored, context-sensitive models that integrate primary care, telepsychiatry, and community assets are likely to be most effective in ecologically vulnerable regions.

The commentary contributes an India-focused perspective on the intersection of climate change, disasters, and adolescent mental health, contextualized by evidence from disaster-prone regions like the Sundarbans and pilot findings from local clinics. It proposes a forthcoming convergent mixed-methods study among 18–19-year-olds to generate robust burden estimates and service access insights, with the goal of informing an integrated, scalable service delivery model. The authors advocate a multi-pronged roadmap: strengthening primary care and referral systems; leveraging local NGOs, self-help groups, non-state providers, and CSR; exploring innovative logistics (e.g., ICMR’s i-DRONE) for hard-to-reach areas; and expanding telepsychiatry using hub-and-spoke models for counseling and caregiver training. Future research should include implementation studies to evaluate these strategies across diverse disaster-prone settings and to measure moderators such as resilience and contextual risks.

The piece is a viewpoint with a small pilot component; detailed sampling frames, sample sizes, and analytic procedures are not provided, limiting generalizability. The adolescent mental health evidence base in disaster contexts is acknowledged to be relatively small in India due to limited skilled human resources, low community awareness and prioritization of mental health, and challenges in recognizing and quantifying mental illness in community settings. Additionally, heterogeneity across disaster events (predisaster conditions, impact, and recovery) complicates extrapolation of findings.