Mental Health & Climate Justice - Reframe 2022 | MHI




Discourse on climate change has intensified in recent years as heat waves, floods, and hurricanes have impacted developed countries in the last three years. While a fair proportion of responsibility for greenhouse gas emissions, global warming and environmental impact is attributable to the Global North, low-middle income countries (LMICs) are more vulnerable to the repercussions of climate change.

Bangladesh faces cyclones, earthquakes, droughts, and floods regularly as one of the most disaster-prone countries in the world. Approximately 135 million people in Bangladesh have been affected by disasters in the last 20 years, including loss of life, injury and homelessness. This exacerbates issues of psychosocial distress, poverty, livelihood, food insecurity, and access to education. Similarly, Haiti and Malawi have also suffered as their systems are unable to address droughts, hurricanes and floods, resulting in widespread distress.

In parallel, mental health has also drawn more attention, especially around the pandemic. While discussions around the intersection of climate change and mental health are nascent, it is clear that both disciplines are Euro-centric and have a top-down scientific expert approach. Discourse neglects, (often deliberately) the effects of industrial economies, electronic waste dumping, deforestation for elite settlements, and the disproportionate impact of western neoliberalism on the environment.

The seamless shift to finding “solutions” without acknowledging that countries have been facing disasters for over 20 years makes it easy to predict that the intersection of the two fields will reflect hegemonic narratives. This is already visible in research and policy – which is scientific, biomedical and disproportionately Global North led. Thus it was necessary to centre experiences from South Asia, one of the regions said to be hardest hit by climate change, in this issue.

While the ambit of ReFrame has always been South Asia, there has been a focus on India. As it occupies a hegemonic role in this region, it was even more important to ensure representation from countries such as Bhutan, Pakistan and Afghanistan.  We tried hard but failed to bring narratives from the Maldives which is often neglected as part of South Asia but is critical in terms of climate change issues faced by Small Island Developing States (SIDS).

However, it is not enough to draw lines based on Global North versus Global South – which is, reductive, as binaries tend to be. While Western imperialism and its legacies are named and visibilised, Global South countries also engage in settler colonialism and neo-liberal economics that continue to oppress marginalised communities. This is reflected across the lines of caste, gender, sexuality, religion, ethnicity, and disability. 

India’s indigenous groups – Adivasi/ Tribal ethnic communities continue to face the brunt of extractivism, settler politics, and the destruction of natural resources. Yet, Adivasi and other indigenous communities worldwide are at the margins of both climate and mental health discourse. The communities most vulnerable to, and most impacted by climate extremes and mental health systems are the ones most marginalised in both fields’ narratives, research, services, and policy. So, this issue also focusses on how disabled persons are invisibilised and oppressed in specific ways in both of these discourses. Individualised narratives of climate activism and mental health are also classist, casteist, and ableist, in addition to being ineffective

That is why disability justice and social justice must be a central lens for addressing mental health and climate change by acknowledging the existence of power imbalance, contexts of oppression, both in terms of vulnerability to and lack of access to recourse. The North-South divide obfuscates and invisibilises shared oppressions and stands in the way of building movements and allyship. Thus, starting with this issue of ReFrame, we hope to foreground voices from historically marginalised folx from any geography and not just South Asia. 

Therefore, the first section, “Re-vision”, in ReFrame, begins by building perspective on shades of power and justice through indigenous, disability, and caste lens; that challenge hegemonic approaches. Alice Barwa and Kyle Hill discuss Adivasi/Indigenous identities, knowledges, and prescriptions on climate justice and mental health. Dr. Ingole and Camellia Biswas reflect on climate injustice and Dalit distress. Ayisha Siddiqa challenges Eurocentric approaches to youth mental health and climate change, while Dr. Asha Hans details challenges faced by women with psychosocial disabilities during disasters. 

The “Contexts” section explores how climate change and advocacy affect folx in varied settings, from Adivasi activists to young Afghan citizens to disabled persons. Dayamani Barla writes on historical and ongoing engagement with climate justice; Ahmad Nisar details the mental health implications of conflict, environment, and poverty in Afghanistan; Chhaya Namchu focusses on the adversities and solidarities of women in transboundary river regions. Candice D’Souza writes on the structural exclusion of disabled persons in climate change and disaster relief;  Kusala Wettasinghe traces the need for a climate change perspective in crisis-hit Sri Lanka’s progressive Mental Health and Psychosocial Support (MHPSS) field. Rituraj Phukan addresses the exclusion of indigenous communities from the Eastern Himalayas and Abhishek Annica details how climate change needs to centre disability justice.  

The final section, “Engage” shares on-ground examples, such as Manshi Asher’s documentation of youth-led struggles and collective action in the West Himalayas, while another piece locates mental health and community-led work in the Darjeeling Himalaya socio-ecology. Contributors from Youth for Unity and Voluntary Action write on environmental justice in urban landscapes, and Kumar and Nair write on mental health in Kerala’s coastal communities. Using the example of Majuli, Assam, Oja lays out policy recommendations while Choden explores the need for disability to be foregrounded in Bhutan’s policy frameworks. Finally, Mitra explores questions of parenthood and climate change in the therapy room. 
Working on this issue of ReFrame, I realise that issues of accessible and affirmative mental health have been referred to as gaps for far too long when, in fact, these are systemic failures.



Even as we continue to adapt to living in a global pandemic, this year has seen other viral infections, heat waves, and floods the world over. There is also a growing global food crisis fuelled by rising prices of food, fuel, and fertiliser due to the war in Ukraine and climate change. Closer home, India has slipped the ranks in the Human Development Index and the Global Hunger Index.

Alongside this, India ranks 135 among 146 countries in the Global Gender Gap Index 2022 and at 146, is the worst performer in the world in the ‘health and survival’ sub-index. This rising inequality despite economic progress is alarming. These issues are serious and relevant for me as a mental health funder. For instance, food insecurity is a risk factor for both mental and physical health. In the last issue of ReFrame, we explored how food insecurity can not only lead to a higher probability of non-communicable diseases but also increase health costs and poverty.  

Unfortunately, our approaches to health care (mental and physical) and health policies do not adequately consider our context and social inequalities. Our health systems also fail to account for discrimination and violence that arise from the way society is structured. For example, poverty and homelessness have links to mental illness and an increased risk of gender-based violence for women. These inequalities are further exacerbated by disease outbreaks and climate change. While India works to tackle child marriage, there have been significant spikes in their numbers. Young girls in the Sundarbans are forced into marriage due to climate emergencies such as storms and rising sea levels which lead to land loss and a fall in farm productivity. The knock-on effects of this may include rising levels of domestic violence, adolescent pregnancies, and mental and emotional distress. 

There is an urgent need to do things differently. There is an over-reliance on medical experts, academic experts, and credentials rather than taking a systems-thinking approach to public health. This is clearly a problem for health and health inequalities as the majority of research is done in and for the wealthiest and healthiest countries. As philanthropists and corporate funders, our emphasis on scale, on national or ‘large’ professional development organisations also play a role in this. However, as it is amply clear, more psychiatrists or more services will not help us address the mental health consequences of food insecurity and multidimensional poverty. 

Thus, I am convinced that we must break out of the ‘business as usual’ mode and renew our efforts to support our vast and vibrant network of community-based organisations – especially those that cannot access foreign funding. I believe that stepping out of our comfort zones, funding outside of those whom we may know personally, funding in varied geographies, or supporting community-based organisations that may not have access to networks of privilege is an investment towards equity – in health, education, and society. 

‘Indigenocracy’- bringing together notions of citizenship with responsibility towards one another and the environment.



  • Frameworks |
  • Paradigms |
  • Structures

What is the need for mental health and climate change to permeate each other’s isolated, expert-led discourses? What is the paradigmatic change needed in conversations of CLIMATE CHANGE, MENTAL HEALTH, and their INTERSECTION? How does privileging voices from the margins inform mental health and climate change? How does climate justice shape mental health understandings of vulnerability and resilience? 


  • Power |
  • Justice |
  • Lived Realities

How can climate-related mental health engage with difficult conversations of DELIBERATE POWER EQUATIONS rather than viewing both mental health and climate consequences as natural givens? In which ways do identities of caste, nationality, ethnicity, religion, gender, ability, occupation, class mediate between ‘risk factors’ such as drought, overgrazing, floods, earthquakes, and the intensity of their implications? How can conversations of therapeutic care go beyond clinician rooms to policies of rehabilitation, citizenship, livelihood security, public healthcare and housing?


  • Practices |
  • Implementation |
  • Psychosocial

What are the required considerations and target outcomes to keep in mind, while designing preventive policy and rehabilitative services and programmes for CLIMATE RELATED DISTRESS? How do we envision mental health care in policy and services for climate induced distress? In both community care and clinical intervention, how can we incorporate a rights-based lens and respond to structural climate trauma?

MHI’s Work Innovation | Insights | Philanthropy | Challenges | Lived Realities

We work with multiple stakeholders, including non-profit organisations, governments, mental health professionals, and activists in the pursuit of an INCLUSIVE mental health ecosystem. Our core strategies include ADVOCACY, CAPACITY BUILDING, GRANTMAKING, KNOWLEDGE CREATION, and TRAINING

About MHI

MHI provides grants and strategic support to organisations and collectives working within communities to provide greater access to mental health services for all.

About ReFrame

Reframe is a mental health journal that is published annually, covering broad, novel themes in this ever-changing landscape of mental health in India. Deliberately centred on the south asian experience, Reframe aims to be a global, internationally recognised platform for mental health from a south asian perspective.

PERMISSIONS: Copyright © 2022, Publisher: Mariwala Health Foundation CONTENT WARNING: Mentions of eco-anxiety, solastalgia, climate-induced distress, Islamophobia, homophobia, suicide, sexual violence, homicide, casteism and caste violence, race, rape, acid attacks, child abuse, colourism, ableism, domestic violence, eating disorders, chronic pain, trauma, mourning, forced migration, acute stress, intergenerational trauma, racism, oppression, confinement, physical trauma, confinement, blackmail, threats, sex trafficking, dysthymia, depression, PTSD, anxiety, communal riots and religious violence, state-imposed curfews and somatic symptom disorder. In the case of material being triggering or upsetting, you can reach out to icall at +91 9152987821 or


Meenal Rawat
Olimpika Oja
Priti Sridhar
Raj Mariwala
Saniya Rizwan


Shraddha Mahilkar
Shruti Nambiar


Amalina S
Olimpika Oja
Shruthi Murali

IMAGES | wikkicommons |


Freight by Joshua Darden
Neue Haas Grotesk by Christian Schwartz, Max Miedinger


The Noun Project



Studio Ping Pong


Studio Mesmer