Coping with the Mental Health Impacts of Climate Change: A Green Script for Sustainable Action

Abstract

The climate emergency is an existential threat to human health and environmental sustainability. Recent climate-induced events, such as Australia’s catastrophic bushfires of 2019–2020 and floods of 2022, demonstrate the impacts of the climate crisis on physical and mental health of populations. Using a cross-sectional online survey (N = 5483), we examine how Australians are coping with climate change impacts on mental health. The survey included qualitative questions (open-ended comment boxes and ‘other’ spaces throughout the survey) and quantitative questions (e.g., Likert and bipolar scales) on demographics and the mental health impacts of climate change, environmental behaviour engagement (EBE), and mental health help-seeking (MHHS). Australians are using a range of individual and collective coping strategies to help cope with climate change problems, experiences, and anxiety. They have developed a range of coping strategies including contact with nature, taking sustainability actions, practicing problem-focused and meaning-focused coping, and mental health help-seeking, that need to be understood and reinforced by health professionals. Our findings also highlight a link between direct experience of a climate change event and participants’ EBE and MHHS. We recommend assessment processes and green prescribing as a sustainability action intervention framework that health professionals can offer as a response to ongoing community concern about climate change.

1. Introduction

Climate change has been described as one of the greatest existential crises ever to face humankind with profound impacts on social, economic, cultural, and environmental sustainability. Health-related aspects of sustainability include significant impacts on human mental health arising from the increasing frequency and severity of extreme weather events and environmental changes [1]. There are multiple pathways through which climate change impacts mental health, such as increasing temperatures, trauma from weather and extreme climate events, and loss of livelihoods and culture, as well as distress relating to anticipated future threats. Whilst working to mitigate climate change, it is also important to support individuals and communities to cope with the concomitant mental health impacts. The aim of the current study was to explore how Australian adults cope with the mental health impacts of climate change. This included exploring the benefits of taking action on environmental sustainability, specifically climate change, on mental wellbeing.

The Australian MJA–Lancet Countdown on health and climate change identifies mental health as a priority and as an often unseen issue, subsequently adding a specific indicator for mental health [2]. The mental health impacts of climate change can be direct, such as trauma associated with extreme weather events, and indirect, occurring through social, economic, and environmental disruptions. Climate change and mental health pathways are multidimensional and lead to a variety of psychosocial consequences. There is increasing evidence that the direct impacts of extreme weather events can lead to a variety of mental health issues, such as post-traumatic stress disorder, anxiety, and depression [3,4,5,6].

The mental health impacts of climate change are not experienced uniformly. The psychological effects of climate change are thought to be intensified for subpopulations in Australia, such as women, young people, people from low socioeconomic backgrounds, and people whose livelihood depends on ecosystem health, such as farmers [4,7]. For example, the 2022 Mission Australia Youth survey reported that 67% of Australian young people were concerned about climate change, and 26% reported feeling very or extremely concerned about climate change [8]. Studies also suggests that Indigenous populations are particularly vulnerable due to a close relationship with the environment, with climate change resulting in disruptions to place attachment, damage to cultural continuity, impacts on food security, and forced migration to unfamiliar environments [9].

Less research has explored how individuals cope with the mental health impacts of climate change. Research among children and young people suggests that they tend to cope by making meaning out of climate change (meaning-focused coping), problem solving strategies (problem-focused coping), and de-emphasizing the seriousness of the issue [10]. Similarly, studies among adults highlight emotional and problem focused strategies [11,12].

Meaning-focused coping strategies draw on beliefs, values, and goals to develop positive emotions when dealing with the concern and worry associated with threats of climate change [11]. Meaning-focused coping lessens negative emotions and encourages problem solving [10]. Problem-focused coping aims to address the problem by taking action or identifying pathways to a solution (e.g., seeking information) [11]. Problem-focused coping may have both positive and negative consequences on how people cope with climate change. For example, in adults, problem-focused coping encourages environment efficacy and pro-environmental behaviors and acts as an effective coping strategy [13]. Conversely, Ojala’s [10] study on coping strategies among children found that problem-focused coping may have a negative effect, i.e., experiences of anxiety and depressive feelings in their day-to-day lives. De-emphasizing the seriousness of the issue involves avoidance, denial, distancing and thinking that climate change is exaggerated. It is related to lower environmental efficacy and values than the other two mechanisms [11]. Emotion-focused coping involves behaviors that aim to moderate negative emotions. These behaviors include avoidance, denial, disregard of individual responsibility, and disengagement [14,15].

Several authors have found that engaging in behaviors to mitigate the impact of climate change is an effective way for individuals to manage their anxieties about the future and transform their feelings into optimism and determination [16,17]. Taking action on climate change can reduce personal stress, increase optimism, and, in turn, reduce adverse mental health impacts [18,19]. Likewise, the mental health benefits of nature connection and green prescribing, where health professionals encourage clients to spend time in natural environments, are well documented [20]. Green prescriptions can contribute both reactively (healthcare) and proactively (health promoting) to public health solutions whilst enhancing the natural environment and promoting environmental sustainability [21].

Sustainable development, as a concept, embodies the pursuit of meeting fundamental human needs while simultaneously integrating environmental development and protection. It aims to achieve equality, ensure social self-determination, foster cultural diversity, and maintain ecological integrity [22,23]. Coping with climate change is essential for achieving sustainable development as it affects environmental, economic, and social determinants targeted by the Sustainable Development Goals, particularly Goal 13 on climate action and Goal 3 on good health and wellbeing [24]. Several national psychological associations have published guidelines on effective strategies for coping with distress relating to climate change and other environmental sustainability issues, drawing from relevant theory and research. The American Psychological Association [25] encourages psychologists to use their current skills to support individuals to manage mental health symptoms, as well as gaining insight into the problem and acting on climate change. Connection with and psychological attachment to nature are linked to diverse health and sustainability-related outcomes [26]: the Australian Psychological Society [27] highlights behavioral, cognitive, relational, and emotional strategies, including acting on climate change and visiting nature. The British Psychological Society [28] also highlights validating and not pathologizing distress due to climate change, building environmental factors into formulation, and green prescribing as a way of linking clients to nature-based interventions and sustainability activities. However, although distress relating to climate change may be relatively common [4], it is unclear whether individuals see mental health support as available and effective.

Given the cascading impacts and multiple stressors of a changing climate, it is important to identify what coping strategies and environmental sustainability-related behaviors individuals are adopting to lessen their ongoing concerns. This paper highlights novel findings from a study of individual and collective coping strategies used by Australians to manage the mental health impacts of climate change. Where these coping strategies are associated with greater mental wellbeing or adaptive behavior, they might be used to inform therapeutic strategies and inform public health responses. In this paper, we address the following question: “What coping strategies do Australians aged 18 years and older practice in response to the mental health impacts of climate change?”

2. Methods

2.1. Participants

The final sample included 5483 individuals who completed all measures of interest and provided data from 11 August to 11 November 2020. Over this period, residents in various Australian states and territories experienced a range of restrictions relating to the COVID-19 pandemic. These restrictions were particularly severe in Victoria, with local and state-wide lockdowns between late June and early November 2020 [29]. Restrictions in other states and territories were relatively minor over the period of data collection. In the survey, we utilized a measure of COVID-19 (problem ranking) and is published elsewhere [18].

Participants were recruited in two stages, including an initial sample that self-selected by responding to survey links advertised via news and social media, and a selective sample of panel research participants that were identified to ensure that the final sample was closely representative of the general Australian population. The initial self-selecting sample included 4089 participants. This group was predominately female (64.4%), of older age (median = 55), with the largest proportion from one state (35% Victoria), living in areas associated with lower socioeconomic disadvantage (mean IRSD quartile = 3.62). As a result, we sought a selective panel of paid research participants that were mostly male (70%), of younger age (50% between 18–35 years), with only 10% from Victoria, and from areas associated with greater socioeconomic disadvantage (IRSD quartiles 1–1.5). The final panel sample included 1055 participants, including 67% males, 11.2% from Victoria, with a median age of 37, and from areas associated with greater socioeconomic disadvantage (mean IRSD quartile = 1.51). The demographic details of the final sample are described in the results.

2.2. Procedure

Participants completed an online survey that was advertised via several avenues including a national broadcaster, the Australian Broadcasting Corporation (ABC), as part of a national science week, as well as on social media (Twitter, Facebook, and Reddit). A link to the survey was made available at the bottom of a “Carbon Counter” webpage, where participants were provided with ideas to reduce their carbon footprint. Members of the research team also provided interviews with the ABC on topics related to climate change, with information offered about the survey. The survey was hosted on the Qualtrics online platform and took approximately ten minutes to complete. Participants were not provided with any incentive to take part, aside from the survey panel of paid research participants. Ethical approval for the study was granted by the Deakin University Human Ethics Research Committee (DUHERC) (Project ID_224_2020).

2.3. Measures

2.3.1. Demographic Questions and Views/Experience of Climate Change

The online survey included several demographic questions, including on gender, age, and postcode. Participants were also asked to express their views on climate change and were able to respond by indicating that climate was occurring and caused by human activity, occurring and not influenced by human activity, occurring and not sure why, not occurring, or “other”, with an open text box for participants to provide their views. Regarding their experience of climate change, participants were asked if they had a direct experience of a climate change-related event/s, with the examples provided including bushfires, floods, and heat waves. Participants were able to respond to this item with yes, no, or unsure.

2.3.2. Environmental Behavior Engagement

In their original study, Clayton and Karazia [30] developed a simple six item measure that endorsed the significance of engaging in individual sustainable behaviors to address climate change. This measure was developed by adapting five items from the Drive for Muscularity Scale [31], which were rephrased as specific and general statements relating to sustainable environmental behaviors, e.g., “I try to reduce my behaviors that contribute to climate change”. A single item was added to this scale, describing behavioral self-efficacy to address climate change “I believe I can do something to help address the problem of climate change”. Participants identified how true each statement is of them on a 5-point Likert scale from 1 (Never) to 5 (Almost Always). The scale indicated high internal consistency in the original study (α > 0.80) and was acceptable in the current study (α = 0.73).

2.3.3. Coping with Climate Change

We reviewed suggested coping strategies for responding to the mental health impacts of climate change recommended by the Australian Psychological Society [27]. These coping strategies highlight a range of effective cognitive, emotional, and behavioral strategies supported by previous research in Australia [32]. We included a question relating to seeking professional mental health support to gauge whether participants had sought support for this issue in the past. The scale included nine items, as well as an option for participants to enter a text response if a coping strategy was not included in the scale. Participants were advised that the items included strategies for coping with climate change and asked to rate how often they engaged in each on a 5-point Likert scale from 1 (Never) to 5 (Always). An example item is “I participate in climate and environmental protests”.

2.3.4. Seeking Mental Health Support

This question aimed to identify attitudes to seeking professional mental health support in relation to mental health issues caused by climate change. The Mental Health Seeking Attitudes Scale (MHSAS) [33] is a 9-item scale that assesses overall evaluation (unfavorable vs. favorable) of help-seeking from a mental health professional. Participants respond to an amended questionnaire instruction “If I had a mental health concern related to climate change, seeking help from a mental health professional would be…” across each of the nine items, which present a 7-point bi-polar scale with an evaluation and its antonym (e.g., good vs. bad). In the original study, the MHSAS score demonstrated high internal consistency (α = 0.93–0.94).

2.3.5. Qualitative Responses

The study also included an open ended, qualitative question that asked participants to provide additional comments about climate change and mental health: “Are there any other comments you would like to make about climate change and mental health?” Approximately 48% of participants (n = 3656) provided a response to this question.

Details of other questions used in the survey are published elsewhere [4,18].

2.4. Analysis

The Australian Bureau of Statistics remoteness areas (Modified Monash Model, MMM) [34] and Socioeconomic Index for Areas (SEIFA) [35] were used to map the demographic data of the respondents. The Index of Relative Socioeconomic Disadvantage (IRSD) was applied and divided into five quintiles, from 1 (most disadvantaged) to 5 (most advantaged). Respondent demographics and responses to a series of climate-related and mental health questions were reported using descriptive statistics. Descriptive statistics were used to identify how often the respondents participated in different coping strategies.

Next, the analysis of covariance (ANCOVA) was used to explore the differences in environmental behaviors and attitudes toward mental health help-seeking between those who had and had not experienced a climate change-related event, controlling for the same variables.

Finally, qualitative responses were employed to illuminate the lived experiences of the respondents, providing further context to the quantitative data. These qualitative responses were analyzed using the Bruan and Clarke [36] approach to thematic analysis. Firstly, only responses that included reflections on coping were included in the analysis. Each response was then coded, with the codes being reviewed by several members of the research team. We then generated themes between responses, which was followed by a review and a reduction in the number of major themes [36].

3. Results

3.1. Preliminary Analysis

We achieved a sample approximately representative of adults in Australia, reflective of age, location (major cities vs. not), state (Victoria, New South Wales, Queensland, and other) and area disadvantage (IRSD quintiles). For gender, there were somewhat more women than men (

Table 1. Demographics details and population norms.

	Frequency	Percent	AUS pop.
Gender			[8]
Male	2194	40.0	50
Female	3187	58.1	50
Non-binary, trans, and gender diverse	54	1.0
Prefer not to say or none of the above	48	0.9
Age Group			[8]
18–24 years	281	5.1	9
25–34 years	811	14.8	15
35–44 years	707	12.9	13
45–54 years	861	15.7	13
55–64 years	1181	21.5	12
65–74 years	1186	21.6	9
75+ years	444	8.1	7
Missing	12	0.2
State
Victoria	1659	30.3	25
New South Wales	1887	34.4	31
Queensland	921	16.8	20
Other	956	17.4	24
Missing	60	1.09
IRSD			[7]
1 (Highest disadvantage)	1075	19.6	17
2	935	17.1	17
3	781	14.2	21
4	969	17.7	20
5 (Lowest disadvantage)	1641	29.9	25
Missing	82	1.5
Location—Remoteness			[9]
Major cities	3717	67.8	72
Inner regional	1269	23.1	18
Other	417	7.6	10
Missing	80	1.5

). The sample had a mean age of 52.71 years (SD = 19.96). Table 1 summarizes the main characteristics of participants, alongside comparative data against Australia population values where available [34]. This data suggests that women, those from 55–74 years of age, and from IRSD 1 and 5 were somewhat overrepresented. In contrast, males, those from 18–24 years of age, and individuals from IRSD 3 and 4 were somewhat underrepresented.

3.2. Coping with Climate Change

We explored the common coping strategies employed by participants by calculating the frequency of responses to each strategy. Figure 1 indicates that the top three coping strategies for respondents, selected by almost always or often, were “becoming informed about problems and solutions” (72%), “viewing or visiting natural environments” (66%), and “changing lifestyle to be more sustainable” (63%). Approximately a quarter of respondents did not identify “thinking optimistically about the future” (never or rarely) as a coping strategy. Fewer participants reported collective coping strategies, with approximately a quarter often or almost always “participating in debate”, “participating in protests”, trying to “influence policy”, and “working with others on climate issues”.

Most respondents did not practice “seeking mental health support” as a coping strategy for climate change (58.65% never, 17.07% rarely). This was evident across all demographic characteristics, with the majority selecting never or rarely, including those that reported having a direct experience of a climate change-related event (53.75% never, 19.52% rarely). However, participants were positive about the potential benefits of seeking professional support in response to climate change (range = 1–7, M = 4.92, SD = 1.35). It was found that females (M = 1.85, SD = 1.13) scored higher on seeking mental health support compared to males (M = 1.67, SD = 1.07). Moreover, younger age groups (M = 2.25, SD = 1.28), people living in major cities (M = 1.83, SD = 1.13), people living in Victoria (M = 1.78, SD = 1.09) and Queensland (M = 1.77, SD = 1.11), and people from low disadvantaged areas (IRSD 4) (M = 1.86, SD = 1.13) scored higher on seeking mental health support compared to their counterparts. These findings suggest that all demographic groups scored low in seeking mental health support (M < 3). See the supplementary file for comparisons between the other coping strategies and independent variables.

Qualitative data from the survey confirmed and extended the findings of the quantitative analysis. This data highlighted themes relating to managing the mental health impacts of climate change, including contact with nature, individual and collective action, seeking social support, and seeking mental health support.

3.3. Contact with Nature

Many participants described the importance of visiting nature to promote their mental health. They acknowledged the calming and positive effects of nature contact on mental health.

I live in the country and thus my mental health is nurtured by walks and plantings. Some feeling that I can contribute, a small area of calm and positivity to the world.

Being outside also brings both the need for climate change and the improvement to mental health together.

3.4. Climate Action

Climate-related anxiety underpinned participants’ motivation to take climate action. Impact on the planet, social injustice, and love for nature acted as motivators for climate action.

I try and use my anxiety to fuel my work in conservation and climate change adaptation. Seeing how broken the world is usually just spurs me to try harder, after I am done crying…!

Participants also described engaging in climate action, which elicited feelings of hopefulness, empowerment, and motivation. Individual action was identified as a way of promoting a sense of control.

I feel hopeful when I do things that I feel are helping fight climate change.

They also felt supported, empowered, and hopeful when they were surrounded by like-minded people.

Connecting with other people in a local climate action group and talking about our concerns has been key for helping with my mental health.

3.5. Seeking Mental Health Support

Seeking mental health support was also identified as a way of coping. Participants expressed both negative and positive views on mental health support regarding climate change concerns. Some reported that mental health professionals are not adequately equipped to deal with climate change-related mental health impacts, that they have been dissatisfied with the support they have received, and that mental health services are not available to all Australians, especially in rural areas. Several participants explained that climate change is more about survival rather than anxiety and, therefore, they are doubtful about getting help through mental health services.

In the country you are constantly alert and mental health professionals are not easily accessible. I live in a rural area, so bushfires are a concern and at my age 68, heat affects your wellbeing.

Mental health professionals are not yet equipped to deal with the effects of climate change. I am an activist, at points I have needed help with burnout to which I have had responses like change your lifestyle.

Some participants also described the value of mental health support. They explained that mental health support is critical for survival and can improve one’s mental health, and, therefore, it is okay to seek help when needed.

I had an overwhelming sense of hopelessness about the future and I still feel we are in crisis but Acceptance and Commitment Therapy has helped me be able to function on a day-to-day level instead of being crippled by fear and anxiety about the future.

Mental health services are critical for survival in this changing world.

3.6. Self-Care and Coping

Individual self-care strategies including mindfulness activities and spiritual and faith systems seemed to lower worry, concern, anger, frustration, and despair among participants.

Practicing meditation and other mindfulness activities help me to keep a sense of a bigger picture, A sense of gratitude and connectedness helps me to keep active in the climate movement.

I’ve orientated to spiritual philosophies as a way to contextualise climate change within the evolution of consciousness.

3.7. Lived Experiences of Climate Change and Coping

Qualitative analysis identified feelings and mental health linked to loss of place, environmental degradation, and experiences of climate change-related events. Survey participants expressed their feelings related to loss of place, environmental degradation, and climate events using terms, such as anxiety, distress, climate-induced depression, feeling sad, feeling scared, and feeling overwhelmed. Several participants reported feelings of grief and guilt related to the destruction of the planet or “inevitable doom”. Some participants had had direct experiences with climate change-related events, such as bushfires. Among them, some participants reported being diagnosed with PTSD. Furthermore, solastalgia, or loss of place, was a recurring theme within the survey comments. Participants expressed feeling sad as they watched their surroundings, flora, and fauna change through the years.

I live in Yarra Valley in the same house for 4 years. In that time, I’ve watched as trees thin themselves out, dropping branches and foliage more than ever before. Makes me very sad to see the death of flora and fauna, but still cherish my yard.

Two ANCOVAs were run to explore differences in levels of EBE and attitudes toward MHHS between participants who had and had not experienced a climate change-related event. Gender, IRSD, and location were entered as covariates to control for their influence. After controlling for these variables, there was a statistically significant effect of experiencing a climate change event on EBE, F (1, 4509) = 203.73, p ˂ 0.01, ƞ² = 0.04, but not on MHHS, F (1, 4171) = 1.62, p = 0.20, ƞ² = 0.00. These findings indicate that participants who experienced a climate change-related event reported significantly higher environmental behavior engagement (M = 35.09) than those without an experience (M = 34.90), with a small-to-medium effect size, though there were no differences in the perceived benefits of seeking mental health support in relation to climate change.

4. Discussion

With the evidence for climate change clear, and the human mental health impacts more apparent, questions of how people can cope in the face of this stressor are becoming more salient. The aim of the current study was to explore how adults cope with the mental health impacts of climate change among a representative sample of the Australian population.

4.1. Individual and Collective Strategies

Our study found that the most common coping strategies reported by the general adult population included individual coping strategies, with fewer participants endorsing collective environmental behaviors, and the lowest proportion identifying seeking mental health support. Consistent with previous research, our study found that adults engaged in sustainability-related behaviors designed to mitigate the impacts of climate change (e.g., climate action) [16,18,19]. Participants described how these actions promoted feelings of hope, empowerment, and a sense of control. In contrast, collective coping strategies were less frequently endorsed, possibly due to the greater effort required to seek out and work with others and the potential impact of COVID-19 pandemic at the time of the study. Despite the potential barriers for social engagement-oriented coping strategies, close to half of respondents were using these more than “sometimes”, and some participants described how these strategies were essential to maintain their mental health. This finding resonates with Koger et al.’s [37] assertion that nature-based activities, as well as a local and collective focus, helps people to grapple with the climate crisis and sustainability issues.

4.2. Problem-Focused and Meaning-Focused Coping Strategies

Becoming informed about problems and solutions was the most common coping strategy, and likely reflects an effective problem-focused coping strategy [11,12], where seeking information and determining the most useful solutions is a first and necessary step. Similarly, individual self-care strategies guided by beliefs, values, and goals as a way of meaning-focused coping [10,11] helped participants in lowering their worries, concerns, anger, and frustrations related to climate change.

4.3. Contact with Nature and Green Prescribing

Visiting natural environments was also frequently endorsed, and participants described how experiences in nature provided experiences of positive affect, consistent with previous research on green prescribing and the mental health benefits of contact with nature [20,21,38]. Greater interaction with and attachment to nature is associated with positive outcomes in health, wellbeing, and sustainability outcomes [26]. On the other hand, the study suggested that for some people with direct experience of climate change-related events, nature engagement with a damaged local area might be harmful. For example, a sense of belonging or a “home” is an important psychological need of humans, and climate change may disrupt this sense of belonging by affecting the bonds between a person and a place and triggering emotional responses to changes in familiar places, i.e., solastalgia [39]. Further research is needed to understand the mechanisms and pathways that influence the relationship between climate change-related experiences, nature engagement, and sustainability.

4.4. Importance of Lived Experience in EBE

Participants who experienced a climate change event also reported significantly higher EBE, but not MHHS. Qualitative findings highlighted how these coping strategies were used to promote mental health, feelings of empowerment, and mixed views about the relevance and helpfulness of professional mental health support. Although participants were somewhat positive about the potential value of seeking mental health support in relation to mental health issues, actually using a mental health professional was the least popular coping strategy. Participants explained that mental health support can be difficult to access, that some professionals were not well equipped to support individuals with their distress, and that the issue itself, being a real matter of survival, was not conducive for mental health support. This is consistent with Henderson et al.’s [40] and Radez et al.’s [41] studies that insufficient knowledge about mental health issues linked to climate change, a lack of awareness regarding the services offered, long waiting times, and stigma are factors that hinder people from seeking mental health support. The study participants’ experiences of receiving mental health support were mixed, with some participants reporting that their concerns were not appropriately handled, and others describing how it helped them to function more effectively rather than being paralyzed by anxiety. Although several national psychological associations have published guidelines on effective support for individuals experiencing climate or environmental distress [25,27,28], it is not clear how well mental health professionals are following these.

5. Limitations and Future Directions

This present study has several strengths, including a large national sample that was somewhat representative of the general Australian population, complementary qualitative and quantitative components, and that it was one of the first to explore coping with the mental health impacts of climate change. However, it should be noted that the self-selected sample may have had biased view and experience of climate change, although the survey panel would have mitigated this effect somewhat. Furthermore, although this paper highlights popular coping strategies, as a cross-sectional survey study we are not able to determine the effectiveness of these. Future longitudinal research that explores the effectiveness of various coping strategies to improve individual well-being and promote environmental behavior would be helpful to provide recommendations to health professionals and the general public. Furthermore, the psychological effects of climate change, like solastalgia, and the strategies people use to cope with them (e.g., problem- and meaning-focused coping), can serve as theoretical underpinnings for the utilization and effectiveness of green prescribing in enhancing overall human health and well-being.

6. Conclusions

Our study suggests that Australians are coping with the mental health impacts of climate change using personal-level sustainability-related strategies of becoming educated, taking climate action, and seeking relief by spending time in nature. For some Australians, taking collective action on climate change helps them deal with climate-related and sustainability concerns. The use of professional mental health supports, whilst valuable for a small number of people, is hampered by issues of access to mental health service and perceived inadequacies in mental health supports and models which are appropriate for climate-related distress. These findings can be used to inform mental health, primary care, and health promotion professionals about the range of possible coping strategies that are commonly used to manage the mental health impacts of climate change, since many are uncertain on how to engage patients and community in climate change [42]. Furthermore, policies aimed at enhancing accessibility and encouraging people to engage and connect with nature are likely to play an important role in attaining health and sustainability goals. Green prescribing strategies tailored for population groups identified in the study as less likely to seek mental health support (e.g., males, people in remote areas, people with lower economic status) may help promote their health and well-being. Future research should evaluate the value of a green or sustainability multi-script approach, including a range of green coping activities (individual or collective) that have resonance for individuals and key populations, with concomitant benefits for climate adaptation, mitigation, and broader sustainability imperatives [38].