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A review of mental health and wellbeing under climate change in small island developing states (SIDS)

This paper reviews research about mental health and wellbeing under climate change in small island developing states (SIDS).
Multiple Authors
Maldives, a small island developing state.


The political grouping of small island developing states (SIDS) is often identified as being highly vulnerable to climate change impacts. Stereotypical island characteristics, such as small land area, small populations, natural resource-based livelihoods, and isolation may contribute to their vulnerabilities and may detrimentally affect the populations’ health. Yet, information on mental health and wellbeing in SIDS is typically underreported.

To help address this research lacuna, this paper reviews research about mental health and wellbeing under climate change in small island developing states (SIDS). The objective is to contribute to understanding climate change adaptation options and implications for mental health and wellbeing.

The text below provides a summary of the open access paper “A review of mental health and wellbeing under climate change in small island developing states (SIDS)” published in Environmental Research Letters in March 2021. Please note that references have been removed. For much more detail and full references you can read the full paper here.

Research method

An overview and qualitative evidence synthesis was the research method used for this study to select and analyse scientific papers on the topic. This method assisted in reconciling major differences among the methods and analysis approaches used across scientific studies.

Google Scholar, MEDLINE, PsycNet, PubMed, Scopus, and Web of Science were searched according to the search strategy in table 1 (extracted from the article, p. 3). Inclusion criteria were peer-reviewed publications in English up until the end of June 2020 without limiting the start date. Then, snowball sampling examined the reference lists of the publications found.

The search string was:

  • Each phrase in Column 1 separated by OR AND
  • Each phrase in Column 2 separated by OR AND
  • Each phrase in Column 3 separated by OR
Table 1. Search strategy
Column 1 Column 2 Column 3

Mental health;

Mental disorder;

Mental illness;

Mental ill health;

Psychosocial distress;

Psychological distress Depression;




Substance abuse;

Substance misuse;

Substance use;


Small Island Developing State;

Small Island Developing States;

SIDS;Anguilla; Antigua;Barbuda; Aruba;

Bahamas; Barbados;

Belize; British Virgin Islands; Cuba; Dominica; Dominican Republic; Grenada; Guyana; Haiti; Jamaica;

Montserrat; Netherlands; Antilles; Puerto Rico; Saint Kitts; Nevis; Saint Lucia;

American Samoa; Cook Islands;

Federated States of Micronesia; FSM;Fidji;French Polynesia;Guam;Kiribati;

Marshall Islands; Nauru;New Caledonia;Niue;

Northern Mariana Islands; Palau;

Papua New Guinea; PNG; Samoa; Solomon Islands; Timor-Leste; Tonga;Tuvalu;Vanuatu;Bahrain;Cape Verde;Comoros;

Guinea-Bissau;Maldives; Mauritius; São Tomé; Príncipe;Seychelles; Singapore.

Climate change;


Sea level;

Global warming;

Climate variability;

Greenhouse effect;

Greenhouse Gas Emissions; GHGE.

Mental health and wellbeing in SIDS under climate change

Changing weather and mental health and wellbeing

Weather impacts on mental health and wellbeing have been documented in some SIDS, with examples including acute stress, anxiety, depression, and post-traumatic stress disorder (PTSD). Such work demonstrates the mental health and wellbeing consequences of stressors, including loss of family and peers, interference with livelihoods, damage to property and land, and post-disaster displacement, especially over the long-term.

In the Pacific, a growing body of literature is linking disasters involving tropical cyclones to mental health and wellbeing impacts such as feelings of loss, grief, sadness, anger, and stress leading to anxiety, depression, and PTSD.

Creeping changes and mental health and wellbeing

Climate change impacts beyond weather appear more slowly, including a warmer ocean and atmosphere, rising sea levels, ocean acidification, ecosystem changes, and alterations in land and freshwater. If SIDS peoples are unable to adapt their livelihoods—both subsistence (such as agriculture, fishing, forestry, and hunting) and non-subsistence (such as tourism and hospitality)— to climate change, then mental health and wellbeing impacts may be exacerbated by unemployment, economic hardship, and inability to meet basic needs.

Food and water insecurity have been associated with symptoms of depression, anxiety, and other mental health and wellbeing difficulties, with gender- and age- differentiated consequences.

Climate change, migration, and mental health and wellbeing

There has been little investigation of the effects of potential migration linked to climate change on mental health and wellbeing in SIDS. The stress of migration can be exacerbated by a lack of social support, poor health systems, insufficient livelihoods, economic hardship, discrimination, and limited access to housing, education, social services, and healthcare.

Research across Pacific SIDS emphasises the importance of land as a foundation for culture and identity. Relocation and migration can therefore have substantial mental health and wellbeing impacts though the loss of place attachment, ancestral connections, and identities, which in turn can lead to eroded belief systems, family ties, and local and cultural knowledges.

Key messages

The key points emerging for mental health and wellbeing in the context of climate change and climate change adaptation for small island developing states (SIDS) are:

  1. This topic has yet to feature prominently and systematically in research covering SIDS.
  2. Major, adverse mental health and wellbeing impacts linked to climate change impacts are likely to affect SIDS peoples.
  3. Similar outcomes might result from discussing climate change related situations, scenarios, and responses, especially when catastrophising SIDS people’s situation in the context of climate change.
  4. Given inadequate health systems and stigmatisation of mental health diagnoses and treatments, climate change narratives might present an opening for conversations about addressing mental health and wellbeing issues for SIDS peoples.

Suggested citation

Kelman, I., Ayeb-Karlsson, S., Rose-Clarke, K., Prost, A., Ronneberg, E., Wheeler, N., & Watts, N. (2021). A review of mental health and wellbeing under climate change in small island developing states (SIDS). Environmental Research Letters, 16(3), 033007.

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