Planetary health and mental health nursing: What will you do?

Relational practice is the foundation of mental health nursing. Being in relationship with the people we work with and for is central to our work, but have mental health nurses also considered their relationship with the planet? In 2020, a joint statement was signed by Australian health groups, calling on the government to recognize climate change in future health policy developments (ANMF, 2020). Internationally, the United Nations Sustainable Development Goals released in 2015 is described as a shared blueprint for peace and prosperity for people and the planet (United Nations, 2015). The list of calls to action is long, global and urgent. As advocates for human health and well-being, nurses have an opportunity to lead adaptation and mitigation efforts to promote planetary health. If we are to improve the relationship between nurses and the planet we need to consider, how we relate to the planet. This special edition brings together papers that will add to this urgent conversation and call to action. Our world is changing rapidly, so much so that we are now considered to be living in a new era of geological history. This era, known as the Anthropocene epoch, is characterized by permanent planetary changes caused by human activity (National Geographic Society, 2019). Human ecosystem interference has resulted in dramatic shifts in Earth's life support systems; rising temperatures, frequent violent weather events, diminished air and water quality and loss of biodiversity are impacting the well-being of all life on Earth (Almada et al., 2017). Accelerating environmental manipulation is a direct result of our disconnection from the Earth and its natural systems. Human exceptionalism allows us to see ourselves as separate and independent from nature and therefore able to exploit the biosphere for our own purposes (Guzman & Potter, 2021). Despite increased attention to issues like climate change and pollution, the link between environmental concerns and local health impacts is generally not considered urgent. Planetary health is an emerging field that recognizes the deep connection between the health of the planet and human health; as Earth's natural systems flourish, so too do human beings. Planetary health concerns have focussed mainly on human physical health; however, the mental health risks are wide-ranging, working in direct and indirect ways. For example, an estimated 25%–50% of those exposed to climate-related extreme weather events, such as droughts, heavy precipitation and flooding, and intense heat, will experience negative mental health outcomes in the form of both acute mental trauma and/or persistent stress disorders such as depression and post-traumatic stress disorder, and other consequences such as substance abuse, domestic abuse and suicidal ideation (Clayton, 2021; Shukla, 2013; Trombley et al., 2017). Populations with fewer socioeconomic resources, such as low-income or marginalized communities and those with pre-existing mental health diagnoses are more likely to be negatively affected and develop mental illness from the climate crisis (Trombley et al., 2017). Every person on Earth will feel the effects of climate change, but children and young people are most likely to suffer climate-related impacts on their mental health and well-being (Sanson et al., 2018). According to UNICEF, a child born today will face increasing exposure to the shocks and stresses of environmental change such as floods, prolonged droughts and wildfires (2021), Children and young people are already experiencing eco-distress and are concerned for their future in a warming world. A survey of 10 000 young people (ages 16–25) found 60% feel ‘very’ or ‘extremely’ worried about climate change, with 50% experiencing feelings of sadness, anxiety, anger, powerlessness and guilt and 45% reporting these feelings negatively impact their lives (Marks et al., 2021). The experience of significant stress is a serious health burden at any stage of development. The global health community is sounding the alarm over the urgent threat of global environmental change to the health of humanity. There is an urgent need to recognize, anticipate and address these impacts. The Planetary Health Education Framework (Guzman & Potter, 2021) is a broad, interdisciplinary framework, designed to act as a starting point for understanding the link between human health and nature (see Figure 1). The Framework places ‘interconnection within Nature’ as the central task for understanding planetary health. This domain promotes recognition of the damaging effects created by perpetuating the false separation between Humans and Nature. As such, this domain emphasizes the need to draw from multiple and diverse ways of knowing in order to ‘enable the emergence of co-benefits for individuals, communities, and our planet’ (Guzmán et al., 2021). By framing human connection to Nature as a lateral bond, the Framework promotes a value-based, transformational approach to education in which ‘the cognitive (the sense of connection), the affective (the caring component), and the behavioural (the commitment to act) are integrated” (Guzmán et al., 2021). This transformational, value-based approach to health is consistent with the existing foundations of mental health nursing education and practice. Mental health nursing is rooted in a practice that involves person-centred and holistic approaches. It focuses on encompassing biological, cognitive, cultural, educational, environmental, physical, psychological, relational, social and spiritual aspects of individuals and communities (Australian College of Mental Health Nurses, 2013). Therapeutic interventions are guided by evidence and include collaborating and connecting with individuals who have mental health concerns, their families and the community, to be on a journey of recovery (Australian College of Mental Health Nurses, 2013). However, healthcare professionals, including nurses, have been slow to recognize their professional role in responding to environmental concerns (Kalogirou et al., 2020; Nicholas & Breakey, 2019). Let's start with what we do best, communication. Let's start a conversation about the health of the planet. The evidence is clear and compelling, the planet's health needs our urgent attention. The Planetary Health Education Framework provides an opportunity for mental health nurses to incorporate their knowledge and experience with relational practice and collaboration to develop and strengthen our relationship with the planet. As nurses, we can take action personally, professionally and politically. Personally, we can be leaders in modelling pro-environmental behaviours within our local communities. Professionally, we can start by reflecting on our practice to evaluate where and how we can incorporate planetary health into our practice. Working in partnership with nature we have seen the healing properties of the planet when incorporated with mental health nursing practice and education. Recovery Camp (Patterson et al., 2017) is a world-leading, award-winning, evidence-based example of collaborative relational practice between humans and the planet. We can begin to build the connection between human health and nature by including nature in mental health practice (e.g. learn more about prescriptions for nature at https://www.parkprescriptions.ca/), and advocating for sustainable workplaces (e.g. learn more about green and healthy hospitals at https://www.caha.org.au/sustainable_health). Politically, we can add our collective voice to efforts focused on building community, national and global hope, connectedness and resilience (e.g. through nursing advocacy groups like the Canadian Association of Nurses for the Environment [https://cane-aiie.ca/]). In the book Braiding Sweetgrass Kimmerer reminds us, ‘if one tree fruits, they all fruit, there no soloists’ (Kimmerer, 2013). We are a large influential group; our collective voice can make a difference. We have championed social justice and human rights issues; our planet now needs our voice and collective wisdom to work together. What will you do? Tanya Park is an associate editor of the International Journal of Mental Health Nursing Lindsay Komar and Laura Reifferscheid are members of the Canadian Association of Nurses for the Environment. Data sharing is not applicable to this article as no new data were created or analyzed in this study.