Integrating child and youth mental health in climate adaptation plans: insights and recommendations from a rapid scoping review and knowledge user engagement

The climate crisis threatens children’s health, particularly environments where they live, learn, and play that are critical for their mental health and well-being. How systems plan and adapt to climate change is crucial for safeguarding child and youth mental health. However, a gap exists in integrating a child and youth mental health focus into public sector climate adaptation plans. Objectives of this study were to: 1) identify existing frameworks that address child and youth mental health within climate adaptation strategies, and 2) engage mental health advocates, climate experts, and public sector leaders in Nova Scotia to share scoping review results, gather insights, and co-develop policy recommendations. A rapid scoping review of academic and grey literature was conducted to identify frameworks addressing child and youth mental health within climate adaptation strategies. A virtual engagement session was held with local experts and knowledge users across Nova Scotia. Data from both sources were deductively analyzed and mapped onto five action areas of the Ottawa Charter for Health Promotion. The scoping reviewincluded 86 sources. Fifty-six knowledge users participated in the partner engagement session. Across both data sources, convergent themes emerged around the need for advocacy at multiple levels for mental health interventions, cross-sector collaboration, investment in climate-resilient infrastructure for child and youth-serving systems, meaningful youth empowerment in climate planning, and equity-focused approaches to structural inequalities. Knowledge users identified four key barriers to integration: difficulty prioritizing child and youth mental health within broader climate plans, insufficient cross-sector collaboration, limited data on climate-related mental health impacts, and absence of dedicated resources for climate-resilient infrastructure. Five policy recommendations emerged: 1) incorporate a Child Rights Impact Assessment into policy and adaptation planning, 2) strengthen intergovernmental and community collaboration at climate-health intersection, 3) invest in climate-resilient infrastructure and policies for child and youth-serving systems, 4) empower children and youth in disaster response planning, and 5) reorient systems to prioritize child and youth mental health and climate knowledge. Protecting child and youth mental health in the face of climate change requires an urgent, rights-based, and cross-sectoral response. Findings underscore the need to combine top-down policy reforms with bottom-up, community-driven approaches that centre the unique vulnerabilities and voices of children and youth.