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International Journal of Environmental Health Research
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Identifying interventions to support mental health for those affected by climate change and related extreme weather events: a scoping review
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Masuma Pervin Mishu, MM Golam Rabbani, Silke Vereeken, Emma Tkach, Jacqueline Martin-Kerry, Τ Faiaz Chowdhury, Abrar Wahab, Saidur Rahman Mashreky, Rumana Huque & Richard Friend
To cite this article: Masuma Pervin Mishu, MM Golam Rabbani, Silke Vereeken, Emma Tkach, Jacqueline Martin-Kerry, Τ Faiaz Chowdhury, Abrar Wahab, Saidur Rahman Mashreky, Rumana Huque & Richard Friend (08 Oct 2025): Identifying interventions to support mental health for those affected by climate change and related extreme weather events: a scoping review, International Journal of Environmental Health Research, DOI: 10.1080/09603123.2025.2568035
To link to this article: https://doi.org/10.1080/09603123.2025.2568035
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REVIEW ARTICLE	9 OPEN ACCESS I^ Check for updates]
Identifying interventions to support mental health for those affected by climate change and related extreme weather events: a scoping review
Masuma Pervin Mishu a, MM Golam Rabbani b, Silke Vereeken b, Emma Tkachc, Jacqueline Martin- Kerry d, Τ Faiaz Chowdhury®, Abrar Wahabf, Saidur Rahman Mashreky 9, Rumana Huque®h and Richard Friend'
Department of Epidemiology and Public Health, University College London, London, UK; bDepartment of Health Sciences, University of York, York, UK; 'School of Global Health, Department of Public Health, University of Copenhagen, Kobenhavn, Denmark; dQualitative Process Evaluation, School/Department, Healthcare, University of Leicester, Leicester, UK; eARK Foundation, Dhaka, Bangladesh; fNCD & Mental Health Division, Centre for Injury Prevention and Research Bangladesh (CIPRB), Dhaka, Bangladesh; 9Department of Public Health, North South University, Advisor, Department of NCD & Mental Health, Centre for Injury Prevention and Research Bangladesh (CIPRB), Dhaka, Bangladesh; hDepartment of Economics, University of Dhaka, ARK Foundation, Dhaka, Bangladesh; Independent Consultant

ABSTRACT
We aimed to identify interventions to support mental health for those affected by climate change and related extreme weather events. We conducted a scoping review in accordance with standard guidelines, searching five databases. We identified 26 studies. All twenty-six included studies (one on the overall impact of climate change, eleven on storms, nine on flooding, and five on wildfires) reported different types of interventions and demonstrated the effectiveness of these interventions in improving mental health outcomes. Most of the interventions were conducted in high-income countries, targeted at the individual level, delivered by specialist or non-specialists, and based on Cognitive Behavioural Therapy (CBT) in different forms (face-to-face, online, mobile phone text messages, etc.). There are few studies available on interventions at community and family support, and on basic services delivered to those exposed to extreme weather events. Given that climate change projections indicate intensified frequency, severity and scale of such extreme weather events, there is a need for multi sectoral coordinated interventions targeting the individual, community support and basic services at system level that are tailored to the specific nature of extreme weather events, the kinds of impact they create, and the needs and circumstances of those who are impacted.

ARTICLE HISTORY
Received 4 August 2024
Accepted 25 September 2025
KEYWORDS
Extreme weather events;
climate change; mental health; interventions
Background
Climate change will bring dramatic increases in temperature and shifts in precipitation and a high degree of variability, as well as increased frequency, severity and scale of climate-related extreme weather events (Intergovernmental Panel on Climate Change 2023). A warmer climate system means intensification of frequency, severity and scale of extreme events such as storms, floods, drought and wildfires (IPCC 2023). When extreme weather events occur (both sudden and gradual onset), there is loss and damage to lives, livelihoods, and well-being (Hayes and Poland 2018). However, despite dire cries of urgency from the scientific community to take action to address climate change, the Cooperation of Parties (COP) has shown how challenging the task is (Mannan et al. 2021). The overall shifts in climate and patterns of weather- related events create pressures on health systems, and impacts on individuals and communities, which causes further disruption in health systems and mental health care globally (Scheelbeek et al. 2021).
The experience of climate change and related extreme weather events has an impact on mental health and well-being. Multiple pathways through which climate change interacts with mental health and wellbeing (Lawrance et al. 2022). Climate change detrimentally impacts various environmental, social, and economic
CONTACT Masuma Pervin Mishu 0 Masuma.mishu@ucl.ac.uk © Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, Faculty of Population Health Sciences, University College London, 1-19 Torrington Place, London WC1E 7ΗΒ, UK
Present affiliation of Emma Tkach is Department of Epidemiology and Public Health, University College London, London, UK
© 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/ licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent. 
factors, which are directly and indirectly related to the mental health and psychosocial well-being of a population. The escalating effects of extreme weather events are exerting more profound and enduring influences on individuals, particularly specific demographic groups vulnerable to hazards associated with climate change and those with pre-existing mental health conditions, disproportionately (World Health Organization 2022). Evidence showed a range of mental health impacts resulting from three types of climate-related events, including acute, subacute, or long-term changes (Palinkas and Wong 2020). The negative impact of acute extreme weather events includes lack of self-esteem, anxiety, schizophrenia, mood disorders (depression), suicidal ideation, aggressive behaviours, and post-traumatic stress disorders (PTSD) (Cianconi et al. 2020; Charlson et al. 2021), specially to those exposed to repeated events. Evidence shows that acute climate-related stressors, such as hurricanes and tornadoes, not only affect mental health in the short term but also have long-term effects (Bryant et al. 2014; Nahar et al. 2014; Schmeltz and Gamble 2017). With an increase in traumatic climate-related extreme weather events, there has also been an increase in PTSD diagnoses (Trombley et al. 2017). Evidence shows that subacute extreme weather events, such as droughts and heat waves, affect mental health (Vida et al. 2012; Bourque and Willox 2014; Obradovich et al. 2018) as well as physical health negatively (Norloei et al. 2017). Increased temperature and temperature variability were associated with increased cases of suicide and suicidal ideation, hospital attendance or admission for mental illness, and poor community health and well-being (Thompson et al. 2023). Ambient temperature is related to increased emergency visit hospital admissions for schizophrenia (Sung et al. 2011; Carlsen et al. 2019; Liu et al. 2022) and deterioration of cases of existing mental health conditions (Schmeltz and Gamble 2017). Even for populations not directly impacted by acute or subacute climate events, the increasing occurrence of wildfires, floods, droughts, and heatwaves. Even for populations not directly affected by acute or subacute climate events, the wider ecological crisis and potential collapse have led to a global occurrence of a novel subcategory of anxiety disorder including “solastalgia” and “ecoanxiety” (Hayes et al. 2018). However, there is a lack of evidence on interventions for eco-anxiety (Baudon and Jachens 2021).
The impacts of climate change on health strain within healthcare systems, especially during extreme events, can lead to increased demands on emergency services and disrupted healthcare services. Mental health-related disease burden already poses a substantial global health challenge due to huge disparities between the demand for mental health support and the available services and infrastructure to meet those needs, especially in countries with limited resources (Thornicroft et al. 2017). The impact of climate change is compounding the already challenging situation of providing mental health services globally. There is very little dedicated mental health support available for people and communities dealing with extreme weather events related to climate change and associated long-term risks (WHO 2022). By increasing mental health and psychosocial support (MHPSS) within disaster risk reduction and climate action, countries can do more to help protect those most at risk (WHO 2025).
One proposed way of managing mental health problems in the face of an ongoing climate crisis is to improve psychological resilience at both individual and community levels for populations most vulnerable to acute and subacute climate-related extreme weather events (Trombley et al. 2017). A scoping review by Xue et al. (2024) identified 16 records through their academic literature search and 24 records from gray literature search on various packages of interventions that act at the levels of microsystem, mesosystem, exosystem, and macrosystem through diverse mechanisms to reduce psychological distress and enhance mental health and wellbeing in the context of climate change. However, the authors acknowledge that most interventions have not been formally evaluated. Moreover, the review lacked detail in its reporting of the interventions. There remains a lack of updated scoping reviews to identify interventions that have been scientifically tested and reported their effectiveness in mitigating the negative psychosocial impacts of climate change following exposure to related extreme weather events. To develop future interventions, it is essential to understand the details of these interventions. Therefore, we undertook this scoping review, primarily aiming to identify updated psychological interventions that have been scientifically tested for their effectiveness in improving the mental health outcomes of individuals exposed to climate change and related extreme weather events.
The WHO acknowledges the need for diverse and targeted MHPSS interventions, particularly in the context of climate change and related events (WHO 2025). To highlight the varying levels of MHPSS interventions, the WHO’s Inter-Agency Standing Committee (IASC) produced the MHPSS pyramid, which categorises MHPSS interventions into complementary layers, meant to emphasise the need for all layers of the pyramid to be met and addressed with inter-sectoral action and tailored interventions (WHO 2007, 2025). Our secondary aim was to understand the current climate-related MHPSS interventions’ position on this pyramid.
Methods
A scoping review was undertaken, in line with guidance by reported in the Preferred Reporting Items for Systematic Reviews (Khalil et al. 2016) and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) Statement (Tricco et al. 2018).
Information sources and search strategy
We searched Ovid MEDLINE, EMBASE, SCOPUS, Cochrane database and Web of Science in May 2025: using a strategy developed with an information specialist and modified for each database (see supplementary file 1).
Study eligibility criteria
Inclusion and exclusion criteria
We included empirical studies reporting the effect of tested interventions that reported mental health outcomes related to climate change and extreme weather events published after 2007. 2007 was considered the cut-off point, as 2007 was a watershed year when the intersection of climate change and public health gained global recognition, significantly shaping subsequent research, policy, and public discourse on the topic and the release of AR4 in 2007 brought widespread global attention to the impacts of climate change (IPCC 2007). This marked a greater attention to climate vulnerability as well as mitigation. The IASC Reference Group on MHPSS also developed the Guidelines for MHPSS in Emergency settings in 2007, highlighting the need for MHPSS interventions in all phases of emergencies - preparedness, prevention, response and recovery (WHO 2025).
No restrictions were placed upon country, and setting. Any reviews, grey literature, commentary, reports, conference abstracts, and studies not written in English were excluded due to resource limitations to conduct the review.
Study selection
All records were de-duplicated using Endnote and then managed using Rayyan software (Ouzzani et al. 2016). The records were independently double-screened by title and abstract by four reviewers (MPM, GR, SV, ET) against the defined eligibility criteria. If at any point it was unclear whether the study met the eligibility criteria, it was retained for full-text screening. Full-text screening was performed by the same three reviewers, with each study independently screened by two reviewers. Any disagreements about inclusion were discussed with a fourth reviewer (JM-K) until a consensus was reached.
Data extraction
Data extraction for each study was performed independently by seven reviewers (MPM, GR, SV, ET, JM-K, FC, AW), using a pre-piloted template. All data were checked by an independent reviewer. Across all studies, the data extracted included: study characteristics (author(s), year of publication, study location, setting), study design, study populations (e.g. participants’ demographics, sample size), climate change exposures, interventions tested in the study, mental health-related outcomes (primary and secondary outcomes as reported in the studies), and final results that each study reported. Each interventions were reported based on an adapted template for intervention description and replication (TIDieR) checklist (Hoffmann et al. 2014).

Quality assessment
The methodological quality of included studies was not assessed as this is not a requirement for scoping reviews (Lockwood et al. 2019), as we were aiming to identify all existing relevant studies not assessing quality of the studies.
Data synthesis
A narrative synthesis of mental health outcomes of all included studies was undertaken. For reporting mental health outcomes, we grouped the studies as they reported climate change event- related exposures:
(1)		Overall impact of climate change
(2)		Storms
(3)		Flooding
(4)		wildfire
To understand where current climate-related MHPSS interventions lie on WHO’s IASC produced pyramid, we mapped our identified interventions and the mental health outcomes within the MHPSS pyramid.

Figure 1. PRISMA flow diagram.
Results
Study selection
Overall, 8900 records were identified through electronic database searching; 5982 remained after title and abstract screening and were screened when duplicates (n = 2918) were removed. Following a 95% agreement rate in the 100% double-screened abstracts, 33 full-text articles were assessed for eligibility. Twenty-six studies were included in the review (Figure 1).
Excluded studies
Of the 33 full-text articles assessed for eligibility, seven studies were excluded: five were excluded because of wrong study design (e.g. not assessing an intervention). Other reasons for exclusion included: not reporting mental health outcomes (n = 1) and protocol paper (n = 1).
Descriptive result
Included studies
The characteristics of the 26 included studies are summarised in Table 1, including a description of each intervention following adapted TIDieR criteria. Of these included studies, one study focused on the overall impact of climate change; eleven focused on the impact of storms (hurricanes, cyclones, and typhoons); nine focused on the impact of flooding; and five focused on the impact of wildfires and bushfires. Studies were undertaken across several countries including the USA (n = 10), Australia (n = 3), Canada (n = 2), Philippines (n = 2), Nigeria (n = 1), China (n = 1), Germany (n = 1), Bangladesh (n = 1), Pakistan (n = 1), Haiti (n = 1), Taiwan (n = 1), Tuvalu (n = 1) and Sweden (n = 1). The study design ranged from cohort studies (n = 9), to randomized control trials (RCT) (n = 6), pilot RCT (n = 1), longitudinal studies (n = 5), quasi-experimental and longitudinal design (n = 3), multiple-baseline single-case experimental design (SCED) (n = 1) and an open treatment study (n = 1).
Narrative synthesis of the interventions and mental health outcomes
Table 1 shows the climate change event-related exposure, related interventions, measures used to assess mental health outcomes, and findings reported in the studies.
Climate change-related distress
Lindhe et al. (2023) tested an individually tailored internet-delivered cognitive behavioural therapy (ICBT) in their pilot RCT and reported that the treatment group had moderate to large between-group effects compared to the waitlist group on measures of depression, stress, quality of life, and climate change-related distress. There were no significant between-group differences on the other outcome measures. The results indicate that individually tailored ICBT can be an effective way to reduce psychological distress associated with climate change.
Storm
Eleven studies (two intervention studies, seven longitudinal studies, and two quasi-experimental and longitudinal design) targeted those who have experienced storms, such as hurricanes, typhoons and cyclones. The two tested interventions included: a) a web-based self-help empowerment program, My Disaster Recovery (MDR) (Steinmetz et al. 2012), and b) a culturally adapted Skills for Life Adjustment and Resilience (SOLAR) program (Gibson et al. 2021). The longitudinal study assesses the impact of interventions included c) a functional community group (i.e. a community choir) (Harvey et al. 2007), d) the development and delivery of Cognitive Behavioural Therapy for Post-Disaster Distress (CBT-PD) (Hamblen et al. 2009), e) the scale-up and evaluation of delivering CBT-PD (Hamblen et al. 2017), f) an individual resilience intervention (Cheng et al. 2012), g) the school-based delivery of Trauma Focused Cognitive Behavioural Therapy (TF-CBT) and Cognitive Behavioural Intervention for Trauma in Schools (CBITS) (Graham et al. 2017), h) a longitudinal examination of the impact of social support on physical and mental health outcomes for Vietnamese
Author, year, study design	Study aim/main research question as mentioned in the paper	Country, setting and participants	Climate change- related exposure, as mentioned	Intervention	Mental health outcomes (primary outcomes)	Secondary outcomes	Main result (as reported in the abstract)	
Overall climate change-related distress
Lindhe et al.	To investigate the effects of a novel
(2023), pilot	ICBT treatment program on	Country: Sweden
Setting: Internet-based (via	Individuals experiencing	Name of Intervention: Tailored internet-delivered cognitive behavioural therapy (ICBT)	Beck Depression Inventory (BDI-II) Generalised Anxiety Disorder-7	Insomnia Severity Index (ISI)	The treatment group had moderate to large between-	
RCT	mental health and well-being due to the consequences of climate change, and perceptions about the ongoing crisis	Iterapi platform)
Participants: Ν = 60:
Intervention group: η = 30;
wait-list control: n = 30
Age: 23-73 years
Gender: Male 4 (13.3),
Female 25 (83.3), other 1(3.3)
Ethnicity: NR	psychological distress associated with climate change.	Theoretical basis: Traditional CBT theory (ICBT for transdiagnostic symptoms)
What materials are used in the intervention: Informative texts and CBT-exercises
Who provided the intervention: Internet-delivered format (Iterapy platform)
Mode of delivery (face-to-face,online, telephone): Online (assigned therapist for online support and feedback), individually tailored.
When and how much the intervention was delivered: eight weeks of therapist-supported ICBT. Total 15 modules, one module per week (work independently with online support and feedback via text message by assigned therapist)
Follow-ups: Pre and post treatment (post wait list for control)
Control group: Waiting list control
Tailoring/Adaptation: NR	scale (GAD-7)
Perceived Stress Scale (PSS)	Patient Health Questionnaire (PHQ-9) Brunnsviken Brief Quality of Life Scale (BBQ) Alcohol Use Disorders Identification Test (AUDIT) ClimateCope Index (CCI-15) Modified version of the Environmental Action Scale (EAAS-M)	group effects compared to the waitlist group on measures of depression, stress, quality of life, and climate change-related distress. There were no significant between-group differences on the other outcome measures. The results indicate that individually tailored ICBT can be an effective way to reduce psychological distress associated with climate change without reducing pro- environmental behaviour.	
Impact of Storms (Hurricane, Typhoon, Cyclone, etc.) Trials/Quasi
Experimental
Studies							
Steinmetz et al.	The aim of this study was to test	Country: Galveston, Texas, USA	Hurricane Ike	Name of Intervention: My Disaster Recovery (MDR)	Perceived Stress Scale (PSS)	NR	MDR reduced participant worry	
(2012), pilot RCT	the efficacy of the My Disaster Recovery (MDR) website to decrease negative affect and increase coping self-efficacy.	Setting: Fifty-six survivors of Hurricane Ike were recruited from a larger study being conducted at the University of Texas Medical Branch on the first anniversary of the storm.
Participants: N = 56 Individuals from the stress and coping study who had access to the internet and met distress criteria (i.e. scored five or greater on the TSQ or a score higher than 20 on the PS5 were invited to participate.)
Age: 21 years or older Gender: 86% female Ethnicity: 91% Caucasian	2008	Theoretical basis: Social cognitive theory
What materials used in the intervention: MDR consists of six interactive modules: 1) seeking professional help, 2) relaxation, 3) social support, 4) unhelpful ways of coping, 5) self-talk, and 6) trauma triggers and memories.
MDR website utilizes interactive experiences tailored to each user (e.g. self tests, video vignettes) to target coping self-efficacy pathways. The comparative information-only site presented all the same information as e-books without the interactive components.
Who provided the intervention: Web-based intervention
Mode of delivery (e.g. face-to-face, online, or telephone): Online, web-based delivery
Whether it was provided individually or in a group: Individually
When and how much the intervention was	Coping Self-Efficacy Scale for
Trauma (CSE)
Modified PTSD Symptoms Scale
(MPSS)
Centre for Epidemiologic
Studies Depression Scale (CES-
D)
Penn State Worry Questionnaire (PSWQ)		more than the other conditions. A similar trend was also identified for depression. Both websites were accessed a small to moderate amount and participants reported mixed satisfaction for both websites. Although the effect sizes for worry and depression were in the moderate to large range, small sample size and timing of the intervention qualify the findings.	
Table 1. Study characteristics, intervention details, and study findings.
M. P. MISHU ET AL.
delivered: 1 month access to websites (minimum 30 days)
Follow-ups: All participants were prompted by email
to take the follow-up questionnaire
Control group: Two groups: 1) Usual care group,
and 2) information only website group
Tailoring/Adaptation: NR
(Continued)

Author, year, study design	Study aim/main research question as mentioned in the paper	Country, setting and participants	Climate change- related exposure, as mentioned	Intervention	Mental health outcomes (primary outcomes)	Secondary outcomes	Main result (as reported in the abstract)	
Hechanova et al.	This study evaluated the impact of	Country: Philippines	Super Typhoon	Name of Intervention: Katatagan	Self-efficacy measured through	NA	Pre- and post-results showed	
(2016), longitudinal study design	Katatagan, a culturally adapted, group-based, and mindfulness informed resilience intervention developed for disaster survivors in the Philippines.	Setting; Three communities in the province Samar, which was impacted greatly by Super Typhoon Haiyan.
Participants: 163 community members volunteered to participate.
Age: NR
Gender: n = 144; 88% of participants were female.
Ethnicity: NR	Haiyan 2013	Theoretical basis: Resilience intervention using the five-part model of CBT as its theory of change (William and Garland 2002).
What materials used in the intervention: consists of six modules: Kalakasan (finding and cultivating strengths), Katawan (managing physical reactions), Kalooban at Isipan (managing thoughts and emotions), Kapakipakinabang na Gawain (engaging in regular and positive activities), Kalutasan at Kaagapay (seeking solutions and support), and Kinabukasan (moving forward)
Who provided the intervention: Facilitators were volunteer psychologists from the Psychological Association of the Philippines. The majority (82%) of facilitators were psychology faculty from various colleges and universities all over the country.
Mode of delivery (e.g. face-to-face, online, or telephone): Face-to-face
Whether it was provided individually or in a group: Small groups of five to seven members (average of six).
When and how much the intervention was delivered: The resilience intervention was implemented across 2 days. Three modules were implemented per day for approximately six hours per day.
Follow-ups: 6 month follow-up
Control group: No control
Tailoring/Adaptation: Yes	domain specific measures related to the six Katatagan modules (standardised tests and scales NR)		improvements in participants' self-efficacy on all six coping skills. The 6-month follow-up revealed significant improvements in four of the six coping skills. Focus group discussions conducted at follow-up revealed that mindfulness, self-care, strengths, and reframing were some of the topics that were most memorable to participants. Among these, participants identified mindfulness as a skill that they continued to use. Participants also shared that they felt stronger because of the intervention and have shared what they learned with others in their communities.	
Hechanova et al.	The purpose of this paper is to	Country: Philippines	Super Typhoon	Name of Intervention: Katatagan	The 20-item state subscale (Form	NA	Results showed significant	
(2018), quasi - experimental and mixed method design	evaluate the effect of
a community-based resilience intervention for Filipino displaced survivors of Super Typhoon Haiyan.	Setting: Temporary resettlement sites for Haiyan survivors in Tacloban City, the Philippines.
Participants: 96 participants volunteered to participate in the program.
Age: Ages between 18 and 70 years old (Mean = 35.19, SD - 12.15).
Gender: 16% male, 84% female
Ethnicity: NR	Haiyan	Theoretical basis: Resilience intervention using the five-part model in CBT as its theory of change (William and Garland 2002).
What materials used in the intervention: consists of six modules: Kalakasan (finding and cultivating strengths), Katawan (managing physical reactions), Kalooban at Isipan (managing thoughts and emotions), Kapakipakinabang na Gawain (engaging in regular and positive activities), Kalutasan at Kaagapay (seeking solutions and support), and Kinabukasan (moving forward)
Who provided the intervention: Three psychology faculty members who had previously facilitated Katatagan served as coaches to the facilitators.
Mode of delivery (e.g. face-to-face, online, or telephone): Face-to-face
Whether it was provided individually or in
a group: Small groups of five to seven members (average of six).
When and how much the intervention was delivered: The resilience intervention was implemented across 2 days. Three modules were implemented per day for approximately six hours per day.
Follow-ups: 6 month follow-up
Control group: Yes, 104 community members who did not volunteer to participate in the intervention. Tailoring/Adaptation: Yes	Y-1) of the State-Trait Anxiety Inventory for Adults to measure anxiety.
An adapted Brief Cope survey to measure adaptive coping.
A ten-item version of the Connor - Davidson Resilience Scale was used to measure the ability of the participants to cope with adversity and measure individual resilience.		improvements in survivors' anxiety scores and resilience scores compared to those who did not undergo the program. However, although there was an increase in adaptive coping of participants immediately after the program, there was a reduction in adaptive coping behaviors for all groups six months after the program. Focus group discussions revealed this might be due to significant environmental challenges among displaced survivors.	
INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH
(Continued)

CO
Author, year, study design	Study aim/main research question as mentioned in the paper	Country, setting and participants	Climate change- related exposure, as mentioned	Intervention	Mental health outcomes (primary outcomes)	Secondary outcomes	Main result (as reported in the abstract)	
Gibson et al.	This study aims to establish the	Country: Tuvalu, Pacific Islands	Tropical Cyclone	Name of Intervention: SOLAR (Skills fOr Life Adjustment	PCL-5 (PTSD)	NR	Large, statistically significant group	
(2021), quasi - experimental control study
Longitudinal Experimental Studies	feasibility, acceptability, efficacy and safety of a culturally adapted version of SOLAR among residents of Tuvalu exposed to Tropical Cyclone Pam using between-group comparisons on psychosocial outcomes post-SOLAR versus post-control.	Setting: Two remote communities in Tuvalu Participants: 99 participants who reported mild-to- moderate symptoms of anxiety, depression, and/or posttraumatic stress symptoms, together with resulting functional impairment in one or more areas of daily life.
Age: 18 years or older Gender: NR
Ethnicity: NR	Pam	and Resilience)
Theoretical basis: SOLAR is an internationally developed, low-intensity intervention designed to target distress and impairment following disaster and trauma - includes a trauma processing component, which is missing from other brief interventions.
What materials used in the intervention: SOLAR is made up of six modules: 1) skills for healthy living, 2) managing strong emotions, 3) getting back into life following disaster, 4) coming to terms with disaster, 5) managing worry and rumination, and 6) maintaining healthy relationships.
Who provided the intervention: Local, nonspecialist facilitators
Mode of delivery (e.g. face-to-face,online, or telephone): Face-to-face
Whether it was provided individually or in a group: Group
When and how much the intervention was delivered: 5 sessions across 5 consecutive days Follow-ups: 6-month follow-up
Control group: The control group had access to Usual Care (UC).
Tailoring/Adaptation: Yes	HSCL-25 (anxiety and depression)		differences in psychological distress were observed after controlling for baseline scores in favour of the SOLAR group. Mean group outcomes were consistently lower at 6-month follow-up than at baseline.	
Harvey et al. (2007), naturalistic cohort study	The aim of this study was to monitor mental health in a community-based intervention in the post-Katrina period.	Country: Louisiana, USA Setting: Culturally appropriate community initiative in the post hurricane period was a choir, organized by Australian choral leader Martin Meader in Baton Rouge, Louisiana
Participants: Ν = 102
Age: NR
Gender: NR
Ethnicity: NR	Hurricane Katrina 2005	Name of Intervention: The Hurricane Choir
Theoretical basis: Functional community interventions
What materials used in the intervention: Choir
rehearsals
Who provided the intervention: Community/choir
members
Mode of delivery (e.g. face-to-face,online, or
telephone): Face-to-face
Whether it was provided individually or in a group: Group
When and how much the intervention was
delivered: 12 week rehearsal period, 3 rehearsals per week during this time
Follow-ups: 12 months after the choir disbanded
Control group: No control	Standardized mental health and attitudinal measures included: 1) Depression, Anxiety, and Stress Scales (DASS), 2) Davidson Trauma Scale 1, 3) Life Orientation Test Revised (LOT-R), 4) Hurricane Coping Self-Efficacy Scale (HCSE), 5) modified version of the Inventory of Socially Supportive Behaviours (ISSB)	NR	NR	
Table 1. (Continued).
M. P. MISHU ET AL.
(Continued)

Author, year, study design	Study aim/main research question as mentioned in the paper	Country, setting and participants	Climate change- related exposure, as mentioned	Intervention	Mental health outcomes (primary outcomes)	Secondary outcomes	Main result (as reported in the abstract)	
Hamblen et al.	This study aimed to develop	Country: Greater Baton Rouge	Hurricane Katrina	Name of Intervention: Cognitive Behavioural Therapy	Distress (The 12-item Short Post-	NR	Participants who were assessed at	
(2009), cohort	a cognitive behavioural therapy	area, USA	and Hurricane	for Postdisaster Distress (CBT-PD)	Traumatic Stress Disorder		referral, pretreatment,	
intervention study	intervention for Hurricane Katrina survivors.	Setting: Adults who had been exposed to either Hurricane Katrina or Hurricane Rita enrolled in InCourage.
Participants: Ν = 88
Age: 19% were age 18-39, 73% were age 40-59, and 8% were age 60 or older
Gender: Men 18% and women 82%
Ethnicity: 52% of the participants were African American, 41% were nonHispanic White, and 7% were other or mixed race/ethnicity (5 Latino, 1 American Indian)	Rita 2005	Theoretical basis: Cognitive Behavioural Therapy What materials used in the intervention: CBT-PD includes four components: 1) psychoeducation, 2) breathing retraining, 3) behavioural activation and 4) cognitive restructuring
Who provided the intervention: Trained community-based therapists
Mode of delivery (e.g. face-to-face,online, or telephone): Face-to-face
Whether it was provided individually or in
a group: Individually
When and how much the intervention was delivered: CBT-PD is a 10 session intervention Follow-ups: 4 months follow-up.
Control group: No control
Tailoring/Adaptation: NR	Rating Interview - Expanded)		intermediate treatment, and posttreatment showed significant and large improvements. The overall prepost effect size was 1.4 in intention-to-treat analyses.	
Hamblen et al.	The current study attempted to	Country: USA	Hurricane Sandy	Name of Intervention: Cognitive Behavioural Therapy	Post-Traumatic Stress (The 12-item	NA	The overall pre post effect size was	
(2017), cohort intervention study	extend and replicate the findings on CBT-PD in a larger sample: explored whether the timing of the intervention and severity of participants' initial distress influenced the changes observed between assessments. We also examined whether improvement was maintained at follow-up.	Setting: Adults who had been exposed to Hurricane Sandy in New York State across areas of Brooklyn, Staten Island, Queens and Long Island.
Participants: 342 adults provided pretreatment data, 230 (67%) completed the program, and 202 (59%) provided complete data on the four repeated assessments.
Information on the timing of the intervention was available for 196 of these completers. Except where noted, the sample description applies to these 196 individuals, 111 (57%) of whom also provided followup data.
Age: Mean age = 57 (SD = 13) years of age, with 10% aged 19 to 39, 50% aged 40 to 59, and 40% aged 60 or older.	2012	for Postdisaster Distress (CBT-PD)
Theoretical basis: Cognitive Behavioural Therapy What materials used in the intervention: CBT-PD includes four components: 1) psychoeducation, 2) breathing retraining, 3) behavioural activation and 4) cognitive restructuring
Who provided the intervention: Trained community-based therapists
Mode of delivery (e.g. face-to-face,online, or telephone): Face-to-face
Whether it was provided individually or in
a group: Individually
When and how much the intervention was
delivered: CBT-PD is an 8 - 12 session intervention
Follow-ups: 5 months follow-up
Control group: No control
Tailoring/Adaptation: NR	Short Post-Traumatic Stress Disorder Rating Interview - Expanded)		1.41, indicating large improvement pre to post treatment. Gains were maintained at follow-up. Timing of the intervention did not affect the outcome. Participants who received the intervention early (i.e. 10 to 15 months after Sandy) had the same improvement as those who received it later (i.e. 21 to 26 months after Sandy). Similarly, there was no difference in outcome between individuals with severe as compared with moderate distress at pretreatment.	
Gender: 80% female
Ethnicity: Most (80%) were non-Hispanic White, 12% were African American, and 8% were other (6% Latino, 2% Pacific Islander or American Indian).
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Author, year, study design	Study aim/main research question as mentioned in the paper	Country, setting and participants	Climate change- related exposure, as mentioned	Intervention	Mental health outcomes (primary outcomes)	Secondary outcomes	Main result (as reported in the abstract)	
Cheng et al.	The aim of this study was to	Country: Taiwan	Typhoon Morkot	Name of Intervention: Individual resilience intervention	Flood Indigenous Victims Post-	NR	The findings show the following: 1)	
(2012), cohort intervention study	examine the effects of, and the factors involved in, an individual resilience intervention of typhoon victims.	Setting: Kaohsiung
Participants: 77 indigenous individuals of Kaohsiung, affected by Typhoon Morakot
Age: Average: 36.02 (SD 11.60 years)
Gender: 55.8% female
Ethnicity: 81.1% were
Christian; 75.3% were Bunun	2009	Theoretical basis: NR
What materials used in the intervention: The intervention programs included the following: 1) individual resilience assessments, which were concerned with their relocation needs after the disaster, emotional adaptation, and interpersonal networks, 2) individual strengthening and maintenance by individual and group-approach services, and 3) resource linking and referral.
Who provided the intervention: Practical operations, including narratives, group discussions, the sharing of experiences, role play, cognitive learning, and strength enhancement were used. Mode of delivery (e.g. face-to-face,online, or telephone): Face-to-face
Whether it was provided individually or in a group: NR
When and how much the intervention was delivered: Intervention was provided Intervention was provided once every 2-3 weeks. The intervention program was conducted from March to October 2010. Follow-ups: NR
Control group: No control
Tailoring/Adaptation: NR	Disaster Individual Resilience Questionnaire (FIVPIRQ) used to assess the following: 1) personal demographics, 2) psychological health conditions, including Posttraumatic Stress Syndrome (PTSS) and depression, 3) changes in living conditions before and after the disaster, and 4) individual resilience that involves six dimensions, including determination and problem solving skills, individual support, positive thinking, confidence and decisiveness, self-balance, and social skills.		after completing the individual resilience intervention program, the participants had higher individual resilience scores than before participating in the intervention program, and 2) individual resilience scores were significantly affected by residency after the typhoon.	
Graham et al.
(2017), cohort intervention
study	The aim of this study was to understand the efficacy of postdisaster school based services for reducing trauma symptoms of youth exposed to Hurricane Katrina and at least one other traumatic experience.	Country: USA
Setting: 26 schools across three parishes in Louisiana (Saint Bernard, Orleans, Plaquemines Parishes)
Participants: 112 students
Age: 8-17 years old
Gender: 53% male, 47% female
Ethnicity: 45% African
American, 46% European
American, 6% Hispanic, 2%
Native American and 1% Asian	Hurricane Katrina	Name of Intervention: Trauma Focused Cognitive Behavioural Therapy (TF-CBT) and Cognitive Behavioural Intervention for Trauma in Schools (CBITS) Theoretical basis: Cognitive Behavioural Therapy What materials used in the intervention: Psychoeducation principals: relaxation, coping, problem solving skill development, trauma narratives, cognitive restructuring, affective modulation.
Who provided the intervention: Clinically trained staff
Mode of delivery (e.g. face-to-face,online, or
telephone): Face-to-face
Whether it was provided individually or in
a group: Individually
When and how much the intervention was delivered: TF-CBT and CBITS sessions were delivered in schools. The number of sessions for students varied between 2 to 32 times, with a mode of 6 (Μ = 8.3, SD = 5.2).
Follow-ups: Students attended between 8 and 40 follow-up sessions per academic year (Μ = 26.4, SD = 10.1).
Control group: No control
Tailoring/Adaptation: NR	Trauma Symptom Checklist for Children (TSCC): includes measures of anxiety, depression, anger, posttraumatic stress and dissociation.	NR	Overall reduction in post-traumatic stress symptoms as well as subscales assessing anxiety, anger, depression, dissociation, overt dissociation, and fantasy dissociation.	
Table 1. (Continued).	(£
M. P. MISHU ET AL.
(Continued)

Author, year, study design	Study aim/main research question as mentioned in the paper	Country, setting and participants	Climate change- related exposure, as mentioned	Intervention	Mental health outcomes (primary outcomes)	Secondary outcomes	Main result (as reported in the abstract)	
Bui et al. (2021),	The aim of this study was to	Country: USA	Hurricane Katrina	Name of Intervention: NR	Mental health (from the Medical	Demographic	Social support soon after Katrina	
longitudinal study	examine how social support assessed soon after Hurricane Katrina influences mental and physical health measured in later years (2007, 2010, and 2018), all while controlling for pre-Katrina physical and mental health and support (measured by the number of helpful relations).	Setting: New Orleans
Participants: Adults
Age: 28-65
Gender: 35% female, 65%
male
Ethnicity: Vietnamese
American	2005	Theoretical basis: Social supports protective and preventive role in mental health (House et al. 1988; Umberson and Montez 2010)
What materials used in the intervention: NA
Who provided the intervention: Communities, families, friends, etc.
Mode of delivery (e.g. face-to-face,online, or telephone): Face-to-face
Whether it was provided individually or in
a group: Group
When and how much the intervention was delivered: NA
Follow-ups: Social support measures were taken in the years after Hurricane Katrina (2007, 2010, 2018) all while controlling for pre-Katrina support.
Control group: No control
Tailoring/Adaptation: NR	Outcomes Study Short Form-12)	variables: age, sex, marital status	was positively associated with physical health and mental health years later in 2010, even after controlling for potential confounders such as Katrina- related housing damage and pre-Katrina health and support.	
Weinzimmer et al.	The aim of this study is to evaluate	Country: USA	Hurricane Harvey	Name of Intervention: Unified Protocol for	Global Assessment of Functioning	Baseline outcome	Global clinical severity, depression	
(2022),	treatment outcomes of Unified	Setting: Integrated	2017	Transdiagnostic Treatment of Emotional Disorders	(GAF): overall measure of	predictors:	and anxiety symptoms, and	
naturalistic	Protocol for Transdiagnostic	Healthcare setting in Greater		(UP)	psychological functioning	demographic	functional impairment	
cohort	Treatment of Emotional	Houston area		Theoretical basis: Psychopathological dysfunction	Global Severity Scale	characteristics,	decreased by end-of-treatment.	
intervention study	Disorders (UP)	Participants: 279 adults
Age: Mean 46.2 (SD 13.3)
Gender: Female (75.3%)
Ethnicity: Hispanic/Latino
59.6%, White 25.3%, African
American 14.7%, Other 0.4%		underlying emotional disorders
What materials used in the intervention: Therapists administered assessment measures to participants during each intake and treatment session.
Who provided the intervention: Licensed master's level clinicians
Mode of delivery (e.g. face-to-face,online, or telephone): Face-to-face
Whether it was provided individually or in
a group: Individually
When and how much the intervention was delivered: The number of treatment sessions in this sample ranged from 2-21 (Μ = 5.22, SD = 4.76) and sessions occurred every 2-3 weeks, on average.
Follow-ups: NR
Control group: No control
Tailoring/Adaptation: NR	Clinical Global Impression Scale - Improvement Hurricane Harvey Impact Questionnaire
PHQ-9: depressive symptoms measure
GAD-7: anxiety symptoms measure	impact from Hurricane Harvey, cooccurrence of depression and anxiety symptoms.	Participants experienced global symptom improvement to a lesser degree than demonstrated in efficacy trials. Participants who experienced greater storm impact reported larger reductions in anxiety symptoms than those less impacted by Harvey.	
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M. P. MISHU ET AL.

Table 1. (Continued).
	Climate change-	
Author, year, study design	Study aim/main research question	Country, setting and	related exposure,	Mental health outcomes (primary	Secondary	Main result (as reported in the
as mentioned in the paper	participants	as mentioned	Intervention	outcomes)	outcomes	abstract)	

Impact of Flooding
Trials/Quasi - Experimental
Goldman et al.	The aim of this study was to	Country: New Orleans, USA	PTSD in flood	Name of Intervention: School Therapeutic	Swanson, Nolan and Pelham	NR	Self-reported distress levels were	
2015, cohort	implement a set of school based	Setting; Middle and high	victims of	Enhancement Program (STEP), adopted from	Questionnaire -4th Edition	also lower than screening group	
intervention	interventions in a greater New	school students screened for	13-14 years	Integrated Psychotherapy Consortium (IPC)	(SNAP-IV): ADHD and	students at post-test. These	
study	Orleans school district one year	behavioral and emotional	old after they	Theoretical basis: Evidence-based procedures,	oppositional defiant symptoms	findings support the efficacy of	
	following Hurricane Katrina.	difficulties at the beginning and end of the school year provided a benchmark for community youth's emotional and behavioral distress.
Participants: N = 11,861
Age: 13-14 years
Gender: 49.7% male, 50.3% female
Ethnicity: 47.3% African- American, 29.1% Caucasian, 10.9% Hispanic, 6% Asian, 1.4% Native American, 9% Mixed/Other	were diagnosed with PTSD in 2000	specifically adapted from cognitive behavioral therapies (CBTs) for depression, disruptive disorders, anxiety disorders, and PTSD
What materials used in the intervention: CBT manuals and Coping power: Child group program workbook as part of the Integrated Psychotherapy Consortium.
Who provided the intervention: JPHSA social workers
Mode of delivery (e.g. face-to-face,online, or telephone): School-based face-to-face.
Whether it was provided individually or in
a group: Individual level
When and how much the intervention was delivered: One year following Hurricane Katrina. The source does not specify the duration
Follow-ups: NR
Control group: No control
Tailoring/Adaptation: NR	Strengths and Difficulties Questionnaire (SDQ): emotional and behavioural symptoms Beck's Depression InventoryYouth (BDI-Y): depressive symptoms	a school based intervention for youth struggling with the aftereffects of a highly disruptive natural disaster.	

(Continued)
Author, year, study design	Study aim/main research question as mentioned in the paper	Country, setting and participants	Climate change- related exposure, as mentioned	Intervention	Mental health outcomes (primary outcomes)	Secondary outcomes	Main result (as reported in the abstract)	
Gros et al. (2019),	This research assesses the	Country: Bangladesh	2017 floods in	Name of Intervention: Forecast-based Financing (FbF)	Psychosocial distress (measured by	NA	The assessment shows that the	
mixed	effectiveness of the forecast-	Setting: Four at-risk	Bangladesh	Theoretical basis: FbF builds on an extensive body of	items loosely based on the		cash grants contributed to	
methods, quasi experimental
study	based cash distribution in helping beneficiaries to take preparatory early actions and reduce the negative impacts of the flood on their health, wellbeing, assets and livelihoods.	communities in Bangladesh's flood prone area, Bogra district (communities were chosen based on their vulnerability profile).
Participants: In the intervention communities, the 1039 most vulnerable households who received forecast-based cash assistance constitute the intervention group of the study.
Age: NR
Gender: NR
Ethnicity: NR	that were caused by heavy monsoon rains which raised river waters that flooded over of Bangladesh.	Early Warning Early Action (EWEA) work within the humanitarian sector and was born out of considerable institutional learning on implementing early actions based on early warnings
What materials used in the intervention: The amount of FbF cash per household is thus set between the Multi-Purpose Cash Grant (MPCG) of BDT 4500 and the Minimum Expenditure Basket (MEB) of BDT 5400. Who provided the intervention: The Bangladesh Red Crescent Society, through a collaboration with the Post Office, implemented the cash distribution to a total of 1039 pre-registered beneficiaries.
Mode of delivery (e.g. face-to-face,online, or telephone): Face-to-face
Whether it was provided individually or in a group: Delivered to individual households.
When and how much the intervention was delivered: Cash was distributed to 1039 households in the four intervention communities between 7th and 11th July 2017; this was seven days before the flood peak in Kamalpur, five days ahead of the flood peak in Kazla, while in Bhandarbari 6&7 as well as Bhandarbari 3 cash was distributed four and three days in advance of the flood peak, respectively.
Follow-ups: No follow-up
Control group: In the comparison communities, the same vulnerability criteria used to determine the intervention group was applied to select the most vulnerable households to be eligible for inclusion in the survey sample; they constitute the comparison group that did not receive FbF cash assistance.
Tailoring/Adaptation: Yes	Perceived Stress Scale: PSS)		improving households' access to food, a reduction in high- interest debt accrual of vulnerable households, and reduced psychosocial stress during and after the flood period, compared to a control group of similarly vulnerable and flood-affected communities that did not receive the forecast-based cash assistance.	
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Author, year, study design	Study aim/main research question as mentioned in the paper	Country, setting and participants	Climate change- related exposure, as mentioned	Intervention	Mental health outcomes (primary outcomes)	Secondary outcomes	Main result (as reported in the abstract)	
James et al. 2019, RCT	The aim of this study was to assess the effectiveness of an integrated mental health and disaster preparedness intervention in Haiti.	Country: Haiti
Setting: Three earthquake affected and flood prone communities in Haiti.
Participants: Ν = 480
Age: 18-78
Gender: 49.8% female,
50.2% male
Ethnicity: NR	Flood prone	Name of Intervention: Integrating mental health and disaster preparedness intervention and communitybased mental health-integrated disaster preparedness intervention
Theoretical basis: Evidence-based procedures and social support theory
What materials used in the intervention:
A manualized standard manual
Who provided the intervention: Trained Haitian lay mental health workers
Mode of delivery (e.g. face-to-face,online, or telephone): face-to-face in three communities Whether it was provided individually or in a group: Group-based no more than 20 participants in one group.
When and how much the intervention was delivered: Four 3-day RCT-interventions were facilitated by trained Haitian mental health workers Follow-ups: Data was collected at three time points: Time 1 (baseline), Time 2 (3-4 months postintervention), and Time 3 (7-8 months postintervention)
Control group: Yes (n = 240)
Tailoring/Adaptation: NR	Zanmi Lasante Depression
Symptom Inventory (ZLDSI):
depression
Modified PTSD Symptom Scale
(MPSS): PTSD
Beck Anxiety Inventory (BAI):
anxiety
Functional impairment (no
scale reported)
Social cohesion (no scale reported)	NA	The intervention increased disaster preparedness, reduced symptoms associated with depression, PTSD, anxiety, and functional impairment, and increased peer-based helpgiving and help-seeking.	
Amin et al. (2020), RCT	The aim of this study was to examine the initial effectiveness of the Support for Students Exposed to Trauma (SSET) program in reducing traumatic stress and related internalising behaviours among children living in flood-affected areas in Pakistan.	Country: Pakistan
Setting: Rural areas of South
Punjab, Pakistan
Participants: 75 children
Age: 7-13 years
Gender: 49 boys, 26 girls
Ethnicity: NR	Floods	Name of Intervention: Cognitive Behavioural Intervention for Trauma in Schools (CBITS) Program Theoretical basis: Support for Students Exposed to Trauma (SSET) is an adaptation of CBITS, which is a program based on evidence-based procedures and specifically adapted from cognitive-behavioral techniques.
What materials used in the intervention:
A manualised standard manual was used for the integration intervention based on evidence-based procedures developed by the Integrated Psychotherapy Consortium
Who provided the intervention: The SSET intervention was delivered by a clinically trained provider and was supported by local school teachers who acted as co-facilitators.
Mode of delivery (e.g. face-to-face,online, or telephone): The school-based intervention program was delivered face-to-face.
Whether it was provided individually or in
a group: The SSET program was delivered in group sessions.
When and how much the intervention was delivered: Students in the intervention group received the SSET program lessons over a period of 12 weeks, a series of 10 structured lessons, including monthly parent meetings.
Follow-ups: No long term follow-ups.
Control group: Children were randomly assigned into experimental (n = 38) and control (n = 37) groups.
Students in the control group received no intervention Tailoring/Adaptation: NR	Child PTSD Symptoms Scale-V (CPSS-V-SR): PTSD symptoms Child and Youth Resilience Measure (CYRM): resilience Child and Adolescent Social Support Measure (CASSS): social support	NA	The findings of the study showed a significant reduction in PTSD symptoms, and improvement in resilience, and perceived social support in the experimental group.	
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Author, year, study design	Study aim/main research question as mentioned in the paper	Country, setting and participants	Climate change- related exposure, as mentioned	Intervention	Mental health outcomes (primary outcomes)	Secondary outcomes	Main result (as reported in the abstract)	
Ede et al. 2022, pretestposttest control group cohort study	This study examines the effect of rational emotive behavior therapy (REBT) intervention on posttraumatic depressed food victims in Nigeria.	Country: Nigeria
Setting: Adults who had experienced floods in Kogi state of Nigeria
Participants: Ν = 98
Age: 30 years or younger (n = 35), 31-40 years old (n = 43), 41 years or older (n = 22) Gender: 44.9% male, 45.1% female
Ethnicity: Igala (n = 32),
Ebira (n = 27), Bassa (n = 24), Other tribes (n = 15)	Flooding	Name of Intervention: Rational emotive behavior therapy (REBT) intervention
Theoretical basis: Cognitive, behavioral and emotive techniques
What materials used in the intervention: REBT Depression Manual was used for the delivery of the intervention
Who provided the intervention: Psychotherapists Mode of delivery (e.g. face-to-face,online, or telephone): Face-to-face
Whether it was provided individually or in
a group: Group (max. 20 participants)
When and how much the intervention was delivered: 20 sessions, each lasting 50 minutes, were held twice in a week for weeks 1-8 and sessions were held once for weeks 9-12
Follow-ups: 2 follow-ups
Control group: Yes, waitlisted control (n = 49)
Tailoring/Adaptation; NR	Depression (measured by the Hamilton Depression Rating Scale (HDRS) and Goldberg Depression Scale)	NA	Result indicated that REBT program led to the significant reduction in posttraumatic depressed food victims in Nigeria, the implication is that posttraumatic thoughts and beliefs of food victims that led to depressive state was addressed, thereby placing the victims under good mental health through the application of REBT evidence-based techniques.	
Cobham and	The aim of this study was to	Country: Australia	Floods in	Name of Intervention: Trauma-focused CBT	Post-traumatic Stress Disorder	NR	Pro-treatment, all children met pre-	
McDermott	expedite access to an evidence	Setting: School based	Queensland,	intervention consisted of two manualized, individually	Reaction Index (PTSD-RI): PTSD		treatment, all 17 students met	
(2024), open treatment
study	based treatment for children.	intervention
Participants: 19 children
Age: 7-12 years
Gender: NR
Ethnicity: NR	Australia, 2011	administered CBT protocols.
Theoretical basis: Trauma-focused Cognitive Behavioural Therapy (TF-CBT)
What materials used in the intervention: Both parents and children received a workbook that was used in each session. Therapists used a script with standard prompt questions to guide the trauma narrative sessions. Various assessment scales were used for screening and diagnosis, including measures for PTSD, anxiety, and depression.
Who provided the intervention: By nine trained clinicians, specifically seven clinical psychology trainees from local universities and two experienced clinicians. The clinicians received a 3-hour workshop training and weekly group supervision
Mode of delivery (e.g. face-to-face,online, or telephone): The school-based program was delivered face-to-face.
Whether it was provided individually or in a group: At individual level.
When and how much the intervention was delivered: The intervention commenced approximately 5-6 months post-disaster. It consisted of two parent sessions (90 minutes each, delivered weekly initially) and eight weekly child sessions (90 minutes each). A booster session was held approximately 2-4 weeks after the completion of the child sessions.
Follow-ups: The intervention was evaluated by completing measures at post-treatment, 6-month follow-up, and 12-month follow-up.
Control group: NR
Tailoring/Adaptation; NR	Child's Depression Inventory
Short Version (CDI-S):
depression
Spence Children's Anxiety Scale
(SCAS-C): anxiety		diagnostic criteria for full or subclinical PTSD. By posttreatment, 10.5% met criteria for PTSD, with 0% meeting criteria at the 12-month followup. The incidence of anxiety and depressive disorders also reduced significantly.	
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Author, year, study design	Study aim/main research question as mentioned in the paper	Country, setting and participants	Climate change-
related exposure, as mentioned	Intervention	Mental health outcomes (primary outcomes)	Secondary outcomes	Main result (as reported in the abstract)	
Longitudinal Studies
Banks and Weems
(2014),	The aim of this study was to examine the associations	Country: USA
Study Ί: New Orleans Age:	Flooding	Name of Interventions: Peer and family support
following	Theoretical basis: Social support theory	PTST-R1: PTSD measure
Modified RCADS: anxiety and		Higher levels of hurricane exposure were related to lower levels of	
longitudinal study	among family and peer social support, level of hurricane exposure, and their links to psychological distress in minority youth.	3-12 years
Study 2: Study 2 was to replicate the concurrent analyses from Study 1 using a longitudinal design (i.e. to determine whether the findings hold over time to predict later distress) Age: 8-15 years
Setting: Classroom settings Participants: a large singletime assessment sample (Ν = 1,098) as well as a longitudinal sample followed over a 6-month period (n = 192)
Age: 7 to 18
Gender: 53% female Ethnicity: 90.8% African-	Hurricane	What materials used in the intervention: Large
Katrina in	single-time assessment sample and longitudinal
August 2005	sample (data were collected through face-to-face
interviews). Participants completed the measures within a group classroom setting and were assisted by trained staff.
Who provided the intervention: Mode of delivery (e.g. face-to-face,online, or telephone): NC Whether it was provided individually or in a group: NC
When and how much the intervention was delivered: NC
Follow-ups: Approximately 36 to 65 months following Hurricane Katrina, longitudinal sample followed over a 6-month period
Control group: Cross-sectional sample was likely done in a survey format.
Tailoring/Adaptation: NR	depression measure
LEC to assess major life events (measures of stress and trauma)		social support from family and peers; higher levels of family and peer social support were associated with acute and longterm lower levels of psychological distress;
protective factors of high peer social support may be diminished by high hurricane exposure (SOCSS was used to assess peer and family support)	
		American					
Dai et al. (2016), cohort followup study	The aim of this study was to measure the prevalence rate of PTSD among the survivors of the Dongting Lake flood in 1998 and identify the association between social support and their recovery from PTSD.	Country: Hunan, China
Setting: Adults who had experienced Dongting Lake flood in 1998 and had been diagnosed as having PTSD in 2000 were enrolled in this study.
Participants: Ν = 321
Age: 29-59 (n = 207), over 60 (n = 114)
Gender: 46.1% female, 53.9% male
Ethnicity: NR	Dongting Lake	Name of Intervention: Social support (The study used
flood in Hunan, the Chinese version of the Social Support Rating Scale China (1998)	(SSRS) to measure social support)
Theoretical basis: Social Support Theory
What materials used in the intervention:
Structured questionnaires were used for data collection.
Who provided the intervention: NR
Mode of delivery (e.g. face-to-face,online, or telephone): Data collection was conducted through face-to-face interviews.
Whether it was provided individually or in a group: NC.
When and how much the intervention was delivered: NC
Follow-ups:The study conducted a follow-up assessment between 2013 and 2014, which was 13-14 years after the participants were initially diagnosed with PTSD in 2000. The original diagnosis occurred more than one year after the Dongting Lake flood in 1998.
Control group: A follow-up survey was done between the years 2013 and 2014 to diagnose the victims again of PTSD.
Tailoring/Adaptation: NR	PTSD (using the DSM-IV criteria)	NA	Out of 321 subjects with prior PTSD, 51 (15.89%) were diagnosed as still having PTSD. Logistic regression analyses indicated that the recovery from prior PTSD was significantly associated with social support (odds ratio (OR) = 0.202, (95% CI: 0.047-0.878), subjective support (OR = 0.236, 95% Cl: 0.080-0.694) and support utilization (OR = 0.245, 95% Cl: 0.071-0.844)	
M. P. MISHU ET AL.
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Author, year, study design	Study aim/main research question as mentioned in the paper	Country, setting and participants	Climate change- related exposure, as mentioned	Intervention	Mental health outcomes (primary outcomes)	Secondary outcomes	Main result (as reported in the abstract)	
Daniel and Michaela (2021), longitudinal study
Wildfire, bushfire	The aim of this study was to explore the long-term mental health status and HRQOL in immediate victims of the 2013 flood disaster in Germany and to analyze their association to specific psycho-social interventions provided by a non-governmental relief organization.	Country; Germany
Setting: All flood affected areas in Germany that were supported by the Malteser Aid Service (MAS) program.
Participants: Ν = 1023
Age: Mean = 57.6 (SD = 13.3)
Gender: 47.7% male
Ethnicity: NR	Flood (2013)	Name of Intervention: NR
Theoretical basis: Psycho-social support program What materials used in the intervention: A paperbased self-report questionnaire.
Who provided the intervention: Malteser Aid Service - volunteers this non-governmental relief organization
Mode of delivery (e.g. face-to-face,online, or telephone): Paper-based questionnaire sent to participants
Whether it was provided individually or in a group: Individually tailored to the specific needs of help-seekers.
When and how much the intervention was delivered: Questionnaire was sent out 12, 18 and 24 months after the flood.
Follow-ups: NR
Control group: A cross-sectional survey (administered 24 months after the flood) in flood- affected but unsupported individuals was conducted as an approximate control group and to specify the characteristics of help seekers to relief organizations.
Tailoring/Adaptation: NR	Depressive post-traumatic stress, and anxiety symptoms were measured with the Brief Symptom Inventory 18 (BSI-18), the Impact of Event Scale Revised (IES-R).
Health-related Quality of Life (HRQOL) and social support were measured with the Health Condition Questionnaire (SF-36) and Questionnaire on Social Support (F-Soz-U-22).	NA	Participants exhibited elevated rates of depression (50.3%), post-traumatic stress (35.5%) and reduced physical health- related quality of life (63.1%) with an overall significant improvement of mental health parameters over time. The control group reported lower rates of depression and post- traumatic stress compared to the MAS group.	
Belleville et al.	The aim of this study was to	Country: Canada	2016 Fort	Name of Intervention: The RESILIENT online treatment	PTSD Checklist for DSM-5 (PCL-5):	NA	Larger effect sizes were observed	
(2023), RCT	evaluate the efficacy of an	Setting: Telephone survey in	McMurray	is a therapist-assisted self help internet based	PTSD		in participants who completed	
nested within the longitudinal study	online CBT intervention with limited therapist contact targeting a range of posttraumatic symptoms among evacuees from the 2016 Fort McMurray wildfires.	Alberta, Quebec
Participants: N = 136
(intervention η = 69 and wait list η = 67)
Age: Mean = 45 years old
Gender: Women (76%)
Ethnicity: White (82%)	wildfires	intervention for the treatment of mild to moderate PTSD symptoms, depression and subthreshold insomnia symptoms.
Theoretical basis: RESILIENT is an online CBT developed for individuals exposed to a natural disaster.
What materials used in the intervention: NR
Who provided the intervention: Therapist guided online self help treatment (Limited therapist contact) Mode of delivery (e.g. face-to-face,online, or telephone): Online
Whether it was provided individually or in a group: Individually
When and how much the intervention was delivered: It includes 12 modules. Access to the module was granted 1 week after the completion of the previous module. The platform also offered 6 interactive tools, up to 12 30- minute weekly contacts with a therapist were offered by video chat, phone or email (participants were given 6 months to complete 12 modules)
Follow-ups: Immediately and 3-months after treatment
Control group: Waiting list control
Tailoring/Adaptation: NR	Patient Health Questionnaire Depression Scale (PHQ-9): depressive symptoms Insomnia Severity Index (ISI): insomnia symptoms
Patient Health Questionnaire Generalised Anxiety Disorder Scale (GAD-7): anxiety symptoms
World Health Organisation Disability Assessment Schedule 2.0 (WHODAS 2.0): functioning and disability.		at least half of the treatment. Significant Assessment Time x Treatment Condition interactions were observed on all outcomes, indicating that access to the treatment led to a decrease in posttraumatic stress, depression, insomnia, anxiety and symptom severity and disability. The RESILIENT online treatment platform was successful to provide access to specialised evidence-based mental healthcare after a disaster.	

(Continued)
Author, year, study design	Study aim/main research question as mentioned in the paper	Country, setting and participants	Climate change- related exposure, as mentioned	Intervention	Mental health outcomes (primary outcomes)	Secondary outcomes	Main result (as reported in the abstract)	
Obuobi-Donkor	The study examines the	Country: Canada	2023 Wildfires in	Name of Intervention: Text4HopeNS and Text4HopeAB	Major Depressive Disorder (MDD),		The results of this study suggests	
et al. (2024),	effectiveness of Text4HopeNS	Setting: interventions were	Alberta and	during the 2023 wildfire season to support the mental	Generalized Anxiety Disorder		that the Text Hope program is	
longitudinal and naturalistic controlled trial designs	and Text4HopeAB in alleviating psychological symptoms and improving wellbeing among subscribers.	launched in Alberta and
Nova Scotia,
Participants (both baseline
and followup): Alberta 80, Nova Scotia 17
Age: 31 to 65 years
Gender: Male 14 (14.4), female 82 (84.5), other 1	Nova Scotia	health of impacted individuals
Theoretical basis: CBT principles to promote selfcare, resilience, social support, hope, and affirmation, as well as to help subscribers manage symptoms of stress, anxiety, and depression and improve mental wellbeing
What materials used in the intervention: Text messages created by psychiatrists, psychologists and mental health therapists
Who provided the intervention: Automated text messages
Mode of delivery (e.g. face-to-face,online, or telephone): The supportive text messages are automatically delivered daily morning (9 am) to the subscribers
Whether it was provided individually or in
a group: Individual
When and how much the intervention was delivered: Free unidirectional supportive daily SMS text messages for three months.
Follow-ups: Baseline to 6 weeks in the longitudinal study and between the intervention and control groups in the naturalistic controlled study.
Control group: New subscribers who had enrolled in the program during the same period but had not yet received any text messages.
Tailoring/Adaptation: NR	(GAD), Post-Traumatic Stress Disorder (PTSD), and suicidal ideation were measured on The Brief Resilience Scale (BRS), the World Health Organization-5 Wellbeing Index (WHO-5), Patient Health Questionnaire 9 (PHQ-9), Generalized Anxiety Disorder 7 (GAD-7) scale, PTSD Checklist - Civilian Version (PCL-C), and the ninth question on the PHQ-9, respectively.		an effective intervention for mitigating psychological symptoms in subscribers during wildfires. This CBT-based text messaging program can be adapted to provide effective support for individuals' mental health, especially in the context of traumatic events and adverse experiences such as those induced by climate change.	
O'Donnell et al.	The aim of this study was to	Country: Australia	South Australian	Name of Intervention: The Skills fOr Life Adjustment	The Kessler Psychological Distress	NA	Findings from this pilot	
(2020), Open
Label Pilot
Study	develop and pilot test an internationally developed, brief, and scalable psychosocial intervention (SOLAR program) that targets distress and poor adjustment following disaster and trauma in the Australian post-disaster context.	Setting: Community
Participants: 15
Age: 39-74 years old
Gender: 53.3% female
Ethnicity: NR	bushfires 2015	and Resilience (SOLAR) program
Theoretical basis: SOLAR is an internationally developed, low-intensity intervention designed to target distress and impairment following disaster and trauma.
What materials used in the intervention: SOLAR is made up of six modules: 1) skills for healthy living, 2) managing strong emotions, 3) getting back into life following disaster, 4) coming to terms with disaster, 5) managing worry and rumination, and 6) maintaining healthy relationships.
Who provided the intervention: Seven frontline workers (trained as SOLAR coaches): a community nurse, an intern social worker, two case workers, and three Australian Red Cross volunteers.
Mode of delivery (e.g. face-to-face,online, or telephone): Face-to-face
Whether it was provided individually or in
a group: NR
When and how much the intervention was delivered: Five sessions: first one is 80 minutes, the following ones are 50 minutes Follow-ups: 3 month follow-up
Control group: No control
Tailoring/Adaptation: NR	Scale (Κ10): measure of global psychological distress
The PTSD Checklist for DSM-5 (PCL-5): PTSD
Impairment: a single-item question to assess functional impairment in major life areas The Mini International Neuropsychiatric Interview Plus 7 (MINI Plus 7): psychiatric diagnosis		demonstrated that the SOLAR program was safe and feasible for non-mental health frontline workers (coaches) to deliver locally after two days of training. Participants' attendance rates and feedback about the program indicated that the program was acceptable. Pre-post quantitative analysis demonstrated reductions in psychological distress, posttraumatic stress symptoms, and impairment.	
M. P. MISHU ET AL.
(Continued)

Author, year, study design	Study aim/main research question as mentioned in the paper	Country, setting and participants	Climate change- related exposure, as mentioned	Intervention	Mental health outcomes (primary outcomes)	Secondary outcomes	Main result (as reported in the abstract)	
Heinz et al. (2022),	The present study examined the	Country: USA	2017 Tubbs	Name of Intervention: Sonoma Rises	Posttraumatic stress symptoms	NA	Sonoma Rises was found to be	
multiple - baseline single-case experimental design (SCED)	feasibility and efficacy of a mobile mental health app for disaster, Sonoma Rises.
A multiple-baseline single-case experimental design (SCED) utilising a research-enabled version of the app was employed with seven adolescents who experienced significant damage to their homes and schools in the wildfires.	Setting: Sonoma County, Northern California Participants: Adolescents directly affected by the 2017 wildfires, having lost their home or being temporarily displaced and presenting with at least four symptoms of PTSD (Ν = 7 at randomised baseline, N = 1 at 1 month follow-up assessment) Age: 13-17 years old (mean age = 16)
Gender: 3 male, 4 female Ethnicity: 5 Caucasian, 1 Hispanic, 1 Filipino/ Caucasian	wildfire	Theoretical basis: Sonoma Rises is a mobile app that was designed for anyone who has been impacted by wildfires or other natural disasters. It is intended to help survivors of disaster find their new normal, build resilience, and increase well-being. The Sonoma Rises content calls upon components of Skills for Psychological Recovery (SPR) and uses select audio tools from the National Center for PTSD mobile app, PTSD Coach.
What materials used in the intervention: Sonoma Rises app
Who provided the intervention: App-based intervention
Mode of delivery (e.g. face-to-face,online, or telephone): Online via app
Whether it was provided individually or in a group: Individually
When and how much the intervention was delivered: Participants were instructed to access the app 7 days a week, for 5-10 minutes, over a 6 week period.
Follow-ups: 4 week follow-up assessment
Control group: No control Tailoring/Adaptation: NR	(Child PTSD Symptom Scale for DSM-5, CPSS-5), internalising and externalising symptoms (The Behavior and Feelings Survey, BF5), psychosocial functioning (Ohio Scale for Youth - Functioning subscale, OSY), and then measures of anxiety (GAD-7), depression (PHQ-9), well-being (Warwick - Edinburgh Mental Well-Being Scale, WEMWBS), sleep (Insomnia Severity Index, ISI), and perceived social support (Wills' Social Support Scale, WSSS)		feasible in terms of engagement, satisfaction, and likelihood of recommending to a friend. During the study, another wildfire occurred and all participants underwent a prolonged mandated evacuation and were subject to a series of extended power outages. Uptake of the publicly available version of the Sonoma Rises app among the general population was modest but engagement among users was sustained.	
Cowlishaw et al.	The aim of this study was to test	Country: Australia	After compound	Name of Intervention: Skills for Life Adjustment and	PTSD Checklist for DSM-5 (PCL-5):	NA	Participants in the SOLAR condition	
(2023), two-	the efficacy of the Skills for Life	Setting: Community	disasters	Resilience (SOLAR) Program	post-traumatic stress symptoms		experienced significantly lower	
arm RCT	Adjustment and Resilience programme (SOLAR) delivered by trained local community members following compound disasters (drought, wildfires, pandemic-related lockdowns) in Australia.	Participants: 66 people with anxiety, depression and/or posttraumatic stress symptoms, and impairment Age: Average = 52.08 years, SD = 10.50
Gender: η = 49 female, η = 15 male, η = 1 non-binary
Ethnicity: NR	(drought, wildfires, pandemic - related lockdowns) in Australia	Theoretical basis: A skills-based, trauma informed, psychosocial programme.
What materials used in the intervention: NR Who provided the intervention: Thirty-six community members were trained to deliver the intervention.
Mode of delivery (e.g. face-to-face, online, telephone): Either face to face or virtually (one-on- one)
When and how much the intervention was delivered: SOLAR programme was delivered across five 1-hourly sessions.
Follow-ups: Participants were assessed pre, post and two months following the interventions.
Control group: Participants were randomized SelfHelp condition (received weekly emails with self-help information including links to online educational videos)
Tailoring/Adaptation: NR	Hospital Anxiety and Depression Scale (HADS): anxiety and depressive symptoms
Dimensions of Anger-5 (DAR-5): anger symptoms
Insomnia Severity Index (ISI): insomnia symptoms
6-item Brief Adjustment Scale (BASE-6): generic measure of psychological distress.		levels of anxiety and depression, and PTSD symptom severity between pre - and post-intervention, relative to the Self-Help condition, while controlling for scores at intake. These differences were not statistically different at followup. The SOLAR programme was effective in improving anxiety, depression and posttraumatic stress symptoms over time.	
William and Garland 2002: https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/cognitivebehavioural-therapy-assessment-model-for-use-in-everyday-clinical-practice /457580EA0C101C8CA0F0609E3AA45747.
House et al. 1988: https://www.science.org/doi/abs/10.1l26/science.3399889
Umberson and Montez 2010: https://journals.sagepub.com/doi/abs/10.1177/0022146510383501.
INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH

Americans (Bui et al. 2021), i) an evaluation of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) (Weinzimmer et al. 2022), and J) community-based resilience intervention for Filipino displaced survivors of Super Typhoon Haiyan (Hechanova et al. 2018) and k) group-based, and mindfulness-informed resilience intervention developed for disaster survivors in the Philippines (Hechanova et al. 2016). Methods of intervention administration varied between web-based delivery (Steinmetz et al. 2012), delivery by clinically trained staff (Graham et al. 2017; Hamblen et al. 2017), and delivery by community members (Gibson et al. 2021) or through existing social networks within communities (Harvey et al. 2007). Adaptation, administration and evaluation of outcomes in local contexts were made across several of these studies (Gibson et al. 2021; Bui et al. 2021; Hechanova et al. 2018, 2016).
These studies were largely focused on mental health outcomes by measuring indicators of poor mental health such as PTSD, depression, anxiety (Steinmetz et al. 2012; Hamblen et al. 2009, 2017; Gibson et al. 2021; Weinzimmer et al. 2022), alongside indicators of good mental health such as self-efficacy, coping and individual resilience (Cheng et al. 2012; Graham et al. 2017; Harvey et al. 2007). Social support was also considered as a mediator and the outcome of interventions’ impacts on mental health (Harvey et al. 2007; Bui et al. 2021). Among the tested interventions, MDR reduced worry and depression (Steinmetz et al. 2012) and SOLAR reduces psychological distress among the participants receiving the interventions (Gibson et al. 2021). All the longitudinal experimental study showed effectiveness in improving mental health outcomes.
Floods
There were nine articles that focused on the mental health interventions tackling the impacts of flooding. Five interventions were tested through trials, including: a) Support for Students Exposed to Trauma (SSET) Program, which is a Cognitive Behavioural Intervention for Trauma in Schools (an adaptation of CBITS) (Amin et al. 2020), b) Trauma-focused Cognitive Behavioural Therapy (TF-CBT) (including manualized protocols like “My Story of the Flood”) (Cobham and McDermott 2024) c) School Therapeutic Enhancement Program (STEP) (used adaptations of “The ACTION Treatment Program”, “Coping Power”, and an anxiety module) (Goldman et al. 2015), d) Rational emotive behavior therapy (REBT) intervention (Ede et al. 2022). e) Community-based integrated mental health and disaster preparedness intervention (James et al. 2019). The impacts of different support systems on Depression, anxiety, and PTSD were observed in three longitudinal studies, including: f) peer and family support (Banks and Weems 2014), g) Psycho-social support provided by relief organizations (e.g. Malteser Aid Service) (Daniel and Michaela 2021), h) social support (Dai et al. 2016), and j) forecast-based cash grants as a potential adaptation strategy to deal with changes in extreme events linked to climate change (Gros et al. 2019).
Interventions are frequently school-based, delivered through group formats or structured lessons. A key characteristic is delivery by non-clinical staff, trained lay workers, or supervised trainees, in addition to clinicians. Many are manualised protocols based on Cognitive Behavioural Therapy (CBT) principles. Content includes psychoeducation, cognitive restructuring, and exposure to the disease. Goals include reducing symptoms like PTSD, anxiety, and depression, building resilience, and enhancing social support. Some approaches integrate disaster preparedness. Adaptation for local contexts is important for feasibility. The effectiveness of mental health interventions on post-disaster trauma has been demonstrated in RCTs on the reduction of depressive symptoms post-flood events. The studies addressed limited mental health capacity in disaster-affected and under-resourced areas.
Wildfire
Among five studies on interventions related to wildlife include: a) RESILIENT online treatment, which is a therapist-assisted self-help internet-based intervention (Belleville et al. 2023), b) Text Hope program (Text-based intervention) (Obuobi-Donkor et al. 2024), and c) The Skills for Life Adjustment and Resilience (SOLAR) program (O’Donnell et al. 2020; Cowlishaw et al. 2023) and d) a public mobile app to reduce symptoms of postdisaster distress in adolescent wildfire survivors.
In response to highly disruptive wildfires in parts of Canada, both the CBT-based online RESILIENT intervention, and Text-based interventions were found to positively affect resilience in the affected population, as well as reducing overall levels of depression, PTSD symptoms, and generalised anxiety disorder symptoms (Belleville et al. 2023; Obuobi-Donkor et al. 2024). Two studies in Australia tested skills- based, trauma-informed, psychosocial programme in Australia and reported that SOLAR was an effective

Mental Health Outcomes of Climate-Related Interventions: MHPSS Intervention Pyramid
Representation

Coping
Anxiety
Depression
Quality of Life
Insomnia Trauma
Stress & Distress
Social Support Anger
Self-Efficacy Dissociation
Individual Resilience ADHD
Suicidal Ideation

Specialised Services
(Amin et al., 2020; Belville et al., 2023;
Cobham et al., 2024; Ede et al., 2021;
Goldman et al., 2014; Graham et al.,
2017; Hechanova, Waelde & Ramos
2016; Hechanova et al. 2018; Linde et
al., 2023; Obuobi-Donkor, 2024;

Anxiety Insomnia
Stress & Distress Social Support Anger

Depression Trauma PTSD Self-Efficacy Functional Impairment Psychosocial Functioning

Weinzimmer et al., 2022)
Non-Specialised Services
(Cowlishaw et al., 2023; Gibson et al.,
2021; Hamblen et al., 2009, 2017;
Heinz et al. 2022; James et al., 2020;

Anxiety PTSD Trauma
Self-Efficacy	Stress & Distress	Depression
Social Support

O’Donnell et al., 2020; Steinmetz et
al., 2012)
Community and Family Supports
.(Banks & Weems, 2014; Dai et al., 2016;

Basic Services
Bui et al., 2021; Cheng et al., 2012; Daniel & Michaela, 2021; Gros et al., 2019)

Harvey et al., 2007)
ty	Trauma	PTSD Individual Resilience
Stress & Distress Social Support Depression
Quality of Life
Figure 2. MHPSS intervention pyramid.
program in improving anxiety, depression and posttraumatic stress symptoms over time after bush fire (O’Donnell et al. 2020; Cowlishaw et al. 2023) and also in compound disasters (drought, wildfires, pandemic-related lockdowns) (Cowlishaw et al. 2023). A research-enabled version of the app employed on seven adolescents in Northern California who experienced significant damage to their homes and schools in the wildfires showed indication of improvement of mental health outcomes (Heinz et al. 2022).
The position of identified climate-related MHPSS interventions and the mental health outcomes on WHO’s IASC produced pyramid are presented in Figure 2. Most of the studies were based on individual level specialised services (n = 11) and non-specialised service (n = 8). Few studies were identified that targeted at community and family support (n = 3) and basic services (n = 4).
Discussion
We included 26 studies in this review. Overall, the included interventional studies in the review showed the effectiveness of targeted psychological interventions in improving mental health outcomes, including reducing symptoms of depression, anxiety, and PTSD following extreme weather events. Through the natural experiment design, the included cohort or longitudinal studies provide evidence of the effectiveness of peer support, community and social support-based interventions or resilience-building programmes on reducing negative mental health impacts. We identified 19 new interventions since the last review (Xue et al. 2024). The effectiveness of mental health interventions identified in the review depends on many factors, including the scale and intensity of the specific event, whether it is a repeat event, and the extent of social, economic and environmental impacts and on mode of intervention delivery, and the target group. Most of the interventions were based in high-income countries.
Though WHO emphasise the need MHPSS interventions in the context of climate-change event-related exposures for all layers of the pyramid to be met and addressed with inter-sectoral action and tailored interventions (WHO 2025), few studies were identified in the review that targeted community and family support and basic services in WHO’s IASC produced pyramid, while most of the interventions were targeted at individual level delivered by specialised services or non-specialised services. Though the guideline of MHPSS interventions were targetted to enable humanitarian actors and communities to plan, establish and implement a set of minimum multi-sectoral responses to protect and improve mental health and psychosocial well-being as soon as possible in an emergency, the is lack of multi sectoral and multi level interventions, our finding highlighted that there is a need of that.
These results align with previous research predicting a decline in global and local health over the next decade, attributed to an increase in epidemics, pandemics, and environmental disasters (Thomas 2020; Marani et al. 2021). The review by Cianconi et al. (2020) was divided into specific areas: the course of change in mental health, temperature, water, air pollution, drought, as well as the exposure of certain groups to these extreme events and critical psychological adaptations. Increased temperature and temperature variability were associated with increased cases of suicide and suicidal ideation, hospital attendance or admission for mental illness, and poor community health and well-being (Thompson et al. 2023). Though ambient temperature showed an association with mental health-related hospital or emergency department visits or hospital admissions in both new cases and people with existing mental health conditions, we did not identify any preventive or supportive interventions in mental health services to address the extreme heat-related mental health impacts.
Chique et al. (2021) conducted a global pooled analysis integrating mental health and well-being metrics between 1980 and 2020 that provide a robust evidence base for developing and implementing public health intervention strategies aimed at ameliorating the psychological impacts of extreme weather among exposed populations. Although the relationship between climate change and extreme-weather-events-related negative health impacts has been established, there is a lack of research on how to support mental well-being in affected people (Hayward and Ayeb-Karlsson 2021). From previous studies as well as this one, evidence shows a need to develop effective mental health support strategies for people affected by extreme weather events. However, a lack of research, strategies, and policies for such measures is evident (Hayward and Ayeb-Karlsson 2021).
Recommendations
Published studies show that climate change is having a long-term impact on the mental health of people susceptible to extreme weather events. This warrants attention in future research, including the development of effective preventive resilience-building interventions, healthcare support provision, and related policy-making. We need to consider both climate change and specific climate-related events, and appropriate mental health interventions. Many of the most vulnerable populations live in areas where health systems are already under considerable strain, which will be exacerbated by climate change. Moreover, the mental health support that is recommended is not readily available, and the systems are not necessarily in place. These challenges will be felt most acutely in parts of the world that experience repeat events and a degree of “loss and damage” for which it is not possible to adapt.
Future research: interventions to support mental health/resilience-related interventions
There is a need for further research to develop resilience-building interventions that are both effective and cost-efficient. These interventions should be customised for a particular climate-change-related occurrence and tailored to the specific setting and population of a country. It is essential to recognise that the impacts of extreme weather events on mental health are felt differently, and some may be more resilient than others (Maloney 2022). Resilience-enhancing training and strategies could be a way forward, as they are a key protective factor for mental health in the face of extreme weather events at both the individual and community level (Sippel et al. 2015). Resilience-building interventions addressing the adverse effects of climate change on mental health encompass designed strategies and programs. These initiatives aim to enhance individuals’ ability to cope with and adapt to the challenges posed by climate change-related events.
Support in mental health provision and accessing mental health services
WHO recommends the five key approaches to address mental health impacts due to climate change (World Health Organization 2022). Mitigating the mental health impacts of climate change requires a multi-faced approach that encompasses prevention, early intervention, and treatment. The approach involves various levels of support and collaboration from individual to community and policy levels. The inclusion of key stakeholders, such as policymakers, healthcare professionals, and vulnerable communities susceptible to mental health issues related to climate change, is critical (The Bartlett UCL 2021). Improved access to mental health services is essential, particularly in underserved communities and vulnerable populations, to ensure that individuals have the support they need (Maloney 2022).
Policy-level recommendation
Climate-induced disaster response policies often ignore mental health due to redirected immediate medical needs (Pilar et al. 2022). Core functions of public health, for example, mobilising partnerships, mitigation and adaptation activities, communication, workforce development, and evaluation, should be integrated into related policy and planning (Fox et al. 2019). Allocation of more funding is key for research on mental health impacts of climate change, encouraging innovation of effective interventions and collaboration among researchers and practitioners. However, this is needed most in places facing constraints of weak health care systems and lack of financial and human resources. There is very little international cooperation on climate change and mental health, sharing knowledge, resources and best practices across borders, especially in developing countries where access to mental health services barely exists (Rata) et al. 2016; King et al. 2023). The cost implications of climate change impacts on mental health need to be considered. Ultimately, climate change adaptation and mitigation solutions need to be chosen that maximise other benefits and avoid negative consequences for mental health (The Bartlett UCL 2021).
Prevention and calamity preparedness-related interventions specially in LMICs
While climate change and mental health is a growing research area, it need accelerated, broader evidencebased adaptation strategies specially in LMICs. Most of the interventions identified in the study were based in HICs. However, outside of high-income countries like Canada where climate disasters are usually met with reparative actions by governments and institutions, people in lower-middle-income countries are experience reduce social support and stability, which are key contributors to psychological resilience (RoseClarke et al. 2020). Interventions at neighborhood or larger-scale levels should focus on strengthening biopsycho-sociocultural factors to increase disaster preparedness and responses, such as fostering communityinclusive development and reducing social isolation (Rose-Clarke et al. 2020). Community resilience describes the combination of individual resilience of members of the community, the intra-group bonds that facilitate interdependence on the members’ coping strategies, and how the individuals and the group react to adverse conditions, which is now seen as critical to national health security, as it is essential in overcoming traumas like environmental disasters (Sippel et al. 2015). Resilience at the individual as well as community levels is central to managing significant contributors and stressors in countries experiencing extreme weather events like flooding and drought crises (Chenoweth and Stehlik 2001).
Strengths and limitations of the scoping review
The review has several strengths. The authors followed standard guidelines for scoping review and applied independent dual screening and data extraction, indicating a rigorous and transparent methodology for identifying relevant studies. It identifies the targeted and tested interventions and provides evidence of the effectiveness of such interventions for negative impacts of mental health related to climate change and related exterme weather events.
There are some limitations to this review. Due to the heterogeneity of the studies, the use of different outcome measures, and the use of study-specific scales, it was not always possible to synthesise the results sufficiently. Due to the diversity of study populations, settings and study design, it was challenging to synthesise the results for a specific population. The authors explicitly state that methodological quality of included studies was not assessed, which is a significant limitation. While acknowledged as not a requirement for scoping reviews, it prevents an understanding of the robustness of the interventions presented.
Conclusion
The mental health implications of climate change have been historically neglected in research, policy and practice. Although the association between mental health and extreme weather events related to climate change is now acknowledged, there is little evidence on available interventions delivered to those exposed to extreme weather events specially in LMICs. We believe that the review will contribute to justifying the rationale of developing intervention in the related field in the future. Key stakeholders need to be brought together to identify promising interventions and coordinate actions to mitigate climate change-related negative impacts on mental health.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Author's contributions
Masuma Pervin Mishu (MPM) contributed to the conceptualization, methodology of the study, database searches, screening, data extraction, write-up of the original manuscript, review and edit of the manuscript, and oversight and leadership responsibility for conducting the scoping review. M M Golam Rabbani (GR), and Silke Vereeken (SV) contributed to screening, data extraction, write-up of the manuscript, review, and editing of the manuscript. Emma Tkach (ET) contributed to database searching, screening, data extraction, manuscript writing, review, and editing. Jackie Martin-Kerry (JM-K) contributed to data extraction, write-up of the manuscript, review and edit of the manuscript. Τ Faiaz Chowdhury (FC) and Abrar Wahab (AW) contributed to screening, and data extraction. Saidur Rahman Mashreky (SRM), and Rumana Huque (RH) reviewed the manuscript. Richard Friend (RF) reviewed and edited the manuscript. All authors read and approved the final manuscript.
Data availability statement
No data is related to this article
Funding
The author(s) reported there is no funding associated with the work featured in this article.
ORCID
Masuma Pervin Mishu http://orcid.org/0000-0002-6545-9117
MM Golam Rabbani http://orcid.org/0000-0001-7475-6853
Silke Vereeken http://orcid.org/0000-0003-1432-8712
Jacqueline Martin-Kerry http://orcid.org/0000-0002-9299-1360
Saidur Rahman Mashreky http://orcid.org/0000-0001-7892-798X
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