A Causal Analysis of the Complex Mental Health Impacts of the Climate Crisis in Young People Project Summary. New research recognizes the role that environmental factors sensitive to climate change and variability (e.g., increasing temperatures, heat waves) may play in the complex pathway linking environmental exposures and negative mental health and well-being outcomes. A recent survey showing 7 out of 10 young people are worried about their future in the context of these planetary changes. Few studies have fully examined climate- mental health on a national level to determine which types or combinations of climate events (extreme heat, hurricanes, extreme heat in the context of a hurricane) are connected to mental health consequences in young people. The overarching goal of this research is to comprehensively examine the sensitivity of mental health impacts to climate disasters in youth, as well as the compounding and cascading effect of concurrent extreme events across the U.S. We will leverage our longstanding partnership with Crisis Text Line (CTL), a global not-for-profit organization that provides free, 24/7, and confidential text-based crisis response service. CTL currently has the largest repository of mental health data in the world and, unlike other data sources, can provide data in real-time. We will perform a causal analysis to address the following aims: Aim 1: Examine the local spatiotemporal patterns of help-seeking for mental health in response to three extreme climate events—hurricanes, wildfires, and heatwaves—and how crisis response varies by event-type and in the acute and chronic phases. Aim 2: Identify the individual and community-level social and environmental factors that promote mental health resilience in youth impacted by a climate disaster. Aim 3: Compare the compounding effect of concurrent extreme events on longitudinal changes in youth mental health. Results will inform crisis response and mental health training efforts and fulfill a vital research gap through the “embrace of complexity” by developing conceptual models critical to understanding how climate impacts mental health. This study’s findings will be enhanced through the quasi-experimental research design, which will leverage rich spatiotemporal data to identify the mental health conditions related to climate disasters and mediating underlying disparities driving these patterns. This project will leverage our rich and productive collaboration to engage undergraduate students, primarily represented by rural ‘first generation’ college students in research. Further, this proposal will enhance the research and learning infrastructure at Appalachian State University, introducing primarily rural college students in geography, public health, and mental health sciences to transdisciplinary research that tackles 21st-century complex environmental and health challenges using causal science approaches and statistical/geospatial techniques. Traditionally underrepresented students will receive mentorship and real-world research experience at the intersection of mental health and climate change, as well as an introduction to science techniques that can identify population-level leverage points for interventions to reduce the impact of climate disasters on mental health. 1

Public Health Relevance. Adolescence and young adulthood are key times for the development of mental health disorders. Despite the frequency of climate-related natural disasters, like hurricanes, wildfires, and heatwaves, little is known about their effects on mental health in this group. The proposed research will further knowledge on the impact of mental health from climate disasters using a quasi-experimental design that seeks to tease out causal effects to build a robust evidence base for climate and mental health relationships.