Since its inception in the early 1970s, psychiatry has leaned on Engel’s biopsychosocial model to comprehend the intricate interplay between nature and nurture, encompassing biological predispositions, psychological constructs, and the relational contexts that shape an individual’s identity. Much like fish in water, we’ve often overlooked the vitality of the medium in which both they and we exist: the sun, atmosphere, air, food, water, oceans, warmth, and energetic processes that sustain our well-being.
Beyond the realm of psychiatry, the biopsychosocial paradigm has been evolving since the 1960s. The ecopsychological perspective has underscored the nonhierarchical, interdependent relationship between human consciousness and the broader ecological and cosmic consciousness inherent in nature. Socioecological theory has conceptualized individuals within a web of broader sociological and ecological systems beyond immediate interpersonal connections.
Five years ago, H. Steven Moffic, MD, urged psychiatry to broaden its conceptual framework—suggesting terms like “bio-psycho-social-environmental” or “bio-psycho-eco-social” to acknowledge the interconnectedness of mental and environmental health. Since then, our understanding of the direct impacts of environmental degradation on the brain has only deepened, with the relentless progression of global warming despite a century and a half of awareness regarding the consequences of carbon-based emissions on the atmosphere.
We now recognize that hotter temperatures correlate with increased violence, that gains from suicide prevention efforts are jeopardized by climate change, and that exposure to traffic-related air pollution elevates rates of dementia and autism. Moreover, wildfires correlate with heightened prescriptions for psychiatric medications, and mortality rates spike during heatwaves. The diminishing presence of micronutrients in rapidly cultivated foods has substantial implications for mental health, as does the pervasive presence of microplastic particles in our environment and bodies.
These microplastics infiltrate breast milk, protrude from atherosclerotic plaques, raising the risk of heart attacks, and, in animal studies, induce changes akin to Parkinson’s disease in the brain.
On this Earth Day of April, 2024, the articles in this Psychiatric Times Special Report shine a spotlight on the intricate relationship between health and the environment. They delve into the ramifications of climate change and food additives, as well as the disparities in health outcomes for global and vulnerable populations amid escalating damage to the planet.
As our comprehension of environmental impacts burgeons, so must our assessment models and professional responses. We must pivot towards incorporating environmental factors into every patient evaluation and embrace our responsibility to care for the planet in our medical ethics and personal conduct as leaders and exemplars within our communities.
