Pacific Islands, explained.
The Pacific Islands are extremely vulnerable to climate-change-induced sea level rise (Getty Images)
The region bears the psychological toll of the climate crisis but without the healthcare force to address it.
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Pacific Islands: The hidden mental health costs of climate changePacific Islands: The hidden mental health costs of climate change
Within the first 30 days of 2026, Australia has experienced multiple cyclones, historic heatwaves, flooding at both endsof the country and bushfires on both sides. In New Zealand, unprecedented rainfall has led to deadly flooding and landslides. In the US, winter storms have claimed lives across the country.
As the world teeters on the brink of the 1.5°C warming threshold laid out in the Paris agreement and major emitters wane in their climate commitments, greater climate volatility can be expected. It has never been more pertinent to focus on climate resilience and adaptation. Nowhere is this more apparent than the Pacific, where small island nations who contribute little to global emissions endure the reality of the climate crisis every day.
Climate change is considered the Pacific’s greatest security threat, due to heightened exposure coupled with inadequate resilience. Acute climate disasters in the region are increasing: primarily more severe seasonal cyclones and flooding but also extreme heat, drought and maritime heatwaves. The Pacific Islands are also extremely vulnerable to climate-change-induced sea level rise, which threatens to submerge the island nation of Tuvalu by 2050. This threat has already created a new category of displaced peoples: climate refugees.
When climate disasters strike, we notice destruction: buildings razed, trees felled, streets cracked, human lives violently lost – the physical scars of environmental extremes. But for the survivors of climate-change-related environmental catastrophes the greatest burden isn’t public infrastructure damage or loss of private assets; it isn’t agricultural damage or impacts on livelihood. According to theOxfam Loss and Damages Dashboard, the most substantial effects are “non-economic losses” – primarily psychological stress.
Suicide rates soar during instances of extreme heat. The prevalence of post-traumatic stress disorder remains elevated for years following flooding. Bushfires bring anxiety, depression, and profound psychological distress.
The Pacific’s mental health workforce falls considerably short of being able to absorb the increased burden driven by climate change.
The indirect impacts of climate disasters on mental health are similarly widespread. Cyclones invariably bring increases in gender-based violence and with them the associated mental health harms. Flooding blocks access to health services as well as education, compounding existing disadvantage and disempowerment.
Slow-onset climate-change-driven stressors are less violent but no less destructive. Prolonged droughts are associated with heightened anxiety, depression and suicide, underpinned by food and financial insecurity. Melting sea ice depletes traditional hunting territories causing, among other things, loss of connection to culture and solastalgia (grief associated with negative environmental changes). That same melted ice contributes to sea level rise, which raises soil salinity in low-lying agricultural regions. High salinity renders the land inarable, once again driving food insecurity and subsequent anxiety and psychological distress.
The Pacific’s mental health workforce falls considerably short of being able to absorb the increased burden driven by climate change. Four Pacific Island nations have an effective ratio of zero psychiatrists per 100,000 people, compared to Australia at 16 per 100,000. Only one nation of the ten for which data are available has more than two psychiatrists tasked with servicing every 100,000 people (Palau: 11 per 100,000). Although issues related to mortality reporting are significant in the Pacific, the data that does exist indicates the Oceanic region has the highest proportion of deaths by suicide in the world.
Compounding healthcare inadequacies is a shift in aid distribution stemming from mounting geopolitical competitiveness. Between 2009 and 2023, development spending on strategic infrastructure in the Pacific grew from US$97 million to US$484 million per annum. Across the same timeframe, health spending dropped from US$290 million to US$256 million, per the Lowy Institute Pacific Aid Map.
Enabling access to quality mental healthcare is key to the continued development of climate resilience in the Pacific region. Most Pacific Island nations have limited capacity for in-country tertiary education, and the opportunity for specialty mental health training is similarly limited in thosecountries that do have a medical school(there are six schools in total across five Pacific nations). Increasing the capacity for domestic training is a worthwhile long-term undertaking. Schemes facilitating training of Pacific Islanders in nearby Australia and New Zealand, such as the Australia Awards Scholarship, provide a more immediate pathway for expanding the Pacific mental health workforce. However, ensuring these internationally trained mental health professionals return to the Pacific post-training, rather than furthering Pacific “Brain Drain”, requires additional domestic incentives, including competitive remuneration, sound infrastructure, and adequate resourcing to deliver quality mental healthcare.
Ensuring quality mental healthcare in the Pacific requires a deep understanding of the unique cultural context. For example, establishing vā, (a sacred Pacific concept referring to the relational space binding and unifying all things), is an important early step in healthcare engagement for many Pacific peoples. Mental health workforce expansion, and approaches to prevention and treatment must be grounded in Pacific principles; investment in local mental health professionals is therefore essential to building genuine climate resilience in the Pacific.
About the author
Connor Graham
Connor Graham is a Research Fellow in the Pacific Islands Program at the Lowy Institute.
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