[music]

Speaker 1: I try not to be alarmist, but I feel like there's some sort of apocalypse that's awaiting around climate change. I fear for people who are living below sea level. I fear for people who are very dependent on agriculture. I can just go to the grocery store, so I have a little bit more time, I have a stable income but calamity can come at any time.

Speaker 2: I think we're getting towards a point where we're not going to be able to reverse the damages to the climate that we make. Yes, I'm a little bit worried to see what the consequences of that might be in the future, especially when I'm thinking about, "Do I want to have kids? Is this a world I want to bring them into? Is it going to be safe for them?" I really don't know.

Speaker 3: I realized that mankind is a tough species to be part of but we're redoing it to the earth, and we have to change. I have grandchildren, so I think about what their lives will be like when mine is no longer here. It doesn't seem to me that things are happening quickly.

Speaker 4: I lived in Staten Island for Hurricane Sandy, and it devastated that borough in New York. It was just because of lack of preparedness because the climate was changing, and the sea wall was rising, and people, they were drowning in their own homes because of floods. I don't know, seeing that as a kid was just really impacting.

David Remnick: In June, a case known as Held versus Montana will go to court. It's a lawsuit about the climate emergency, the first ever of its kind to reach trial. 16 young plaintiffs are suing the state of Montana for failing in its obligation under the Montana Constitution to provide them with a healthy environment. Among the harms the plaintiffs will lay out is the emotional distress of watching the world around them get more and more threatened every day.

An expert witness the plaintiffs will call in the health case is the psychiatrist Lise Van Susteren. She's a co-founder of the Climate Psychiatry Alliance, a network of mental health providers concerned with educating colleagues and the public about the climate crisis. I think it's axiomatic now that we have, in ways that are hard to quantify, a mental health crisis in the United States, and a lot of it is ascribed to the pandemic and its aftermath and any number of other factors, social media, and one of them is the climate crisis. How would you at least broadly outline that crisis where it has to do with climate and psychology?

Lise Van Susteren: Let me take it from the top. The pandemic created enormous pressures on kids, because they weren't able to socialize and do the things that helped them to break away from their parents and adjust to a new world, et cetera. The fact that there was additional challenges to kids is undeniable, but for some reason, when it has come to understanding that kids are hearing scientists tell us that we are looking at extinction of species, and maybe even of our own.

Unless they're living in a cave, it's going to bother them. Yes, we have a very serious mental health crisis in kids, and yes, it is disproportionately on them, because they will disproportionately feel the cumulative effect of climate instability.

David Remnick: Is it possible to quantify the crisis, especially when it comes to climate?

Lise Van Susteren: The short answer is no. Anxiety exists in the brain. Think of it as a big, dark, black pool. In that big pool, it is impossible to quantify today, "I'm anxious about climate this much, about not looking good, that much, and about not getting into the right school, a different amount." Here's what I can tell you. I participated in a survey that we launched in 2021 and had the results in the fall. In it, we surveyed 10,000 kids from 10 countries all over the world.

Here's what we found. Three-quarters of the kids are worried about the future because of climate. Almost half of them say it affects their daily lives. More than half say they feel a sense of doom about the future, and here's what's interesting to somebody like me, because I'm really focusing on policy, two-thirds of those kids lay the blame firmly at the feet of government.

David Remnick: I grew up with a nuclear threat. Even I'm probably the last generation of kids who scurried into a hallway or under desks.

Lise Van Susteren: Under desks, what was that going to do for us, I ask you?

David Remnick: The desk was going to prevent you from nuclear annihilation that's happened. Obviously, this fit into our anxiety but it was inchoate and rarely spoken of. How is this different?

Lise Van Susteren: Think about it. We, at the time, thought the Soviets or the Russians, wasn't more communists, in my mind, were going to do something really bad. I didn't exactly know, you probably didn't either, what nuclear war was, but that is very different from what the kids know today. If you're a kid today, you can see a fire, a flood, a storm, you can hear about homes and places that have been leveled. This is something that is extremely visual. They can understand at a very grassroots level what this means. Nuclear war and mushroom cloud, what is that?

David Remnick: You see patients, right?

Lise Van Susteren: Sure, I do see. Yes.

David Remnick: What do they tell you? What are you hearing directly from kids that you talk to?

Lise Van Susteren: I have spoken with young people extensively, but not as patients. We need to recognize that we must not pathologize climate distress, but kids are talking about their anger, they're talking about their fear, they're talking about their despair, they're talking about feelings of abandonment, they are talking about betrayal, and they don't understand why the adults in the room are not taking more action. Let me just say one thing that is pretty characteristic that I have found, and in many of the most sensitive kids is what I dubbed pre-traumatic stress, which is anticipation of future harms, and has all the hallmarks of post-traumatic stress but it's in conjuring what will happen in the future.

David Remnick: You said that we shouldn't pathologize climate distress. What do you mean by that?

Lise Van Susteren: Not to think of it as a mental illness. If it was to be a mental illness to-- if you saw somebody on the tracks and the train was coming, to be alarmed and scream at the person to get off the tracks, well, that's the equivalent.

David Remnick: What you're saying, this is a logical response to an imminent threat?

Lise Van Susteren: It's more than logical. It's a survival strategy. I started a group called The Climate Aware Therapists, because I got so many calls from people who were non-functional. That's when you can begin to talk about it as an entity that should be recognized within my professional groups as becoming a mental-- maybe illness is too strong a term, but a condition.

David Remnick: How prevalent is that?

Lise Van Susteren: Climate distress itself, I believe we're all anxious now, whether we know it or not, whether we like it or not, whether we admit it or not but when it reaches the level of a person who is no longer functional, I can't tell you the numbers, but I certainly have heard them anecdotally.

David Remnick: Do you experience it yourself, climate anxiety?

Lise Van Susteren: Oh my God, are you kidding? I try to keep it, this is the big quandary. How much of it do I show my family? Like they don't know. I've laughed and said very openly, I could open a pharmacy with all of the medications I've had my colleagues prescribe for me to address my climate anxiety.

David Remnick: We've been talking about young people. What you're saying is that people who are in middle age or older, obviously, feel a climate anxiety, and how does it differ for them?

Lise Van Susteren: First of all, the kids are more attuned to it because they're not the problem. We're a little bit old dogs new tricks, plus we're used to a high-carbon lifestyle, and we're not so ready to give it up, so we deny, we disavow, and all the rest. As for our anxiety, for those of us I know, I think one critical key issue is that many of us feel more empowered than kids do. There's something that I can do. I can reach out to legislatures, the new climate chief in Massachusetts, there's a lot. I can talk to you, there's a lot I can do. The kids, basically, they can gather their voices, but they're not empowered, and that helplessness is the worst.

David Remnick: What do you do and what do your colleagues do with young people who are feeling overwhelmed by climate anxiety? How do you help them cope? You can't tell them a political fairytale.

Lise Van Susteren: No, of course, you can't, and they won't listen to it. The remedy is, there's a standard remedy, and that is depending upon the age of the child, I once had a patient whose kid thought that Charlie, their dog, was going to die because of extinction of the species. If it's a little kid like that, you say, "Oh gosh. No, Charlie's safe, et cetera." A 10-year-old is different from a teenager. It might be for a younger child you'll say, "Well, let's make a garden so that we can grow our own vegetables, that will help the planet."

You can engage in activities that are age-appropriate. If it's a teenager, you might say, "I stand by your protest today and not going to school, and do you want me to come with you?" You describe the dangers in a way that meets their particular stage of development and then you quickly segue to, "Here's what we can do about it." That is the secret sauce to feeling empowered and empowerment is the secret sauce in reducing anxiety and that feeling of helplessness.

David Remnick: You are an expert witness in two climate cases, one that sued the federal government, and the other against the State of Montana, which is a case scheduled for June. The plaintiffs are young and some of them are still in their teens. Tell us broadly about what these cases allege and what you were brought in to testify about.

Lise Van Susteren: The two cases you're speaking of are Juliana versus the US government. 21 youth plaintiffs and the climate scientist, James Hansen.

David Remnick: This is James Hansen who rang the bell about climate change long ago, as much as 40 years ago.

Lise Van Susteren: That is correct. In 1988, he testified before Congress about climate and greenhouse gases on what they would cause. The suit is based on constitutional grounds. We are guaranteed a right to life, liberty, and property. Those three protections are profoundly being challenged by climate disruption. That's the Juliana case. In Held versus the State of Montana, it's essentially a same format, 16 youth plaintiffs suing the State of Montana. Montana State Constitution explicitly says that the residents of Montana have a right to a healthful environment and they don't have that as a result of their policies that are favoring the fossil fuel industry or fossil fuel exploration, extraction, transport, et cetera in the State of Montana.

David Remnick: If I'm understanding this correctly, these are suits, these are actions that are on the level of political action and symbol. What do you hope comes out of them?

Lise Van Susteren: Oh gosh.

David Remnick: What's possible, and what is the discovery process like?

Lise Van Susteren: Okay. I wrote reports cataloging the long list 25-page report of all of the harms that are coming to kids as a result of climate inaction. I also previously worked for the federal government as a psychological profiler of world leaders. I profiled the kids. By that I mean I looked at where they are today and made projections about what I thought could be foredom in the future as a result of our climate policies, and particularly what could be foredom if we fail to take the action that we need to.

David Remnick: Would you want to see insurers cover climate anxiety as a condition, or is that pathologizing this?

Lise Van Susteren: No. Great. I meant to bring this up before. The reason is so important for us to have professionally ways to describe climate distress is that when-- we can give it a number as we do in the diagnostic and statistic manual for insiders, then we can get insurance companies to pay for help with the climate distress that you have. We can create a way not to suggest that a person is mentally ill, but rather struggling with a very real issue and that this very real issue can exacerbate preexisting conditions.

David Remnick: Dr. Van Susteren, thank you so much.

Lise Van Susteren: Thank you, David. Thanks for all you do.

David Remnick: Lise Van Susteren, a co-founder of the Climate Psychiatry Alliance. In June, she'll be testifying on behalf of 16 youth plaintiffs in Held versus Montana.

[music]

Copyright © 2023 New York Public Radio. All rights reserved. Visit our website terms of use at www.wnyc.org for further information.

New York Public Radio transcripts are created on a rush deadline, often by contractors. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of New York Public Radio’s programming is the audio record.