June 22, 2021

Insights from ‘The Interplay Between the Environment and Mental Health’ –  Part III

This article shares some of the complexity and potential opportunities in considering environmental impacts on mental health, and is the final in a series covering the National Academies of Science’s workshop, “The Interplay Between the Environment and Mental Health.”

Workshop presenters emphasized the array of environmental influences on mental health, including ecosystems, lifestyle factors, social influences, and physical/chemical elements. More specifically, speakers discussed exposure to pollution/toxins, population/structural density, access to nature, climate events, and other environmental factors as both physical and social determinants of health. Where there are risks and exposures, most of us will be resilient, and determining how and why harm occurs in some is an important focus of this work.

While underlying genetic differences or sensitivities are important foundational factors to any individual, the stressors, and the harm, often come from the environment, not our genes. In particular, underlying conditions are relevant, and compounded threats for marginalized populations can involve multiple exposures to toxins/events and additive life course concerns layered on to existing stresses and deficits. Because mental health conditions and circumstances causing mental distress are factors that raise risks of suicidal thoughts and behaviors, the work of these scientists and these discussions contribute to JKBF’s focus on improving understanding of modifiable and biological factors that affect suicide risk.


In the first session, discussions of pollutant exposures included some known effects of timing and context, and nuances in assessing and addressing these factors. The speakers outlined a need to explore mechanisms, measure health outcomes as a range of brain/mental effects instead of a particular diagnosis, and look at life course as well as immediate impacts. Elevated depression and anxiety rates, and twice the rate of psychotic features occur in those raised in urban environments. While we generally recognize that air pollution raises physical health risks such as stroke, heart disease, and lung disorders, most of us are unaware that it also associates with neurological concerns such as dementia and psychotic and mood disorders.

Pollutants affect the developing brain, and organophosphate exposures over the lifespan result in neurodegeneration, psychiatric and motor changes, and sleep disturbances. Studies of lead exposure show that variances can occur with timing and lifespan effects, with behavioral phenotypes presenting as externalizing behaviors in children but internalizing behaviors in adults. Compounded effects were described in the risk of developing ADHD, which doubles with lead exposure, and doubles with tobacco exposure, but is eight times more likely when a child is exposed to both.

The speakers emphasized that evaluating the magnitude of exposure and impact on some individuals may be more relevant measures of harm than assessing breadth of impact across a population. Instead of asking ‘how many?’ perhaps the inquiry should be ‘how deeply?’ were some affected, and why.


A session on environmental disruptions focused mainly on disasters, manmade as well as natural (e.g. wildfires and hurricanes), which are happening with more frequency and severity. The ensuing mental health effects, both psychological and behavioral, far exceed the medical effects. Multifactorial evaluations are essential, as zip code is more influential than genetic code due to layering and compounding of mental health risks. These issues raise concerns of vulnerability and social justice.

Lessons from the Flint water crisis included ways of leveraging disciplines, community, and technology to better understand and address challenges. Due to high variability of risk and resilience factors, community responses need to target limited resources towards those who need them most. Where most will survive these disasters, and many will improve and show increased resilience, a focus on protection of the vulnerable is critical for overall community resilience. Communication, partnership, collaboration, use of local, culturally-relevant expertise, and sensitive media utilization are essential in preparation, during an event, and post-event, since all of these can either help to heal or compound the distress.

Nature Benefits

A session on the mental health benefits of healthy and natural environments highlighted considerations related to combatting structural racism and employing urban nature and placemaking to foster community resiliency. Studies on the introduction of urban gardens, greening of vacant lots, and access to nature showed benefits of placemaking through improved mental health and reduced crime rates, structural racism, and urban influences. Evaluations of the effects of Hurricane Katrina and the Gulf Oil Spill exposed the triple risks to some communities—historical disparities, environmental health, and disaster climate effects–and outlined elements of resilient community structures that can help to reduce these burdens.

Path Forward

Panels engaged in thoughtful discussions of emerging opportunities, ideas for future collaborations, and alternatives in funding options to help address challenges. Suggestions included advances in tools and technology, convergence across research disciplines, enhancements to public health policy, and implementation science (designing scientific studies to generate data that can foster changes in policy and priorities.)  Creative thinking about integrated, collaborative, and multi-agency efforts even included mention of a research focus on modifiable factors, such as diet and coping strategies.

JKBF was pleased to learn about a NIEHS funding mechanism, the Environmental Risks for Psychiatric Disorders, which fosters evaluations of biological factors and translational and trans disciplinary environmental research and is taking applications through November, 2021. 

With an approach that resonated with JKBF, presenter Sarah Love suggested we think harder about the questions we are asking in order to get the answers we need. Broader thinking will promote investigative convergence, since currently we are often limited by what we know (specialization), who we know (networks and communication partners), and how we do/fund science. Solutions might include more connections across disciplines, drawing on expertise, innovation and cross disciplinary thinking, and training the next generation to be more collaborative from the start.

A panel discussion emphasized the need to consider mental health in policy considerations, engaging community, and gathering data and thresholds that define translational effects. Research protocols could involve environmental justice advocates in study design to ensure power, impact, and potential for policy or treatment effects. Creative funding frameworks and changes in the structure of review panels might promote culturally attuned and community based research projects.

The workshop ended with discussion around what might be addressed on community levels to have broader population effects. The importance of mental health means that in addition to treating a patient with a syndrome, thought needs to go into what needs to be done to reduce the number of patients who develop such a syndrome. This mindset needs broad and collaborative consideration, bridging NIH research funding and studies, partnering with other agencies, and translating to structural elements, such as considering effects of pollutants on a population when the DOT plans roadways.

The focus of this workshop was on mental health, and we know that mental distress, whether part of a recognized condition or the result of life’s curveballs, plays a significant role in suicidal behaviors. Furthermore, as these discussions highlighted, what may rebound off of one individual may severely alter the life of another. Evaluating both individual and population vulnerabilities, assessing multifactorial risks, and promoting features of resilience are also needed in suicide research and prevention. JKBF believes that these and other efforts for further evaluation and consideration of underlying environmental and modifiable factors, and a population approach to health and resilience, will be instrumental to reducing suicide loss. We appreciate the speakers and organizers for these interesting and informative discussions and the creative thinking that should reduce suffering and save lives.

For more detail, watch the conference proceedings on the NAS website, or review the recently released summary released by the organizers: Proceedings of a Workshop—in Brief.