This article is part of an ongoing series where experts talk about the link between climate change and mental health.

Jesse Bell is the person you want to talk to if you need an understandable explanation of what climate change can do to a person’s mental health. He’s a research scientist at North Carolina State University (NCSU) / North Carolina Institute for Climate Studies (NCICS). Bell works on many projects, and is an author on the U.S. Global Change Research Program report aptly titled The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment.

Bell spoke to Thrive about the links between drought and mental health and what it’s like to be working on climate change research when so many governmental agencies intended to support this research are disappearing.

The below interview has been edited for length and clarity.

Thrive Global: What do you feel are the most concerning links are between climate change and mental health?
Jesse Bell: I probably approach this from a little bit different perspective than some of the other people that you’ve talked to. I’m much more from the physical science standpoint. So I’m the one that’s trying to understand the extreme events, and then bring that information and data over to public health and environmental health. Climate change and mental health is an important area and I think it’s one that a lot of people are not paying attention to. One of the areas that I’ve researched is drought and mental health.

TG: Tell me more about that.
JB: When we first started looking over the report and I was trying to figure out the impacts of various extreme events on human health, I noticed that one thing really popped up that was missing, and that was the impact of drought on human health in the United States.

Internationally, droughts kill a lot of people. There is evidence that they kill more people than any other extreme weather related disaster. And in the United States, there’s obviously a missing component in there. We really don’t identify drought as a natural disaster that kills people. And so I started digging around the literature as we were working on the extremes chapter, and I realized in other countries, a lot of people die because of droughts. And one of the mechanisms is suicide. Australia did a lot of work on this. They started developing some of those relationships, because they saw an uptick of suicides and mental health issues in rural populations, especially in the agricultural sector, when droughts would occur.

I also noticed that there was some literature in the United States that was all the way back in the 1980s that showed an an uptick in suicides and mental health issues with drought events. With some of my colleagues from the Departments of Emergency Medicine and Environmental Health at Emory University, we went through and did a full evaluation of all the literature that we could find to figure out what pathways exist between a drought event and the resulting mental and behavioral health outcomes. The whole purpose of this study was to basically fill in the gaps because when you have an extreme event like a drought, a heat wave, a hurricane—the mental health consequences aren’t direct.

The big thing that we were trying to do is identify those pathways, understand what are all the potential influences, and then use that to illustrate to public health officials and anybody that’s working on the ground trying to address these issues, where the potential places for mitigation to actually reduce the potential impacts [are]. I think that’s the same thing with all these different extreme events.

TG: Could you tell me a little bit more about what the pathways between climate change and mental health outcomes look like?
JB: You have a climate driver or climate impact and it doesn’t necessarily always lead to a mental health outcome. There’s the exposure pathway and then there’s the societal and behavioral factors that influence the pathway, and then also the environmental and institutional factors that influence the pathway and all of these things can lead to mental health outcomes.

Each one is specific and unique. What can happen is you have the climate driver, you have the drought. You have the exposure pathway, which is a loss of agricultural production. Maybe a loss of livelihood because the farmer can no longer support their family because the crops are dead and they don’t have the ability to make the money that they need to support their family. Then because of that, and additional factors, you can have mental health outcomes: stress, maybe substance abuse, anxiety. Different issues can potentially arise because of it.

“Where is the support group for those people? Is there good community involvement to help stabilize any of the issues that may have happened. What’s their family situation like? Do they have insurance, and will that be able to sustain them during that time period?”

But that doesn’t always occur. What happens is you have those other factors that are influencing that pathway. You have the societal and behavioral factors: does the person have preexisting mental health conditions? What’s the socioeconomic status of that region? Where is the support group for those people? Is there good community involvement to help stabilize any of the issues that may have happened. What’s their family situation like? Do they have insurance, and will that be able to sustain them during that time period? You also have the environmental factors. Does the local public health department understand the implications of drought on mental health? Is there messaging and information out there so that they can get the necessary help that they need in these times? Those are all factors that play in there as well. At the end, that’s what potentially drives that mental health outcome.

TG: What is it like working on research at a time when so many governmental agencies intended to help support this research are disappearing?
JB: I would say I’m always trying to be an optimist with this stuff because I feel like you have to be. For a long time obviously there has been some pushback and some hesitation as far as climate change and understanding the impacts of climate change on any issue. I feel like some of that momentum is changing in some ways. But for us, this has been an issue that the United States has addressed for a long period of time. It goes all the way back to the first Bush administration. It was basically the start of the National Climate Assessment, and so every five or so years people had to come together and we brought all these scientific committees and teams together to understand the impacts of climate change and climate variability on a variety of topics in the United States and how it impacts different sectors.

Each time these reports have come out, the results have only become more and more conclusive that climate change is occurring, that we are seeing these changes, and it is going to have a broad impact on a variety of different sectors across the United States. So even though maybe we don’t have complete political support on this particular topic at this time, the evidence and the signals are only getting stronger. I believe over time, even if we’re not addressing these issues, it’s going to become more and more apparent that we need to address these issues in the future.

And these changes are going to have influence on human health. One of the first findings that came out of the The Climate Health Assessment in 2016 was that climate change is a significant threat to the health of the American people. And I felt like that was a pretty big thing coming from a U.S. document on climate change and how it impacts human health.

When you went through the entire report and you saw all the different ways that the climate is changing, with increases in temperature, changes in all the different extreme events, sea level rise, you name it, it was changing. And it’s changing across a lot of the United States. And because of that, it’s influencing all sectors of health. We’re talking about respiratory illness, water quality, water quantity issues, seeing changes in vector ecology, mental health. All these different factors are potentially being influenced by climate change because the climate’s already changed and it will continue to be influenced into the future. We’re only going to see the impacts become greater into the future.

TG: I have the report up in front of me and there doesn’t seem to be an area of climate impact that doesn’t affect human health and mental health.
JB: I think it’s one of the big things that people pay attention to—they pay attention to their health. I hate to use this example, but if you talk about polar bears and ice caps melting, people might be sad, but that’s so far away from them. But when we’re talking about health, that’s something that’s impacting them directly. And so I think over time, with more education, with people like you who are out there writing these types of articles, I think it’s going to help inform the public, it’s going to help inform the people that need to understand this, and you’re going to see a change in people’s attitudes toward climate change and realize that it’s actually something that’s impacting us.

TG: On that note I’m wondering if there’s a factor that you feel like people are missing in the conversation or that you want people to be talking about more based on what you’ve found in your research.
JB: I would say for me, a lot of times when we talk about climate change and we talk about just the context of climate change, people think of it 25-50 years into the future or more. And one of the things I hope that people start moving away from or the conversation starts moving away from is that. It’s kicking the can down the road, that it’s way into the future. Because climate change is happening now. We’re seeing, and we’ve already seen, changes in extreme events. Heat waves are more intense today than they were 50 years ago. Flooding and rain are more intense and severe today than they were 50 years ago. So we’re already feeling and experiencing these impacts today.

“Heat waves are more intense today than they were 50 years ago. Flooding and rain are more intense and severe today than they were 50 years ago.”

So that’s one of the things I hope we started doing and start addressing, is understanding how this is actually impacting us today and not thinking of it and how is it impacting us into the future. Some of my colleagues do attribution studies and so they can look at a specific extreme event that occurs, say a heat wave, and they can figure out how much more intense or severe that heat wave is today than it would have been without climate change. And that’s something that we’re starting to try to work on, is understanding what that actually means in the context of human health.

TG: How can people prepare for climate change?
JB: I really believe in acting locally. Going out, voting, talking to local politicians, making them understand that these impacts are being felt in their region—that’s a huge first step. If you want resiliency, you really have to act locally. You can’t expect the federal government or larger institutions to make those steps. It’s actually about going out there and talking to local politicians, talking to local groups, local practitioners and helping them understand the impacts of climate change on their constituents.

And doing that in a non combative manner, because I think that’s one of the big issues and I’m sure you already know about this. But we’re so divided on everything. Somebody asked me a week ago, “Why is this such a polarized political issue?” And I remember I said back to them, “What isn’t a polarizing political issue in the U.S. right now?” And so figuring out ways of bridging those conversations and talking about things that both sides can understand. Health I think is one of them, for sure. Economics as well. There are ways of actually making strides of improving local economies and working on the mitigation side as well.