A Critical Gap in Addressing Mental Health in Heat-Health Action Plans Worldwide

Extreme heat is associated with mental health conditions such as suicide, anxiety, and substance use disorders. However, the integration of mental health in heat-health planning remains limited and no comprehensive assessment of its inclusion exists to date. This review aims to (1) identify and categorize mental health-related content in heat-health action plans globally; and (2) analyze the gaps in included interventions related to extreme heat and mental health.

A review of 83 heat-health action plans from 24 countries revealed that while 75.9% of plans mentioned mental health, only 31.3% acknowledged its specific impacts and 21.7% included targeted interventions. These plans covered approximately 2.2 billion people, representing about 26% of the 2024 global population. Most interventions were directed at the societal level, with limited attention to individual or community-level support. Individuals with mental illness were commonly grouped with other vulnerable populations without tailored support. Low-income countries were not represented, while 44 plans (53.0%) came from high- and upper-middle-income countries. Among lower-middle-income countries, most plans originated from India (35; 89.7%). Despite recognition of the impacts of extreme heat on mental health, heat-health action plans lack comprehensive strategies to address these risks. The findings highlight a broader challenge within climate adaptation policies, where the recognition of mental health risks is often not matched by necessary resources, planning, and interventions. Given the critical gaps in mental health inclusion, greater efforts and resources are needed to integrate targeted mental health strategies into heat-health plans and policies.