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When they’re saying what is completely opposite to what you morally believe’: (in)action on climate change by State authorities and powerful bodies drives moral injury and eco-distress in UK young people

Published online by Cambridge University Press:  30 October 2024

Ines Zevallos Labarthe
Affiliation:
University of Bath, Claverton Down, Bath, UK
Elizabeth Marks*
Affiliation:
University of Bath, Claverton Down, Bath, UK Bath Centre for Mindfulness and Community, University of Bath, Bath, UK
*
Corresponding author: Elizabeth Marks; Email: [email protected]
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Abstract

Abstract

Young people are increasingly distressed by the climate and ecological crises (eco-distress). This has been associated with the failure of people in power to act appropriately, which may cause moral distress and moral injury. We examined this hypothesis by interviewing 13 young adults (19–25 years) in the UK about their climate concerns and perceptions of how State actors and authorities are responding to climate change. Using reflexive thematic analysis, four themes were developed: (1) Climate change is a wicked problem, (2) Moral distress is associated with witnessing acts of omission and commission, (3) Moral distress drives eco-distress, and (4) Opportunities for moral repair. Climate concerns extended to broader concerns about ecological degradation (eco-distress), linked to feelings of moral distress arising from repeatedly witnessing powerful people failing to act on climate change. Eco-distress was also exacerbated by (a) witnessing others in society failing to take appropriate responsibility, (b) realising the limitations of individual action, and (c) being embedded within a culture where personal contribution to climate change is inescapable. In contrast, eco-distress was lessened by seeing authorities engage with the issues morally, and further mitigated by collective, ethical, pro-environmental action. This adds empirical evidence to support the hypothesis that eco-distress involves moral distress and injury arising when State authorities and other powerful bodies engage in wrongful acts and omissions on climate change. We argue that this is affecting the wellbeing of young people and supports the argument that such wrongful (in)action infringes human rights. Clinical implications are discussed.

Key learning aims

  1. (1) To understand how and why moral distress and moral injury relate to the distress that young people feel about climate change (eco-distress).

  2. (2) To consider the clinical implications of formulating eco-distress in a way that includes reference to the violation of core moral codes.

  3. (3) To explore what opportunities exist that could reduce moral distress and support young people.

  4. (4) To understand how research into moral distress and moral injury in relation to climate change can offer important insight into the relevance of eco-distress to human rights infringements and justice-oriented care.

  5. (5) To discuss practical solutions that might support moral repair, both in psychotherapy settings and in broader social policy.

Type
Invited Paper
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of British Association for Behavioural and Cognitive Psychotherapies

Introduction

Anthropogenic climate change and ecological degradation pose significant threats to human and planetary health, and are caused by greenhouse gas emissions and unsustainable behaviour for over a century (Intergovernmental Panel on Climate Change (IPCC), 2022). Negative consequences are already here, with climatic change, extreme weather conditions and endangered biodiversity (Clayton, Reference Clayton2020; Stern et al., Reference Stern, Patel and Ward2021) and set to worsen. Climate change is ‘the single biggest health threat facing humanity’, with social and environmental health (physical and mental health) impacts predicted to cause millions of additional deaths over the next 20 years (World Health Organization, 2021).

Climate anxiety/climate distress

Less direct impacts of climate change on mental health include the psychological burdens experienced when people become aware of the significance of the threats and losses caused by the climate and ecological emergencies (CEE). Various terms attempt to encapsulate these psychological burdens including climate anxiety, eco-anxiety, eco-distress, ecological grief (Burke, Reference Burke2021; Comtesse et al., Reference Comtesse, Ertl, Hengst, Rosner and Smid2021; Verlie, Reference Verlie2022) and climate trauma (Woodbury, Reference Woodbury2019). Such terms signal the multi-faceted emotional, cognitive and behavioural experiences that occur when people recognise how planetary health is deteriorating due to anthropogenic causes such as climate change (Pihkala, Reference Pihkala2020). Here we use the term climate distress as we are focused on the range of reactions people have in response to change (including sadness, anger, guilt, anxiety, and hopelessness – Cianconi et al., Reference Cianconi, Betrò and Janiri2020; Pihkala, Reference Pihkala2020; Stanley et al., Reference Stanley, Hogg, Leviston and Walker2021). We note that climate distress often arises alongside more ‘positive’ lived experiences which may be valued by people and form part of an adaptive response. For example, worry about climate change is correlated with ‘pro-environmental’ action (Verplanken et al., Reference Verplanken, Marks and Dobromir2020), and Pihkala (Reference Pihkala2019) explores how climate distress, when not overwhelming, may be collectively desirable. It can motivate pro-environmental behaviours (Budziszewska and Jonsson, Reference Budziszewska and Jonsson2021), a sense of personal responsibility, and support for positive climate policies (Bouman et al., Reference Bouman, Verschoor, Albers, Böhm, Fisher, Poortinga, Whitmarsh and Steg2020).

Work on climate distress has focused on individual responses to the CEE and thus how individuals can manage; for example, via individual action or coping with painful emotions. The way in which an individual perceives the risks, causes of and potential solutions to climate change is important because this will shape their cognitive-affective-behavioural responses, which in turn will affect their mental health and wellbeing (Van der Linden, Reference Van der Linden2017). However, limiting our understanding to an individual dimension is insufficient, and urgent global responses to the CEE require collective action and policy-based approaches. The scientific consensus is clear for all to see (IPCC, 2022), but governments are failing to act and regulate in line with this.

A recent landmark study of 10,000 young people from ten countries demonstrated the prevalence of climate distress in young people (aged 16–25 years) around the globe. Many reported being worried about climate change (59% very or extremely worried) and over 50% reported other painful emotions relating to this (such as sadness, anxiety, anger, guilt and powerlessness). Painful thoughts were common (e.g. 75% said they believe the future is frightening and 83% think that people have failed to take care of the planet), and 45% also reported functional impairment related to this distress. Furthermore, this study demonstrated a positive association between young people’s climate anxiety and functional impairment, and their perception that governments were failing to act appropriately or sufficiently on climate change (and the scientific consensus); as well as a positive association between young people’s climate anxiety and feeling abandoned and betrayed by such governments (Hickman et al., Reference Hickman, Marks, Pihkala, Clayton, Lewandowski, Mayall, Wray, Mellor and van Susteren2021). The authors suggested that climate anxiety arises not just because of the threats of climate change but also from the distress that is provoked by the moral failures of those in power to act appropriately, which could equate to moral injury.

Moral distress and injury

Moral distress arises when there is a moral conflict, for example if someone witnesses, experiences or is involved in a morally distressing situation or potentially morally injurious event (Čartolovni et al., Reference Čartolovni, Stolt, Scott and Suhonen2021; Hall et al., Reference Hall, Everson, Billingsley and Miller2022). A morally distressing event is one appraised as being in violation of one’s moral codes or sense of justice, and may be intentional or unintentional. It often involves an organisation or powerful actors preventing the ability of the individual to act in line with their moral codes, so is exacerbated by having a lack of power or voice, or having a repeated experience of this kind (Epstein et al., Reference Epstein, Whitehead, Prompahakul, Thacker and Hamric2019). The result tends to include negative feelings including guilt, anguish and powerlessness and potentially functional impairment.

A related term, moral injury (MI), has been used to describe a psychological wound that can be more enduring, deeper, and more traumatic than moral distress (Sheather and Fidler, Reference Sheather and Fidler2021). As with moral distress, this can arise from ‘perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations’ (Litz et al., Reference Litz, Stein, Delaney, Lebowitz, Nash, Silva and Maguen2009; p. 697). However, moral injury is thought to be more dependent on experiencing potentially morally injurious events which may be traumatic or linked to immoral action, involving human suffering or cruelty. Moral injury also leads to negative feeling states as above, but the harm can be more lasting and include psychological, biological, behavioural, social and spiritual changes (Litz et al., Reference Litz, Stein, Delaney, Lebowitz, Nash, Silva and Maguen2009). Thus, moral distress and MI are overlapping but distinct terms, and although more research is needed, authors suggest that moral distress may develop into MI if there are severe or recurrent exposure to moral violations (Hall et al., Reference Hall, Everson, Billingsley and Miller2022). Another aspect of MI is the delineation of MI-other (referring to codes being violated by other people) and MI-self (when the self is perceived to be the perpetrator). MI is linked to morality-based emotions (guilt, shame, anger); MI-other possibly more with anger, and MI-self more with guilt and shame (Lancaster and Harris, Reference Lancaster and Harris2018).

Moral distress and MI have mainly been studied in military personnel and healthcare workers (particularly during the COVID-19 pandemic from 2020). Not themselves mental health conditions, such experiences are correlated with negative psychological effects and conditions including exhaustion, anxiety, depression, suicidality, PTSD (Litz et al., Reference Litz, Stein, Delaney, Lebowitz, Nash, Silva and Maguen2009; Hall et al., Reference Hall, Everson, Billingsley and Miller2022), isolation and anhedonia (Griffin et al., Reference Griffin, Purcell, Burkman, Litz, Bryan, Schmitz, Villierme, Walsh and Maguen2019), reduced social interactions, depersonalisation, and diminished ability to care (Wocial, Reference Wocial2022). For example, research has found positive correlations between healthcare workers experiencing potentially morally injurious events and adverse mental health symptoms (Williamson et al., Reference Williamson, Lamb, Hotopf, Raine, Stevelink, Wessely, Docherty, Madan, Murphy and Greenberg2023). Applying moral distress and MI to the experience of eco-distress is nascent, but there are clear parallels with descriptions of people reporting climate distress (Pihkala, Reference Pihkala2020).

Moral injury, climate change and climate distress

As described, betrayal by those with power in a way that transgresses personal values and moral beliefs can be regarded as potentially morally injurious events, and as such could potentially lead to moral distress and even MI (Griffin et al., Reference Griffin, Purcell, Burkman, Litz, Bryan, Schmitz, Villierme, Walsh and Maguen2019). This includes witnessing authorities acting inadequately in response to extremely high-risk situations (Shay, Reference Shay2014), and the CEE is such a situation. The scientific consensus has clearly been demanding urgent, deep cuts in carbon emissions and systemic transformation for years, in order to prevent the most catastrophic outcomes which will harm and even kill billions of humans and other species (IPCC, 2022). But for years, governments and other powerful authorities have engaged in acts of commission and omission clearly counter to the science, and this continues.

As described above, the recent global study by Hickman and colleagues (Reference Hickman, Marks, Pihkala, Clayton, Lewandowski, Mayall, Wray, Mellor and van Susteren2021) showed climate anxiety as prevalent in young people, related to seeing governments fail in their action on climate change, and experiencing this as a betrayal. The authors’ arguments fit with broader theories around moral distress, and that such (in)action by governments on climate change represents a moral failure in their responsibility to care for and protect others (particularly those with less power). This then results in anguish, moral distress, and moral injury. Such experiences were seen as particularly pertinent for younger generations who may have less power and voice and be more aware of the repeated implications climate change has for their futures (Epstein et al., Reference Epstein, Whitehead, Prompahakul, Thacker and Hamric2019; Hickman, Reference Hickman2020).

Weintrobe (Reference Weintrobe2020) describes the ‘heartfelt and heartsore’ aspects of moral distress in climate distress because the global situation is such that it is almost impossible to live in the modern world (particularly in high-income countries) without also contributing personally to the crisis, even if desperate not to do so. This is an aspect of the CEE that may differentiate experiences from other types of moral distress and MI in terms of being an unwilling perpetrator (MI-self). Our global socio-economic system expects or encourages people to live high-carbon lifestyles, and attempts to live differently can be difficult, expensive, inaccessible, or even frowned upon, depending upon one’s circumstances and identity.

A recent theoretical paper suggested that moral injury could offer an inclusive framework through which the psychological and mental health implications of climate change can be understood (Henritze et al., Reference Henritze, Goldman, Simon and Brown2023). However, empirical evidence for this is limited, a deeper understanding is required, and a complex topic such as this requires robust qualitative methodologies. As such, this study used reflexive thematic analysis to explore the following primary research questions: (1) how do young people reporting climate distress think and feel about the (in)action of those with power and authority, including governments?, and (2) how do young people relate this to their experiences of climate distress?

Method

Design

Qualitative data were obtained from 13 semi-structured interviews (n=9 online; n=4 in person) of 35–65 minutes duration. Interviews were transcribed and analysed using the six-phases of reflexive thematic analysis (RTA; Braun and Clarke, Reference Braun and Clarke2006; Braun and Clarke, Reference Braun and Clarke2019). Good practice involved familiarisation with the data, generating semantic codes, and constructing themes around the developed codes using a reflective, recursive approach (Forbes, Reference Forbes2022; Terry et al., Reference Terry, Hayfield, Clarke, Braun, Willig and Staiton-Rogers2017).

This project was mainly inductive, with a deductive element, where exploration of transcripts was focused upon the research question around climate distress and moral distress. A critical realist approach was followed, suited to the research questions which aimed to comprehend the experience of participants, seeing this as a reality created by and experienced by them, and co-existing in a wider sociological context (Terry et al., Reference Terry, Hayfield, Clarke, Braun, Willig and Staiton-Rogers2017). A contextualist element to the approach was integrated in the analysis, through the assumption that access to this experienced reality was shaped by the socio-cultural interpretations and meanings of both participants and the researchers (Terry et al., Reference Terry, Hayfield, Clarke, Braun, Willig and Staiton-Rogers2017). The researchers brought their own understanding and reflection to the analysis (see below), with the goal of providing a rich description of the dataset and developing a map of semantic themes.

Participants

Eligibility criteria required participants to be young people residing in the UK (16–25 years) reporting at least some concern about climate change. The study was advertised across a range of online platforms, displayed in a university setting and via professional networks. A total of 13 participants took part (7 males), aged 19–25 years. Table 1 provides socio-demographic characteristics in more detail.

Table 1. Sample characteristics (n=13)

Measures

Participants completed eligibility questions and socio-demographic questionnaires via Qualtrics; those meeting criteria and providing full informed consent were invited to interview. The interview schedule was developed initially through a review of the literature on moral injury and climate anxiety and climate distress. Young people with lived experience were involved in refinement of the questions, and four young people piloted and made changes to the interview schedule. The final questions assessed factors relating to climate distress, specifically actions of people in positions of power or authority, including governments around the world. The interview included seven open-ended questions with additional prompts. For example: ‘What do you think about how your government has been and is responding to climate change?’ (see Supplementary material for more examples).

Data analysis

Transcripts were uploaded to NVivo 1.5.1 which supported the generation of semantic codes. The research team met repeatedly over several months to examine the codes, identify potential relationships between codes, and develop themes and subthemes (Braun and Clarke, Reference Braun and Clarke2006). The first author developed an initial thematic map and the research team reviewed this repeatedly, using an iterative, reflective process, moving towards more concise and definitive conceptualisations for each theme and more concise and definitive themes (Braun and Clarke, Reference Braun and Clarke2006). Throughout, the team developed a narrative discourse to explain the different themes, and their relationship to each other and the research questions (Braun and Clarke, Reference Braun and Clarke2006; Braun and Clarke, Reference Braun and Clarke2019).

Reflexivity

The researchers were thoughtful, explicit, and deliberate about their process (Braun and Clarke, Reference Braun and Clarke2019). They reflected on personal assumptions and positionings regarding climate change, justice, and the importance of representing opinions of potentially vulnerable groups (Braun and Clarke, Reference Braun and Clarke2006), and these were discussed in the analysis process. Both authors are female and middle class. The first author is from South America, and ethnically identifies as Latina. She has experience living in a lower-middle income country (LMIC) with significant climate vulnerabilities, and historic environmental challenges including deforestation of the rainforest and devastating ecological damage due to human activity including informal mining with limited government regulation. The senior author is from the UK, identifies as white, and has a strong sense of environmental identity. She has a background in clinical psychological work and research, including eco-distress. Both live in the UK, one of the most privileged countries in the world, well protected from the initial impacts of climate change. Both are concerned about the significant threats of climate change in the UK, and beyond, and recognise the need for urgent action to limit the worst outcomes.

Results

Four over-arching themes were developed. Theme (1) Climate change is a wicked problem was present across all themes but is reported separately to elucidate how participants regarded climate change (and related distress) as interwoven with flawed global socio-political and cultural systems. Three other themes described how participants’ psychological experiences were related to this wicked problem. These were: (2) Moral distress associated with witnessing acts of omission and commission, (3) Moral distress drives eco-distress, and (4) Opportunities for moral repair. Table 2 provides an outline of the themes, and the thematic map can be found in the Supplementary material. Although the interview questions focused on climate change, participant responses clearly demonstrated links to broader environmental degradation; as such, the term eco-distress (rather than climate-distress) is used to describe their experiences throughout.

Table 2. Outline of themes and subthemes

Theme 1: Climate change is a wicked problem

Climate change could seem large and complex for the individual, with planetary health described as dependent upon multiple interacting systems: ‘climate change is the wicked problem because it’s … a complex problem with a complex set of things feeding into it and it will require complex solutions’ (P08). Three subthemes described participants’ awareness of (1.1) Interdependence – humans and the natural world are threatened together, (1.2) Global economic growth vs planetary thriving and (1.3) Embedded socio-political structures.

Subtheme 1.1: Interdependence – humans and planet are threatened together

Participants understood connections between climate change, ecological degradation, and threats to ‘humanity and … to all the creatures on this planet’ (P07). Environmental impacts of climate change were known to have substantial repercussions on ecosystems, and human systems: ‘… flooding, especially Bangladesh because … [this] could potentially displace … millions of people, which is going to be a huge … humanitarian crisis’ (P03).

Participants saw how human activities were devastating habitats and altering natural conditions for all forms of life: ‘… animals that used to live there, don’t live there anymore because it became too warm for them. So, they had to migrate even further north’ (P06). This could be painful, infringing upon personal values around connection to, and care for nature: ‘I think nature is … really gonna suffer and that’s gonna be … really sad to see, as someone who spends a lot of time outdoors’ (P11).

Participants also reflected upon how many people appear to have forgotten about humanity’s dependence on ecological systems for essential aspects of life: ‘People have lost the relationship with the idea of farm to table and having … connection with your food and where it comes from’ (P08).

The scale of the problem was seen to require large-scale action. This felt unachievable without concerted effort from authorities and governments. For example, schemes for rewilding, conservation, and strong regulation of damaging practices, such as banning toxic pesticides and imposing consequences upon polluters: ‘tackling … deforestation … on a global scale … protecting these areas of natural wildlife or natural beauty’ (P09).

Subtheme 1.2: Global economic growth versus planetary thriving

Participants saw climate change as part of a global economic system which equates value with money, GDP and economic growth, and how powerfully this shapes decisions taken by governments and corporations. The degree to which this economic story is embedded across society limited how hopeful participants felt about making the types of systemic changes required to safeguard people’s futures: ‘the economy is always above everything that is more important, such as our living space’ (P05). Reliance on fossil fuels was seen as central to this economic system: ‘… my concern is over the … economic aspect of being dependent on fossil fuels’ (P10). The morality and venality of people running such industries was questioned: ‘… they know that the end of fossil fuels is on the horizon, and they are fearful … and … really motivated to make as much money as they possibly can … before it dries up’ (P08).

Interviewees regarded economic factors as the key drivers underpinning a capitalist hegemony, limiting what decisions those in power make about environmental issues: ‘Decades of capitalism … that mentality … profits drive every incentive’ (P02). This hindered positive action (e.g. transitioning away from fossil fuels):

Investment into wind energy or solar power aren’t … immediately economically viable … seeing as an economic investment is kind of flawed … a lot of things have value in their own rights without producing economic value.’ (P10).

It also related to policies that might positively shape individual behaviour: ‘They say bicycles are any economist’s worst nightmare, because … they don’t contribute much, but they contribute to community well-being and … health’ (P11). Participants pointed out the flawed logic because ‘… there’s no economy in a broken world’ (P11).

Subtheme 1.3: Embedded socio-political structures

Participants saw today’s economic and socio-political structures as inextricably linked: ‘something that we really have to address fundamentally in our … political systemour wider … social structures’ (P08). This highlighted the ‘wicked’ scale of the problem, requiring shifts in perspectives and behaviours across society, and individual lifestyles: ‘ … It would mean changing the whole capitalist structure of government, structure of society, way of behaving, not just the government’s way of thinking, but everyone’s individual mentality’ (P05). Governmental leadership is essential alongside involving everyone in society. Individual action might alone be insufficient, but there was seen to be a moral imperative for individuals and communities to take some responsibility for change: ‘Everyone needs to collectively come together … Ordinary people, if they’re together, they’re far more powerful than on their own … what I would like to see from everyone is more of a collaborative approach, not just governments’ (P12).

Theme 2: Moral distress is associated with witnessing acts of omission and commission

Participants reported cognitive-emotional experiences aligned to moral distress, particularly in witnessing moral failures by others in: (2.1) Witnessing failures to care, (2.2) and Witnessing failures to act appropriately.

Subtheme 2.1: Witnessing failures to care

Participants conveyed a lack of trust in governments (i.e. those authorities given power by citizens to protect citizens), making them feel let down, betrayed and deceived. They described this as a failure to care: ‘… they are being immoral in the sense that … they’re not caring enough’ (P12) and to empathise with the majority of people: ‘… they just need to have more of an understanding of what it’s actually like to be, not from … the wealthy backgrounds that they’re from’ (P09). The emotional toll upon ordinary people was seen to be dismissed: ‘… the emotional distress that can have on someone … should still be something that’s considered’ (P01). Painful feelings arose when witnessing authorities failing to protect vulnerable parts of the natural world: ‘… the nature in the Arctic is so gentle … gas and oil, it will spill into the ocean and it’s … very harmful’ (P06).

Greater responsibility was seen to lie with larger, wealthier nations, who appear to be putting short-term, national interests before planetary health: ‘Climate change is connecting the whole world’ (P02), ‘… it will take … collective action by all governments working together to fight the crisis … smaller countries… can’t do it on their own’ (P04). As well as national interest, participants linked such failures to profiteering:

… there is nothing to suggest that there is genuine care … when the UK government is allowing, for example Shell to make £19 billion of profit … in 2021 and not pay any tax on that, that’s a problem …’ (P08).

This was not limited to any one nation: ‘government responses are shaped by capitalism and greed, and … corruption, no matter Russia or UK or other countries’ (P06) and was experienced as a moral transgression:

‘… you don’t feel like they’ve got … the nation’s interest at … the core of what they do … keeping themselves in the positions that they’re in and keeping the luxuries in their lives … I don’t find that aligned to my … moral values at all’ (P09).

The resulting moral distress involved confusion: ‘I find it really challenging to understand, because … I’ve followed a similar path to … a lot of those individuals … However, I only really care about making the world a more … equitable place and fixing the … issues, so … I’m confused … what goes wrong for them?’ (P08).

Intersection with other social issues demanding care for others was highlighted, e.g. migration and conflict: ‘… the whole policy on refugees… that’s really frustrating … I want to look after other people … [it] doesn’t go with my moral codes’ (P11). As was the relevance of human rights: ‘their actions are gonna be … affecting people’s human rights’ (P11). Participants saw this betrayal extending across time as well as space: ‘the moral thing would obviously be to act for future generations, but I don’t think that at all … was being done’ (P10); ‘they’re betraying people who … fought for peace … this climate change is gonna bring wars’ (P11).

Subtheme 2.2: Witnessing failures to act appropriately

Governments’ failure through a lack of action was key, particularly regulating polluters, breaking promises they had made on positive action and persisting in environmentally destructive policies. This was worsened by those leaders living conspicuously high-carbon lifestyles:

Regulation, in certain industries … cuts in emissions … certainly, being more proactive. The problem is … to be proactive in that way would be anti-business … But that’s definitely what we need at this point’ (P03).

Moral transgressions arose when governments failed to enforce ethical standards for other powerful groups (particularly as big business) or even encouraged unethical behaviour, through policy: ‘It’s not ethical for … a business to … allow untreated waste to go into the oceans … but it’s … expected at this point, because it’s the cheapest … way to get rid of waste’ (P02). Climate concerns were exacerbated by slow responses from the powerful: ‘… the … key concern I have is … not being able to do it fast enough…’ (P01); as well as a lack of ambition in government policy which is ‘not as ambitious as [the] Paris Agreement’ (P07). For some the lack of action was less equated to morality and more to negligence: ‘their actions are so non-existent, it would feel like it’s a bit more careless rather than immoral, negligent’ (P12).

Participants knew the scientific consensus on climate change, and witnessing authorities wilfully disregarding such clear science was met with disgust: ‘they’re investing in new oil and gas sites, that’s hideous, we should not be doing that, and that’s not science based … they’ve got vested interests … that’s what their decisions are based on’ (P11). Betrayal came from the incongruence of words (‘those promises’ (P11)) and deeds, causing anger: ‘It’s just frustrating to see the UK government continuously cite things … done in the past to prove its current … lack … of action’ (P01). This transcended national borders; even the global COP26 was felt to be unreliable, offering only verbal appeasements rather than proper action: ‘they talk a lot about what they want to do … what they gonna pay for’ (P05) but ‘… they’ve been saying this for 20 years’ (P10). Such global leaders were also seen to personally transgress moral codes through lifestyle: ‘my mistrust … after she’d attended COP26, Von der Leyen … took a private jet from Vienna to Bratislava, which is literally an hour train ride … it laughs in the face of people who actually are trying’ (P09).

When leaders did not offer concrete action aligned to their words, participants well-being was affected:

‘… for me it’s not about talk, they can say whatever they want. I actually wanna see policy in place … signing this into law … regulations … I would like to see consistent action for me to really … be hopeful and to feel relaxed’ (P04).

Governments were seen to be able to act with impunity because of poor global oversight too: ‘there really is no overarching international body authority [to] hold … countries … accountable for what they’re doing’ (P04).

Theme 3: Moral distress drives eco-distress

In describing climate distress, participants described their own contributions to the CEE, linking moral distress to both: (3.1) Coercion to betray own moral codes and (3.2) Broad psychological sequelae.

Subtheme 3.1: Coercion to betray own moral codes

Participants felt uncomfortable living in a social system where the norms coerced lifestyle choices counter to personal moral codes. Personal choices to avoid environmentally destructive behaviours are limited by access to money, employment, and social approval across life domains such as travel: ‘no one can afford to take the trains anymore … it’s forcing people to drive more …’ (P09) and work: ‘as a freelancer you’re totally replaceable. So, if I speak up too much, I don’t get any work … that’s really hard ’cause working at a company that isn’t … recycling properly really grinds against my morals’ (P11). This was painful, making participants feel ‘very sad … completely powerless’ (P05).

Social norms and government policies were unfair in neither supporting nor rewarding ethical behaviour: ‘… it’s like doing a team project … there’s some people pulling their weight and some people not’ (P05). This made personal sacrifices harder: ‘the government says “ohh you can keep flying”. That’s frustrating, when I’ve made that decision to stop flying … when they’re saying what is completely opposite to what … you morally believe.’ (P11).

Subtheme 3.2: Broad psychological sequelae

All participants reported painful emotions related to the CEE, which were deeply connected to the moral failures of authorities. This included anger, a common experience in moral injury that is associated with moral codes being violated by other people: ‘… [people in power] have the most amount of influencing change … definitely most of my anger and frustration it’s … dedicated to people in power’ (P12). When something valued by an individual was disregarded or economic reasons were prioritised over societal good anger arose: ‘things like … cultures disappearing, it doesn’t seem to be as good as an incentive, as … economic worries’ (P02).

Anger turned to defeat and hopelessness when powerful people seemed unassailable: ‘I’m annoyed … there’s not much … I can personally control over their decisions … So, I feel quite … defeated when I think about people in power’ (P12). This included sadness, helplessness, isolation and disillusionment: ‘it’s quite depressing … heading towards disaster. And there’s nothing anyone can really do about it’ (P03); ‘… you’ve gone to a lot of effort in your personal life and it’s very demotivating to see that it’s not matched by your government or people in power … you feel very … alone’ (P09). Such feelings were so potent, participants questioned the viability of fundamental life choices, including starting a family: ‘… do I really want kids? … to give a planet like this one to my future children?’ (P05).

Feelings of fear and overwhelm, were seen to be particularly strong because of the inaction of the powerful:

… it makes all of those climate change concerns even more frightening … Whereas, if we had governments and business leaders … who are acting appropriately and taking action accordingly … climate change wouldn’t seem as … scary or as daunting’ (P01).

Anger and powerlessness also linked to the futility of an individual attempts at pro-environmental behaviours: ‘irritated … if these people are not making the necessary changes, then what sense is it that I’m drinking from a paper straw?’ (P04); and ‘… disempowered … cycling to university isn’t really gonna make that much of a difference’ (P01). Over time, as common in moral injury, these experiences grew to disengagement and cynicism:

I’ve become a bit apathetic … I’m not interested in a way of finding out more about it [the climate crisis], I’ve learned enough … because I think it’s gonna be like more bad stuff, and it’s gonna be like, ohh action is needed, but then nothing’s gonna happen…’ (P10)

Participants would then attempt to cope by forgetting or avoiding the subject: ‘Just pretend it’s not happening, which seems to be what they’re doing’ (P03).

Some participants were able to be kinder to themselves when putting their personal action into the bigger context discussed above: ‘ … if I mess up … even though [it] makes me feel frustrated … the guilt … is tiny compared to what other people are doing’ (P12). However, another interpretation of this is that repeatedly witnessing moral failures by authorities stripped participants of motivation, purpose and energy, furthering disconnection and powerlessness. This might be particularly true for people less equipped to act pro-environmentally: ‘Makes me feel extremely small … extremely alone … even if I wanted to change something, I don’t have the money to dress fully sustainably … to buy … farmer vegetables …’ (P05).

Overall, witnessing inaction, and being part of a system that encourages ecologically destructive behaviours stole participants’ hopes for the future, and their faith in humanity: ‘… even if we in the end lose the battle against climate change, if the governments were doing their part on helping the climate … I would feel that at least we did what we could … I would feel more hopeful’ (P06).

Theme 4: Opportunities for moral repair

As found elsewhere in the eco-emotion literature, eco-distress arose alongside valued and positive experiences particularly when participants were connected to or inspired by others. Succour came from engaging with ethical, caring action, in contrast to moral transgressions. This indicates one way through the moral distress via moral repair and (4.1) Positive impacts of witnessing moral behaviours and (4.2) Positive impacts of collective action.

Subtheme 4.1: Positive impacts of witnessing moral behaviours

When asked to consider what happens for them when governments act meaningfully on climate change, participants reported positive emotional shifts: ‘Very happy because … it’s not in vain’ (P09), ‘I think it would be a relief … I will feel a lot more secure in my future’ (P02). This indicates that there is time and scope for governments to repair their moral transgressions and injuries, through proactive climate engagement. Indeed, this may well improve citizens’ wellbeing and mental health:

… if the government was acting the way it should be, with the level of urgency … it would definitely make me feel happier … more positive and … hopeful that the future could be better … It would be … empowering and uplifting’ (P01).

They gave existing examples: ‘New Zealand … and Bhutan is a very good example … they do give me hope’ (P11). The emotional impact increased a sense of purpose and therefore sustainable action: ‘it’d be much more motivating … if what you were doing was … matched by people in power’ (P09). Existing experiences of moral repair were mainly outside of the political or corporate sphere, as participants were inspired by scientists and activists who were ‘leaders in your life’ (P11). The time and energy they gave to the crises aligned with shared moral codes: ‘these environmental campaigners are very inspiring and that does inspire my actions’ (P11) (in stark contrast to moral distress from government inaction). Participants appreciated how such people were motivated by conscience and care, not greed: ‘the scientists who are on the IPCC don’t make a cent … They are world leading experts … and they don’t have to do this’ (P08). People with other forms of power also have the opportunity to effect positive change on bigger systems: ‘my dad’s pretty vocal about it … that’s been the big driver for my whole family’ (P10); ‘[a] sustainability teacher at our school was very … encouraging … he educated me significantly on it’ (P11).

Subtheme 4.2: Positive impacts of collective action

When individual changes were possible, participants viewed their main impact not as coming from small reductions in personal carbon emissions, but because these changes can affect broader social stories. The power in small personal actions lies in showing new ways of living with care and action: ‘if we all … unite and … do something together … we can achieve a big thing … not underestimating one’s power’ (P07).

United communities have power in influencing political will: ‘the responsibility really lies with … policy and governments … I think it falls on the individual to try and pressure the government into making the changes’ (P13). This in turn has a positive effect on individuals by building resilience and reducing distress: ‘work with other organisations … related to climate change … makes me feel like I’m doing something’ (P04).

By choosing to speak and act outside of the social norms, individuals find new responses to the failures of the powerful. But of course, this alone is not enough; responsibility must lie with us all: ‘I’m one person on this huge planet, … if I let myself … get carried away and experience eco-anxiety, I’ve … missed the point’ (P01).

By discussing their concerns and choices with others, participants saw opportunities to influence wider networks, via a ripple effect. One person’s reduction in CO2 emissions might be insignificant, but influencing a community in demanding change might have profound effects: ‘it’s difficult to be a vegetarian … people ask … why I’m doing this … then I can talk about the reasons … raising awareness’ (P07).

Thus individual engagement in meaningful, ethical, pro-environmental behaviour improves intrapersonal congruence by living aligned to moral codes and can have an interpersonal effect when others recognise this and respond accordingly. This requires that others listen, and when this happens it can be a lifeline, building connection, moral repair and reducing distress. This may be particularly true for people (particularly young people) whose social networks include people with more power and influence than them: ‘A lot of CEOs … the main thing that influenced their decision to … act about climate change more, was their kids coming to them and saying: mum, dad, what are you doing about climate change?’ (P11).

Discussion

This novel study has explored how young people in the UK reporting eco-distress think and feel about the (in)action of those in power on climate and ecological issues, and how this affects their distress. The findings show that moral distress is an important aspect of their eco-distress. The interviewees have repeatedly witnessed moral transgressions by other people, particularly governments and powerful bodies, through their failure to act with due care and urgency on the climate crisis. Young people’s eco-distress is exacerbated by witnessing powerful groups making decisions that negatively affect planetary health, and that are driven by greed and a desire for personal wealth at the expense of protecting citizens and the natural world. Furthermore, their moral distress is felt to arise from personal entanglement with a modern, globalised socioeconomic system which prevents individuals from avoiding perpetration of environmentally destructive actions themselves. The values of current socioeconomic systems are seen to be based more on the value of money and individual gain than the community and planetary wellbeing. Modern lifestyles and associated social norms cause pain by running counter to peoples’ core moral values and ethical codes. Individuals, even when they work together, feel powerless to avert the harms of climate change, as they recognise that ‘the institutional, corporate and regulatory dimensions of climate change necessitate a mass law and policy overhaul by State authorities on a global scale’ (Mavronicola, Reference Mavronicola2022). The findings from this study support the argument that the painful elements of eco-distress (moral distress, hopelessness, betrayal) are experienced as part of people’s understanding of the socioeconomic and political failings arising from national and global frameworks which have been shaped by law and policy choices (including both acts and omissions) of governing authorities.

At least some of these young participants appear to report experiences of moral distress and moral injury (MI), arising from the repeated failure of the powerful to act on the climate crisis, despite clear scientific evidence and guidance. As discussed, vulnerability to MI is increased by recurrent moral violations (Hall et al., Reference Hall, Everson, Billingsley and Miller2022), particularly those involving human suffering or cruelty. This aligns with the testimonies here where young people are repeatedly witnessing authorities breaking promises and transgressing moral expectations related to their responsibility to care and protect people (and planet). For some this has led to lasting spiritual, behavioural and social harms (Litz et al., Reference Litz, Stein, Delaney, Lebowitz, Nash, Silva and Maguen2009), including participants becoming apathetic, avoidant or disengaged from the CEE, despite knowing that such issues are of great importance to them (e.g. Wocial, Reference Wocial2022). All participants described how these feelings associated with moral injury (hopelessness, powerlessness, loneliness and isolation) (e.g. Griffin et al., Reference Griffin, Purcell, Burkman, Litz, Bryan, Schmitz, Villierme, Walsh and Maguen2019) arose because of acts and omissions by powerful bodies. The anger and frustration from seeing transgressions by others in society participants described fit well with descriptions of MI-other (Lancaster and Harris, Reference Lancaster and Harris2018); whilst MI-self was described in their guilt and self-blame for personal actions. Both forms of MI arose from the sociopolitical and economic contexts described. This supports the argument that the legal and policy choices (acts and omissions) of governing authorities (including conditions making anti-environmental action inescapable) are potentially morally injurious events.

As described elsewhere, eco-distress arises when people are aware of the negative impacts of climate change. In addition, these findings support the claim that eco-distress is further exacerbated by the (in)actions of others, particularly political authorities. This extended to others in society failing to show thoughtful engagement with the CEE. Such findings align to large-scale studies (Hickman et al., Reference Hickman, Marks, Pihkala, Clayton, Lewandowski, Mayall, Wray, Mellor and van Susteren2021), clinical reports and theoretical claims that the psychological pain of the climate crisis includes feeling betrayed (Henritze et al., Reference Henritze, Goldman, Simon and Brown2023; Weintrobe, Reference Weintrobe2020).

The theme ‘climate change is a wicked problem’ speaks to how participants recognise the wrongdoings underpinning the CEE and how climate change is deeply interwoven with broader ecological degradation (Hogg et al., Reference Hogg, Stanley, O’Brien, Wilson and Watsford2021) and other significant global challenges. Participants see the hegemonic sociopolitical, economic contexts, late-stage capitalism, individualism, and consumerism as perpetuating the CEE. As such they recognise the complexities and uncertainties making the CEE so overwhelming to consider, possibly explaining why some people avoid thinking about the CEE despite the evidence about its dangers. ‘Climate change as a wicked problem’ threads throughout all themes but was offered here separately as the over-arching context in which distress arises.

The themes ‘moral distress is associated with witnessing acts of omission and commission’ and ‘moral distress drives eco-distress’ indicates how witnessing moral transgressions (Sheather and Fidler, Reference Sheather and Fidler2021), has significant emotional impacts upon participants. The climate crisis causes anxiety, fear, and sadness, intensified into anguish (powerlessness, helplessness and loneliness) because of failures by those in power. This could be seen to infringe their human rights. As argued elsewhere it is ‘cruel, inhuman, degrading, or even torturous’ to subject young people to moral injury and distress related to the CEE (Hickman et al., Reference Hickman, Marks, Pihkala, Clayton, Lewandowski, Mayall, Wray, Mellor and van Susteren2021; Heri, Reference Heri2022; Mavronicola Reference Mavronicola2022). This runs counter to the absolute right protected by Article 3 of the European Convention on Human Rights (the right to freedom from torture and inhuman or degrading treatment), which is part of UK law under the Human Rights Act 1998. The current findings lend support to growing legal arguments, where human rights violations arise when State authorities engage in wrongful acts and omissions. We argue that the callous (in)actions of State authorities in addressing the CEE with due care and urgency, in line with the scientific consensus, are subjecting people to a distress that can be said to fall within the ambit of the right not to be subjected to torture or inhuman or degrading treatment or punishment. This claim is for example being made by the six young applicants in Duarte Agostinho and others v Portugal and others (2020) in front of the European Court of Human Rights (ECtHR). An in-depth analysis of the relevance of Article 3 to State (in)action in relation to climate change is beyond the scope of this paper, and the reader is referred to Mavronicola (Reference Mavronicola2022).

Despite the harm being done, the final theme (Opportunities for moral repair) shows us that there is potential for (powerful) actors to improve the mental state of others when they work to address the CEE positively. If powerful people acting in line with climate science could mitigate eco-distress and moral injury, there is an argument that their failure to do so would be another wrongful act. Findings from this study are aligned to other research where engaging in collective pro-environmental action is associated with less overwhelming eco-distress, and supportive social networks that enable this are highly valued (Ojala and Bengtsson, Reference Ojala and Bengtsson2019). A recent speech by the UN Secretary General indicates the cultural relevance of these findings: ‘It is immoral for oil and gas companies to be making record profits from this energy crisis on the backs of the poorest people and communities, at a massive cost to the climate’ (Guterres, Reference Guterres2022).

Participants in our study have illuminated how the aspects of life that are most valued and essential to their humanity are those which unite us all as a planetary community; that we want and need a safe and liveable world for ourselves and others, including the more-than-human. Yet powerful people, economic systems and cultural stories about consumption and hyper-individualism fail to acknowledge this, and continue to destroy the planet. The disconnection between the socio-economic world in which participants are living and their deeper values can even make them unwilling participants in the destruction of what they hold most dear. These findings echo the work by Weintrobe (Reference Weintrobe2020) on how modern cultures of ‘uncare’ underpin eco-distress.

Limitations

It is important to recognise the limitations of this study. The sample size is relatively small but is appropriate for the reflexive thematic analysis methodology, in-depth, evolving, recursive interpretation, and development of strong themes. We argue that following a process toward ‘data saturation’ would have been inappropriate in line with recent discussions in the literature (Braun and Clarke, Reference Braun and Clarke2021). The themes across the dataset offer insight into the lived experience of young people with eco-distress living in the UK, but far more research is required to investigate whether such experiences are similar in young people living elsewhere. Relationships between people, governments and the powerful will vary significantly across nations, cultures and ages, so more research in different groups is required. We regard representation across genders as a strength but note limitations related to most of the sample being White. We also recognise bias arising from a sampling methodology that used recruitment from online platforms, universities, and professional networks, limiting representation from UK young people more broadly. Future research should attempt to recruit young people from more varied socio-economic and cultural backgrounds and nationalities. It is also important to consider the relevance of age to power and also explore what happens in countries where climate impacts are already having significant impacts on lives and livelihoods, particularly countries who have historically contributed the least to carbon emissions. Finally, using online technology for interviewing is a strength in that recruitment could cover a broader area, but this potentially limited interpretations of non-verbal cues.

Strengths of reflexivity

The lead researcher’s native language was not English, affecting the process of analysis, which may have benefited from additional thought and reflection between the researchers. The authors recognise their own standpoint and degree of lived experience, as both have personal and professional concerns about the CEE. They are aware of the IPCC reports and understand how climate science demands immediate and deep reduction in carbon emissions, which requires government policy and leadership, and development of infrastructure and technology to support necessary lifestyle changes. This stance provided the authors with insight to the experiences of the participants which will have shaped their final interpretations.

Clinical implications

Clinicians encountering eco-distress in patients should consider multiple potential factors driving distress, including moral distress and moral injury caused by people in power. Assessment and formulation of eco-distress should extend beyond ecological degradation and consider broader sociopolitical issues. Further research is required in diverse samples, but considering the scope of factors affecting eco-distress, clinicians should consider how intersection with aspects of an individual’s identity (e.g. social graces such as nationality, geography, age, culture, ethnicity, etc. (Burnham, Reference Burnham2018)) might affect beliefs about how authorities are failing in the face of the CEE.

With current research in this area nascent, specific practice advice is difficult to offer. We need to develop an evidence base for approaches that could benefit those with eco-distress. The most pressing practical implication from this study is to develop and apply theoretical approaches of moral injury in eco-distress, potentially adapt existing clinical applications relevant to such experiences. This includes consideration of the relational aspect in eco-distress; if individuals feel betrayed by those in power, does the only resolution lie in finding pathways to moral repair to this ruptured relationship? Such moral repair requires governmental change. But the therapist can offer one aspect of this when they validate, honour and heed patients’ emotional responses to the CEE, rather than dismissing or disavowing them.

The broader literature on moral injury and moral repair indicates benefit may come from developing personal resilience, e.g. by practising psychological flexibility, compassion, and meaning making (e.g. to develop their understanding of why they have such feelings, and how they are underpinned by significant personal values). It can also come from developing group resilience, for example by engaging with like-minded communities. Still, clinicians must recognise that eco-distress reflects issues beyond personal internal conflict, and hence the reach of the therapy room.

Recognising moral distress as an aspect of eco-distress has implications for understanding when eco-distress motivates pro-environmental behaviour (Whitmarsh et al., Reference Whitmarsh, Player, Jiongco, James, Williams, Marks and Kennedy-Williams2022), why anger can be an important motivator at times (Gregersen et al., Reference Gregersen, Andersen and Tvinnereim2023), and when it might lead to disengagement. For example, when moral injury happens repeatedly, it causes deeper psychological wounds, apathy or hopelessness (Hall et al., Reference Hall, Everson, Billingsley and Miller2022). Researchers and mental health professionals must urgently learn to better understand this experience (Dodds, Reference Dodds2021), to respond with appropriate support (Baudon and Jachens, Reference Baudon and Jachens2021), both individually and collectively (Bailey et al., Reference Bailey, Poole and James2021).

Conclusion

For some young people, moral distress and moral injury are integral to their experience of eco-distress. This is the first study to demonstrate how this arises in young people in the UK, and more research is urgently needed to examine how this response is relevant to other groups across the world. The findings have potential implications for how we talk and think about eco-distress, and as therapists we must offer justice-oriented care by recognising the impacts the CEE are having upon our patients. When those in power fail to act urgently on the CEE they are transgressing fundamental moral codes, causing undue anguish and failing to uphold human rights.

Key practice points

  1. (1) It is essential to recognise eco-distress in patients as valid and appropriate responses to the CEE, which may have elements of moral distress.

  2. (2) Time spent validating and honouring emotional responses to the CEE is an essential therapeutic act, particularly when working with young people who have previously had such feelings dismissed or ignored.

  3. (3) Patients may benefit from being supported to find ways to engage with collective, pro-environmental action with like-minded people, and they may also benefit from information about those in power engaging in positive action on larger scales, if it offers opportunities for moral repair.

Supplementary material

The supplementary material for this article can be found at https://doi.org/10.1017/S1754470X23000284

Data availability statement

The data that support the findings of this study are available on request from the corresponding author (E.M.). The data are not publicly available due to information that could compromise the privacy of research participants.

Acknowledgements

We would like to thank Natasha Mavronicola for her advice pertaining to Human Rights law and suggestions in the manuscript. We would like to thank Teah Douglas for her help in preparing the manuscript. We extend deep gratitude to all our research participants for the time they gave to speak to us about their experiences of eco-distress.

Author contribution

Ines Zevallos Labarthe: Conceptualization (supporting), Data curation (lead), Formal analysis (lead), Investigation (equal), Methodology (lead), Project administration (lead), Resources (equal), Validation (equal), Visualization (equal), Writing – original draft (lead), Writing – review & editing (supporting); Elizabeth Marks: Conceptualization (lead), Data curation (supporting), Formal analysis (supporting), Investigation (equal), Methodology (supporting), Project administration (supporting), Resources (equal), Supervision (lead), Validation (equal), Visualization (equal), Writing – original draft (supporting), Writing – review & editing (lead). Both authors contributed equally to this work, and both reviewed and approved the final manuscript.

Financial support

This research received no specific grant from any funding agency, commercial or not-for-profit sectors.

Competing interests

The authors declare none.

Ethical standard

Both authors have abided by the Ethical Principles of Psychologists and Code of Conduct as set out by the BABCP and BPS. Ethical approval was provided by the University of Bath Psychology Research Ethics Committee number 22 061. This included obtaining necessary informed consent to participate and for the results to be published.

References

Further reading

Marks, E. M., & Hudson, K. (in press). Cognitive behavioral principles for conceptualizing young people’s eco-emotions and eco-distress. In Haase, H., & Hudson, K. (eds), Youth Mental Health and Climate Change: Multidisciplinary Perspectives (1st edn). Cambridge University Press.Google Scholar
Henritze, E., Goldman, S., Simon, S., & Brown, A. D. (2023). Moral injury as an inclusive mental health framework for addressing climate change distress and promoting justice-oriented care. The Lancet Planetary Health, 7, e238e241.CrossRefGoogle ScholarPubMed
Weintrobe, S. (2020). Moral injury, the culture of uncare and the climate bubble. Journal of Social Work Practice, 34, 351362.CrossRefGoogle Scholar

References

Agostinho and others v Portugal and others (2022). App No 39371/20 (Communicated Case of 13 November 2020, relinquished to Grand Chamber on 29 June 2022).Google Scholar
Bailey, C., Poole, N. A., & James, A. (2021). Crisis care: tackling the climate and ecological emergency. BJPsych Bulletin, 45, 201204. https://doi.org/10.1192/bjb.2021.33 CrossRefGoogle ScholarPubMed
Baudon, P., & Jachens, L. (2021). A scoping review of interventions for the treatment of eco-anxiety. International Journal of Environmental Research and Public Health, 18, 9636. https://doi.org/10.3390/ijerph18189636 CrossRefGoogle ScholarPubMed
Bouman, T., Verschoor, M., Albers, C. J., Böhm, G., Fisher, S. D., Poortinga, W., Whitmarsh, L., & Steg, L. (2020). When worry about climate change leads to climate action: how values, worry and personal responsibility relate to various climate actions. Global Environmental Change, 62, 102061. https://doi.org/10.1016/j.gloenvcha.2020.102061 CrossRefGoogle Scholar
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77101. https://doi.org/10.1191/1478088706qp063oa CrossRefGoogle Scholar
Braun, V., & Clarke, V. (2019). Reflecting on reflexive thematic analysis. Qualitative Research in Sport, Exercise and Health, 11, 589597. https://doi.org/10.1080/2159676X.2019.1628806 CrossRefGoogle Scholar
Braun, V., & Clarke, V. (2021). To saturate or not to saturate? Questioning data saturation as a useful concept for thematic analysis and sample-size rationales. Qualitative Research in Sport, Exercise and Health, 13, 201216. https://doi.org/10.1080/2159676X.2019.1704846 CrossRefGoogle Scholar
Budziszewska, M., & Jonsson, S. E. (2021). From climate anxiety to climate action: an existential perspective on climate change concerns within psychotherapy. Journal of Humanistic Psychology, 002216782199324. https://doi.org/10.1177/0022167821993243 Google Scholar
Burke, S. E. L. (2021). Environmental impacts on mental health. In Handbook of Rural, Remote, and very Remote Mental Health (pp. 657674). Springer Singapore. https://doi.org/10.1007/978-981-15-6631-8_32 CrossRefGoogle Scholar
Burnham, J. (2018). Developments in Social GRRRAAACCEEESSS: visible–invisible and voiced–unvoiced 1. In Culture and reflexivity in systemic psychotherapy (pp. 139160). Routledge.CrossRefGoogle Scholar
Čartolovni, A., Stolt, M., Scott, P. A., & Suhonen, R. (2021). Moral injury in healthcare professionals: a scoping review and discussion. Nursing Ethics, 28, 590602. https://doi.org/10.1177/0969733020966776 CrossRefGoogle ScholarPubMed
Cianconi, P., Betrò, S., & Janiri, L. (2020). The impact of climate change on mental health: a systematic descriptive review. Frontiers in Psychiatry, 11. https://doi.org/10.3389/fpsyt.2020.00074 CrossRefGoogle Scholar
Clayton, S. (2020). Climate anxiety: psychological responses to climate change. Journal of Anxiety Disorders, 74, 102263. https://doi.org/10.1016/j.janxdis.2020.102263 CrossRefGoogle ScholarPubMed
Comtesse, H., Ertl, V., Hengst, S. M. C., Rosner, R., & Smid, G. E. (2021). Ecological grief as a response to environmental change: a mental health risk or functional response? International Journal of Environmental Research and Public Health, 18, 734. https://doi.org/10.3390/ijerph18020734 CrossRefGoogle ScholarPubMed
Dodds, J. (2021). The psychology of climate anxiety. BJPsych Bulletin, 45, 222226. https://doi.org/10.1192/bjb.2021.18 CrossRefGoogle ScholarPubMed
Epstein, E. G., Whitehead, P. B., Prompahakul, C., Thacker, L. R., & Hamric, A. B. (2019). Enhancing understanding of moral distress: the measure of moral distress for health care professionals. AJOB Empirical Bioethics, 10, 113124. https://doi.org/10.1080/23294515.2019.1586008 CrossRefGoogle ScholarPubMed
Forbes, M. (2022). Thematic analysis: a practical guide. Evaluation Journal of Australasia, 22, 132135. https://doi.org/10.1177/1035719X211058251 CrossRefGoogle Scholar
Gregersen, T., Andersen, G., & Tvinnereim, E. (2023). The strength and content of climate anger. Global Environmental Change, 82, 102738. https://doi.org/10.1016/j.gloenvcha.2023.102738 CrossRefGoogle Scholar
Griffin, B. J., Purcell, N., Burkman, K., Litz, B. T., Bryan, C. J., Schmitz, M., Villierme, C., Walsh, J., & Maguen, S. (2019). Moral injury: an integrative review. Journal of Traumatic Stress, 32, 350362. https://doi.org/10.1002/jts.22362 CrossRefGoogle ScholarPubMed
Guterres, A. (2022). New York [Speech audio recording]. https://youtu.be/n3YNv6z3wVI Google Scholar
Hall, N. A., Everson, A. T., Billingsley, M. R., & Miller, M. B. (2022). Moral injury, mental health and behavioural health outcomes: a systematic review of the literature. Clinical Psychology & Psychotherapy, 29, 92110. https://doi.org/10.1002/cpp.2607 CrossRefGoogle ScholarPubMed
Henritze, E., Goldman, S., Simon, S., & Brown, A. D. (2023). Moral injury as an inclusive mental health framework for addressing climate change distress and promoting justice-oriented care. The Lancet Planetary Health, 7, e238e241. https://doi.org/10.1016/S2542-5196(22)00335-7 CrossRefGoogle ScholarPubMed
Heri, C. (2022). Climate change before the european court of human rights: capturing risk, ill-treatment and vulnerability. European Journal of International Law, 33, 925951. https://doi.org/10.1093/ejil/chac047 CrossRefGoogle Scholar
Hickman, C., Marks, E., Pihkala, P., Clayton, S., Lewandowski, R. E., Mayall, E. E., Wray, B., Mellor, C., & van Susteren, L. (2021). Climate anxiety in children and young people and their beliefs about government responses to climate change: a global survey. The Lancet Planetary Health, 5, e863e873. https://doi.org/10.1016/S2542-5196(21)00278-3 CrossRefGoogle Scholar
Hickman, C. (2020). We need to (find a way to) talk about … eco-anxiety. Journal of Social Work Practice, 34, 411424. https://doi.org/10.1080/02650533.2020.1844166 CrossRefGoogle Scholar
Hogg, T. L., Stanley, S. K., O’Brien, L. v., Wilson, M. S., & Watsford, C. R. (2021). The Hogg Eco-Anxiety Scale: development and validation of a multidimensional scale. Global Environmental Change, 71, 102391. https://doi.org/10.1016/j.gloenvcha.2021.102391 CrossRefGoogle Scholar
IPCC (2022) Summary for Policymakers. In: Climate Change 2022: Mitigation of Climate Change. Contribution of Working Group III to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change [P.R. Shukla, J. Skea, R. Slade, A. Al Khourdajie, R. van Diemen, D. McCollum, M. Pathak, S. Some, P. Vyas, R. Fradera, M. Belkacemi, A. Hasija, G. Lisboa, S. Luz, J. Malley (eds)]. Cambridge University Press, Cambridge, UK and New York, NY, USA. doi: 10.1017/9781009157926.001CrossRefGoogle Scholar
Lancaster, S. L., & Harris, J. I. (2018). Measures of morally injurious experiences: a quantitative comparison. Psychiatry Research, 264, 1519. https://doi.org/10.1016/j.psychres.2018.03.057 CrossRefGoogle ScholarPubMed
Litz, B. T., Stein, N., Delaney, E., Lebowitz, L., Nash, W. P., Silva, C., & Maguen, S. (2009). Moral injury and moral repair in war veterans: a preliminary model and intervention strategy. Clinical Psychology Review, 29, 695706. https://doi.org/10.1016/j.cpr.2009.07.003 CrossRefGoogle ScholarPubMed
Mavronicola, N. (2022) ‘The Future is a Foreign Country: State (In)Action on Climate Change and the Right against Torture and Ill-Treatment’, 2022/2, no. 6, Europe of Rights & Liberties/Europe des Droits & Libertés, pp. 211–237.Google Scholar
Ojala, M., & Bengtsson, H. (2019). Young people’s coping strategies concerning climate change: relations to perceived communication with parents and friends and proenvironmental behavior. Environment and Behavior, 51, 907935. https://doi.org/10.1177/0013916518763894 CrossRefGoogle Scholar
Pihkala, P. (2019). Climate Anxiety. Helsinki: MIELI Mental Health Finland.Google Scholar
Pihkala, P. (2020). Anxiety and the ecological crisis: an analysis of eco-anxiety and climate anxiety. Sustainability, 12, 7836. https://doi.org/10.3390/su12197836 CrossRefGoogle Scholar
Shay, J. (2014). Moral injury. Psychoanalytic Psychology, 31, 182191. https://doi.org/10.1037/a0036090 CrossRefGoogle Scholar
Sheather, J., & Fidler, H. (2021). Covid-19 has amplified moral distress in medicine. BMJ, n28. https://doi.org/10.1136/bmj.n28 CrossRefGoogle ScholarPubMed
Stanley, S. K., Hogg, T. L., Leviston, Z., & Walker, I. (2021). From anger to action: Differential impacts of eco-anxiety, eco-depression, and eco-anger on climate action and wellbeing. Journal of Climate Change and Health, 1, 100003. https://doi.org/10.1016/j.joclim.2021.100003 CrossRefGoogle Scholar
Stern, N., Patel, I., & Ward, B. (2021). Covid-19, climate change, and the environment: a sustainable, inclusive, and resilient global recovery. BMJ, n2405. https://doi.org/10.1136/bmj.n2405 CrossRefGoogle ScholarPubMed
Terry, G., Hayfield, N., Clarke, V. & Braun, V. (2017). Thematic analysis. In Willig, C. & Staiton-Rogers, W.. The SAGE Handbook of Qualitative Research in Psychology, 2, 1737.CrossRefGoogle Scholar
Van der Linden, S. (2017). Determinants and measurement of climate change risk perception, worry, and concern. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.2953631 CrossRefGoogle Scholar
Verlie, B. (2022). Learning to Live with Climate Change: From Anxiety to Transformation (p. 140). Taylor & Francis.Google Scholar
Verplanken, B., Marks, E., & Dobromir, A. I. (2020). On the nature of eco-anxiety: How constructive or unconstructive is habitual worry about global warming? Journal of Environmental Psychology, 72, 101528. https://doi.org/10.1016/j.jenvp.2020.101528 CrossRefGoogle Scholar
Weintrobe, S. (2020). Moral injury, the culture of uncare and the climate bubble. Journal of Social Work Practice, 34, 351362. https://doi.org/10.1080/02650533.2020.1844167 CrossRefGoogle Scholar
Whitmarsh, L., Player, L., Jiongco, A., James, M., Williams, M., Marks, E., & Kennedy-Williams, P. (2022). Climate anxiety: what predicts it and how is it related to climate action? Journal of Environmental Psychology, 83, 101866. https://doi.org/10.1016/j.jenvp.2022.101866 CrossRefGoogle Scholar
Williamson, V., Lamb, D., Hotopf, M., Raine, R., Stevelink, S., Wessely, S., Docherty, M., Madan, I., Murphy, D., & Greenberg, N. (2023). Moral injury and psychological wellbeing in UK healthcare staff. Journal of Mental Health, 32, 890898. https://doi.org/10.1080/09638237.2023.2182414 CrossRefGoogle ScholarPubMed
Wocial, L. (2022). Moral Distress. Guidance for Healthcare Ethics Committees, 47.CrossRefGoogle Scholar
Woodbury, Z. (2019). Climate trauma: toward a new taxonomy of trauma. Ecopsychology, 11, 18. https://doi.org/10.1089/eco.2018.0021 CrossRefGoogle Scholar
World Health Organization (2021). COP26 Special Report on Climate Change and Health: The Health Argument for Climate Action.Google Scholar
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Table 1. Sample characteristics (n=13)

Figure 1

Table 2. Outline of themes and subthemes

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