Growing (Up) in Times of Multiple Crises – A Call for Mental Health (Research) Action Editorial Growing (Up) in Times of Multiple Crises – A Call for Mental Health (Research) Action Julia Asbrand 1, Tanja Michael 2, Hanna Christiansen 3,4, Gerhard Reese 5 [1] Department of Psychology, Friedrich-Schiller-University Jena, Jena, Germany. [2] Department of Psychology, Saarland University, Saarbrucken, Germany. [3] Department of Psychology, University of Marburg, Marburg, Germany. [4] Deutsches Zentrum für Psychische Gesundheit (DZPG), Bochum/Marburg, Germany. [5] Department of Psychology, RPTU Kaiserslautern-Landau, Campus Landau, Landau, Germany. Clinical Psychology in Europe, 2023, Vol. 5(3), Article e12713, https://doi.org/10.32872/cpe.12713 Published (VoR): 2023-09-29 Corresponding Author: Julia Asbrand, Friedrich-Schiller-University Jena, Department of Psychology, Semmelweisstr. 12, 07743 Jena, Germany. E-mail: julia.asbrand@hu-berlin.de The rock band Fury in the slaughterhouse sang that “every generation got its own disease”, however, remaining in that wording, the current generation of children and adolescents in Europe has to cope with several severe “diseases” at the same time: the war of Russia against Ukraine, the social and mental health consequences of the Covid-19-pandemic, the economic downturn, societal polarization, and last but not least, the twin crises of biodiversity loss and climate change. Each of these crises have visible and measurable consequences, and some crises mutually reinforce each other. The climate crisis, for instance, has already brought irreversible damage to some societies and natural habitats around the world. According to the Intergovernmental Panel on Climate Change (IPCC, 2023), weather phenomena such as droughts, storms and floods will become more likely and more intense. It is estimated that people who are born today will experience heat waves up to seven times more often than people who are in their forties to sixties today (Thiery et al., 2021). Furthermore, climate change is linked to macroeconomic consequences negatively affect­ ing the economic situations of states and individuals and is thus a driving force behind increasing poverty (e.g., Kotz et al., 2021). The climate crisis also accelerates biodiversity loss. Further, both environmental degradation as well as climate change undermine peace and increase the likelihood for conflict between groups, representing additional stressors for development both on an individual and a societal level (e.g., Palmer, 2022). Unsurpris­ ingly, a recent meta-analysis shows that climate events are negatively correlated with mental health (Cuijpers et al., 2023), and a recent review demonstrates that the risk for This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License, CC BY 4.0, which permits unrestricted use, distribution, and reproduction, provided the original work is properly cited. https://crossmark.crossref.org/dialog/?doi=10.32872/cpe.12713&domain=pdf&date_stamp=2023-09-29 https://www.psychopen.eu/ https://cpe.psychopen.eu/ https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/ mental health problems among young people is particularly high (Ma, Moore, & Cleary, 2022). The Covid-19 pandemic decreased mental health in the general population, and younger age groups in particular (Santomauro et al., 2021). Furthermore, several studies show that the worsened mental health of young people remained up to two years after the onset of the pandemic (Hansen et al., 2023). A recent study among German adolescents also shows that both pandemic-related and climate-related distress are linked to more depression and anxiety symptoms and to reduced health-related quality of life. Distress related to the Russia-Ukraine war was associated with greater anxiety. Critically, these associations remained significant when controlling for important covariates (e.g., gender, distress caused by personal problems), showing that the crisis measures have incremental predictive value (Lass-Hennemann et al., 2023). However, self-efficacy and, though to a lesser extent, expressive flexibility were associated with better mental health. There are no studies yet examining how the war influences mental health of children and adolescents living in an area directly exposed to the war. Despite the increased need to address mental health problems among young people (e.g. Deng et al., 2023), sufficient in-patient and outpatient mental health care systems are yet to be implemented. Actually, waiting times have doubled during the pandemic and low-threshold effective interventions are lacking (e.g. Overhage et al., 2023). In sum, the current evidence suggests that global crises impact the mental health and healthy upbringing of young people. Therefore, policies should include interventions that help children and adolescents in particular to cope with the stress caused by the crises. The Systemic Structure Underneath: What Can We (Not) Do? However, it is not enough to only develop strategies to help individuals to cope better with stress or to increase mental health care capacities. Large scale crises, as the ones depicted above, have in common that they are usually a result of collective (in-)action and as such, these crises cannot be remedied by individual action alone: As an individual, I can neither address the pandemic, solve the climate crisis nor end a war all by myself. In other words: An individual can hardly experience self-efficacy when faced with these challenges. These challenges can only be addressed by collective efforts, and these efforts must be implemented on various societal levels. For example, the multilevel model of societal change introduced by Geels and Schot (2007) represents a framework that helps to understand how and which levels of society need to be addressed to achieve societal change. In short, the model suggests that certain pressures such as climate change or resource scarcity open windows of opportunity within a political regime. Networks of Growing (Up) in Times of Multiple Crises 2 Clinical Psychology in Europe 2023, Vol. 5(3), Article e12713 https://doi.org/10.32872/cpe.12713 https://www.psychopen.eu/ innovators and groups with joint ideas can then use such a window to engender change within society. For example, the Fridays-for-Future movement did so, and changed the way climate change is treated in politics and society. Recent psychological models sug­ gest the pathways through which collective and participatory efficacy beliefs can foster such collective actions (Hamann et al., 2023). Building on these systemic considerations, clinical psychology and psychotherapy, both at the level of care and research, urgently need to move away from an exclusively individual approach to a consideration of the individual in the system, its structures, and their relevant life-environments such as schools or the work-place. How could this look like? A Call for Health(y) Action First of all, broader prevention structures focusing on systemic levels of mental health as well as self-efficacy (Lass-Hennemann et al., 2023) and adaptive coping are necessary (Mah et al., 2020). These need to be implemented and institutionalized within structural levels, and have to provide an outreach service – independent of youth’s knowledge about health care structures or individual resources. Second, these prevention structures must also be flanked by measures that mitigate major risk factors for mental health and a negative trajectory when growing up. Specifically, these are all measures targeting financial and social injustices and inequity, i.e. installing appropriate climate protection measures, providing access to education and living above the poverty line is part of health care. Third, our research must do justice to the complex interplay between the individual and society, also in the field of mental health. This means that research approaches must be promoted in clinical psychology and psychotherapy that situate the individual in society and clarify the effects of society on the individual, e.g. which systemic structures limit treatment success? How do societal crises affect mental health? We believe that the current age of multiple crises holds several challenges for mental health care and research, foremost the fact that we are affected by these crises as health care professionals and researchers. To adequately address these challenges, we need to expand (preventive) healthcare, intensify our research efforts and at the societal level to help young people grow up healthy. Funding: The authors have no funding to report. Acknowledgments: The authors have no additional (i.e., non-financial) support to report. Competing Interests: The authors have declared that no competing interests exist. Asbrand, Michael, Christiansen, & Reese 3 Clinical Psychology in Europe 2023, Vol. 5(3), Article e12713 https://doi.org/10.32872/cpe.12713 https://www.psychopen.eu/ References Cuijpers, P., Miguel, C., Ciharova, M., Kumar, M., Brander, L., Kumar, P., & Karyotaki, E. (2023). Impact of climate events, pollution, and green spaces on mental health: An umbrella review of meta-analyses. Psychological Medicine, 53(3), 638–653. https://doi.org/10.1017/S0033291722003890 Deng, J., Zhou, F., Hou, W., Heybati, K., Lohit, S., Abbas, U., Silver, Z., Wong, C. Y., Chang, O., Huang, E., Zuo, Q. K., Moskalyk, M., Ramaraju, H. B., & Heybati, S. (2023). Prevalence of mental health symptoms in children and adolescents during the COVID-19 pandemic: A meta‐analysis. Annals of the New York Academy of Sciences, 1520(1), 53–73. https://doi.org/10.1111/nyas.14947 Geels, F. W., & Schot, J. (2007). Typology of sociotechnical transition pathways. Research Policy, 36(3), 399–417. https://doi.org/10.1016/j.respol.2007.01.003 Hamann, K. R., Wullenkord, M. C., Reese, G., & van Zomeren, M. (2023). Believing that we can change our world for the better: A triple-A (agent-action-aim) framework of self-efficacy beliefs in the context of collective social and ecological aims. Personality and Social Psychology Review. Advance online publication. https://doi.org/10.1177/10888683231178056 Hansen, J., Galimov, A., Unger, J. B., Sussman, S. Y., & Hanewinkel, R. (2023). Mental health and physical complaints of German children and adolescents before and during the COVID-19 pandemic: A repeated cross-sectional study. International Journal of Environmental Research and Public Health, 20(5), Article 4478. https://doi.org/10.3390/ijerph20054478 Intergovernmental Panel on Climate Change. (2023). Climate Change 2023: Synthesis Report. Contribution of Working Groups I, II and III to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change [Core Writing Team, H. Lee and J. Romero (Eds.)]. https://doi.org/10.59327/IPCC/AR6-9789291691647 Kotz, M., Wenz, L., Stechemesser, A., Kalkuhl, M., & Levermann, A. (2021). Day-to-day temperature variability reduces economic growth. Nature Climate Change, 11, 319–325. https://doi.org/10.1038/s41558-020-00985-5 Lass-Hennemann, J., Sopp, M. R., Ruf, N., Equit, M., Schäfer, S. K., Wirth, B. E., & Michael, T. (2023). Generation climate crisis, COVID-19, and Russia-Ukraine-War – Global crises and mental health in adolescents [Preprint Version 1]. Research Square. https://doi.org/10.21203/rs.3.rs-3131485/v1 Ma, T., Moore, J., & Cleary, A. (2022). Climate change impacts on the mental health and wellbeing of young people: A scoping review of risk and protective factors. Social Science & Medicine, 301, Article 114888. https://doi.org/10.1016/j.socscimed.2022.114888 Mah, A. Y., Chapman, D. A., Markowitz, E. M., & Lickel, B. (2020). Coping with climate change: Three insights for research, intervention, and communication to promote adaptive coping to climate change. Journal of Anxiety Disorders, 75, Article 102282. https://doi.org/10.1016/j.janxdis.2020.102282 Overhage, L., Hailu, R., Busch, A. B., Mehrotra, A., Michelson, K. A., & Huskamp, H. A. (2023). Trends in acute care use for mental health conditions among youth during the COVID-19 pandemic. JAMA Psychiatry, 80(9), 924–932. https://doi.org/10.1001/jamapsychiatry.2023.2195 Growing (Up) in Times of Multiple Crises 4 Clinical Psychology in Europe 2023, Vol. 5(3), Article e12713 https://doi.org/10.32872/cpe.12713 https://doi.org/10.1017/S0033291722003890 https://doi.org/10.1111/nyas.14947 https://doi.org/10.1016/j.respol.2007.01.003 https://doi.org/10.1177/10888683231178056 https://doi.org/10.3390/ijerph20054478 https://doi.org/10.59327/IPCC/AR6-9789291691647 https://doi.org/10.1038/s41558-020-00985-5 https://doi.org/10.21203/rs.3.rs-3131485/v1 https://doi.org/10.1016/j.socscimed.2022.114888 https://doi.org/10.1016/j.janxdis.2020.102282 https://doi.org/10.1001/jamapsychiatry.2023.2195 https://www.psychopen.eu/ Palmer, L. (2022). Solving twin crises. Nature Sustainability, 5, 816–817. https://doi.org/10.1038/s41893-022-00973-x Santomauro, D. F., Herrera, A. M. M., Shadid, J., Zheng, P., Ashbaugh, C., Pigott, D. M., Abbafati, C., Adolph, C., Amlag, J. O., Aravkin, A. Y., Bang-Jensen, B. I., Bertolacci, G. J., Bloom, S. S., Castellano, R., Castro, E., Chakrabarti, S., Chattopadhyay, J., Cogen, R. M., Collins, J. K., . . . Ferrari, A. J. (2021). Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. Lancet, 398(10312), 1700–1712. https://doi.org/10.1016/S0140-6736(21)02143-7 Thiery, W., Lange, S., Rogelj, J., Schleussner, C.-F., Gudmundsson, L., Seneviratne, S. I., Andrijevic, M., Frieler, K., Emanuel, K., Geiger, T., Bresch, D. N., Zhao, F., Willner, S. N., Büchner, M., Volkholz, J., Bauer, N., Chang, J., Ciais, P., Dury, M., . . . Wada, Y. (2021). Intergenerational inequities in exposure to climate extremes. Science, 374(6564), 158–160. https://doi.org/10.1126/science.abi7339 Clinical Psychology in Europe (CPE) is the official journal of the European Association of Clinical Psychology and Psychological Treatment (EACLIPT). PsychOpen GOLD is a publishing service by Leibniz Institute for Psychology (ZPID), Germany. Asbrand, Michael, Christiansen, & Reese 5 Clinical Psychology in Europe 2023, Vol. 5(3), Article e12713 https://doi.org/10.32872/cpe.12713 https://doi.org/10.1038/s41893-022-00973-x https://doi.org/10.1016/S0140-6736(21)02143-7 https://doi.org/10.1126/science.abi7339 https://www.psychopen.eu/ Growing (Up) in Times of Multiple Crises (Introduction) The Systemic Structure Underneath: What Can We (Not) Do? A Call for Health(y) Action (Additional Information) Funding Acknowledgments Competing Interests References