"It's so hard to put tangible figures to it:" Examining climate change impacts on Inuit mental health in Nunatsiavut, Labrador.

Transformational climate change across the Circumpolar North is disrupting Indigenous Peoples’ access to land, sea, and ice, leading to emotional distress, interpersonal stress, anxiety, depression, substance use, and increased use of mental health services. While there are strong theoretical understandings of the mechanisms that link climate and mental health, there is relatively little known about how the mental health of the most climate-sensitive populations is being impacted. Therefore, this research used a community-driven population health approach to examine how weather and seasonality impacts Inuit mental health in Nunatsiavut, Labrador, Canada in the context of climate change. First, a scoping review explored global Indigenous climate-mental health relationships. This review characterized the ways in which the emotional and psychological impacts of climate are connected to changing place attachment, disrupted cultural continuity, forced human mobility, and intangible loss and damages. Then, to characterize the lived experiences of climate impacts on Inuit mental health, in-depth interviews from across Nunatsiavut (n=116 interviews) were analysed. Results indicated that weather impacted mental wellness through: shaping daily lived experiences including connection to place; altering mood and emotion on a transient basis; and seasonally influencing individual and community wellbeing. To examine these climate-mental health interconnections in Nunatsiavut, a regional time series analysis examined quantitative associations between temperature and mental health clinic visits. Mental health clinic visits significantly increased following warmer temperatures and decreased following temperature ranges that allow land use and access. These results demonstrated the important role that temperature plays in Inuit mental health; however, these impacts on mental health will not be uniformly distributed across communities. To understand the distribution of weather-mental health associations among communities, time series regression examined how place modified the effect of temperature on mental health clinic visits. No two communities had the same weather-mental health associations, demonstrating the extent to which place matters in the context of Inuit mental health and climate change. This work provides new insights into climate change impacts on mental health and has important research, policy, and planning implications for regions such as Nunatsiavut, which are already experiencing the fastest rates of warming on the planet.