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United Nations Department of Economic and Social Affairs Sustainable Development

W4CCMH - Water for Climate Change Mental Health - Integrating inclusive water strategies in climate services

United Nations University - MERIT (UNU-MERIT) (
United Nations / Multilateral body

    Objectives: Water insecurities and water-related disasters can impact mental health through direct and indirect impacts. Possible mental health and psychosocial outcomes are extensive (WHO, 2022). The existing mechanisms to support the impacts of water-related climate risks on mental health by government and non-government agencies are often disaggregated, and in many countries, specific action plans and initiatives to support affected households and communities are limited or absent (WHO, 2014). There is a visible gap in the coordination of effective practices to provide affected people with the required mental health and psychosocial services (MHPSS). As communities continue to cope with and respond to water-related climate risks and environmental degradation, we argue that water governance frameworks must be amplified to include these dimensions and support practitioners to build psychological resilience within communities and ourselves. Building on existing research from the United Nations University - Climate Resilience Initiative project (, our water action agenda will support a collective ‘call for action’ towards the aggregated knowledge and better understanding of robust evidence and ‘fit to propose’ solutions to address mental health implications of water insecurities and disaster events, and overall, boosting the water for climate resilience agenda. Implementation methodologies: Our agenda is threefold. Research (understanding , developing indicators), Capacity development (awareness building, climate literacy, training for service providers, educational materials, workshops / webinars, publications for practitioners), Policy (customised recommendation, multi-stakeholder consultations). The engagements will be based on the following activities: Enhancing the understanding of the interlinkages of climate change and climate change related disasters and mental health / psychological well-being, a) how they influence populations’ decision-makings such as family planning, mobility, consumption choices, pro-environmental behaviour, climate activities; b) vulnerability factors and inequalities (e.g., gender, age, intergenerational inequity, socioeconomic status) Multi-country comparative research on current status of a) existing support services that can acknowledge psychological and psychiatric needs, b) identifying multisectoral and community based approaches that enables reducing vulnerabilities and mental health impacts of climate risks Increasing climate literacy and awareness building: a) interlinkages of climate literacy and awareness and engagement to pro-environmental behavior, b) developing the tools or platforms for capacity development (climate communication, role of media, NGOs), b) how can we utilize the capacity to reduce the impacts of climate change on mental health? Identify unique advantages of youth and future generations that contribute to the vision of an inclusive climate resilient future: a) how can we empower the future generation to climate action, b) role of schools and climate education Collate the data and tools from the above, and develop policy recommendations and multi-stakeholder consultations towards integrated climate services to enable building mental health resilience for all Follow-up mechanisms: By developing tools and materials for capacity development based on the aggregated insights from the research, we will ensure that the actors who are involved will be informed, and will be able to gain follow-up sessions, access to published materials, and attend to multi-stakeholder consultations.

    Expected Impact

    We aim to enhance understanding of the following elements by assessing gaps and needs in the existing support mechanisms through capturing reflections from different geographic regions across the world, voices from practices and youth and their capacities to integrate support services in water strategies to contribute in addressing SDG 3, 5, 6, and 13 in particular: Interlinkages of water insecurity and water related disasters, climate change and mental health and psychosocial well-being, with a focus on vulnerability factors and inequalities (e.g., gender, age, indigenous status, disability, socioeconomic status), and how support services can acknowledge psychosocial and psychiatric needs Environmental degradation in landscapes / waterscapes and biodiversity, and its impact on mental health; Emerging concepts of mental health outcomes such as climate change anxiety, eco-grief, solastalgia and how they relate to water insecurities Empowering and accelerating unique advantages of the youth and future generations could contribute to the vision of an inclusive climate resilient future Developing multisectoral and community based approaches to reduce vulnerabilities and mental health impacts of water insecurity and water related disasters; how we can build and implement smart water strategies in climate services to enable building mental health resilience for all


    UN system: UNU-MERIT UNU-CRIS UNU-EHS UNU-IAS UNU-INWEH WHO - Climate Change and Health Unit UNICEF - Climate Change Consultant for Climate, Environment, Energy, and DRR UNESCO (tbc: Water and Gender Working Group ) UN-MGCY - DRR Member states: United Kingdom of Great Britain and Northern Ireland Directorate for Energy and Climate Change, The Scottish Government Ministry of Sustainability, Innovation and the Environment, Government of Anguilla Ministry of Health, Democratic Republic of São Tomé and Príncipe Academic institution Glasgow Caledonian University, UK University of Florence, Italy (tbc) Imo State University, Owerri, Nigeria Private sector: Bulgarian Association for Personalized Medicine (tbc) Cigna Healthcare (tbc) Civil society, NGOs: Associazione Italiana Ansia da Cambiamento Climatico Italian Institute for Planetary Health ICATALIST, Spain Green Hope Foundation, Canada (tbc)

    Additional information

    UN Water Conference Virtual side event website

    Video clip for the UN Water Conference virtual side event

    Video clip for the COP 27 UN System Side event in Egypt, Nov 2022

    United Nations University - Climate Resilience Initiative (CRI)

    This research line is a part of the UNU-Climate Resilience Initiative (CRI) and showcases various insights from different geographic regions and practices to enhance the understanding of the interlinkages between climate change, mental health and psychosocial well-being by capturing reflections from different geographic regions and their capacities to integrate support services in climate response strategies.

    UNU-MERIT institutional website 

    UNU-CRIS institutional website

    Related publications:

    World Water Development Report 2023, Chapter 6 Health (2023). World Water Development Report 2023

    Sanae Okamoto and Nidhi Nagabhatla (2023). Climate Change’s Impact on Mental Health Is Overlooked and Misunderstood — Here’s What Can Be Done Our World, UNU

    Sanae Okamoto, Nidhi Nagabhatla (2022). Climate change’s impact on mental health is overlooked and misunderstood – here’s what can be done, THE CONVERSATION

    Sanae Okamoto, Nidhi Nagabhatla (2022). Especial | Como a COP27 repercutiu no mundo e sua influência nos rumos da ação climática (Interview in Portuguese), MEDIA TALKS

    Nagabhatla, Werners, S.E., Bhandari, S., Okamoto, S., & Caucchi, S. (2022). Learning From European Floods 2021 Towards Resilience-Focused Recovery Pathways: Flood Risk Governance To Facilitate Climate-Resilient Pathways. Joint Publication REPORT: Climate Resilient Water Resources Management - Driving the Conversation Forward. Water and Climate Coalition (WCC) p.10-13. 

    Nidhi Nagabhatla, Sanae Okamoto, Sisir Bhandari (2021). The new normal of ‘climate grief’: why mental health must feature in adaptation and resilience planning, UNU-MERIT Blog

    Goal 3

    Ensure healthy lives and promote well-being for all at all ages

    Goal 3


    By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births

    Maternal mortality ratio


    Proportion of births attended by skilled health personnel


    By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births

    Under-five mortality rate


    Neonatal mortality rate


    By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases


    Number of new HIV infections per 1,000 uninfected population, by sex, age and key populations


    Tuberculosis incidence per 100,000 population


    Malaria incidence per 1,000 population


    Hepatitis B incidence per 100,000 population


    Number of people requiring interventions against neglected tropical diseases


    By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being

    Mortality rate attributed to cardiovascular disease, cancer, diabetes or chronic respiratory disease


    Suicide mortality rate


    Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol


    Coverage of treatment interventions (pharmacological, psychosocial and rehabilitation and aftercare services) for substance use disorders


    Alcohol per capita consumption (aged 15 years and older) within a calendar year in litres of pure alcohol


    By 2020, halve the number of global deaths and injuries from road traffic accidents

    Death rate due to road traffic injuries


    By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes


    Proportion of women of reproductive age (aged 15-49 years) who have their need for family planning satisfied with modern methods


    Adolescent birth rate (aged 10-14 years; aged 15-19 years) per 1,000 women in that age group


    Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all


    Coverage of essential health services


    Proportion of population with large household expenditures on health as a share of total household expenditure or income


    By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination

    Mortality rate attributed to household and ambient air pollution


    Mortality rate attributed to unsafe water, unsafe sanitation and lack of hygiene (exposure to unsafe Water, Sanitation and Hygiene for All (WASH) services)


    Mortality rate attributed to unintentional poisoning


    Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate

    Age-standardized prevalence of current tobacco use among persons aged 15 years and older


    Support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade-Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all


    Proportion of the target population covered by all vaccines included in their national programme

    Total net official development assistance to medical research and basic health sectors

    Proportion of health facilities that have a core set of relevant essential medicines available and affordable on a sustainable basis


    Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States

    Health worker density and distribution


    Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks


    International Health Regulations (IHR) capacity and health emergency preparedness


    Percentage of bloodstream infections due to selected antimicrobial-resistant organisms

    Goal 5

    Achieve gender equality and empower all women and girls

    Goal 5


    End all forms of discrimination against all women and girls everywhere


    Whether or not legal frameworks are in place to promote, enforce and monitor equality and non‑discrimination on the basis of sex


    Eliminate all forms of violence against all women and girls in the public and private spheres, including trafficking and sexual and other types of exploitation

    Proportion of ever-partnered women and girls aged 15 years and older subjected to physical, sexual or psychological violence by a current or former intimate partner in the previous 12 months, by form of violence and by age


    Proportion of women and girls aged 15 years and older subjected to sexual violence by persons other than an intimate partner in the previous 12 months, by age and place of occurrence


    Eliminate all harmful practices, such as child, early and forced marriage and female genital mutilation

    Proportion of women aged 20-24 years who were married or in a union before age 15 and before age 18


    Proportion of girls and women aged 15-49 years who have undergone female genital mutilation/cutting, by age


    Recognize and value unpaid care and domestic work through the provision of public services, infrastructure and social protection policies and the promotion of shared responsibility within the household and the family as nationally appropriate


    Proportion of time spent on unpaid domestic and care work, by sex, age and location


    Ensure women’s full and effective participation and equal opportunities for leadership at all levels of decision-making in political, economic and public life


    Proportion of seats held by women in (a) national parliaments and (b) local governments


    Proportion of women in managerial positions


    Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences


    Proportion of women aged 15-49 years who make their own informed decisions regarding sexual relations, contraceptive use and reproductive health care


    Number of countries with laws and regulations that guarantee full and equal access to women and men aged 15 years and older to sexual and reproductive health care, information and education


    Undertake reforms to give women equal rights to economic resources, as well as access to ownership and control over land and other forms of property, financial services, inheritance and natural resources, in accordance with national laws


    (a) Proportion of total agricultural population with ownership or secure rights over agricultural land, by sex; and (b) share of women among owners or rights-bearers of agricultural land, by type of tenure


    Proportion of countries where the legal framework (including customary law) guarantees women’s equal rights to land ownership and/or control


    Enhance the use of enabling technology, in particular information and communications technology, to promote the empowerment of women

    Proportion of individuals who own a mobile telephone, by sex


    Adopt and strengthen sound policies and enforceable legislation for the promotion of gender equality and the empowerment of all women and girls at all levels


    Proportion of countries with systems to track and make public allocations for gender equality and women’s empowerment

    Goal 6

    Ensure availability and sustainable management of water and sanitation for all

    Goal 6


    By 2030, achieve universal and equitable access to safe and affordable drinking water for all


    Proportion of population using safely managed drinking water services


    By 2030, achieve access to adequate and equitable sanitation and hygiene for all and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations


    Proportion of population using (a) safely managed sanitation services and (b) a hand-washing facility with soap and water


    By 2030, improve water quality by reducing pollution, eliminating dumping and minimizing release of hazardous chemicals and materials, halving the proportion of untreated wastewater and substantially increasing recycling and safe reuse globally


    Proportion of domestic and industrial wastewater flows safely treated


    Proportion of bodies of water with good ambient water quality


    By 2030, substantially increase water-use efficiency across all sectors and ensure sustainable withdrawals and supply of freshwater to address water scarcity and substantially reduce the number of people suffering from water scarcity

    Change in water-use efficiency over time


    Level of water stress: freshwater withdrawal as a proportion of available freshwater resources


    By 2030, implement integrated water resources management at all levels, including through transboundary cooperation as appropriate


    Degree of integrated water resources management 


    Proportion of transboundary basin area with an operational arrangement for water cooperation


    By 2020, protect and restore water-related ecosystems, including mountains, forests, wetlands, rivers, aquifers and lakes

    Change in the extent of water-related ecosystems over time


    By 2030, expand international cooperation and capacity-building support to developing countries in water- and sanitation-related activities and programmes, including water harvesting, desalination, water efficiency, wastewater treatment, recycling and reuse technologies

    Amount of water- and sanitation-related official development assistance that is part of a government-coordinated spending plan


    Support and strengthen the participation of local communities in improving water and sanitation management


    Proportion of local administrative units with established and operational policies and procedures for participation of local communities in water and sanitation management

    Goal 11

    Make cities and human settlements inclusive, safe, resilient and sustainable

    Goal 11


    By 2030, ensure access for all to adequate, safe and affordable housing and basic services and upgrade slums


    Proportion of urban population living in slums, informal settlements or inadequate housing


    By 2030, provide access to safe, affordable, accessible and sustainable transport systems for all, improving road safety, notably by expanding public transport, with special attention to the needs of those in vulnerable situations, women, children, persons with disabilities and older persons

    Proportion of population that has convenient access to public transport, by sex, age and persons with disabilities


    By 2030, enhance inclusive and sustainable urbanization and capacity for participatory, integrated and sustainable human settlement planning and management in all countries

    Ratio of land consumption rate to population growth rate


    Proportion of cities with a direct participation structure of civil society in urban planning and management that operate regularly and democratically


    Strengthen efforts to protect and safeguard the world’s cultural and natural heritage


    Total per capita expenditure on the preservation, protection and conservation of all cultural and natural heritage, by source of funding (public, private), type of heritage (cultural, natural) and level of government (national, regional, and local/municipal)


    By 2030, significantly reduce the number of deaths and the number of people affected and substantially decrease the direct economic losses relative to global gross domestic product caused by disasters, including water-related disasters, with a focus on protecting the poor and people in vulnerable situations


    Number of deaths, missing persons and directly affected persons attributed to disasters per 100,000 population


    Direct economic loss attributed to disasters in relation to global domestic product (GDP)


    (a) Damage to critical infrastructure and (b) number of disruptions to basic services, attributed to disasters


    By 2030, reduce the adverse per capita environmental impact of cities, including by paying special attention to air quality and municipal and other waste management


    Proportion of municipal solid waste collected and managed in controlled facilities out of total municipal waste generated, by cities


    Annual mean levels of fine particulate matter (e.g. PM2.5 and PM10) in cities (population weighted)


    By 2030, provide universal access to safe, inclusive and accessible, green and public spaces, in particular for women and children, older persons and persons with disabilities

    Average share of the built-up area of cities that is open space for public use for all, by sex, age and persons with disabilities


    Proportion of persons victim of physical or sexual harassment, by sex, age, disability status and place of occurrence, in the previous 12 months


    Support positive economic, social and environmental links between urban, peri-urban and rural areas by strengthening national and regional development planning


    Number of countries that have national urban policies or regional development plans that (a) respond to population dynamics; (b) ensure balanced territorial development; and (c) increase local fiscal space


    By 2020, substantially increase the number of cities and human settlements adopting and implementing integrated policies and plans towards inclusion, resource efficiency, mitigation and adaptation to climate change, resilience to disasters, and develop and implement, in line with the Sendai Framework for Disaster Risk Reduction 2015-2030, holistic disaster risk management at all levels


    Number of countries that adopt and implement national disaster risk reduction strategies in line with the Sendai Framework for Disaster Risk Reduction 2015–2030


    Proportion of local governments that adopt and implement local disaster risk reduction strategies in line with national disaster risk reduction strategies


    Support least developed countries, including through financial and technical assistance, in building sustainable and resilient buildings utilizing local materials

    Goal 13

    Take urgent action to combat climate change and its impacts

    Goal 13


    Strengthen resilience and adaptive capacity to climate-related hazards and natural disasters in all countries


    Number of deaths, missing persons and directly affected persons attributed to disasters per 100,000 population


    Number of countries that adopt and implement national disaster risk reduction strategies in line with the Sendai Framework for Disaster Risk Reduction 2015–2030


    Proportion of local governments that adopt and implement local disaster risk reduction strategies in line with national disaster risk reduction strategies


    Integrate climate change measures into national policies, strategies and planning


    Number of countries with nationally determined contributions, long-term strategies, national adaptation plans and adaptation communications, as reported to the secretariat of the United Nations Framework Convention on Climate Change


    Total greenhouse gas emissions per year


    Improve education, awareness-raising and human and institutional capacity on climate change mitigation, adaptation, impact reduction and early warning


    Extent to which (i) global citizenship education and (ii) education for sustainable development are mainstreamed in (a) national education policies; (b) curricula; (c) teacher education; and (d) student assessment


    Implement the commitment undertaken by developed-country parties to the United Nations Framework Convention on Climate Change to a goal of mobilizing jointly $100 billion annually by 2020 from all sources to address the needs of developing countries in the context of meaningful mitigation actions and transparency on implementation and fully operationalize the Green Climate Fund through its capitalization as soon as possible


    Amounts provided and mobilized in United States dollars per year in relation to the continued existing collective mobilization goal of the $100 billion commitment through to 2025


    Promote mechanisms for raising capacity for effective climate change-related planning and management in least developed countries and small island developing States, including focusing on women, youth and local and marginalized communities



    Number of least developed countries and small island developing States with nationally determined contributions, long-term strategies, national adaptation plans and adaptation communications, as reported to the secretariat of the United Nations Framework Convention on Climate Change

    Name Description

    Research: the interlinkage of climate risks - mental health - water insecurities / water-related disasters (e.g., support systems, epidemiological landscape, gaps/needs, communities, role of media, education in the different geographic regions.

    Capacity development: Develop tools for practitioners and educators; multi-stakeholder consultations, guidebook for media and knowledge disseminations

    Policy relevance: Policy recommendations, transition roadmaps

    Publication: We aim to disseminate via hosting events (side events at international conferences, webinars, etc.) and to publish ongoing projects and outcomes via reports, policy briefs, Op-eds articles, media outlets, scientific publications continuously.

    In-kind contribution
    The partners (especially academic partners) will contribute in the advancement of conducting research and disseminating knowledge, evidence and outcomes
    Staff / Technical expertise
    Relevant partners above will contribute their technical expertise to devote for the deliverables
    No progress reports have been submitted. Please sign in and click here to submit one.
    Action Network
    water logo
    20 March 2023 (start date)
    31 December 2028 (date of completion)
    United Nations University - MERIT (UNU-MERIT)
    1. Africa
    2. Europe
    3. Asia and Pacific
    4. North America
    5. Latin America and the Caribbean
    6. West Asia
    7. Global
    Other beneficiaries

    Local Government Units Healthcare service providers National or international DRR sectors Civil societies, IGOs, NGOs and NPOs, Donors, and other agencies Youth, children, schools, higher educational institutions Populations with vulnerabilities and inequalities (e.g., gender, age, displacement, socio-economic status, disabilities) Indigenous Peoples Local communities (under alternative learning systems)

    Website/More information
    Sao Tomé and Principe
    Sao Tomé and Principe
    State of Palestine
    State of Palestine
    Ibero-American Network of Life Cycle Assesment
    Contact Information

    Sanae Okamoto, Dr.