An international commission of more than 20 experts is calling on governments, city authorities and research funders to make brain and mental health a standard measure of environmental, urban and climate policy. The Earth Brain Health Commission also sets a goal for the next decade: no major environmental intervention should be planned or evaluated without considering its effects on mental health. Its report is published in Nature Mental Health.
The commission finds that climate and weather extremes, air and noise pollution, urban stressors, biodiversity loss and widening social inequality are associated with increased risks of anxiety, depression, trauma-related disorders and cognitive decline. These exposures rarely occur in isolation. They cluster in the same places and populations, and act together through biological, psychological and social pathways across the life course, from prenatal development through old age.
Crucially, the commission concludes that the main barriers to action are organisational and financial rather than a lack of evidence. The cohorts, earth-observation systems, analytical methods and policy tools needed to act already exist – but are maintained separately, while mental health is rarely measured where environmental decisions are made. The commission therefore frames its recommendations as concrete commitments.
The report is equally clear about what remains uncertain. Much of the evidence is still correlational, with the strength of findings varying across different exposures and populations. The causal pathways linking environmental changes to their effects are only partly understood. There is also a major geographical gap: much of the available data comes from high-income countries, while the most rapid environmental and urban transformations are taking place elsewhere.
“Environmental change is not only an ecological or economic problem. It reaches the brain,” said Professor Gunter Schumann, who chaired the commission. “The question is no longer whether the environment matters for mental health, but which specific exposures matter, for whom, at what stage of life, and which of them we can change. Our pledge is deliberately concrete: within 10 years, a government deciding whether to invest in a cooling programme, flood defences or a clean-air zone should be able to look at its own data and know what that decision means for the mental health of the people it serves.”
The burden falls unevenly. Children, older adults, people with disabilities, displaced populations and communities in low- and middle-income countries (LMICs) and small island developing states often face greater exposure while having fewer resources to adapt. The commission warns that interventions designed without attention to equity can deepen these inequalities: measures such as urban greening and cooling tend to reach better-resourced communities first, leaving those most at risk further behind.
The commission’s response is to direct action where the need is greatest and to set a concrete commitment for research: at least 30 per cent of the research it recommends should be led by LMIC and affected-community partners. It also calls for communities to help design interventions from the outset, before funding is released.
AHRI faculty member and mental health lead, Prof Xanthe Hunt, led the report’s ‘health’ theme. As part of this work, she led the group who synthesised findings on vulnerable populations, and evidence on interventions to reduce environmental risks in relation to mental health conditions.
“Across Africa, heat, pollution, extreme weather events, insecure housing, and limited access to mental health care don’t arrive one at a time. They land together on the same people, households, and communities all at once. For me, that clustering is a significant part of the climate and mental health story, borne out in the evidence we showcase in this commission. Studying exposures one by one, or designing interventions that assume they affect people in isolation, will consistently underestimate risk and harm, and also miss the people carrying most of it,” said Prof Hunt.
Among the commission’s eight commitments are a series of practical measures designed to turn evidence into action. From 2027, climate plans, environmental impact assessments and urban policies should include mental health indicators, with projects that omit them required to justify why. Existing population cohorts should be systematically enriched with environmental exposure data, rather than building new ones. Heat and air-quality early-warning systems should be linked to proactive mental-health outreach, using models with evidence of benefit.
AI-based risk prediction should be permitted only after published fairness and validation audits. Publicly funded greening investment should include participatory community use, with their impact assessed not only by the number of trees planted but also by measures of loneliness and belonging. Within five years, at least five countries should pilot well-being and planetary-health accounting alongside GDP.
Finally, the commission calls for an Earth–Brain–Health Research Fund and Global Observatory, operational by 2028, to track progress and report annually on each commitment.
“Climate services, early-warning systems and adaptation planning are already well established, but they were not designed with mental health in mind,” said Professor Jürg Luterbacher of Justus Liebig University Giessen, a commissioner and former director of science and innovation and chief scientist at the World Meteorological Organization. “Many of the measures that can protect mental health sit outside the health sector, in planning, housing, transport and environmental regulation. That is precisely why mental health needs to be part of how those decisions are assessed, and how their impact is reported.”
The commission brought together specialists in epidemiology, neuroscience, psychiatry, environmental and climate science, geography, social science, public health, ethics and digital innovation, from institutions in Europe, Asia, Africa and the Americas. Its assessment is a structured narrative synthesis, drawing on systematic reviews and meta-analyses where available, with qualitative appraisal of evidence strength, uncertainty, equity implications and implementation needs.
*Find the full article here: https://www.nature.com/articles/s44220-026-00737-y and the policy brief here: https://www.nature.com/articles/s44220-026-00750-1