The quiet toll of climate extremes

Written by Suryaprabha Sadasivan for The New Indian Express

This year hasn’t given people much of a breather. A punishing summer rolled straight into a relentless monsoon, and many families have lurched from coping with extreme heat to mopping up after floods. We count lives lost and homes damaged, as we should. But we rarely make space for the quieter toll—anxiety, sleeplessness, trauma, and the long shadow these events cast on people’s ability to study, work, and rebuild their lives.

The summer of 2025 was one of the harshest on record for India. The Lancet Countdown warns that Indians are exposed to hundreds of hours of heat stress annually, and doctors across India reported spikes in psychiatric emergencies, sleep disorders and confusion during the peak heatwave. Even the ministry of earth sciences has acknowledged symptoms such as anxiety, palpitations, and behavioural changes linked to extreme temperatures, showing that the mental health toll of heat is no longer invisible.

Then came the rains. By early September, all-India monsoon rainfall was nearly 8 percent above normal, which is good for reservoirs but was marked by an erratic intensity. In many places, the rains arrived with cloudbursts, floods, and landslides that uprooted families, especially the poorest in low-lying settlements or on unstable slopes.

While the national numbers for 2025 are being compiled, last year offers a perspective: 5.4 million disaster displacements through 2024, including 2.4 million due to monsoon floods. Displacement is not just physical movement; it is psychological dislocation that can linger for years. Research after floods in Uttarakhand, Kerala and Assam found consistently high prevalence of posttraumatic stress, depression, and anxiety among survivors, often persisting long after the waters recede.

Yet, when we look at policy, heat and mental health continue to move in silos rather than converging. Heat action plans, now numbering more than a hundred across states, districts and cities, have saved lives through early warnings, work-hour advisories and hydration support. But reviews highlight weak localisation, unclear funding, and the absence of mental health considerations.

At the same time, India has expanded access to mental healthcare. Tele-MANAS, launched in 2022, has fielded over 2 million calls across 36 states and Union territories. The district mental health programme operates in more than 700 districts, offering a platform on which climate-linked stress could be integrated without creating a new structure.

The national guidelines on psychosocial support in disasters were updated in 2023, urging integration of such care into disaster systems. Civil society has contributed to NGOs in Kerala and Assam, which have piloted community-based interventions after floods, working with schools, women’s groups, and youth clubs. These examples show that India has assets to build on. The challenge is that they remain scattered and disconnected from climate resilience frameworks.

That disconnection is precisely what needs to be addressed. Heat action plans and disaster management plans should be expanded to include modules on psychosocial support. These can set out simple protocols for frontline workers— ASHAs, anganwadi workers, teachers, panchayat members, and relief volunteers to recognise distress, offer psychological first aid, and refer cases onwards to formal care. Training people in these skills before each summer or monsoon season is inexpensive, yet it can make a measurable difference to recovery.

Equally important is the creation of data systems that capture climate-linked stress. Currently, Tele-MANAS does not enable counsellors to tag calls related to heat or flood trauma. Adding such categories would, over time, build a map of where distress spikes after extreme events, helping authorities deploy resources where they are most needed. Without such information, planning remains blind to one of the most pervasive effects of climate extremes.

Preparedness must also extend to adolescents. Evidence shows that young Indians carry a heavy psychological burden after disasters if support is delayed. Schools, therefore, should be part of recovery strategies, offering group sessions that help normalise reactions, rebuild routines, and identify students who need specialised care. This is not about labelling every emotional response as a disorder, but about ensuring that distress does not harden into long-term damage.

Another critical gap is resources. Psychosocial care often slips off the priority list during budget allocations. Creating a dedicated budget line for mental health within climate and disaster resilience plans would signal seriousness and ensure continuity. Linking relief and livelihood support with mental health outreach can also help, since financial stress is often the most powerful trigger of psychological distress after a disaster.

India does not need to reinvent the wheel. The foundation is already established. What is required is a deliberate effort to link these pieces together under one climate-resilience agenda. If that happens, the country will be able to move beyond merely counting lives saved from heatstroke or houses rebuilt after floods, to also ensuring that survivors can sleep, work, study and hope without carrying the silent weight of unaddressed trauma.

Suryaprabha Sadasivan | Senior Vice President, Chase Advisors

(Views are personal)