Small island developing states (SIDS) have limited absolute resources for responding to national disasters, including health emergencies. Since the first confirmed case of COVID-19 in the Caribbean on 1st March 2020, non-pharmaceutical interventions (NPIs) have been widely used to control the resulting COVID-19 outbreak. We document the variety of government measures introduced across the Caribbean and explore their impact on aspects of outbreak control. Drawing on publically available information, we present confirmed cases and confirmed deaths to describe the extent of the Caribbean outbreak. We document the range of outbreak containment measures implemented by national Governments, focussing on measures to control movement and gatherings. We explore the temporal association of containment measures with the start of the outbreak in each country, and with aggregated information on human movement, using smartphone positioning data. We include a set of comparator countries to provide an international context. As of 25th May, the Caribbean reported 18,755 confirmed cases and 631 deaths. There have been broad similarities but also variation in the number, the type, the intensity, and particularly the timing of the NPIs introduced across the Caribbean. On average, Caribbean governments began controlling movement into countries 27 days before their first confirmed case and 23 days before comparator countries. Controls on movement within country were introduced 9 days after the first case and 36 days before comparators. Controls on gatherings were implemented 1 day before the first confirmed case and 30 days before comparators. Confirmed case growth rates and numbers of deaths have remained low across much the Caribbean. Stringent Caribbean curfews and stay-at-home orders coincided with large reductions in community mobility, regularly above 60%, and higher than most international comparator countries. Stringent controls to limit movement, and specifically the early timing of those controls has had an important impact on containing the spread of COVID-19 across much of the Caribbean. Very early controls to limit movement into countries may well be particularly effective for small island developing states. With much of the region economically reliant on international tourism, and with steps to open borders now being implemented, it is critical that the region draws on a solid evidence-base to balance the competing demands of economic wellbeing and public health.

The climate and ecological crisis will constitute the defining public health challenge of the twenty-first century, posing an unprecedented global threat to all determinants of health, and to healthcare delivery systems. We believe that mental health professionals have a crucial role to play in responding to this crisis. Whilst responding to the mental health consequences of the climate crisis will remain a key role for us as mental health professionals, we argue that our remit goes beyond this, and should include advancing public understanding of the climate crisis, highlighting its impact on physical and mental wellbeing, and advocating for systemic changes to limit its impending harms. This paper is an urgent call to action for all mental health professionals to take up a role in the context of the climate and ecological crisis. This paper will describe the relationship between mental health and climate change, and frame it within wider systemic and conceptual frameworks. It will demonstrate that as mental health professionals we are well placed to act as leaders of change—arguing that we have a duty to do so—and suggest actions that can be implemented depending on interests, skill sets and opportunities.

The aim of this paper is to share our experiences of engaging with the climate crisis as citizens and mental health professionals (MHPs). We hope the outputs will usefully validate the experiences of fellow MHPs and support them to reflect on their role in this crisis. We came together as eight MHPs, participating in group discussions and one-one interviews with the first author to reflect on our experiences. The collaboratively generated themes reflect how engagement with the crisis has: (i) disrupted our personal and professional experiences; (ii) helped us adapt and grow; and (iii) enabled us to live, work and act in more accordance with our values. A key reflection was that these experiences are not linear and we continue to wrestle with our responses to the climate crisis. Discussions also elicited visions of how mental health paradigms could be better adapted to meeting the escalating public health need that this crisis is generating. We conclude by advocating for MHPs to process and respond to the climate crisis and recognize that their skills can make a vital contribution to this global challenge.

As climate change continues unabated, research is increasingly focused on capturing and quantifying the lesser-known psychological responses and mental health implications of this humanitarian and environmental crisis. There has been a particular interest in the experiences of young people, who are more vulnerable for a range of reasons, including their developmental stage, the high rates of mental health conditions among this population, and their relative lack of agency to address climate threats. The different geographic and sociocultural settings in which people are coming of age afford certain opportunities and present distinct challenges and exposures to climate hazards. Understanding the diversity of lived experiences is vitally important for informing evidence-based, locally led psychosocial support and social and climate policies. In this Project Report we describe the design and implementation of the “Changing Worlds” study, focusing on our experiences and personal reflections as a transdisciplinary collaboration representing the UK, India, Trinidad and Tobago, Guyana, Barbados, the Philippines, and the USA. The project was conceived within the planetary health paradigm, aimed at characterizing and quantifying the impacts of human-mediated environmental systems changes on youth mental health and wellbeing. With input from local youth representatives, we designed and delivered a series of locally adapted surveys asking young people about their mental health and wellbeing, as well as their thoughts, emotions, and perceived agency in relation to the climate crisis and the global COVID-19 pandemic. This project report outlines the principles that guided the study design and describes the conceptual and practical hurdles we navigated as a distributed and interdisciplinary research collaboration working in different institutional, social, and research governance settings. Finally, we highlight lessons learned, specify our recommendations for other collaborative research projects in this space, and touch upon the next steps for our work. This project explicitly balances context sensitivity and the need for quantitative, globally comparable data on how youth are responding to and coping with environmental change, inspiring a new vision for a global community of practice on mental health in climate change.

Mental health professionals (MHPs) have roles supporting mitigation, preparation, and recovery in the global climate crisis. This commentary describes initiatives in the Caribbean to address climate-related threats to individuals and communities focussing on the role of MHPs in supporting community-based projects, regional public health disaster responses, and climate research.