Climate Change — Eco-Anxiety in Young Patients

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• Eco-anxiety is not in DSM-5 as a standalone diagnosis, but it is a recognised psychological response to climate change — particularly among young people and Indigenous communities whose cultural identity and livelihood are tied to the natural world. The APA has published reports on the mental health impacts of climate change, and NZ has significant literature on the psychological effects for Māori. This is a real and valid clinical presentation; name it clearly and without minimising it.
• For this patient, the climate anxiety is not abstract — it is tied to a specific place (her marae), specific relationships (her whānau), and specific practices (mahinga kai, food gathering). This is layered grief: potential loss of home, cultural identity, and ancestral connection simultaneously. Acknowledging this specificity — 'It sounds like you're grieving something that's not fully lost yet but that you can see coming' — validates the experience precisely and shows genuine cultural understanding.
• Clinical responses: validate the feeling (it is a rational response to real evidence), explore coping strategies (involvement in kaitiakitanga activism as protective agency, connection with climate-engaged communities), assess for clinical depression separately (she may have both eco-anxiety and depression), refer to a counsellor with environmental/cultural competence if available. Do not minimise, do not over-medicalise, and do not offer false reassurance that climate change will be solved.