Mental Health

They are all inter-related, like a cycle: an exploratory qualitative study of climate change, chronic stressors and mental health among displaced populations on the Thailand-Myanmar border.

TL;DR

In this conflict-affected, resource-constrained setting, climate change was rarely raised spontaneously as a life stressor, but may act as an indirect stressor through its impacts on livelihoods and exacerbation of structural precarity.

Key Findings

Climate change was rarely raised spontaneously as a life stressor among displaced migrant populations on the Thailand-Myanmar border.

  • 58 participants took part across eight focus group discussions (FGDs)
  • Participants were rural migrant populations including pregnant women, adolescents, agricultural workers and healthcare workers living in Tak Province, Thailand
  • Climate change was only discussed after direct prompts from researchers, not volunteered as a primary concern
  • Participants' narratives centered instead around stressors related to precarious legal status, financial insecurity and conflict-related trauma

Following direct prompts, participants described increasing exposure to extreme heat, flooding and environmental degradation that disrupted livelihoods.

  • Climate-related experiences included extreme heat, flooding, and environmental degradation
  • These climate phenomena were described as disrupting livelihoods and exacerbating existing hardship
  • Climate change was perceived as an indirect rather than primary stressor, operating through its effects on economic and livelihood conditions
  • Against a backdrop of acute legal and economic stressors, climate-related distress was not perceived as the most pressing concern

The multiple stressors participants described interconnected to form a complex web of challenges affecting mental health.

  • Stressors included precarious legal status, financial insecurity, and conflict-related trauma
  • These stressors were described as inter-related and mutually reinforcing, described by participants as 'like a cycle'
  • Migrants and refugees experience multiple intersecting vulnerabilities including conflict, poverty and limited access to healthcare
  • Climate change, displacement, poverty and mental health were found to be inter-related challenges requiring integrative responses

The study used an exploratory qualitative design with thematic analysis of focus group discussions among four distinct participant groups.

  • Participant groups included pregnant women, adolescents, agricultural workers, and healthcare workers
  • FGDs were audio-recorded, translated and analyzed thematically
  • The study was conducted in Tak Province, Thailand, on the Thailand-Myanmar border
  • Total sample was 58 participants across eight FGDs

The authors concluded that addressing inter-related challenges requires integrative, climate-sensitive and migrant-inclusive health policies and care.

  • The study identified a need for policy approaches that simultaneously address climate change, displacement, poverty and mental health
  • Climate-sensitive health policy was identified as necessary given the indirect pathways through which climate change affects mental health in this population
  • Migrant-inclusive approaches were highlighted given the disproportionate vulnerability of migrant and refugee populations
  • The Global South and marginalized populations were identified as experiencing disproportionate impacts of climate change

What This Means

This research studied how displaced migrant communities on the Thailand-Myanmar border perceive climate change and its effects on their mental health. Researchers held group discussions with 58 people from four groups — pregnant women, teenagers, farm workers, and healthcare workers — living in Tak Province, Thailand. The key finding was that when participants talked freely about what stressed them, climate change almost never came up on its own. Instead, people focused on more immediate worries: fears related to their uncertain legal status as migrants, financial hardship, and trauma from conflict in Myanmar. When researchers specifically asked about climate change, participants did describe real and worsening problems — more intense heat, flooding, and damage to the natural environment — but these were understood mainly through how they made existing economic hardships worse, for example by destroying crops or making outdoor work dangerous. Rather than seeing climate as a separate crisis, participants experienced it as one thread in a tightly woven web of difficulties that all made each other worse, which is what inspired the study's title about challenges being 'inter-related, like a cycle.' This research suggests that for people already dealing with extreme poverty, displacement, and conflict, climate change may not feel like a distinct or primary threat — even when it is genuinely worsening their lives through indirect pathways like lost income and food insecurity. This has practical implications for how climate health programs and policies are designed: rather than treating climate change in isolation, approaches that also address legal protections for migrants, economic security, and trauma care may be more effective and relevant for vulnerable populations like those studied here.

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Citation

Fellmeth G, Thwin M, Aung J, Nosten S, Wai N, Nosten F, et al.. (2026). They are all inter-related, like a cycle: an exploratory qualitative study of climate change, chronic stressors and mental health among displaced populations on the Thailand-Myanmar border.. Frontiers in public health. https://doi.org/10.3389/fpubh.2026.1846043