The toll of the cyclone: mental health impacts of tropical cyclones in coastal communities of India.

With extreme weather events growing in severity and frequency, interventions aimed at preventing associated health disorders in coastal communities have become salient. Coastal communities are expected to develop coping mechanisms to climate change related stressors. However, these frontline communities may need special assistance to effectively adapt to unprecedented climatic disasters. Existing infrastructure and policy support systems may be inadequate, resulting in residual vulnerabilities that require attention. We examine whether tropical cyclones inflict adverse mental health impacts on coastal communities, and if the negative effect is disproportionately greater in coastal areas relative to non-coastal and coast-adjacent areas. We leverage the landfall and inland penetration of cyclones in India between April 2018-March 2023, and a novel dataset of select mental disorder treatment medicine sales across districts over the five-year period to analyze the cyclone-effect using district-year panel data. We use autoregressive distributed lag (ARDL) models with fixed effects to control for unobserved location-specific and time-specific factors affecting aggregate mental health status at the district level. Our findings suggest that cyclone occurrence negatively affects the mental health of communities in coastal districts, with 144% higher sales in that year; the one-year lagged effect is stronger at 173% higher sales than the contemporaneous effect, and the effect weakens over time. We do not find any statistically significant cyclone-effect in non-coastal districts. The cyclone-effect on coast-adjacent districts appears after a longer lag. Coastal communities already face relatively greater climate risks; our study highlights the additional burden of mental health challenges and calls for greater planning and policy attention to mental health to build resilient communities.