Occupational therapists must embrace rapid change for a sustainable future

Almost 3 years ago, I wrote an editorial for the British Journal of Occupational Therapy urging occupational therapists to join the fight against climate change (Reagon, 2020). Since then, so much has happened. Covid-19 has swept through the world, wreaking havoc, breaking into communities and families, reminding us of both our fragility and resilience. Then, just as some of us were finding our feet again, Russian troops invaded Ukraine. World events have thrown us on a rollercoaster of uncertainty, despair, and, now and again, such as in the advancements made by medical science in response to the pandemic, glimmers of hope.

Meanwhile, the threat created by global warming has edged ever closer, ever more deadly. We now know unequivocally that human activity has led to unprecedented rates of climate change and that this affects all regions of the earth (IPCC, 2021). We also know that the health consequences of global warming (cancer, asthma, dehydration, anxiety, depression and disease and illness resulting from droughts, floods and human displacement, etc.) are dire and will become more so as our planet warms (Romanello et al., 2021). Those living in developing countries or with existing disadvantages are likely to feel these effects more keenly, but the responsibility lies with all of us. What we do in our corner of the world has global effect (Dobson et al., 2021; Romanello et al., 2021; Watts et al., 2018; World Health Organisation, 2021).

Over the last 2 years, we have learnt something else about the human condition. Unless the threat is immediate and obvious – as in the Covid-19 pandemic – we can be remarkably complacent. However, it is clear we need to change in order to safeguard our future and the future of our planet. The UN Climate Change Conference in 2021, COP26, launched the health programme including initiatives to build climate resilient, low carbon, sustainable health systems. It also urged healthcare professionals to be advocates for sustainable change (World Health Organisation, 2021, 2022).

In the UK, the National Health Service has pledged to reach net-zero carbon dioxide emissions by 2045 (NHS, 2020; Tennison et al., 2021). A 100 years since the end of the Second World War, the significance of this date is not lost. In 1945, occupational therapists were continuing their heroic effort to rehabilitate veterans with physical and, somewhat less so, mental health disabilities resulting from 6 years at war; it was a golden opportunity to demonstrate the transformative power of occupation. As today, occupational therapists in 1945 sat outside of the dominant medical model, using creativity to rehabilitate the wounded (Holder, 2001).

Today, this creative, alternative thinking is needed more than ever before. Diaz and Richardson (2021) argue that occupational therapists are uniquely placed to address the challenges of climate change due to their existing focus on behaviour change, healthy and often greener occupations, community level advocacy and focus on prevention. In my last editorial, I urged occupational therapists to lead by example, living greener lifestyles, and incorporating sustainable principles into their practice, lobbying ministers, joining the global call to do more to tackle the threat to our planet. These things still stand, but now we need to multiply our efforts. Many consider the targets set by global leaders too little too late (Climate Crisis Advisory Group, 2022). The threat is not going away, but we have the power to do something about it. Occupational therapists have already demonstrated that they are creative problem solvers, able to think outside the box (Schmid, 2004). Let us harness this strength for a sustainable future.

We need to be incorporating sustainability into everyday practice rather than adding it to the end of our exhausting To-Do Lists. Everything we do, every occupation we endorse, should be processed through an environmental lens. Are we using our resources wisely? Are we advocating greener lifestyles? Are we helping our communities develop in a sustainable way? Are we calling for greener spaces and universal access to greener occupations? Are we running our services in the most sustainable way possible? Are we shouting loudly enough about the link between health, occupation and greener living?

For many years, the Royal College of Occupational Therapists used the phoenix logo, the bird born again from the ashes of the fire. The rebranding initiative likewise offers a transformative message to ‘rise up, build up, lift up and open up’. Many occupational therapists around the world also associate their profession with the colour green. With the world ‘burning’ and the very-pressing need for sustainable living, these symbols of our profession are profound.

Rapid action needs to be taken now if we are to meet the ambitious targets set by world leaders. We have a responsibility to our planet, humanity and the health of all whether near or far. Collectively as occupational therapists, as the popular adage goes, let us be on the right side of history.