By Koren Wetmore
After years of studying the environment’s impact on health, Jeremy Wortzel, MD’22, MPH’22, encountered something new: climate anxiety in children.
His fiancé, Lena Champlin, came home troubled about a conversation she had with a little girl while doing outreach work at the Academy of Natural Sciences of Drexel University. Champlin had asked the child what she knew about climate change. Before the girl could answer, her caregiver said, “Oh, no. We don’t talk about that.”
The exchange left Champlin, an environmental science doctoral student at Drexel, wondering whether she had done something wrong.
Wortzel assured her that she had not. Rather, the caregiver’s reply echoed his experience discussing difficult subjects in therapy sessions with parents and their children. “A parent will lean over and say, ‘We’re not talking about death or divorce’ because those are topics we tend to shield young people from,” he said. “But this time it was climate change.”
Then a third-year medical student at the Perelman School of Medicine (PSOM) who planned to specialize in psychiatry, Wortzel was intrigued. So he dug into the scientific literature and found that climate change not only proved hard to talk about but also created anxiety in children and adolescents. He further learned that few resources existed to guide age-appropriate conversations on the subject.
“The narratives around climate change traditionally places the entire burden on fixing the problem on the younger generation. We tend to say ‘my generation messed up, good luck fixing it,’” he said. “Lena and I wanted to reframe that to something more empowering.”
That goal led the couple to co-author a children’s book to help parents, teachers, and therapists have what they call ‘The Climate Talk’ with children.
Their book, Coco’s Fire: Changing Climate Anxiety into Climate Action, depicts the journey of a young squirrel named Coco. It addresses Coco’s fears about climate change, offers tips for reducing anxiety and suggests actions that even a young child can take.
Wortzel first began thinking critically about the health effects of a person’s environment – indoor, outdoor, and social – when still an undergraduate at Brown University. While there, he landed an internship with the Green & Healthy Homes Initiative, a nonprofit focused on creating healthy, energy-efficient homes for low-income and immigrant families. The work placed him in conversations with politicians, social workers, and physicians who sought to “use medicine to write prescriptions for healthy homes and communities.”
The experience inspired him to pursue an MD/MPH to better understand the connections intersecting psychiatry, social justice, and environmental health.
As a student at PSOM Wortzel did research on the relationship between socioeconomic disparity and asbestos exposure with the Center of Excellence in Environmental Toxicology. He also got involved with the Covenant House youth homeless shelter in Philadelphia, working with children who had been exposed to both chemical toxins and physical and emotional abuse.
“It showed me the incredible influence of environmental determinants on mental health as well as the power of resilience in young people. A young person could walk into the clinic burdened by their life experiences and through this magic of therapy – talking, listening, and seeing them as they are meant to be seen – they can begin to overcome and work through some of those traumas.”
In a similar way, Coco’s Fire provides another tool clinicians can use to help children overcome an environmental stressor, said Wortzel, who began his residency this summer in Psychiatry on the Child Track at Brigham and Women’s Hospital in Boston.
Collaborating creatively with his fiancé came naturally to Wortzel, who confesses their shared apartment displays many of the couple’s past craft projects.
It was the COVID-19 pandemic that altered their experience – for the better. Working remotely removed the time lost to commuting, giving them more time together. Plus, the book gave them the opportunity to create something positive together during a very challenging time.
“It was fun to see the different strengths we brought to it,” said Champlin. “Jeremy’s really good at seeing the big picture, whereas I’m often focused on the smaller details of executing a project.”
The process, however, evoked their own anxieties surrounding climate change.
“It’s an emotionally challenging topic, so it was essential to have a partner who inspires and supports you,” Champlin said.
It was also vital to consult with experts who could ensure their book’s content was developmentally and age appropriate.
The couple reached out to the Group for the Advancement of Psychiatry’s (GAP) Climate Committee, which agreed to collaborate with them on the project. Together with GAP’s team of mental health professionals and educators, they revised and shaped the manuscript.
“We thought a lot about the images used in storytelling, because they can influence climate fears or climate action,” said Champlin, who also illustrated the children’s book. “Many of the pictures associated with climate change focus on forest fires or show a lone polar bear stranded on an ice cap. These images increase fear in young children.”
They tested their materials using focus groups that included teachers, environmental scientists, therapists, parents, and their target market – children ages 6-10.
After an eighteen-month collaboration, they finalized their text and illustrations and published Coco’s Fire in October 2021. A majority of the sales proceeds (65 percent) will help support research on climate change and mental health – an area where Wortzel’s connections continue to deepen.
The project linked him to a vast network of professionals from GAP, the American Psychiatric Association, the Climate Psychiatry Alliance, and the American Academy of Child and Adolescent Psychiatry. These newfound colleagues expanded his knowledge, understanding, and passion for exploring the intersection of environmental science and health.
“For many years I felt alone in thinking about these more nuanced issues of mental health. Now I realize there’s a growing community of psychiatrists and pediatricians who care about how the environment shapes our health and development,” he said.
Coco’s Fire has received praise from a variety of readers. Parents, grandparents, and teachers have sent grateful email messages, along with photos of children reading the book. Members of the mental health community have lauded its value and welcome it as a much-needed resource for parents wanting to have ‘The Climate Talk’ with their children.
The power of this book is that it starts a dialogue,” said Wortzel. “One that will shape a future generation’s approach to addressing climate change.”