[Paper Review] Temperature and Mental Health: Evidence from Helpline Calls

Benedikt Janzen|arXiv (Cornell University)|Jul 11, 2022

Psychological and Temporal Perspectives Research4 citations

TL;DR

This study uses administrative data from nearly 500,000 anonymous helpline calls in Germany to show that extreme temperatures significantly increase demand for mental health support. It finds that call volumes rise by 3.4% on days above 25°C and 5.1% on days below 0°C, with hotter days reducing call duration, highlighting temperature as a key environmental stressor on mental well-being.

ABSTRACT

This paper studies the short-term effects of ambient temperature on mental health using data on nearly half a million helpline calls in Germany. Leveraging location-based routing of helpline calls and random day-to-day weather fluctuations, I find a negative effect of temperature extremes on mental health as revealed by an increase in the demand for telephone counseling services. On days with an average temperature above 25°C (77°F) and below 0°C (32°F), call volume is 3.4 and 5.1 percent higher, respectively, than on mid-temperature days. Mechanism analysis reveals pronounced adverse effects of cold temperatures on social and psychological well-being and of hot temperatures on psychological well-being and violence. More broadly, the findings of this work contribute to our understanding of how changing climatic conditions will affect population mental health and associated social costs in the near future.

Motivation & Objective

• To assess the causal impact of ambient temperature on mental health using real-time, high-resolution administrative data.
• To address the gap in causal evidence linking temperature extremes to mental health outcomes beyond clinical or self-reported measures.
• To examine heterogeneity in effects across age, gender, and call topics to identify vulnerable groups and mental health dimensions most affected.
• To explore whether temperature influences not only the volume but also the intensity (duration) of help-seeking behavior.

Proposed method

• Leverages location-based routing of helpline calls to link each call to its corresponding regional counseling center and local weather data.
• Employs a difference-in-differences approach with fixed effects for counseling centers, days of the week, months, and holidays to isolate temperature effects from confounding factors.
• Uses random day-to-day weather fluctuations as an instrumental variable to identify causal effects of temperature on helpline usage.
• Applies nonlinear temperature dummies (e.g., <0°C, 0–5°C, 5–10°C, etc.) to capture non-linear relationships between temperature and mental health demand.
• Analyzes call duration as a proxy for counseling intensity, using a linear model with temperature as a continuous predictor.
• Conducts mechanism analysis by classifying calls into topics (e.g., social well-being, psychological well-being, violence) to identify pathways through which temperature affects help-seeking.

Experimental results

Research questions

• RQ1 What is the causal effect of extreme ambient temperatures on the volume of mental health helpline calls in Germany?
• RQ2 How do the effects of temperature on helpline usage vary by age, gender, and call topic?
• RQ3 Does temperature influence the duration of counseling sessions, and if so, what does this imply about help-seeking intensity?
• RQ4 What are the primary mental health domains (e.g., psychological well-being, social well-being, violence) most affected by temperature extremes?
• RQ5 To what extent do temperature-related changes in call volume and duration reflect shifts in time preferences or counselor behavior?

Key findings

• On days with average temperatures above 25°C, helpline call volume increases by 3.4% compared to mid-temperature days.
• On days with temperatures below 0°C, call volume rises by 5.1% compared to mid-temperature days.
• Call duration decreases by 0.3% for every 1°C increase in temperature, a statistically significant and robust finding.
• The adverse effects of cold temperatures are most pronounced on social and psychological well-being, while hot temperatures primarily affect psychological well-being and violence-related concerns.
• The increase in call volume on extreme temperature days is driven mainly by calls related to social well-being, psychological well-being, and violence.
• The study finds no evidence that shorter call durations are due to caller impatience, but acknowledges the possibility of temperature effects on counselor performance.