In the Courtroom, A Psychiatrist’s Perspective: Youth Take Case to Court to Protect Their Futures and Win

Psychiatric TimesVol 40, Issue 10

A psychiatrist shares her first-hand experience with the landmark case of Held v State of Montana.

courtroom psychiatry



I had the extraordinary opportunity to be in the courtroom in Helena, Montana, for the presentation of the first ever constitutional lawsuit in which youths sued for the right to a clean and healthy environment, Held v State of Montana. Sixteen young individuals from Montana put forward the legal claim that the state has violated their rights, caused injury, and threated their future well-being. The judge ruled in their favor.1

This historic first case is only one of several in the pipeline (pun intended) with youth flexing their legal muscles to challenge the government. Lawsuits in other states, including Hawaii, Utah, Virginia, and Florida, are in planning stages, and Juliana v United States, which has been in the courts since 2015, has gotten the green light to proceed to trial.2

Held v State of Montana is rooted in the revised 1972 Montana Constitution, in which an explicit right to “a clean and healthful environment for the present and future” was codified. The plaintiffs claimed that the Montana government has consistently promoted the extraction and burning of fossil fuels, despite available clean energy alternatives, and is thus causing harm to these youth and worsening the climate crisis. These young individuals brought their worries, fears, and hopes to public view as they told the judge—and the world—about the ravages of climate change and how it is damaging their health, families, and hopes for the future. The complaint focuses on 2 statutes: (1) provisions of Montana’s state energy policy, which explicitly promotes the use of fossil fuels, and (2) an amendment to the Montana Environmental Policy Act, which prevents the state from considering the impacts of climate change in the permitting process.

The Stories

Scholars, scientists, and policy makers, including a Nobel Peace Prize–winning climate scientist and psychiatrist, Lise Van Susteren, MD, cofounder of the Climate Psychiatry Alliance, testified about the anthropogenetic causes of climate disruption, climate change-induced adverse childhood experiences, and intergenerational injustices as well as the resulting psychiatric sequelae. Expert testimony presented evidence that was interspersed with testimonies from the plaintiffs, who shared how the climate crisis is affecting their lives.

The energy and enthusiasm were amazing. Each day the parade of plaintiffs accompanied by their legal team was cheered on by enthusiastic community supporters as they entered the courtroom. These young plaintiffs are a remarkable group; they are observant of what is happening in their world; they are articulate, active, and worried. They come from different parts of the state, with the youngest aged 5 years and the oldest aged 22 years. Except for the very youngest, whose parents joined for them, each plaintiff joined the case because of their direct experience with impacts of climate change on their lives and observations of what is happening to their families and beloved land.

I wish I could tell all of these young people’s stories, but here are a few examples:

  • Rikki Held, aged 22 years, for whom Held v State of Montana is named, told of working on her family’s ranch amid extreme heat and smoke. She held back tears when describing the droughts and floods that have damaged the ranch, killed their livestock, and threatened their home and livelihood. She has deep worries about her family’s future.
  • Sariel S., who is a member of the Confederated Salish and Kootenai Tribes said, “It is really scary seeing what you love disappear before your eyes.”
  • Badge B., who was named after a beloved family camping site, spoke of his grief when seeing this place turned to ashes after wildfires. The family will not return there.
  • Lander B. spoke of his special relationship with his father through hunting. His family relies on hunting as a winter food source, but the yield is markedly diminishing. Kian T. had a similar story about precious shared time with his father and the noted reduction of fish in the rivers.
  • The plaintiffs spoke of the loss of ability to be outdoors, depriving them of competitive sports, pleasure in nature, ways to manage their anxiety, and especially loss of family bonding through shared adventures.
  • Claire V. said, “When I think about summer, I think about smoke. It sounds like a dystopian movie, but it is real life.” Another said, “The smoke is just a really weird postapocalyptic experience…taking a pretty big toll on our happiness and comfort.” Mica K. said he felt trapped when unable to go outside for extended periods. Wildfires and smoke have become the new normal during summer months in Montana. The youth spoke of living with these conditions, including the asthma that many of them have developed, and the emotional toll on their lives—the terror and anxiety of packing up treasured belongings to prepare to flee their homes as wildfires raged nearby.
  • Claire V. was appalled that there was no funding for solar installation on a new school building, so she raised the funds to cover this.
  • Olivia V., a 20-year-old emerging artist, displayed a piece of her art that depicts her extreme grief, with rivers of tears flowing from the face of a woman. She described her lifelong desire to be a mother and how she is now conflicted about bringing a child into this world.

As the youth spoke, there were few dry eyes in the court. Our Children’s Trust is attuned to the emotional stress the plaintiffs are experiencing, the psychological challenge of publicly sharing their stories, and the stress of testifying.

Psychiatry in the Courtroom

The plaintiff’s case reached a crescendo with the final testimony of Van Susteren. She outlined the mental health toll of climate change on youth in general and on these specific plaintiffs. She spoke of how anxiety, depression, and loss of trust in elders has affected the normal development for youth. She toggled between presenting the science of published literature to providing vivid examples, often using the plaintiffs’ experiences, to drive home the emotional experience.

The State’s Defense

The first week was devoted to the plaintiffs’ case. The defense cross-examination focused on its claim that since Montana’s contribution to fossil fuel emissions pales in comparison with total global emissions, the state should not be held responsible for these activities.

By the beginning of the defense’s case, 2 expected defense expert witnesses who had previously been deposed had withdrawn from the trial. The only state experts were 2 administrators for the Montana Department of Environmental Quality, who claimed they can only carry out the law and follow procedural guidelines, which do not include considering climate change impacts. The final witness was Terry Anderson, an economist and senior fellow at Stanford University’s Hoover Institution in California who stated that Montana’s greenhouse gas emissions are so minor compared with the global numbers that they should not be considered. The plaintiff’s attorneys challenged his facts as incorrect and a misrepresentation of the reality. The defense rested their case within an hour of the second day. Much to the surprise of many of us in attendance, the conclusion felt like an unexpected fizzle.

Youth Holding On to Hope

The plaintiffs spoke of the hope that would be ignited if they were to prevail in this ruling: “Despair is defined as the lack of complete and utter hope. I have to find hope even in my despair, because no hope, and not looking for any hope, is too devastating. The flowers [depicted in my painting] are the hope that humans are resilient enough, nature is resilient enough, and we can and will work together to stop the climate crisis.” The plaintiffs hope this case has an impact beyond their state.

Outcome: The Ruling

On August 15, Judge Kathy Seely announced her decision ruling wholly in favor of the plaintiffs. She declared that given the state’s actions of systematically promoting fossil fuels and ignoring climate change, Montana had violated the plaintiffs’ constitutional rights and injured them by such actions.1

Concluding Thoughts

I feel enormously lucky to have been witnessed this historic trial and to have represented the voice of Climate Psychiatry Alliance as a supporter. But we cannot all be present in the courtrooms during these trials. We can show our solidarity by acting on the climate crisis in the many spheres of our influence. Consider joining Climate Psychiatry Alliance to follow updates and ways to engage, or advocate within the American Psychiatric Association for bringing the weight of our profession to various policy issues.

Dr Cooper is clinical associate professor in the Department of Psychiatry at the University of California, San Francisco. 


1. Selig K. Judge rules in favor of Montana youths in landmark climate decision. The Washington Post. August 14, 2023. Accessed August 18, 2023.

2. Juliana v. United States. Our Children’s Trust. Accessed August 18, 2023.

Related Videos
Dune Part 2
© 2024 MJH Life Sciences

All rights reserved.