Climatic shocks and environmental changes are increasingly recognised as one of the greatest threats to human health of the 21st century. Extreme weather, such as heatwaves, tropical cyclones, heavy rainfall, floods, wildfires and droughts, can trigger mental and physical ill-health. Individuals living in poor settings and rural areas are likely to be worst hit by these climatic shocks, given that many experience limited access to water, food and healthcare. Most studies that have examined the association between climate change and worsening mental health outcomes have been done outside the continent of Africa. But there is an urgent need to enhance our understanding using data from African settings who also experience climate change shocks. In a recent study my co-researchers from the Brain and Mind Institute and I sought nuanced insights on the effects of exposure to climate change shocks on depressive symptoms and suicidal thoughts. The site of study was the coastal Kilifi region, which is one of Kenya’s poorest areas. Between 2010 and 2022 this area frequently experienced drought, heatwaves and less rain. Flooding occurred in 2024, causing great human suffering. We focused on two population groups in Kilifi: women from informal rural slum-like households without running water and flushing toilets, and rural women from households with running water and basic amenities. This approach allowed us to delve deeper into the mental health effects of climate change in different socio-economic contexts. We focused on women because we could not get a decent sample size to capture the views of men, who often come home late owing to work-related duties.The findings show strong associations between climate shocks and detrimental mental health outcomes. For example, women from informal settlements experienced a 10.8 percentage point higher incidence of depressive symptoms compared to their counterparts in more stable rural areas. This mental health crisis has ripple effects, elevating instances of suicidal thoughts among women in already vulnerable communities.The intertwining of economic and environmental stresses heightens the urgency for action. In many rural areas of Kenya, women play a crucial role as the primary breadwinners for their families. These women engage in various income-generating activities, from farming to small-scale trade, contributing not only to their households but also to the broader community.However, the mental well-being of these women is often subjected to various shocks, such as economic hardships, social pressures, and a lack of support, leading to adverse effects on household stability. When women experience stress, anxiety, or depression, it can ripple through the family unit, affecting not just their health but also their ability to provide for and nurture their families. Climate shocks and mental health of womenResidents of Kaloleni and Rabai, where our study was centred, rely on informal subsistence agriculture for survival. The yield is low and erratic and does not contribute significantly to the local economy. The population is adversely affected by poor housing, overcrowding, and the lack of clean water, sanitation, and transport facilities. The area has a high unemployment rate and poorly equipped schools, all of which impede healthy community development.Here we sought to answer the following questions: What impact do climate shocks (less rain, more heat, drought) exert on the depressive symptoms and suicidal thoughts of these women? Are there regional differences in the impact of the climate shocks? How do climate shocks and high food prices put pressure on the mental health outcomes of these women?We employed a 15-item questionnaire to assess perceptions of rainfall patterns. This was complemented by meteorological data. The combined approach allowed us to analyse how variations in climate shocks might influence mental health outcomes, specifically depression and suicidal thoughts. We also applied a widely used questionnaire which assesses the presence and severity of nine common depression symptoms. Respondents are asked to rate how often they had experienced each symptom over the past two weeks, using a scale of 0 (not at all) to 3 (nearly every day). A total of 14,801 participants (each representing a household) completed the surveys and were included in the analysis. We can generalise from this sample.Data from the study highlights stark correlations between climatic conditions and mental health issues. A reduction in rainfall correlates with a 28.7% increase in suicidal thoughts, indicating the psychological burden that comes with uncertainty and loss of livelihood. Heat waves were shown to contribute to a 14.9% rise in suicidal thoughts. Drought conditions led to a 36.7% increase in suicidal thoughts. This suggests that the stressful nature of drought stoked a state of hopelessness.The cumulative effects of climate change and soaring food prices led to a staggering 48.3% increase in suicidal thoughts among the rural women from informal settings.What nextThe Kenyan government has been coordinating various stakeholders to address the impact of climate shocks. However, these efforts have not yet yielded meaningful practical programmes on the ground to assist vulnerable populations.Kenyan policymakers must develop and implement mental health services tailored to the needs of communities suffering from the repercussions of climate change. The provision of mental health services together with distribution of food, water, agricultural inputs and cash transfers in the aftermath of climate change-related shocks is recommended. This is done in countries such as India.The government must acknowledge both the physical and mental health effects of climate change.Addressing mental and emotional well-being is essential for building resilient communities that can withstand future climate shocks.Mental health support needs to be integrated into climate adaptation strategies. This could drastically improve the quality of life for vulnerable populations in Kenya. This might include initiatives that promote mental health awareness, provide access to mental health care, and create community support networks. By empowering women and fostering resilience within communities, Kenya can begin to mitigate the long-term impacts of climate change not only on the environment but also on the mental health of its citizens.Cyprian M. Mostert does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.