Climate change and mental health: A multinational study of climate-anxiety, coping, and psychosocial responses.

Background Climate change is an increasingly important determinant of global mental health, affecting emotional, cognitive, behavioral, and social functioning. The emergence of climate-anxiety and the unequal distribution of environmental risks highlight the need for cross-cultural evidence to inform equitable adaptation strategies.Aim To examine the psychological and functional impacts of climate change across diverse populations, focusing on climate-anxiety, emotional responses, coping strategies, and perceived psychosocial support within a geopsychiatry framework.Methods A multinational cross-sectional survey was conducted among 388 adults from 44 countries using the Hogg Climate Anxiety Scale (HCAS) and additional items on climate-related experiences, functional disruption, coping strategies, and access to essential resources. Data were analyzed using descriptive statistics, non-parametric tests, multiple linear regression, and thematic analysis of open-ended responses.Results Overall, 83.5 % of participants reported exposure to at least one extreme climate event in the past five years, most commonly heatwaves, floods, and severe storms. Climate anxiety differed by gender in affective symptoms, rumination, and personal impact anxiety (Kruskal-Wallis, p ≤ .007). Participants exposed to extreme events reported higher affective (p = .017), behavioral (p = .001), and personal impact anxiety (p = .045). The regression model explained 25 % of the variance in total HCAS scores (R² = 0.25, p < .001), with climate-related functional disruption as the strongest predictor.Conclusions Climate change is associated with substantial emotional and functional burden, particularly among vulnerable groups. Findings support integrating mental health screening and brief psychosocial interventions into climate adaptation policies, primary care, and community-based resilience programs.