Unseen scars: Understanding the mental health burdens of climate change on indigenous and rural Peruvian women

Climate change is disproportionately affecting the mental health of marginalised populations, particularly women in the Global South. Peru, highly vulnerable to environmental hazards, presents a complex landscape where rural and indigenous women face intersecting ecological and social stressors. This study investigates the nexus between climate change impacts and mental health among underserved Peruvian women. It explores their coping mechanisms, community support systems, barriers to formal mental health services, and potential community-driven solutions. Between April and June 2022, we conducted 48 in-depth walking interviews with adult women from the Peruvian north coast, Amazon rainforest, and central and southern Andes regions. We recruited our participants using purposive and iterative snowball sampling, targeting key community informants. Data were analysed thematically. We identified six main themes: (1) Direct mental health impacts of climate change, manifesting as psychological distress and trauma responses; (2) Complex local issues, including gender-based vulnerabilities and male outmigration; (3) Indirect impacts through livelihood loss and food insecurity; (4) Community coping mechanisms, centred on women’s leadership and spiritual traditions; (5) Barriers to mental health support, including institutional mistrust and stigma; and (6) Community-based solutions emphasising culturally responsive interventions. Participants reported acute psychological responses to environmental disasters while demonstrating resilience through adherence to spiritual traditions and social networks, with women emerging as environmental leaders despite facing disproportionate climate-related burdens. This study emphasises the urgent need to integrate mental health considerations for rural and indigenous women into climate adaptation strategies in Peru. Climate change exacerbates social inequities, significantly impacting mental wellbeing through the erosion of traditional practices, particularly in Indigenous communities. Culturally responsive, community-based interventions that amplify women’s leadership and address structural barriers to mental health care are essential for inclusive, equitable climate solutions.