Climate change experiences among women with psychiatric illness - a qualitative exploration of lived experiences and service needs.

People with pre-existing psychiatric illnesses are recognized as a high-risk group in climate-health research, yet few qualitative studies explore their experiences. This study explored the gendered experiences of women with psychiatric illnesses in relation to climate stressors and identified the tailored supports they perceive as necessary to maintain their mental health and wellbeing. Between January and December 2025, 23 participants took part in four focus groups at an academic psychiatric hospital in Toronto, Canada. The study used a service-user-informed qualitative design in collaboration with people with lived experience, who contributed to developing the interview guide and interpreting the findings. Codebook analysis with an intersectional lens was applied to examine pathways linking climate stressors to mental health impacts and service needs in this under-studied population. Three main domains emerged: (1) mechanisms by which climate stressors exacerbate psychiatric symptoms, (2) how these impacts intersect with gendered roles and responsibilities, and (3) patient-identified priorities for climate-informed mental health interventions. Participants reported disrupted care, forced isolation, difficulties with medication adherence, strained communication with clinicians, and bidirectional interactions between physical and mental health. Women described reproductive guilt, caregiving burdens, reactivation of sexual trauma, and feelings of disempowerment. Participants identified actionable priorities, including accessible climate preparedness resources, clinician training, peer support spaces, and hospital-based programs fostering social connection and adaptive coping strategies. These findings reveal social and institutional pathways linking climate stressors to mental health risks, and provide guidance for gender-responsive, service-user-informed interventions to enhance resilience in the context of climate change.