ABSTRACT Climate-induced health hazards are increasingly evident and frequent, with mental health emerging as a critical concern. Our study focuses on assessing mental health challenges related to climate variability in Northeastern Thailand. Using descriptive cross-sectional analysis and the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10), we analyzed mental health morbidity from 2018 to 2022. High average monthly temperatures exceeding 30°C and exposure to floods or droughts elevate the risk of mental health challenges. To address these risks, a holistic approach integrating Sustainable Development Goals and mental health initiatives is essential. This approach should prioritize understanding the impacts of climate change on the environment and human health. Supporting marginalized communities with indigenous knowledge and evidence-based programs can effectively prioritize sustainable mental health support, especially for vulnerable populations, fostering progress in human development and wellbeing.