**Background:** Climate change-induced displacement is a growing public health crisis in low-income coastal nations. Mozambique’s coastline is highly vulnerable to cyclones and sea-level rise, but the mental health consequences for displaced populations are not well understood.

**Purpose and objectives:** This study investigated the prevalence and key determinants of psychological distress among individuals displaced by climate-related events in selected coastal communities of Mozambique.

**Methodology:** A cross-sectional, mixed-methods design was employed. Quantitative data were collected via structured interviews, including the Kessler-10 (K10) scale, from a randomly sampled 412 adults displaced between 2021 and 2025. Concurrently, 32 in-depth qualitative interviews explored lived experiences. Data collection occurred in six coastal districts across three provinces from March to August 2025.

**Findings:** Quantitative analysis revealed a high prevalence of moderate to severe psychological distress, with 68% of participants scoring above the K10 clinical threshold. Qualitative data identified three predominant themes driving distress: profound grief over lost livelihoods and ancestral land, pervasive insecurity regarding future shelter, and weakened community support structures following displacement.

**Conclusion:** Climate-related displacement in Mozambique is strongly associated with a significant mental health burden. The distress extends beyond the immediate shock of the event, encompassing ongoing stressors related to livelihood loss and an uncertain future.

**Recommendations:** Integrate mental health and psychosocial support into national climate adaptation and disaster response frameworks. Develop community-led, culturally appropriate interventions that address both material insecurity and psychological trauma.

**Key words:** climate change, displacement, mental health, psychological distress, Mozambique, coastal communities

**Contribution statement:** This research provides the first district-level, mixed-methods evidence quantifying and contextualising the mental health impact of climate displacement in Mozambique between 2021 and 2025, informing urgent policy and intervention development.