Climate change is now recognised as contributing to an increasing number of emergencies globally, which are having substantial effects on mental health and wellbeing of affected populations. In this report, we give case studies of mental health and psychosocial support (MHPSS) activities linked to climate change-related emergencies in Bangladesh, Burkina Faso, Madagascar, Nigeria, Sierra Leone and Zimbabwe. The emergencies range from floods and cyclones to drought and food scarcity, often in complex humanitarian settings including conflict affected regions. A range of activities, based on the Inter-Agency Standing Committee Guidelines for MHPSS in emergency settings, are discussed, many of which also focus on inclusion of people with disabilities. These include preparedness and resilience building as well as responses such as provision of basic needs, strengthening community capacity to provide psychosocial support and mental health system strengthening. We conclude that meeting basic needs is an essential prerequisite to address mental distress, that MHPSS is an essential component of any climate change-related response, that advance preparedness and adaptation is a good investment, and that meaningful participation of people in the global South, particularly marginalised communities such as people with disabilities and the very poor, is essential for the transformative change needed in addressing climate change.