BACKGROUND: A 2004 study showed adolescents living in rural Australia were aware of the impact of drought on self, family and community, but did not report levels of emotional distress higher than adolescents of similar age and gender in the Australian community. It was proposed that the rural lifestyle had helped adolescents build resilience for managing this environmental adversity. OBJECTIVE: To re sample adolescents from the same rural area and determine if this resilience remained after ongoing drought three years later. DESIGN: A mixed methods approach using focus groups and a self-report questionnaire. SETTING: Government Central Schools within the Riverina region of New South Wales. PARTICIPANTS: Male and female adolescents (n Euro Surveillance (Bulletin Europeen Sur Les Maladies Transmissibles; European Communicable Disease Bulletin) 111) aged 11-17 years completed the self-report questionnaires, while some adolescents (n Euro Surveillance (Bulletin Europeen Sur Les Maladies Transmissibles; European Communicable Disease Bulletin) 61) within this group also participated in focus groups. MAIN OUTCOME MEASURE: The Strengths and Difficulties Questionnaire and a Drought and Community Survey for Children comprised the self-report survey. RESULTS: Adolescents reported significantly higher levels of emotional distress than those in the previous study (t (191) Euro Surveillance (Bulletin Europeen Sur Les Maladies Transmissibles; European Communicable Disease Bulletin) 2.80, P < 0.01) and 12% of adolescents scored in the clinical caseness range. Thematic analysis showed consistency with the previous study as well as new themes of grief, loss and the impacts of global climate change. CONCLUSIONS: Results indicate a reporting of lesser well-being than was reported by a comparable group of young people four years earlier. A preventative intervention with a focus on family and community is recommended to address the mental health of adolescents enduring a chronic environmental adversity such as drought.