This paper considers how climate change may affect rural Australian mental health. Rural Australians live with various systematic disadvantages and many feel marginalised; climate change, especially drought, has worsened this. With drier conditions and more sever droughts expected in much of southern and eastern Australia over coming decades, and the demands for change and adaptation that this will present, we urgently need to understand the likely consequences for the mental health and wellbeing of people in rural Australia. Existing knowledge can guide us through understanding likely mental health impacts of acute environmental events, such as natural disasters, but less is known about what chronic long-term environmental changes, such as drought, have brought in recent years. While we know how community and social factors affect mental health, and how best to help people cope with change or respond to health risks, we will need to apply such knowledge to this novel issue of climate change. In the expectation of more and generally worse adverse weather events, policy for rual mental health will need to (i) plan for consistent, long-term sustainability and adaptation, no reacting to each event as if it occurs in isolation, and (ii) be aware that social and ecnoomic factors -- which climate change will affect -- shape mental health.