People in many parts of the world, especially in poorer (developing) countries, subsist routinely from the lands they occupy and are often only partly within the cash economy. To such people, climate change is less of an economic challenge but rather an issue of survival. It is not something they believe can be overcome with money but rather solutions that assure livelihoods, especially food security. For this reason, the mental health challenges of climate change in such places are often fundamentally different to those in richer countries like Australia. Several studies by the authors (and other collaborators) are exploring these challenges in the Pacific Islands region. This report is from the Fiji Islands where, between 2008 and 2017, relevant data has been collected using semi-structured interviews (in preferred vernacular languages) and focus groups from forty-three rural communities throughout the archipelago. The researchers found that every community visited had witnessed environmental changes in recent years/decades that it regarded as anomalous. Common examples included shoreline recession, increased lowland flooding, uncertain seasons (and associated fruiting of wild plants). To understand the psychological impacts of these observations, we conducted several in-depth interviews and found that there are indeed high degrees of anxiety. Yet much comfort at an individual level is obtained from people’s spiritual beliefs and religious participation, while much resilience derives from confronting such challenges as a community rather than alone. These insights identify key directions for future research.