Community Mental Health Service Weather-Triggered Outreach Rescheduling and Missed Depot Injections in Drought-Affected Kenyan Catchments: A Target-Trial Emulation of Climate Exposure

Drought in Kenya's arid and semi-arid catchments disrupts the community outreach visits through which many patients with severe mental illness receive long-acting injectable antipsychotics. The mean temperature was 18.914 °C (SD 3.107) and the warming trend was 0.2001 °C per decade. The framework specifies eligibility, treatment strategies, assignment, time zero, follow-up, outcome, causal contrast and analysis plan, and it identifies the assumptions under which a catchment-level emulation would recover a causal effect. The contribution is a transferable design that makes climate exposure an explicit, auditable treatment strategy in community mental health services research rather than an unmodelled contextual nuisance.