People with severe mental disorders are a neglected and vulnerable group in complex emergencies. Here, we describe field experiences in establishing mental health services in five humanitarian settings. We show data to quantify the issue, and suggest reasons for this neglect. We then outline the actions needed to establish services in these settings, including the provision of practical training, medication, psychosocial supports, and, when appropriate, work with traditional healers.

This special edition of Intervention is dedicated to applied research in the field of mental health and psychosocial wellbeing. Here ‘applied’ refers to research useful in programme design, monitoring and evaluation. The issue focuses on disasters and complex emergencies, because conducting research and interventions under these conditions is one of the field’s major challenges.

The IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings were helpful in organizing mental health and psychosocial support services for Burundians who were expelled from Tanzania. Key aspects of the guidelines were the restoration of social support for people in acute distress, the use of Psychological First Aid, and the provision of care for those with pre-existing mental health problems.

War, civil war and other political violence often revisit countries after brief periods of ‘peace’ or armistice. Some countries are ravaged by multifarious violent conflict during two to four decades. Many cease-fires and peace agreements do not cure the underlying social pathology which led to the bloodshed in the first place. I started this study to explore how a country which has gone through civil war might be helped to avoid the next war.