While working for an international humanitarian organisation in the Sudanese refugee camps at the Chad border, British child psychiatrist Lynne Jones kept a personal diary. In this diary, she reflects on the practical challenges and moral dilemmas facing a mental health practitioner working in this difficult context.

Keywords: Chad, ethics, mental health care, people with severe mental disorders, Sudanese refugees

(In order to protect confidentiality, personal details of agencies, colleagues and patients have been altered.)

This concluding paper of the Intervention Special Issue on integrating mental health care into health systems during and after complex emergencies summarises the main findings and conclusions of each of the programmes presented. This paper further integrates these findings into a common framework in order to extract key factors and recommendations on actions that can be taken, and those to avoid, to enable humanitarian emergencies to be transformed into opportunities in the psychosocial field.

In 2000 the nongovernmental organisation (NGO) HealthNet TPO started mental health and psychosocial support services in Burundi, a country that has been severely affected by civil war. Within a time frame of eight years, a wide range of mental health and psychosocial services were established, covering large parts of the country. During the programme period the NGO activities shifted from the delivery of direct services to capacity building activities aimed at embedding psychiatric services and psychosocial assistance within existing local health services and social systems.

In 2008, the local nongovernmental organisation TPO Uganda and the Uganda Ministry of Health began a project aimed of improving the availability of mental health services in three districts in Northern Uganda.