Intensified fighting and insecurity in Damascus has limited the ability of the Iraqi refugees, displaced Syrians, partners and staff to physically access many of the fixed facilities offering mental health and psychosocial services. Those that do, have to travel substantial distances through checkpoints and ‘hot areas’. However, before the conflict in 2011, UNHCR Syria was already in the area, operating a comprehensive mental health and psychosocial support programme for Iraqi refugees, building on the resources and capacities of the refugee population.