The massive influx of Iraqi refugees into Syria in 2006put an immense strain on the already underresourced mental health sector. This prompted a consortium of international agencies to create an Interagency Working Group (IAWG) in 2008, with the goal of national capacity building This Interagency Working group merged into a National Advisory Board that included the Syrian government. An integrated one-year master training programme for mental health professionals was designed.

The recent earthquake in Haiti exposed all the weaknesses in the mental health care system existing prior to the earthquake. This paper describes the strategy developed by the Dutch nongovernmental organisation Cordaid for providing integrated mental health and psychosocial support in Haiti after the earthquake. The strategy aimed to address mental health and psychosocial needs in the early recovery and reconsolidation phases, and to build mental health capacity of community level and primary health care providers.

Complex humanitarian emergencies, whether arising from armed conflict or natural disaster, challenge the mental health system of a country in many ways. Not least because they increase the risk of mental disorder in the population, and undermine the pre-existing structures of care. They may, however, also bring new opportunities to create change. In this way, new structures and paradigms may emerge from the midst of a crisis. The probabilities for such a change to occur vary from one setting to another.

There is a growing recognition of the significant psychological and psychosocial damage caused by natural and manmade disasters. This phenomenon has increased the demand for trained professionals with the necessary skills to address these problems, in diverse populations around the world.