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Overcoming social/cultural practices and beliefs in setting up a community mental health programme in a complex emergency: reflections arising from the work done by TPO in Somalia

Since the collapse of the central government of Somalia in 1991, large parts of the country have been in turmoil. Fighting, poverty, hunger and gender based violence have all contributed to high levels of mental and psychosocial problems. Excessive consumption of khat may also be a major contributor to mental health problems, specifically in men. In Somalia, few services respond to the needs of people with mental health problems. The nongovernmental organisation TPO Uganda used community support structures to increase access to, and delivery of, psychosocial support services, through local implementing partners, and the line ministries. This paper describes the steps to create a capacity building programme in an unstable and fragile context, with the aim of mainstreaming psychosocial support in public services.