ABSTRACT
On 25 April 2015, an earthquake of magnitude 7.8 struck Nepal, which, along with the subsequentaftershocks, killed 8897 people, injured 22 303 and left 2.8 million homeless. Previous efforts to provideservices for mental health and psychological support (MHPSS) in humanitarian settings in Nepal have beenlargely considered inadequate and poorly coordinated. Immediately after the earthquake, the Governmentof Nepal declared a state of emergency and the health sector started to respond. The immediate responseto the earthquake was coordinated following the Inter-Agency Standing Committee (IASC) cluster approach.One month after the disaster, integrated MHPSS subclusters were initiated to coordinate the activities ofmany national and international, governmental and nongovernmental, partners. These activities were largelyconducted on an ad-hoc basis, owing to lack of focus on MHPSS in the health sector’s contingency plan foremergencies. The mental health subcluster attempted to implement a mental health response accordingto World Health Organization and IASC guidelines. The MHPSS response highlighted many strengths andweaknesses of Nepal’s mental health system. This provides an opportunity to “build back better” throughreform of mental health services. A strategic response to the lessons of the 2015 earthquake will deliver bothimproved population mental health and increased preparedness for the future
