With humanitarian crises increasing worldwide, from conflicts, disasters and health emergencies, mental health and psychosocial well-being are under growing strain.
WHO’s Build Better Before initiative includes a series of innovative global capacity-building workshops coupled with multi-sectoral, full-scale field-based simulation exercises. The aim is to scale up mental health and psychosocial support (MHPSS) preparedness and response capacities. Nearly 300 humanitarian professionals, policy-makers and front-line responders from ministries, international and national NGOs and UN agencies from all six WHO regions participated.
The latest edition of the event took place in Ethiopia in May 2025, following previous editions in Estonia, Tunisia, and Türkiye. With European Union support, WHO partnered with the Government of Ethiopia and Africa CDC to conduct the four-day exercise. Africa CDC sponsored mental health leads from Member States in the African Region, bringing regional representation alongside participants from all six WHO regions to strengthen emergency readiness and decision-making.
“The EU supports the WHO Build Better Before initiative to prepare countries, humanitarian partners and communities for the mental health impact of different crises,” said Annick Villarosa, Acting Head of Unit – Humanitarian Aid Policies and International Humanitarian Law, EU Humanitarian Aid. “Following the full-scale simulations, WHO also provides dedicated, bilateral follow-up technical support to participating organizations to embed mental health and psychosocial support into their operational readiness plans, as a core humanitarian capacity.”
Impact in Ethiopia
Just five months after the training, the initiative has already strengthened Ethiopia’s MHPSS system, positioning it as a potential model for other countries in the region. “Partners in different parts of the country have started implementing preparedness activities such as capacity building and the mapping of resources for mental health prior to emergencies”, said Dr Medhin Selamu, Mental Health Lead for WHO in Ethiopia. “In the past preparedness for mental health was not common but now our preparedness is comprehensive.”
Several Ethiopian participants have already applied the training: EngenderHealth has educated teachers and community members on MHPSS and gender-based violence, organized Self-Help Plus sessions for adults in the Amhara region and partnered with the Addis Ababa Health Bureau to lead self-care and stress management sessions for 429 health professionals. “The technical follow-up by WHO provided strategic guidance for planning and implementation and helped standardize activities in our local context”, said Nahom Birru Jember from EngenderHealth.
MdM Ethiopia integrated Group Problem Management Plus in their MHPSS preparedness programme. “The knowledge, tools, and collaborative spirit from the Build Better Before initiative are guiding our efforts, ensuring our training and implementation are structured around an operational readiness framework rather than ad-hoc responses,” said Demeke Demilew from MdM Ethiopia.
Scaling up regional and global preparedness
.jpg "Confronted with dynamic scenarios mimicking real-life emergencies, participants performed technical tasks across various locations, including hospitals, schools, and civil defense facilities, to mirror office and field responsibilities.")
.jpg "The initial two days were dedicated to theory, enriched by hands-on, practical learning challenges demanding a multi-sectoral response")
.jpg "Bringing together 75 participants from 26 countries, the exercise aimed to enhance capacities of Member States and partner organizations in mental health and psychosocial support operational readiness.")
Participants from other countries and organizations report similar successes: Dr. Carol Labor, advisor to Africa CDC and head of the Mental Health Secretariat of Sierra Leone, established a coordination mechanism and assessed national preparedness to streamline MHPSS efforts.
Edo Lihic, Global Emergency Health Advisor at Malteser International, established a 23-member working group to develop a specialized MHPSS care team, launched monthly MHPSS case discussions, and integrated MHPSS into Malteser International’s Infection, Prevention and Control response mechanism.
Experts from the interagency MHPSS surge roster, hosted by the Netherlands Enterprise Agency, also participated. The programme coordinator noted: ”Practicing real-world scenarios allows our MHPSS roster members to gain hands-on experience and build operational readiness for short-notice deployments.” Dr Sarah Wilson, from Egypt highlighted: ”The simulation helped us explore ways of engaging stakeholders more meaningfully using language that resonates, mobilizes, and leads to action;” whereas Adib Asrori, from Indonesia, highlighted: ”As a humanitarian worker who started my career from scratch with a local NGO in Java, I have gained knowledge and experience related to humanitarian responses primarily through practical learning in the field over the years. The Build Better Before training was instrumental in providing a comprehensive framework for implementing the MHPSS programmes, especially in terms of concrete actions within the context of Disaster Risk Reduction.”
The World Psychiatry Association also participated, with Dr. Simon Stafrace reflecting: ”A key lesson I learned was about the value and adaptability of MHPSS. It is not a standalone response but rather embedded into every element of humanitarian work. For psychiatrists, this means recognizing that our role extends beyond diagnosis and treatment. We can contribute through capacity-building, supervision, systems leadership, advocacy, and coordination, alongside clinical care. Importantly, our work should support and not displace the critical contributions of community-based and psychosocial practitioners who are at the heart of disaster response.”
Continuing support and implementation
.jpg "Visits to diverse locations, like a field hospital, allowed participants to face actors and multidimensional scenarios designed for their learning.")
.jpeg "Throughout the exercise, participants engaged in numerous field visits, interacting with actual individuals as well as role-playing actors, including a visit to a firefighter station.")
WHO continues to provide ongoing technical support to past participants with the support of European Union, to ensure lessons learned are effectively implemented. Notable examples include:
– CBM Global, which developed strategic indicators to reinforce MHPSS integration in disaster risk management projects in high-risk areas.
– MdM France, which developed MHPSS disaster preparedness and response guidelines at a global level.
– TPO Nepal, which created a Standard Operating Procedure for MHPSS Disaster Management in local provinces.
– Plan International Ireland, which designed a community-based MHPSS scale-up initiative called Playful Minds for Wellbeing for children and staff in Cameroon and Egypt
– UNFPA, which conducted a comprehensive desk review of the MHPSS situation in Papua New Guinea.
According to the WHO Mental Health Atlas 2024, the Build Better Before initiative has had a measurable global impact: the share of Member States with MHPSS preparedness systems rose from 28% in 2020 to 48% in 2025. While the progress is impressive, continued collaborations, shared learnings and investment will be vital to maintain this momentum.
Watch the recap video of the event here.
Due to high demand, WHO is planning the next iteration of Build Better Before in December 2025.
Contact: Buildbetterbefore@who.int.