Mental health readiness as health security infrastructure: lessons from four African countries

Mental health and psychosocial support remain excluded from many emergency preparedness frameworks despite predictable psychological consequences of crises. This commentary presents four policy examples from African health systems arguing that mental health readiness should function as core health security infrastructure. Sierra Leone embeds mental health professionals in emergency governance; Liberia designates psychotropic medicines as essential with buffer stocks; Uganda deploys community health workers trained in mhGAP-HIG with supervision during floods; Ethiopia integrates mental health screening into chronic disease pathways. We outline a four-part implementation framework: year-round preparedness, activation within 72 hours, structured supervision during weeks one through eight, and equity safeguards. Mental health readiness stands as essential infrastructure comparable to vaccines and surveillance systems.