This chapter provides an overview of the situation of the 1.3 million Sudanese refugees in eastern Chad, who endure severe shortages of food, shelter, healthcare, and protection services. The ongoing crisis severely impacts mental health and psychosocial well-being, leading to an overwhelming demand for mental health and psychosocial support (MHPSS), services which are currently struggling with major funding shortages and capacity deficiencies. The chapter reviews earlier efforts undertaken by humanitarian organizations over the past two decades to integrate MHPSS into primary care and community services. Additionally, it describes new initiatives to strengthen MHPSS in Chad in sustainable ways. Drawing on both published academic literature and grey literature, such as reports by NGOs and UN agencies, the chapter highlights the challenges faced and the responses initiated to address these pressing issues.