EC Psychology And Psychiatry

Mental health services in Sudan face significant challenges due to decades of socio-political unrest, centralization of services, limited resources, and more recently, the impact of ongoing armed conflict. This study aimed to analyze the current state of mental health services in Sudan, assess the impact of conflict on service delivery, and identify strategic opportunities for improvement. A systematic situation analysis was conducted using the PRIME Situation Analysis Tool, alongside a review of policy documents, health system reports, and recent conflict data, to evaluate the integration of mental health into primary healthcare (PHC), infrastructure gaps, and governance challenges. Findings reveal severe disparities in mental health access, particularly in rural and conflict-affected areas, where health infrastructure destruction, professional displacement, and economic instability have further restricted service availability. Despite the Mental Health Act (2018) and structured psychiatry training programs, weak governance and high emigration rates among specialists have deepened the workforce crisis. Key strategies for strengthening the system include decentralization, task-shifting, PHC-based mental health integration, and community-driven interventions. Addressing stigma, gender-sensitive mental health services, and suicide prevention, along with sustainable financing, infrastructure investment, and international collaboration, is critical for long-term resilience. Sudan must prioritize policy enforcement, workforce retention, and post-conflict recovery planning to build an accessible, integrated, and sustainable mental health system capable of meeting the nation’s evolving needs.

 Keywords: Mental Health; Sudan; Health Systems; Primary Health Care; Policy Analysis; Decentralization; Task-Shifting; Armed Conflict; Health System Strengthening; Mental Health Integration

1. Ndetei DM., et al. “Traditional healers in East Africa: Socializing or psychologizing”. World Psychiatry 9.2 (2010): 93-94.
2. Okasha A. “Mental health in the Arab world: Challenges and prospects”. Eastern Mediterranean Health Journal 11.3 (2005): 354-367.
3. Sub-Saharan Africa: Regional Analysis 148 Regional Spotlight: From Global Jihad to Local Insurgencies: the Changing Nature of SubSaharan Jihadism 160 Country Profiles: Mali 166 Burkina Faso 172 Niger 178 Nigeria 184 Cameroon 192 Chad 198 Central African Republic 204 South Sudan 210 Ethiopia 216 Somalia 222 Democratic Republic of the Congo 226 Rwanda 234 Uganda 238 Mozambique 242 Sudan 248. Armed Conflict Survey 9.1 (2023): 148-253.
4. World Health Organization. “Public health situation analysis: Sudan conflict”. World Health Organization (2024).
5. Thornicroft G., et al. “Community mental health care worldwide: Current status and further developments”. World Psychiatry 15.3 (2016): 276-286.
6. Patel V., et al. “Treatment and prevention of mental disorders in low- and middle-income countries”. Lancet 370.9591 (2007): 991-1005.
7. Shoib S., et al. “Sudan’s unmet mental health needs: A call for action”. Annals of Medicine and Surgery (London) 78 (2022): 103773.
8. Baasher TA. “First Tigani El Mahi Memorial Lecture”. Sudanese Journal of Paediatrics 13.1 (2013): 79-89.
9. Sirag A. “Dr Taha Ahmed Baasher”. Psychiatric Bulletin 33.2 (2009): 78.
10. Amal Elamin., et al. “Sudan: from a forgotten war to an abandoned healthcare system”. BMJ Global Health 9.10 (2024): e016406.
11. Ismail M. “Regional disparities in the distribution of Sudan’s health resources”. Eastern Mediterranean Health Journal 26.9 (2020): 1105-1114.
12. United Nations Development Programme (UNDP). “The socio-economic impact of armed conflict on Sudanese urban households”. United Nations Development Programme (2024).
13. Eyita-Okon E. “Urbanization and human security in post-colonial Africa”. Frontiers in Sustainable Cities 4 (2022).
14. Semrau M., et al. “Strengthening mental health systems in low- and middle-income countries: recommendations from the Emerald programme”. BJPsych Open 5.5 (2019): e73.
15. Osman AHM., et al. “Sudan’s mental health service: challenges and future horizons”. BJPsych International 17.1 (2020): 17-19.
16. United Nations Office for the Coordination of Humanitarian Affairs. “Sudan: Clashes between Sudanese Armed Forces and Rapid Support Forces - Flash Update”. ReliefWeb (2023).
17. World Health Organization (WHO). “Health impact of the Sudan conflict: WHO report”. Retrieved from WHO (2023).
18. World Health Organization. “WHO-AIMS report on mental health system in Sudan”. World Health Organization.
19. Ali SH and Agyapong VIO. “Barriers to mental health service utilisation in Sudan - perspectives of carers and psychiatrists”. BMC Health Services Research 16 (2016): 31.
20. Alfahal MS., et al. “Assessment of psychiatry trainees’ satisfaction towards postgraduate psychiatry clinical MD in Sudan”. Journal of Educational and Psychological Research 5.3 (2023): 685-709.
21. Ali S., et al. “Evaluation of a mental health training project in the Republic of the Sudan using the Mental Health Gap Action Programme curriculum”. International Psychiatry 9.2 (2012): 43-45.
22. World Bank. “Sudan Emergency Safety Nets Project: Implementation status and results report”. World Bank Group (2023).
23. World Health Organization and World Organization of Family Doctors (Wonca). “Integrating mental health into primary care: A global perspective”. World Health Organization (2008).
24. Funk M., et al. “Integrating mental health into primary healthcare”. Mental Health in Family Medicine 5.1 (2008): 5-8.
25. Padmanathan P and Rai D. “Access and rational use of psychotropic medications in low- and middle-income countries”. Epidemiology and Psychiatric Sciences 25.1 (2016): 4-8.
26. Azevedo MJ. “The State of Health System(s) in Africa: Challenges and Opportunities”. Historical Perspectives on the State of Health and Health Systems in Africa 2 (2017): 1-73.
27. Sorketti EA. “Sudan’s national mental health programme and burden of mental illness”. International Psychiatry 6.1 (2009): 16-18.
28. Sorketti EA., et al. “Collaboration between traditional healers and psychiatrists in Sudan”. International Psychiatry 7.3 (2010): 71-74.
29. Mahdanian AA., et al. “Human rights in mental healthcare A review of current global situation”. International Review of Psychiatry 35.2 (2022): 150-162.
30. Elamin A., et al. “Sudan: from a forgotten war to an abandoned healthcare system”. BMJ Global Health 9.10 (2024): e016406.
31. Widdig H., et al. “The political economy of priority-setting for health in South Sudan: a case study of the health pooled fund”. International Journal for Equity in Health 21.1 (2022): 68.
32. International Organization for Migration. “Sudan crisis response plan 2024-2025” (2024).
33. Bashir F and Allen LN. “Health financing in Sudan: key informant interviews in the wake of the 2023 conflict”. medRxiv (2023).
34. Awad MSA., et al. “Assessment of displaced Sudanese school-age children’s mental health at Ad-Damar, River Nile, Sudan, 2024: a descriptive cross-sectional study”. BMC Public Health 24.1 (2024): 3473.
35. Ayazi T., et al. “Community attitudes and social distance towards the mentally ill in South Sudan: a survey from a post-conflict setting with no mental health services”. Social Psychiatry and Psychiatric Epidemiology 49.5 (2014): 771-780.
36. World Health Organization. “Sudan conflict and refugee crisis: Multi-country external situation report No. 2” (2024).