Since 2023, the armed conflict in Sudan has displaced nearly 900 000 people into eastern Chad, adding to pre-existing refugee populations and placing immense strain on already fragile health and social systems. Sudanese refugees experience high levels of psychological distress, yet Chad’s mental health services remain rudimentary, characterised by severe shortages of trained professionals and fragmented service provision. Despite underfunding, humanitarian agencies have explicitly prioritised mental health within their response framework, integrating mental health support into primary care and community-led initiatives. Cultural idioms of distress, stigma and language barriers continue to complicate care delivery, while simultaneously underscoring the importance of locally grounded approaches. Sustainable progress will require closer integration between humanitarian and development efforts, the strengthening of national systems and the expansion of community capacity. Innovative partnerships such as the Greentree Acceleration Plan offer pathways for scalable, culturally relevant interventions that may ultimately strengthen mental health systems for both refugees and host populations in Chad.