Early engagement of participants and a partnership approach with clear roles and responsibilities for all parties was key to ensuring ownership of and commitment to the service (Box 1). The health ministry and the hospital management responded positively to mental health and psychosocial support services being incorporated into a general hospital. Shared supervision was essential for maintaining clinical standards, developing competencies and providing a support network for the mental health nurses. The mental health service at the hospital is effective, integrated and has strengthened local capacity. People are now able to access affordable mental health care at a general hospital.