During the Ebola virus outbreak, the Sierra Leone psychiatric hospital was closed to admissions to prevent disease transmission. Existing government plans to create new decentralized mental health units across the country11 were brought forward as part of the emergency response. Mental health nurses who had received 12–18 months’ mental health training in 2012–2013 from a bespoke nursing curriculum12 were deployed to general hospitals in various districts. We describe here our experience of establishing one of the new units ‒ a nurse-led mental health and psychosocial support service at Connaught hospital in Freetown, the largest government hospital in the country with approximately 300 beds.