The service was launched in March 2015 and was available to those living within the Freetown city area (about 1 million people) or anyone admitted to Connaught hospital. The partnership devised a standard operating procedure. Individuals of any age with a known or suspected mental health problem or psychosocial need met the referral criteria. A service level agreement with the Sierra Leone psychiatric hospital allowed transfers for inpatient care. In keeping with hospital protocol a registration fee was levied and waived if service users were unable to pay. A single mental health nurse provided the service, with prescribing of medication carried out by a linked hospital medical physician. A range of treatments were provided. Psychological interventions were the most common, comprising basic counselling and problem-solving therapy. The WHO Mental Health Gap Action Programme (mhGAP) intervention guide,14 was the model of care used. A proforma for initial assessment of patients (including demographic information, psychiatric and risk assessment) was created. Monthly monitoring and evaluation data were collected manually from the clinic ledger and presented to the hospital and health ministry management teams.