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Complex humanitarian emergencies and other low-resource settings can be exceedingly difficult places to provide quality mental health (MH) care. Yet these environments also often have a high burden of mental health care needs. This collection presents a set of articles describing how MSF teams have adapted and evaluated ways of bringing clinically impactful MH care to neglected communities and patients—from forcibly displaced populations in northern Nigeria to Syrian refugees in Lebanon and typhoon survivors in the Philippines. It also highlights work on developing new tools for providing clinical supervision and for identifying those patients most in need of care in fragile settings, and on new approaches to delivering MH services during the Covid-19 pandemic.