During a recent visit to Nakivale refugee settlement in Uganda, we saw the realities of the new humanitarian world at first hand: rising needs, shrinking resources, and growing pressure on systems that are already stretched thin.
Nakivale is one of Uganda’s oldest and largest refugee settlements. Public figures vary, but it is commonly described as hosting well over 170,000 people and, in many local accounts, closer to 200,000. It is a vast, green, widely spread settlement made up of many different communities. The long, bumpy road into Nakivale is lined with signs of many different aid agencies, giving the impression of a strong and active humanitarian presence.
But once inside, a different reality becomes visible.
We found offices that had already closed. We saw a half-empty UN compound, empty WFP warehouses, abandoned child-friendly spaces, and yet busloads of new arrivals. The message from government authorities and UNHCR counterparts was consistent: resources are shrinking, resources are shrinking, and the system is under extreme strain.
This is not unique to Nakivale. Uganda’s 2026 Refugee Response Plan explicitly describes a context of declining humanitarian resources and rising needs, with a more selective and prioritized response now required across sectors.
For us at the Peace of Mind Foundation, this reinforces a question that is becoming more urgent: how do we design MHPSS support differently in a humanitarian environment that can no longer sustain responses across all sectors?
One answer, in our view, lies in linking mental health and psychosocial support much more deliberately with livelihoods programming.
Two of the most significant stressors facing displaced communities are economic pressure and war- and displacement-related traumatic experiences. These are often treated separately in humanitarian and development programming, even though they interact constantly in daily life. Economic insecurity fuels stress, anxiety, and family strain. Traumatic experiences affect people’s capacity to cope, to plan, to care for children, to engage in community life, and to pursue opportunities for learning or work. Addressing one without the other is often insufficient.
There is a strong case for thinking more integratively. WHO notes that mental health support needs to extend beyond the health sector and into schools, communities, and other parts of daily life, while also emphasizing that decent work can contribute to recovery, inclusion, confidence, and social functioning. UNHCR has also highlighted the positive relationship between employment and refugee mental health.
The evidence base for combining psychosocial and livelihood support is also growing. A World Bank brief on psychosocial support in fragile and conflict-affected settings describes how such support is increasingly being integrated across sectors, including social protection and reintegration. A WHO-hosted review similarly found promising indications that combining psychosocial and livelihood support can improve development outcomes in fragile and conflict-affected settings.
This matters in places like Nakivale.
In a context where humanitarian resources are shrinking, it is no longer enough to defend MHPSS only as a specialized or stand-alone area of programming, however essential specialized services remain. Mental health must also be understood as a connector: between education and learning, between livelihoods and self-reliance, between family wellbeing and community resilience, and ultimately between survival and the possibility of rebuilding a meaningful future.
That is one of the ideas we will be following up on more deliberately at the Peace of Mind Foundation: how to connect MHPSS more strongly with livelihoods support in ways that are practical, context-sensitive, and grounded in local realities. Not because trauma can be reduced to economics, but because many of the pressures people face are intertwined, and our responses need to reflect that.
The humanitarian sector is entering a different phase. The operating environment is more constrained. Expectations remain high. Needs continue to grow. In this new reality, we will have to move beyond siloed thinking and make much more deliberate use of approaches that are integrated, complementary, and able to strengthen both wellbeing and agency.
Investing in mental health saves lives. But linking mental health meaningfully with livelihoods can also help communities cope with the two major pressures that define so many displacement settings today: economic stress and the psychological consequences of war, loss, and prolonged uncertainty.
If this is the new humanitarian world, then the task ahead is not simply to do less with less.
It is to think better, connect better, and support people more holistically.