# How can a mental health programme scale across sites or counties?

URL: https://tymirahealth.com/resources/faqs/how-can-a-mental-health-programme-scale-across-sites-or-counties
For: Executives | Mental health practice | Reviewed by Independent clinical reviewer, Registered mental health clinician, Kenya | Last reviewed 8 November 2026

**Answer:** Start with a situation analysis in each new area, as WHO's mhGAP operations manual recommends, covering need, workforce, medicines, referral routes and county priorities. Standardise training, supervision, documentation and data, and adapt language and delivery to local culture. The Friendship Bench's scale-up in Zimbabwe relied on government partnership, stakeholder engagement and sustained funding. In Kenya, engage the county mental health council and the county health department early, and confirm licensing for each site.

Sources: World Health Organization: https://qualityhealthservices.who.int/quality-toolkit/qt-catalog-item/mhgap-operations-manual - King's College London: https://www.kcl.ac.uk/news/spotlight/friendship-bench-community-led-approach-to-mental-health-care - Kenya Law: https://new.kenyalaw.org/akn/ke/act/1989/10/eng@2023-12-11

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