The latest UN Global Appeal cites the number of refugees and internally displaced persons at 71.4 million. An estimated 10 % suffer from trauma and many more from loss, uncertainty and chronic adversity. Exposure to trauma and chronic adversity impacts individuals, families and communities. People who need a high level mental health and psychosocial support are frequently left behind in situations of shock, without access to quality services and support. The intersection of multiple risk factors compounds vulnerability, impacting an individual's cognitive functionality and the ability to engage in relationships, livelihood and education. In the pledge of leaving no one behind and reaching the most marginalised, what can be done to enable them to access and benefit from quality services?