Reflexivity, as defined by Haggerty, resembles an intellectual performance that engages the author in a dynamic relationship with the field and is fully realized in the act of writing itself [1] . It aligns with the epistemology of positionality [2] , where knowledge production is situated, embodied, and contextual. However, reflexivity should not fall into excessive introspection centered on the self, as this risks drifting toward hermeneutic narcissism detached from analytical relevance. Such an approach would compromise reflexivity’s essential role: contributing to critical and potentially transformative knowledge [3] .

From this perspective, reflexive analysis is not about justifying or retrospectively rationalizing unconscious biases or motivations. Rather, it must be rooted in rigorous professional practice, allowing for a clear distinction between subjective considerations and those related to the professional domain. The reflexive author must adopt an ethical stance—recognizing the limits of their involvement while valuing their position as an engaged actor [4] .

This paper emerges from that same spirit, grounded in a unique field experience: the management of mental health policies in Senegal during the critical and unforeseen context of the COVID-19 pandemic. That period required the mobilization of creativity, adaptability, and decision-making under pressure. Five years after the initial impact of the crisis, it is timely to conduct a reflexive analysis to better understand the scope of actions undertaken and to extract useful lessons. This process aims to contribute to a more structured conceptualization of crisis response practices and to enrich public policy through the lens of learned experiences.

On January 30, 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a Public Health Emergency of International Concern, following the second meeting of the Emergency Committee under the International Health Regulations, convened to address the outbreak [5] . In response to the first reported COVID-19 cases in Europe, Senegal held an emergency meeting of its National Epidemic Management Committee (CNGE), which decided on January 22, 2020, to activate a preparedness plan. During that meeting, the concerns of Senegalese families whose children were studying in Wuhan were raised. The parents requested the repatriation of their children. As the government declined this proposal, the Mental Health Division of the Ministry of Health and Social Action (MSAS) implemented a remote psychological support strategy. A psychological support call center was established within the Directorate General of Public Health (DGSP). Senegal recorded its first confirmed COVID-19 case on March 2, 2020 [6] . The government quickly adopted several measures to care for patients and to enhance epidemiological surveillance: the Health Emergency Operations Center (COUS) was activated; public gatherings, interregional travel, and mass events were banned; air, land, and sea borders were closed, along with schools and places of worship. Mask-wearing became mandatory in public spaces. A state of emergency was declared, followed by the imposition of a curfew [7] . In parallel with these restrictions on movement and contact, additional measures were introduced to strengthen surveillance and improve healthcare delivery nationwide, requiring health facilities to implement institutional protocols to reduce contamination in medical settings [8] .

The COVID-19 pandemic led to psychosocial risks and had significant repercussions on mental health and well-being across different groups—primary victims (confirmed cases), secondary (contacts), tertiary (health workers), and even quaternary (decision-makers and the general population) [9] . Given this context, psychosocial care gained substantial importance in both the response to and prevention of mental health problems.

Figure 1 illustrates the strategic progression of Senegal’s national psychosocial care system in response to the COVID-19 pandemic. It presents a dual vertical and horizontal view of both the evolution of psychosocial response mechanisms (top) and the different epidemiological scenarios (bottom) encountered between January and May 2020. The process began in January 2020 (Scenario 1) with the repatriation requests concerning Senegalese students living abroad. In response, a remote psychological assistance call center was launched—marking the start of a reactive, distance-based intervention. With the detection of the first imported cases in March (Scenario 2), a national psychosocial care unit was established. This unit coordinated actions, conducted training for responders, and supervised early care responses. In April, faced with the emergence of localized clusters (Scenario 3), an operational decentralization process began through the creation of regional response units, enabling quicker and more contextually adapted interventions. Finally, by May (Scenario 4), with the rise of widespread community transmission, the system was further decentralized to health districts, thereby reinforcing the local anchoring of the psychosocial response. This figure reflects the progressive adaptation of Senegal’s mental health system, transitioning from a centralized and reactive response to a territorial, coordinated, and preventive approach. It also illustrates the growing competencies of institutional and community actors in the face of an evolving crisis.

This scientific contribution adopts a reflexive analytical approach, understood as an intentional intellectual activity aimed at critically revisiting a situation, problem, or intervention based on the lived experiences of the actors involved. The objective is to generate new understandings capable of informing and guiding future actions [10] . This study focuses specifically on mental health interventions implemented by Senegal’s Ministry of Health and Social Action (MSAS) during the first year of the COVID-19 pandemic. It offers a retrospective analysis of the strategies adopted, the institutional dynamics at play, and the concrete situations encountered in the field. The reflection draws on multiple empirical sources: interviews conducted with key stakeholders, analysis of activity reports, and an examination of the mechanisms used for coordinating and implementing the actions.

The reflexive analysis employed here is grounded in a position of strategic distance, enabling a deeper inquiry into how the intervention was designed, structured, and executed, as well as the methods and strategies used to achieve the intended outcomes. It also interrogates the gaps between initial intentions and observed effects, with a view toward institutional learning.

The analysis is structured around a detailed description of key actions, followed by a critical examination designed to extract cross-cutting lessons. This process aims to identify what worked well, the challenges encountered, and areas for potential improvement. In doing so, it transforms experience into operational knowledge that can inform the planning and enhancement of future interventions. Reflexive analysis, in this sense, becomes a valuable tool for strengthening stakeholder capacity and promoting more coherent, adaptive, and resilient mental health policy management [10] [11] .

A structured reflexive analysis framework was developed based on four complementary dimensions, centered around a core objective: the formulation of lessons learned from a given intervention. This methodological tool enables a critical and constructive review, incorporating descriptive, evaluative, and forward-looking elements (see Figure 2 ).

1) Descriptive narrative of the action

This first component sets the factual foundation of the analysis: when, where, by whom, and how the action was implemented. It helps contextualize the intervention by identifying the actors involved, the initial objectives, implementation modalities, and the resources mobilized. This step is essential for situating the analysis within a precise spatiotemporal and institutional framework.

2) What worked well in the action

This section highlights the successes or strengths of the intervention. It draws attention to the factors that contributed to achieving the goals, whether through effective methods, collaborative dynamics, stakeholder engagement, or tangible outcomes. It forms a basis for knowledge capitalization and potential replication.

3) What did not work well in the action

This component seeks to identify weaknesses, obstacles, or dysfunctions encountered during the intervention. These may include planning limitations, field constraints, resistance, or methodological shortcomings. Such critical analysis is essential for a nuanced and honest understanding of the experience.

4) What could be improved to enhance the intervention

This final dimension directs the analysis toward future improvement. It involves formulating concrete, realistic, and context-sensitive recommendations to optimize future actions. This forward-looking perspective reinforces the transformational intent of reflexive analysis.

5) At the center of the framework is the section titled “Lessons Learned from the Action”, which synthesizes the reflections developed across the four dimensions. These lessons are not merely observations—they represent actionable knowledge that can guide future practice, inform decision-making, and enhance the effectiveness of subsequent interventions.

The analysis of mental health interventions implemented during the COVID-19 pandemic reveals a multidimensional response combining institutional coordination, community mobilization, and innovation in psychiatric practices [12] . Far from being static, this response gradually adjusted to epidemiological dynamics, illustrating both adaptive capacity and underlying structural vulnerabilities [13] .

The mobilization of multidisciplinary teams—including healthcare professionals, social workers, and community leaders—enabled a holistic approach to addressing psychosocial impacts [14] [15] . The increase in psychiatric disorders during the pandemic context [16] [17] highlights the importance of initiatives such as psychiatric teleconsultations. These phone-based consultations improved both accessibility and health safety within service provision [14] [18] .

The actions undertaken by community-based organizations, brought together within a dedicated network, demonstrate that community actors [14] are powerful levers for reaching vulnerable populations, particularly homeless individuals with mental illness. The creation of a community-based shelter center represents a local innovation in psychosocial rehabilitation. To maximize the impact of these adaptations, it is essential to systematize them through national standards, dedicated digital infrastructure, and sustained technical support [12] .

Despite the relevance of this study in documenting institutional and community-based mental health responses during the COVID-19 pandemic, several limitations must be acknowledged. Some data could not be uniformly collected across all regions of Senegal due to institutional fragmentation, the lack of standardized reporting, and the informal nature of certain community-based interventions. While the study focuses on a critical period (2020-2021), it does not longitudinally track the post-crisis evolution of the mental health system. As a result, certain dynamics, such as the waning of activities, redeployment of resources, or abandonment of initiatives, could not be thoroughly analyzed.

The Senegalese experience demonstrates that a mental health response to a major public health crisis can be rapid, innovative, and multilevel. However, its sustainability relies on the quality of multisectoral coordination, the integration of community actors, and the structuring of technological innovations. This experience offers a valuable foundation for building a more resilient, equitable, and integrated mental health system that is better prepared to respond to future crises.

Ultimately, this reflective analysis reveals that, beyond its health impacts, the COVID-19 pandemic served as a catalyst for collective learning and innovation. It opens up new perspectives for strengthening psychosocial care systems—making them more inclusive, community-based, and better equipped for future emergencies.

The author would like to extend sincere gratitude to all mental health professionals in Senegal who contributed to the psychosocial response during the COVID-19 pandemic. Special thanks go to the Mental Health Division of the Ministry of Health and Social Action, the Directorate of Social Action, and the Health Emergency Operations Center (COUS) for their unwavering institutional support. Appreciation is also extended to the Institute of Health and Development (ISED) for its academic guidance and collaboration.

Warm thanks are due to the community-based actors mobilized through the REPOSAMS network, whose commitment was instrumental in reaching vulnerable populations. The author also acknowledges the crucial support of financial partners and NGOs, whose contributions enabled the implementation of key psychosocial initiatives.

Finally, heartfelt appreciation is extended to the families who, through their solidarity and care, played an essential role in supporting individuals with mental health conditions during this unprecedented health crisis.