Abstract
Understanding and responding to patient expectations is crucial for providing high-quality, person-centred mental healthcare, but remains underexplored in humanitarian settings. This study examines the preferences and experiences of Syrian mental health and psychosocial support (MHPSS) service users in Northwest Syria and Türkiye. We conducted structured interviews with 378 displaced Syrians (55% female, mean age: 31 years). Participants completed the Client Satisfaction Questionnaire-8 and responded to nine open-ended questions. An abductive qualitative content analysis guided by the World Health Organization's health system responsiveness framework was used to interpret their accounts. Participants most frequently described the importance of time and understanding (62%), dignity (43%), confidentiality (36%) and continuity of care (31%), with notable variation by gender. Interpersonal aspects of care were crucial for building trust and sustaining service engagement. Service-level factors, such as adequate time with practitioners and integrated and coordinated care, ensured high-quality support in a context of ongoing conflict, displacement and poverty. These findings underscore the importance of embedding person-centred approaches in MHPSS service design and delivery. As efforts to rebuild Syria's health system begin, prioritising service user experiences could improve the quality of care and restore health system trust and legitimacy.