In Ethiopia, as in many other low-and middle-income countries, health professionals, particularly mental health workers, are scarce. The purpose of this case study is to describe the process of establishing training child psychiatry and capacity building to implement clinical care for child and adolescent mental health. We present a case study on training of child and adolescent psychiatry embedded within the master’s degree program in integrated clinical and community mental health at the department of psychiatry in Jimma University, Ethiopia. This program is jointly developed in collaboration between Jimma University and Ludwig-Maximilian-University, Germany. The core elements of the training were to train mental state description, making decisions on possible disorders, perform occupational activities, and design psychosocial interventions. The WHOmhGAP guide is considered as appropriate knowledgebase for our teaching program. Each course was evaluated bidirectional with multiple methods. From 2010 to 2024, twelve trainings were organized. We structured the program in three phases. The initial phase (2010–2014) was to establish collaboration with guest lecturers and to develop, implement, and evaluate the training. The second phase (2015–2019) changed to mentorship and transition from guest lecturers to local trainers and included a refresher course. Phase three (2020–2024) was independent work. An outpatient clinical service for children was implemented by the lead author and now is running at Jimma University. The implementation of the training took place in small steps. A long-term commitment of local and guest lecturers enabled to develop culturally appropriate solutions for the local context. A similar approach can be applied to effectively start and expand child and adolescent mental health care in other resource limited settings.