Coercion has always been integral to the care and treatment of people who are mentally ill and there is no ‘perfect’ model in which coercion is absent. A number of interventions have shown promise in reducing the use of coercion, however, and we believe the evidence points to ways forward that may improve both the experience and the outcome of care.

The availability and use of mental health treatments are influenced by many different factors. Prominent among these are scientific evidence, cost, ethics and politics. However, the social sustainability of treatments can also have a considerable influence on their use.

Recovery colleges offer an educational approach which is believed to develop people's strengths rather than focusing attention on their problems. We have reviewed the literature on this subject, with the aim of determining whether this approach to the management of mental health disorders is socially acceptable. We found preliminary evidence that they are indeed acceptable to families and service users. However, the literature is limited. We therefore recommend that further research is undertaken to confirm the status of recovery colleges, with particular reference to the attitudes of family and friends.

People were not well prepared for the psychological aftermath of the earthquake in Nepal in April 2015. A higher rate of mental disorder was noted in the ensuing months and there was a need to develop psychosocial interventions, especially for those with poor mental health literacy. Acceptable, affordable and accessible mental health awareness programmes were required. Through examples of strategies adopted by the author, this article asserts that the aftermath of natural disasters can give mental health professionals opportunities to improve mental health literacy.

There is robust evidence that electroconvulsive therapy is an effective treatment for some mental illnesses. Despite this, its use remains controversial and is declining in some countries, with a consequent loss of skills and knowledge. This, and the view of it as a ‘treatment of last resort’, may undermine its sustainability.

In this issue we sail to three countries that provide the Atlantic border at the western end of Europe: France, Ireland and Portugal.

The French Republic has had four laws governing the detention of people with a mental illness. The first dates from 1838 and remained in place until 1990. The most recent one was issued on 27 September 2013; it confirmed the role of the judge and strengthened the legal procedures. This new French mental health law is an attempt to find a balance between the protection of patients' rights and the need for treatment.

This article provides a brief overview of the legislation that has been enacted in Ireland with respect to mental health, in particular the 2001 Mental Health Act. Although that Act was a positive step towards developing an Irish mental health service that protects the human rights of service users, a number of concerns remain, including issues related to consent and capacity, involuntary out-patient treatment and admission, the adversarial nature and timing of tribunals, and the lack of safeguards for voluntary patients.

This paper details the grounds for compulsory treatment, compulsory admissions in an emergency department and compulsory out-patient treatment in Portugal. Portuguese mental health legislation has improved significantly over recent years, with enhanced safeguards, rapid and rigorous review and clear criteria for compulsory treatment, although much remains to be done, especially in relation to the ‘move into the community’.

Chile has been successful in integrating mental health and primary care. This paper describes the Chilean mental health service in primary care and the experience of scaling up a depression treatment programme. A new mental health plan is due to be introduced in 2016.

Prevention of mental illness and mental health promotion activities across Europe have gathered some pace since the launch of the European Union's Pact for Mental Health and Well-Being in 2008. Within the context of a large treatment gap in mental health and limited resources to meet the high demand for mental healthcare, a concerted effort is now needed to ensure that initiatives in both mental illness prevention and mental health promotion become a fundamental part of where we are educated, work and live. Cost-effective, evidence-based approaches in prevention and promotion make these initiatives more accessible.