There is an urgent global need for accessible and cost-effective pro-mental health infrastructure. Public green spaces were officially designated in the 19th century, informed by a belief that they might provide health benefits. We outline modern research evidence that greenspace can play a pivotal role in population-level mental health.

It is now widely acknowledged that low- and middle-income countries in Africa are among global hotspots for high vulnerability to climate change, despite making comparatively low contributions to this phenomenon. Climate change has been shown to affect mental health as a result of disruption of social and economic structures that populations depend on for good health, including mental health. After decades of neglect, recent efforts by governments such as in Kenya to address the twin issues of climate change and mental health demonstrate the growing importance of these issues. Here we briefly review the evidence of climate change impacts on mental health in Africa and demonstrate that there is need for more contextual awareness and research in this area in Africa to mitigate or forestall potential mental health crises in the near future. We recommend systematic efforts to support funding for research and interventions at the nexus between climate change and mental health in Africa, and urge institutions and governments in Africa to begin paying attention to this emerging threat to the health of African populations.

Healthcare workers employed in the COVID-19 emergency are at high risk of stress, burnout and post-traumatic stress disorders. The most important occupational risk factors that employers should address include insufficient staff training and resources available, and lack of training and treatment protocols. In Italy, recent guidelines were released for providing all healthcare workers who are employed in this emergency with psychological support services based on coping strategies for managing stress. We suggest that preventive measures and a psychological intervention plan should be framed within the mandatory occupational health surveillance programme, and carried out by occupational physicians in cooperation with mental healthcare providers in the workplace.

National information on mental health services in the Philippines indicates that there are substantial gaps and inconsistencies in the delivery of mental healthcare. The recently enacted Mental Health Act legislation provides a platform for the delivery of comprehensive and integrated mental health services. However, there remain many challenges in the provision of accessible and affordable mental healthcare.

Recent reports have highlighted human rights concerns in Ugandan mental healthcare. This article describes the current situation in terms of healthcare funding and provision, concerns regarding legislation, and health inequalities. Possible reasons for the difficult situation are briefly discussed, including the economy, pervasive stigma and ongoing unrest in the region. We then describe some encouraging initiatives in Uganda that are empowering those with mental health problems to have a better quality of life and identify opportunities for change.

The brain drain of medical professionals from lower-income to higher-income countries contributes to the current inequity that characterises access to mental healthcare by those in need across the world and hinders efforts to scale up mental health services in resource-constrained settings, especially in Nigeria and other West African countries. The migration of skilled workers is driven by a combination of the globalisation of the labour market and the ability of highly resourced countries to attract and retain specialists from poorer countries. If we are to ameliorate the worldwide shortage of mental health professionals, we need to find innovative ways of attracting young doctors into psychiatric training in all countries. We must also introduce measures to improve health worker retention in low- and middle-income countries.

Mental health is a significant factor for a sound and productive life; nevertheless, mental disorders do not often receive adequate research attention and are not addressed as a serious public health issue in countries such as Bangladesh. Part 1 of this two-part profile describes the current situation of mental health in Bangladesh in its wider sociocultural context, outlining existing policies and highlighting mental illness as a neglected healthcare problem in the country using a narrative synthesis method. The prevalence of mental disorders is very high and augmented in nature among different population groups in Bangladesh. A lack of public mental health facilities, scarcity of skilled mental health professionals, insufficient financial resource distribution, inadequately stewarded mental health policies and stigma contribute to making current mental healthcare significantly inadequate in Bangladesh. The country has few community care facilities for psychiatric patients. Furthermore, the current mental health expenditure by the Bangladeshi government is only 0.44% of the total health budget. Less than 0.11% of the population has access to free essential psychotropic medications.

Nature-based interventions for mental health are beginning to become more common in the UK. The evidence for their usefulness is building. Taking the ‘A Dose of Nature’ project in the south-west as an example, factors for making such interventions a success are described.

When pursued professionally, the demands of musical training and performance can interfere with musicians' well-being and health. Music performance anxiety, while energising at optimal levels, impairs performance quality when excessive. A range of interventions has been explored to address it. However, the poor methodological quality of such studies and the complexity of this issue should mobilise further research resources in this direction.

Mental health ecosystems research is an emerging discipline which takes a whole-systems approach to mental healthcare, facilitating analysis of the complex environment and context of mental health systems, and translation of this knowledge into policy and practice. Evidence from the local context is needed in the analysis of complex interventions and of geographic variations in the outcomes of care. Technical tools and support have been developed to gather and interpret evidence from the local context and translate it in a meaningful and relevant manner for planners and policy makers to guide their decision-making.

This paper summarises the core scientific claims of psychoanalysis and rebuts the prejudice that it is not ‘evidence-based’. I address the following questions. (A) How does the emotional mind work, in health and disease? (B) Therefore, what does psychoanalytic treatment aim to achieve? (C) How effective is it?

Through music we can learn much about our human origins and the human brain. Music is a potential method of therapy and a means of accessing and stimulating specific cerebral circuits. There is also an association between musical creativity and psychopathology. This paper provides a brief review.

Some fear that provoking widespread worry about climate change may harm mental health. The Regional Wellbeing Survey, a large study of health, well-being and life in rural and regional Australia, examined climate change worry and attitudes. Most respondents were worried about climate change and agreed that fossil fuel use causes global warming, but there was no evidence to suggest that worry about climate change is linked to mental health in the general population. Respectful, calm, considered public debate about how to respond to climate change is unlikely to be harmful to population mental health. Individually focused clinical approaches are unlikely to be effective as a primary approach in managing the mental health impacts of climate change. Instead, collective, systems-based approaches will be needed.

The Lebanese Ministry of Public Health has launched a National Mental Health Programme, which in turn has established the Mental Health and Substance Use Strategy for Lebanon 2015–2020. In parallel, research involving refugees has been conducted since the onset of the Syrian crisis. The findings point to an increase in mental health disorders in the Syrian refugee population, which now numbers more than 1 million.

There is a widening mental health treatment gap for children and adolescents in sub-Saharan Africa. The region has few economic or human resources dedicated to the mental health of children and young people. The World Health Organization's Mental Health Gap Action Plan and the push for mental health to be included in the Millennium Development Goals have raised the profile of child mental health but comparatively few studies have estimated prevalence rates or assessed needs or tested interventions in African countries. In most countries there is no clear pathway to access treatment, especially in-patient facilities. This article considers these issues from clinical, educational and research perspectives.

University students are in transition to adulthood and face multiple challenges that may lead to suicide. They are reported to have a higher risk of suicide by the World Health Organization. As there is no national suicide database in Uganda, we analysed student suicide using the press/media reports of suicides published between 2010 and 2020. A total of deaths by 23 suicide were identified: 19 were males, relationship problems were the main suicide reason (n = 6) and hanging was the most frequently used suicide method (n = 7). A strategic intervention to tackle suicide risk among university students is warranted.

Music is a universal human trait. The healing power of music has been acknowledged in almost all traditions of music. Music therapy is moving from a social-science model focusing on overall health and well-being towards a neuroscience model focusing on specific elements of music and its effect on sensorimotor, language and cognitive functions. The handful of evidence-based music therapy studies on psychiatric conditions have shown promising results. Traditional music, such as Indian classical music, has only recently been evaluated in evidence-based research into music therapy. The need for systematic research in this area is underscored.

This paper focuses on the importance of involving patients, families and other carers when offering and deciding on treatment and care options. It highlights the activities of international and national organisations in facilitating collaboration with patients and families in treatment, research, teaching and training related to mental healthcare.

A hallmark of Colombia is population-wide exposure to violence. To understand the realities of mental health in Colombia requires attention to the historical context of 60 years of unrelenting armed conflict overlaid upon high rates of homicide, gang activity and prevalent gender-based and intra-familial violence. The number of patients affected by trauma is extremely large, and the population burden of alcohol misuse and illicit drug use is significant. These patterns have brought the subspecialties of trauma and addiction psychiatry to the forefront, and highlight the need for novel treatments that integrate psychotherapeutic and psychopharmacological modalities.

This paper describes the current state of mental health services in Nepal and reflects on the significant changes over the past decade. The main challenges to overcome are proper implementation of community-based services, the high suicide rate, stigma of mental illness, financial constraints, lack of mental health legislation and proper utilisation of human resources.