The paper describes the current provision of psychiatric services in Algeria – in particular, in-patient and out-patient facilities, child psychiatry and human resources. Education, training, associations and research in the field of mental health are also briefly presented. The challenges that must dealt with to improve psychiatric care and to comply with international standards are listed, by way of conclusion.

Stress and burnout are major issues affecting medical trainees, especially psychiatry trainees, throughout the world. Stress and burnout were studied using an online survey among psychiatry trainees of the National Institute of Mental Health and Neurosciences (NIMHANS) which is one of the oldest and largest training centers in India. Postgraduate training in academic institutions like NIMHANS, while offering excellent teaching experience, may impact the mental and physical health of trainees due to complex clinical challenges and academic pressure. Measures need to be taken to enhance trainee well-being by ensuring support from colleagues and seniors, allowing for an adequate work–life balance, introducing departmental level committees to address grievances and providing therapy and mentorship. Providing safe and non-stigmatizing spaces to seek help in workplace promotes whole-person growth and well being.

Climate change can have various psychopathological manifestations which have been more actively addressed by scientific research only in recent years. Indeed, extreme weather events and environmental changes have been shown to be associated with a range of mental health problems. Following the destruction of ecosystems, biodiversity loss can cause mental distress and emotional responses, including so-called ‘psychoterratic’ syndromes arising from negatively felt and perceived environmental change. Studies investigating relationships between biodiversity and mental health reveal a complex landscape of scientific evidence, calling for a better understanding of this challenging issue.

This article briefly assesses the historical trajectory of psychiatric institutions in the Middle East. It underlines a key observation: the persistence and expansion of psychiatric institutionalisation, specifically in the Arab world. In contrast to the deinstitutionalisation that eventually closed large psychiatric hospitals in the 1960s and 1970s, notably in Europe and North America, psychiatric hospitals have continued to grow in size in the Arab world. This absence of deinstitutionalisation marks a major departure from how psychiatry developed in the West, which is worth reflecting on if we are to understand the current crumbling infrastructure of in-patient psychiatric facilities in the Arab region.

This paper first briefly reviews the history of psychiatric services in Egypt. It then details the legislation in place during the last years of the Mubarak regime and goes on to set out recent developments, in particular the Code of Practice introduced for the Mental Health Act of 2009.

The Gaza Strip has been badly affected by war and conflict over the past four decades. Palestinians are exposed to repeated incursions of the border areas, with many resulting casualties. At the end of December 2008, more than 230 Palestinians were killed and at least 770 were injured, including 100 in critical condition, after an Israeli airstrike. This was followed by a military operation that continued for 23 days, in which 1420 Palestinians, including 446 children, were killed. At least 4000 houses were totally destroyed and 16000 partially damaged (Palestinian Red Crescent, 2008).

After a large-scale humanitarian disaster, 30–50% of victims develop moderate or severe psychological distress. Rates of mild and moderate mental disorders increase by 5–10% and severe disorders by 1–2%. Those with such disorders need access to mental healthcare. Primary care clinics are appropriate due to their easy accessibility and the non-stigmatising environment. There is a consensus among experts that the mental health effects of disaster are best addressed by existing services, that is, through capacity building rather than by establishing parallel systems. Mental health interventions in emergencies should begin with a clear vision for the long-term advancement of community services.

The international community has been slow to appreciate the growing problem of the participation of armed children and youths in non-political disputes, encountered in both developed and developing countries, from Haiti to Northern Ireland. While there is widespread recognition of the issue of ‘child soldiers’ (e.g. www.childsoldiers.org/) there are also many children who participate in organised armed groups that function outside traditionally defined war zones. Nowhere is this issue more acute than in Rio de Janeiro, Brazil. There may be more people (and specifically children) dying from small-arms fire in Rio de Janeiro than in many armed conflicts elsewhere. Most are bound up in the relentless conflicts involving factions of drugs traffickers fighting within and between Rio's favelas, or shanty towns, and their burgeoning drugs trade.

China's healthcare is improving together with rapid economic growth. Yet, mental healthcare is lagging behind. Prevalence of perinatal depression is high among women of the one-child generation, but access to qualified care is limited. Chinese healthcare professionals, policy makers and patients alike express concerns about insufficient knowledge among the public as well as healthcare providers regarding mental disorders. There appears to be a general lack of help-seeking behaviour for mental disorders owing to perceived risk of social stigmatisation. Social support through family and friends, use of online resources and community healthcare services are preferred, rather than seeking help from mental health specialists.

Research on the topic of poor perinatal mental health in South America is scarce. Nevertheless, studies have shown that it is not uncommon, and that it is linked to women's experience of sexual and intimate partner violence and to inequality, poverty and low educational attainment. High-quality research in large samples with rigorous methodology is a priority, so that data from this region may be compared and analysed in systematic reviews. The links with intimate partner violence need to be explored. Risk and protective factors must be investigated with a strong intercultural perspective. Service integration needs to be implemented. This will require improvements in the availability, accessibility and quality of obstetric and mental health services. There is a need for targeted evidence-based interventions for women and children at risk that incorporate a strong gender and rights perspective.

In Denmark, the parliament passed the first Mental Health Act (MHA) in 1938. A new Act was passed in 1989, based on a thorough report from the Ministry of Justice. The 1989 Act emphasised the protection of citizens' legal rights in relation to compulsory admission, detention and treatment in psychiatric hospitals. That Act is still in operation, although it has been amended several times. In 2006 the definition of ‘compulsion’ was changed, and a 2010 amendment introduced compulsory treatment in the community for a trial period of 4 years.

The Mental Disorders Act of 1969 is the primary legislation relating to mental health in Botswana. Despite the country not being a signatory to the United Nations Convention on the Rights of Persons with Disabilities, its Act has a self-rated score of four out of five on compliance to human rights covenants. However, it can be argued that the Act does not adequately espouse a human rights- and patient-centred approach to legislation. It is hoped that ongoing efforts to revise the Act will address the limitations discussed in this article.

Following a 10-year war of liberation (fought by the Mau Mau against the British), Kenya attained full independence from colonial rule in 1963. For 10 years the country enjoyed rapid economic growth (6–7% per annum) but this slowed steadily to near stagnation in the 1990s. Poor governance, abuse of human rights, internal displacements of citizens, large numbers of refugees from neighbouring countries and the AIDS pandemic conspired to reduce Kenyans’ life expectancy to 47 years (in the UK it is presently 77 years). Some 42% of the population now live below the poverty line, and 26% of Kenyans exist on less than US$1 per day. The annual per capita income in Kenya is US$360 (in the UK it is $24 000) (World Bank, 2002). AIDS currently has an estimated prevalence rate of 12%. In large parts of rural Kenya many sexually active adults are unable to work, and elderly grandparents are left to look after orphaned children (some already infected with HIV), as they struggle to deal with their own grief for the loss of many of their own children. In December 2002 a new government was elected, which gives some grounds for optimism in an otherwise bleak situation.

The association between ethnicity and pharmacology has been reported in the medical literature for several decades. However, the relationship between ethnicity and psychopharmacology has become widely recognised only in the last two or three decades. The large-scale migration which started after the Second World War, at first to the USA and more recently to other higher-income countries, as a result of globalisation, has greatly contributed to the attention and focus given to these migrant groups. In this context, these migrant groups primarily comprise ethnic and racial minority groups. This article briefly reviews the relationship between ethnicity and psychopharmacological agents.

Quality of prescribing is an important aspect of clinical practice. In a study of the effect of electronic prescriptions on prescription quality in the UK, Donyai et al (2008) found errors in 3.8% of their sample before the introduction of electronic prescription. In a psychiatric setting in Leeds in the UK, Nirodi & Mitchell (2002) found that 16.1% of prescriptions written for a cohort of elderly patients were illegible, and a third lacked information on dose, frequency or indication of use of medications. They found that only 18% were legible and free of all errors.

As clinicians, we are used to making often fast and life-altering decisions. As professionals, the clinical decisions we make depend upon our training, knowledge base, supervision, expertise and experience. Sociodemographic factors such as age, gender, ethnicity and cultural background can also influence our views. However, rarely do we step back to think about the mental processes behind our decision-making. In cognitive–behavioural therapy and in our general dealings with patients, we aim to help them identify their cognitive schema and attribution errors as a way forward; but we rarely reflect on our own cognitive schema and possible misattribution in making decisions. Both patients and healthcare professionals are affected by cultural norms, mores and expectations.

Italian psychiatry is probably more debated than known in the international arena. Law 180 of 1978, which introduced a radical community psychiatry system, has drawn worldwide attention and debate, with comments ranging from the enthusiastic to the frankly disparaging (Mosher, 1982; Jones et al, 1991). More recently, this interest was marked by a well-attended symposium ‘Lessons Learned from Italian Reforms in Psychiatry’ held at the 2003 annual meeting of the Royal College of Psychiatrists in Edinburgh.

This paper reports admission rates within the acute service at a major South African tertiary psychiatric facility, Lentegeur Psychiatric Hospital (LPH) in Cape Town.

In Thailand, we have only two programmes for residency training in psychiatry: one is general or adult psychiatry, which takes 3 years to complete; the other is child and adolescent psychiatry, which takes 4 years. There are nine institutes that offer residency training but only three medical schools have the capacity to offer training in both general and child psychiatry (Table 1).