India is a low-income country that is characterised by huge diversity within and between its 35 states and union territories. For example, the infant mortality rate (per 1000 live births) ranges from a low of 16.3 in Kerala to a high of 86.7 in Uttar Pradesh, over a fivefold difference (International Institute for Population Sciences & ORC Macro, 2001). This considerable variation is evident in virtually every aspect of human development in India, and any summary figures are likely to be unrepresentative of most parts of the country. Within the scope of this short article, this important limitation of averages must be recognised at the outset.

The estimated prevalence of alcohol misuse among Indian women is less than 5%. Misuse has been associated with the upper socio-economic classes, primitive tribal cultures and certain rural traditions. The problem of substance misuse in India has been underdiagnosed and underreported, but various health agencies and media reports suggest it is increasing.

Globally, health providers and patients alike have been forced to adapt rapidly to the use of telemedicine during the COVID-19 pandemic. Although telepsychiatry has been tested and found just as effective as face-to-face care, there still remains little uptake of this form of care provision in sub-Saharan Africa. This case study highlights the use of telepsychiatry in a previously telemedicine-naive private mental health facility in Kenya. We describe the challenges and lessons learned from the experience. We conclude on the need to test the effectiveness and acceptability of this mode of therapy in sub-Saharan Africa.

With an area of 450 000 km2, Sweden is one of the largest countries in Western Europe. It is 1500 km from north to south. It has nearly 9 million inhabitants (20 per km2). It is a constitutional, hereditary monarchy with a parliamentary government. Sweden is highly dependent on international trade to maintain its high productivity and good living standards. Many public services are provided by Sweden's 289 municipalities and 21 county councils. Municipal responsibilities include schools, child care and care of the elderly, as well as social support for people with a chronic mental illness. The county councils are mainly responsible for healthcare, including psychiatric care, and public transport at the regional level. Sweden is characterised by an even distribution of incomes and wealth. This is partly a result of the comparatively large role of the public sector.

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.

During a visit to Baghdad, I was able to visit several key centres in Iraqi psychiatry: the Ministry of Health, Baghdad General Hospital, Ibn Rushd Hospital and Al Rashad Hospital. This was my first experience of mental healthcare outside England, and it left me with a range of discussions and experiences to reflect on. I hope that this article offers a fair flavour of Iraqi psychiatry from the perspective of a UK-trained doctor.

Like all European countries, Greece has developed its national legislation based on the principles of equality and the right of representation, but there is no separate, specific mental health law in Greece. This paper describes the law for involuntary psychiatric admission. The law concerning criminal and civil responsibility and the law relating to individuals with addictions committing drug-related crimes are also outlined.

Sri Lanka boasts of making significant strides in the indicators of maternal healthcare during the past few decades. However, these indicators mostly look only at the physical well-being of women. Lack of awareness regarding maternal mental health problems among grass-root level healthcare workers, poor integration of services, and the culture and stigma regarding perinatal mental disorders are barriers to improving services in maternal mental healthcare in Sri Lanka.

Mental health law in Algeria originates from the French colonial era. Although several pieces of legislation deal with mental disorders, their implementation remains unsatisfactory and does not meet the real needs of healthcare providers. Amendment of the current mental health law is required to enhance the delivery of care but also to protect those with a mental disorder from abuse.

We studied Chinese psychiatrists' understanding of gambling addiction, as well as their experiences of and confidence in assessing and treating these patients. To this end, we carried out a postal questionnaire survey of 110 psychiatrists working in China. A majority had seen people with gambling addiction in their practice but only 1 of the 110 psychiatrists had ever received any training in the management of the condition. A large majority of psychiatrists indicated that gambling addiction was an important public health problem and 71.8% said they would like to be more involved in its management. Much more needs to be done to improve the identification and treatment of gambling addiction in China.

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.

Having returned from a period of volunteering with a healthcare charity working with the refugee camp population of Lesbos in Greece, a junior doctor reflects on the common presentations he saw and the current state of mental healthcare for these patients. The placement of already-traumatised people in an overcrowded and under-resourced camp environment creates a perfect storm for the emergence of post-traumatic stress disorder, depression and anxiety. With extremely limited psychiatric care in place, he considers the simple interventions he could use to help his patients with their distressing symptoms. This prompts exploration of the importance of giving time to listen as well as encouraging small but significant lifestyle changes. After exploring the ethics of psychiatric diagnosis in this setting, the author concludes that while we must acknowledge the political origins of some of the symptomatology in this population, we must continue to strive to treat psychiatric illness with all the appropriate interventions available to us in order to help those in this patient group recover and move forward.

Few countries (if any) have experienced the abundance of material welfare Norway has had for the last decades. The report of the Organisation for Economic Co-operation and Development (OECD) for 2004 places Norway on the very top of the list of ‘best countries to live in’. One might therefore expect that mental disorders would not thrive in Norway, but this is not so.

Mental health and psychiatric services in Afghanistan have gone through various stages of development and crisis but the long-term impact of recent wars and conflict on the country's mental health services has not been evaluated. What is obvious is the shortage of trained mental health professionals in the country.

Sudan occupies 2 500 000 km2 in East Africa. It has borders with nine countries, two of which are Arab: Egypt, Libya, Kenya, Uganda, Congo, Chad, the Central African Republic, Ethiopia and Eritrea. Sudan is the largest country in Africa. The heart of the country, in terms of population, lies at the confluence of the Blue and White Niles. The complex of the ‘three towns', comprising the three largest cities, Khartoum, Khartoum North and Omdurman, is situated there and contains almost 20% of the population. The total population of Sudan is about 35.4 million (projected from the 2005 census). The urban population was estimated at 33% of the total. About 2.2 million are still entirely nomadic. Sudan's peoples are as diverse as its geography. There are 19 major ethnic groups and 597 subgroups.

During the Edo period in Japan (1603–1867), people with mental illness were not excluded from society. Upon the introduction of European psychiatry around the 1870s, Japanese society became more discriminatory, however. In 1900 a primary law was introduced to regulate the custody of patients. In 1919 another law was approved to facilitate the establishment of public psychiatric hospitals. In 1950 the Mental Hygiene Law was enacted to prohibit home custody. However, these regulations did not assure quality of care or protect service users' rights. Also, after the Second World War, many private psychiatric hospitals were built, but this expansion of the sector was not well thought out or well coordinated. In Japan, the government regulates the private health sector only insofar as it sets standardised fees for treatments and carries out basic quality assurance.

Romania is now in a period of transition from communism to democracy. Geographically, Romania, like other Eastern European countries, is on the border between the Western world and the Middle East and Asia; until December 1989 it was behind the ‘Iron Curtain’.

Cultural psychiatry as a clinical specialty sprung mainly from Europe and North America, in order to respond to growing concerns of ethnic minorities in high-income countries. Academic psychiatrists pursuing comparative international studies on mental health, together with medical anthropologists conducting clinical ethnographies, contributed to its theoretical basis (Kleinman, 1987; Littlewood, 1990). What at first appeared to be a marginal specialty is no longer so. For example, the UK alone has witnessed a steady growth of the field, as evidenced by its mandatory inclusion in mental health training curricula, and the existence of several taught masters courses, academic positions in universities and three dedicated journals, as well as, more recently, lead papers in mainstream publications that have debated the cultural position of ‘biology’ itself (Timimi & Taylor, 2004). Additionally, with a proliferation of clinical jobs for ‘ethnic minority’ services in hospital trusts across the country, there is ample scope for employment. The overall evidence indicates that ‘cultural psychiatry’ in the UK is now a specialty in its own right.

The global economic downturn seems to be associated with a rise in suicide rates in many countries but we should not assume that this is a social rather than a clinical phenomenon. Mental health patients may be particularly vulnerable to unemployment and other hardships and to cuts in the care they receive. There is now no shortage of evidence on how clinical services and health policies can reduce suicide, and in England a new suicide prevention strategy was recently launched for public consultation. What we lack is an effective forum where a rigorous examination of international evidence can take place, with the findings translated into actions.