On 10 January 2006, ITV2, a UK television channel, ran a 90-minute programme called Britain's Youngest Boozers. It claimed that one in three younger people are binge drinkers and that one in six is dependent on alcohol. The comments in interviews with adolescents and families were stark and worrying. Although the age parameters were not clear at the start of the programme, it focused on those aged up to 25 years and presented enormously serious concerns about the changed patterns of drinking among Britain's younger people.

Laos (officially the Lao People's Democratic Republic) is a land-locked country in South East Asia, and one of the three former French colonies of Indochina. Since 1989, when it was opened to foreigners, there has been an influx of non-governmental organisations (NGOs) and tourists. From 1998 tourist numbers have increased every year, and Laos has become the ‘must see’ destination in a travel industry that craves the exotic. It has an old and rich culture with a diverse population. The climate is tropical, with a cool dry season and a hot wet season, when temperatures reach 38°C.

Evidence-based practice (EBP), which is commonly implemented in high-income countries (HICs), integrates the best research evidence, clinical expertise and patient preferences in the planning and provision of healthcare for both physical and mental health conditions. Although the same principles of EBP apply in low- and middle-income countries (LMICs), research into and implementation of such interventions in these countries remains significantly behind compared with HICs. This article presents a brief overview of the global mental health agenda and initiatives aiming to address this pressing gap through the promotion of research and scaling up services, identification of barriers to developing and implementing EBP in LMICs, and possible solutions to overcome them.

Cambodia is a low-income country in south-east Asia. It covers an area of 181 035 km2 and has a population of 14.5 million, of whom 42% are less than 15 years old. Life expectancy is 56.8 years and 36% of the population live on less than US$0.50 per day. Cambodia experienced a brutal civil war and genocide in the 1970s under the Khmer Rouge regime, during which approximately 1.7 million Cambodians were killed (Chandler, 1999) and the social and medical infrastructure was almost completely destroyed. No mental health services existed throughout the conflict and subsequent Vietnamese occupation, despite the incalculable impact of the Khmer Rouge regime on Cambodians' mental health. The current political situation is more stable, although there remain concerns about human rights abuses (Khan, 2005).

Malaysia is a tropical country in the heart of South East Asia, at the crossroads of the ancient east–west sea trade routes. Although independent from British colonial rule only in 1957, it has a recorded history dating back to at least the first century CE, when the region was already the source of valuable mineral and forest produce that found markets in China, India and further west.

A tradition of Romano-Germanic or civil law defines the legal system in Finland. Laws of relevance to psychiatry are the 1990 Mental Health Act and, insofar as it pertains to forensic psychiatry, the Criminal Law (1889) and the Law on State Mental Hospitals (1987, revised 1997). These are outlined in the present paper.

Tajikistan, in Central Asia, gained its independence in 1991, with the break-up of the Soviet Union. There followed a period of civil war, 1992–97. In 2003, 64% of Tajikistan's population was poor, which was defined as living on less than US$2.15 per day at purchasing power parity by the UN Appeal for Tajikistan (2006). The Tajik healthcare budget appropriations decreased from 4.5% of gross domestic product in 1991 to 1.3% in 2005. The average annual rate of population growth is 2.19%. The estimated 7 320815 population of the country is mainly rural (73.5%) and about 38% of the country's population is under the age of 14. Life expectancy at birth is 62 years for males and 68 years for females. The infant mortality rate is 106.49 deaths per 1000 live births.

In Turkey, mental health professionals, together with patients and carers, have been involved in the drafting of the Mental Health Bill which is presently under consideration by Parliament. While the Mental Health Law is pending, various pieces of legislation are being used for different types of involuntary admission. The prospective Mental Health Law is of paramount importance for doctors, patients and families.

Brazil is a country with 170 000 000 inhabitants (census for the year 2000), of whom 138 000 000 live in urban areas. The illiteracy rate, that is, people over 15 years of age who cannot write or read even a simple message, is 13.4%. About 25.6% of the population live on a family income less than half the minimum wage (1999 figures). Brazil's gross internal revenue is R$564 800 per capita (1998 figures, about US$1680 today).

Over the past few decades, the emergence of evidence-based practice medicine (EBP) has allowed a change in the integration of knowledge with policy making and health service development, and Chile has been influenced by EBP with no exemption. In this paper, we will describe the impact of the EBP model at different levels of the Chilean health system, including the development of national clinical guidelines, medical training and in-patient involvement in health awareness.

This paper evaluates a model of community mental health service (CMHS) in Al Ain in the United Arab Emirates. The hospital records were reviewed and the total number of patient admissions and duration of in-patient care before and after enrolment in the CMHS were documented. Patient satisfaction with the CMHS was assessed using a questionnaire. The total number of admissions and the number of days that the patient spent in hospital per year were significantly reduced by the CMHS. Patients had high satisfaction rates with the information and advice they received, with their relationships with CMHS workers, with their access to mental health services and with their drug treatment.

The paper reports a descriptive survey of the referrals received by a new psychiatric liaison service in Rawalpindi in the first 2 years. The survey showed a rapid increase in use of the service, particularly by the emergency department. There was a lower proportion of referrals for self-harm and substance misuse than occurs in similar services in high-income countries but a higher proportion of patients presenting with dissociative (conversion) disorders. The large proportion of patients who had abnormal findings on physical examination remains unexplained and warrants further investigation.

Many legal mechanisms can be used to authorise compulsory community mental healthcare: leave or conditional discharge for compulsory in-patients; adult guardianship (or incapacity) legislation; treatment as a condition of a community-based criminal sentence, like probation, or of parole from imprisonment; or a full-fledged community treatment order (CTO) scheme. It is the specific mix of mechanisms employed in a particular jurisdiction that will characterise how that legal system manages the delivery of compulsory (or quasi-consensual) community psychiatric care.

In China, ‘community’ was an alien word. Many people used to live in dormitories (Danwei), to which they were assigned by government according to their work units. ‘Dormitory form’ community was closely linked to where people worked, and thus administration and supervision were simple, as was the provision of health services. In each Danwei, a clinic provided basic healthcare not only for its employees but also for the other residents of the dormitory. The old primary care service was based on this. In fact, the ‘golden age’ of community mental healthcare was at that time, when psychiatric hospitals extended their service to communities via the Danwei's clinics in the cities and via ‘barefoot doctors’ in the rural areas. Home beds, occupational therapy stations and shelter factories were set up in some cities and mobile mental health teams played important roles in the villages. Although this did not really represent the ‘integration’ of mental health into primary care, it was a good example of maximising the utilisation of the very limited mental health resources by stretching the psychiatric service, using administrative power, and mobilising family members (Shen et al, 1990; Zhang & Yan, 1990; Zhang, 1999).

There is limited information about stakeholder perceptions of health service provision in low- and middle-income countries. We conducted a cross-sectional survey of 821 stakeholders of the community mental health services in Pemba Island, Zanzibar, Tanzania. The aim was to obtain systematic information about coverage, barriers, accountability and room for improvement as a baseline before implementation of a new mental health policy to strengthen mental health services.

This paper compares across six nations the mental health systems available to prisoners with the highest acuity of psychosis and risk combined with the lowest level of insight into the need for treatment. Variations were observed within and between nations. Findings highlight the likely impact of factors such as mental health legislation and the prison mental health workforce on a nation's ability to deliver timely and effective treatment close to home for prisoners who lack capacity to consent to treatment for their severe mental illness. The potential benefits of addressing the resulting inequalities are noted.

Austria covers an area of some 84000 km2 and has a population of 8.1 million. According to World Bank criteria, Austria is a high-income country. The overall health budget represents 8% of gross domestic product (World Health Organization, 2005). The state of Austria is divided into nine federal provinces, which have significant legislative rights, including in healthcare provision.