Different kinds of disaster create dissimilar conditions for survivors, and the specific realities associated with each must guide our helping responses. This in no way negates the importance of having general principles to follow in responding to major disasters (Sphere Project, 2004; van Ommeren et al, 2005).

This commentary highlights the poor availability of essential psychiatric medicines at public sector facilities in India and illustrates why even a flourishing generics industry does not assure access to affordable psychiatric medicines for most Indian patients. The paper outlines the Indian government's pricing regulations and then enumerates recommendations for reform.

New Zealand's healthcare system has undergone significant changes in recent times, among them being the establishment in 1993 of a purchaser/provider split and the specific attention given to the development of mental health services. Funding for mental health services (Fig. 1) increased from NZ$270 million in 1993/94 to NZ$866.6 million per annum in 2004/05, a real increase (adjusted for inflation) of 154% (Mental Health Commission, 2006). The bi-partisan political commitment sustaining this funding has had a major impact on the development of recovery-based and culturally specific models of care unrivalled by few countries in the world. However, recent reports (Mental Health Commission, 2006) indicate that, particularly with regard to access, much still remains to be done to address the mental health needs of New Zealanders.

Most scientists are now aware of what has been called the 10:90 divide (Saxena et al, 2006): the fact that 90% of the published scientific activity in the world comes from the richest 10% of countries. Many would like to brush off this simple fact as unimportant, but at another level it could be regarded as a scandalous disequilibrium of the planet's resources. One small way of reversing this is for editors to publish more papers from low-income countries and counter what can be described somewhat strongly as editorial racism (Horton, 2003). We have tried to do so in the British Journal of Psychiatry (Tyrer, 2005); this paper describes some of the difficulties.

Chile has approximately 600 psychiatrists for its 15 million people. Although in the capital city, Santiago, the provision (per capita) is twice as high as in the rest of the territory, it is possible to see over the past decade a progressive increase in the number of these specialists in the other main cities. There are no more than 50 child psychiatrists and several cities have no local resource in this sub-speciality.

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.

The Eastern Mediterranean Region of the World Health Organization has recently developed a comprehensive strategy and action plan to promote mental health and provide for the integrated prevention, treatment and rehabilitation of mental, neurological and substance use disorders. By strengthening national mental health policies, plans and legislation, scaling up integrated services, capacity-building, promoting human rights and prioritising vulnerable groups, the strategy aims to improve mental health and to help countries achieve their national development objectives.

In Pakistan, an increasing proportion of psychiatric patients present to community health services as crisis admissions, with their relatives as the main decision makers. Patients are bound to perceive this process as coercive. Farnham & James (2000) report that elements of coercion are found even in voluntary hospital admission, in the form of verbal persuasion, physical force and threats of commitment. Few patients consider hospitalisation justified and most view the process of admission negatively (Swartz et al, 2003; Katsakou & Priebe, 2006; Priebe et al, 2009).

There is now an increased awareness of the high rates of depression among women with young children in impoverished communities. Poor maternal mental health affects the home environment, family life, child care and parenting. This paper summarises some of the issues related to the determinants, consequences and management of maternal mental health during and after pregnancy in Pakistan, a low-income country.

In 2001, Richard Smith, then editor of the BMJ, asked why doctors were so unhappy. He provoked a huge international response. The suggested reasons included: changes in the social structures of work; the demographic shift and difficulties in the recruitment and retention of staff; the replacement of trust with accountability; changes in relationships with people and bodies that are responsible for policy and practice; and negative media reporting.

The Mental Health Ordinance 2001 was the last comprehensive legislation on mental health policy in Pakistan, replacing the Lunacy Act 1912. Since then, most of the amendments to the act have only delineated the jurisdiction of the provincial governments. Failure to account for mental illness in Pakistan brings with it unique challenges, such as the criminalisation of suicide and exploitation of blasphemy laws. There is a need for organised efforts to promote awareness of mental illness, amend the obsolete legislation in conformity with the scientific evidence, implement mental health policy effectively and deal with sensitive issues that have a strong sociocultural or religious background.

Drug dependence treatment in Nigeria is at an early stage of development. The first ‘stand alone’ drug dependence treatment in-patient unit in Nigeria, the Drug Addiction Treatment Education and Research (DATER) unit, Aro, Abeokuta, Nigeria, was established in 1983. Prior to this, patients with drug dependence received care along with other patients in psychiatric wards and traditional healing homes (United Nations International Drug Control Programme, 1998). Currently, there is no national body in Nigeria actively involved in regulating or facilitating good practice in drug dependence treatment.

As part of a pilot programme to scale up community mental health services, local health centre directors, community health workers and key informants were interviewed in two neighbouring political districts of Niger. Major priorities for improving services included training staff on the diagnosis and treatment of mental illness, collaborating with traditional healers, educating the community about the origins of psychiatric illness and building infrastructure for medication delivery. Barriers to care included long distances for travel to the nearest hospital and lack of funding for home-based visits by health workers. This study was the first step in Niger's plan to implement the World Health Organization's Mental Health Gap Action Programme (mhGAP) at a national level.

Suicide rates and rates of self-harm are high in Mauritius. This report concerns a comprehensive analysis of the incidence of self-poisoning on the island. The incidence of self-poisoning could be minimised if all the causative factors contributing to the practice were identified. Since this form of self-harm is influenced by demographic patterns, the social and economic environment, legal provisions and the healthcare system, a study specific to Mauritius will be of great relevance.

Brunei Darussalam occupies a sliver of land on the northwest coast of the island of Borneo with a geographical area of just 5765 km2 (Government of Brunei, 2004). It is divided into the four districts: Brunei-Muara, Temburong, Tutong and Belait. Two-thirds of the land is covered by lush tropical rainforest and the climate is perpetually warm and humid. It is ruled by Sultan Hassan Al-Bolkiah, the head of a dynasty which has governed Brunei for 650 years.