We used medical record abstraction to conduct research in a psychiatric hospital with paper-based medical records. The challenges we encountered included: the difficulty in retrieving files; the extensive effort and time needed to extract clinical information; the lack of a standardised documentation system of medical records; and the need for advanced computer literacy. To promote future research using electronic medical records, potential solutions include creating a registry of all patients receiving treatment, as well as equipping busy clinicians with computer skills.

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.

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.

In 2014, Brunei implemented the Mental Health Order, which replaced the 1929 Lunacy Act. This new legislation was designed to improve the treatment of mental disorders and to protect the rights and welfare of people with mental disorders. This short report describes the experience and challenge of implementing the new legislation, with a particular focus on the use of involuntary treatment and the restrictions imposed on people with mental disorders despite the new legislative framework.

The Bolivarian Republic of Venezuela covers 916 445 km2; to the north is the Caribbean Sea, to the south-east the Amazonian region and the plains of Brazil and Colombia, and to the west the Andes and the Colombian Guajira peninsula. Its estimated population (2004) is 25 226 million, which is concentrated along the north coastal area, where the population density exceeds 200 inhabitants per km2; most of the territory remains almost inhabited (fewer than 6 inhabitants per km2), in particular the border areas. The population is mainly urban: 70% live in cities with more than 50 000 inhabitants.

Health care will undoubtedly change over the next 20 or 30 years as eHealth technologies become increasingly used and accepted (Treister, 1997; Yellowlees, 1997, 2001). At a global level, the health care system is moving away from episodic care to concentrating on continuity of care, especially for patients with chronic diseases (Yack, 2000), who will give rise to the greatest disease burden in the future (Murray & Lopez, 1999). Many countries are gradually moving away from a focus on the service provider to a focus on the informed patient, and from an individual approach to treatment to a team approach. Increasingly there is a concern less with the treatment of illness and more with the need for wellness promotion and illness prevention, which, of course, parallels a shift away from traditional care to community care.

When the world of public health considers the health of women, one tendency is first and foremost to link the well-being of women to that of children and the family, and, legitimately, to the health of society overall. Epidemiological data point to sex differences in the patterns and clusters of psychiatric disorders and psychological distress. The origins of much of the pain and suffering particular to women can be traced to their social circumstances. Depression, hopelessness, exhaustion, anger and fear grow out of hunger, overwork, domestic and civil violence, entrapment and economic dependence. Understanding the sources of women's ill health demands awareness of how cultural and economic forces interact to undermine their social status. This article highlights aspects of social suffering among women in Iran. Self-inflicted burns, a significant indicator of mental health among Iranian women, are discussed in order to increase awareness of the phenomenon among the international community, as a first step towards initiating an improvement in the health of women in Iran.

According to Beauchamp & Childress (2001) the fundamental principles of biomedical ethics include ‘justice'. But how do we approach ‘justice'? Justice may be thought of in relation to an individual or society. An individual may be just or unjust. Justice in society may be thought of as ‘retributive justice’ (fair punishment), ‘civil justice’ (fair recompense), ‘distributive justice’ (fair shares) or ‘social justice’ (a fair social contract for citizens of a society).

This article looks at the evidence that not only did mental health problems affect people in the past, but that the physicians of past eras made numerous attempts to understand, classify and treat mental illness. Our aim is to show the strong scientific reasoning during the medieval era, in the Islamic world in particular, and how the complexities encountered by physicians centuries ago still haunt psychiatrists today.

The Philippine Mental Health Act upholds the rights and inclusivity of all people, regardless of gender and sexual orientation, within mental health services and programmes. Nevertheless, a noteworthy challenge lies in the inadequate attention given to the needs of LGBT+ individuals within the medical and health professions education in the country. Therefore, it is imperative to integrate LGBT+ mental health into psychiatric residency training. To address this gap, this paper proposes the inclusion of concepts relevant to LGBT+ mental health, including minority stress, intersectionality, identity concealment and LGBT+-affirming practices, to enhance the understanding and response to the needs of LGBT+ Filipinos.

The Kingdom of Bahrain is an archipelago of 33 islands, located in the Arabian Gulf, covering 2400 km2. The main island, Manama, is the nation's capital. The total population stands at 742 562, 62.3% of whom are local Bahrainis and the remaining 37.7% expatriates (Central Statistics Organisation Directorate, 1991). Bahrain first entered the historical stage around 3000 BC, and for almost 2000 years was the centre of the old Dilmun civilisation (Bibby, 1969). Dilmun was perceived as a sacred land by the Sumerians and Babylonians; it was a burial ground for their dead, and Bahrain has over 100 000 burial mounds each containing 200-250 bodies. In the old Babylonian epic of Gilgamesh, which antedates Homer's Iliad, Dilmun is described as a paradise where the worthy enjoy eternal life (Clarke, 1981).

The International Congress of the International Association of Child and Adolescent Psychiatry and Allied Professions (IACAPAP) takes place every other year. It is an opportunity for specialists from around the world to meet, exchange ideas and plan new projects. Since 2006, the Donald J. Cohen (DJC) Travel Fellowship has been an integral part of the Congress. It aims to foster the professional development of ‘emerging leaders’ in child and adolescent mental health (Adler et al, 2007).

In-patient treatment is a complex system of recursively interacting components. Patient characteristics interact with caregiver characteristics, home context and ward factors. Quality improvement requires primary focus on the interacting factors over which the ward itself potentially has influence. Ward practice has to integrate the demands of the hospital owner, the legal framework for treatment and what we know facilitates effective treatment plans. We describe how we have implemented a quality improvement system that addresses these interplaying influences in acute adolescent psychiatry in Norway. The process involved with this system (developed in the UK for child and adolescent psychiatric units) is independent of the organisational structure of the department and which alternative resources it has to rely on. It is independent of the characteristics of the patient population, although specific standards can be developed for local requirements.