Having spent a considerable amount of time thinking about the uses of large-scale descriptive psychiatric epidemiological needs assessment surveys in our capacity as co-directors of the World Health Organization's World Mental Health Survey Initiative, we agree with many of the conclusions of Henderson and Andrews. Most importantly, we agree:

1. ∘ that among the most important benefits of these surveys have been their political value in documenting high prevalence and high disability

2. ∘ that the time has come to expand the focus to study causes.

Recently, the UK government expressed concern about the rising tide of antisocial behaviour among young people who, in certain areas of the country, were habitually engaging in acts of minor delinquency – often fuelled by drink. On the other hand, legislation was introduced to make it legal for premises that sell alcohol to remain open longer, up to 24 hours a day. This latter arrangement has courted considerable controversy. For example, the British Medical Association commented that any extension to licensing hours requires a programme of research, after its introduction, to look at its health consequences - both acute and chronic.

This note is written for two reasons: the first is to thank Drs Ndetei, Karim and Mubbashar for their fine article (Ndetei et al, 2004) and for reminding the readers of International Psychiatry of the problems arising from the ‘brain drain’; and the second is to comment on the astonishing argument presented in the paper written in reply by Catherine Jenkins, of the UK Department of Health (Jenkins, 2004).

Services for people with intellectual disabilities, in the UK as elsewhere, have changed dramatically over the last 30 years; deinstitutionalisation has probably been the largest experiment in social policy in our time. The vast majority of people with intellectual disabilities, their families and carers have benefited from having a better quality of life as a result of deinstitutionalisation. However, much still needs to be done to integrate this population more into society and to ensure they are offered the appropriate supports to meet their needs.

For over a thousand years, the Hippocratic system of medicine prevailed in Europe. It went into oblivion during the Dark Ages, when there was a reversion to the demoniacal theories of mental illness. Hippocrates’ works survived, however, in the library at Alexandria, where they were translated into Arabic. These and other classical works were retranslated into Latin and Greek from the 12th century on, ushering in the Renaissance.

The Shetland Isles are a place of breathtaking landscapes and pristine wildlife. As harsh as the weather can be, so warm and welcoming are the people and their proud half-Scottish, half-Scandinavian culture. Practising psychiatry in this northernmost outpost of the UK involves significant challenges. The authors were the only two psychiatrists based on this remote island group, which is home to 23 000 people.

A brief account of the three stages of development of a new mental health law in Iran is given. At each stage, the expert opinions of mental health professionals and lawyers interested in the rights of psychiatric patients were obtained. The final draft of the law consists of six sections and 50 articles. It has been submitted for ratification by Parliament.

In the wake of the COVID-19 pandemic, healthcare systems rapidly embraced technology as a means of providing care while adhering to social distancing protocols. In this brief article, we report on a new telehealth initiative recently implemented in an out-patient psychiatric setting and outline the novel role telehealth may serve in facilitating psychiatric care globally. The uptake of telehealth represents a new and exciting opportunity to increase both access to, and quality of, care for people with mental illness.

This paper discusses the services and treatments that are offered in Montenegro to persons who are mentally ill. A short history is given. The law on the protection of the rights of patients who are mentally ill is described, along with the regulations governing voluntary and forced treatment. An action plan for promoting mental health has been partly already realised but some of its aims still need to be accomplished.

The landscape of some low- and middle-income countries is sadly all too often littered with the remains of well intentioned health development projects that have failed. The Kintampo Project in Ghana is an education intervention that is set to achieve the most elusive of outcomes in development work, namely genuine sustainability. This article focuses on the challenges faced by the project and the factors that have allowed it to reach its targets.

Despite attempts made in recent years to address the diagnosis and treatment of mental illness in Mozambique, service provision remains deficient. The present paper focuses on the attitudes to mental illness and its diagnosis and treatment in Mozambique. This paper is based on both a thorough literature search and on the results of qualitative interviews carried out with six individuals of Mozambican origin now living in the UK.

This paper describes a postgraduate training programme in child and adolescent mental health (CAMH) in Nigeria. It explains the background, curriculum development, teaching, evaluation and outcomes. By its 10th year the programme had trained 166 CAMH professionals from 14 African countries. Many of the graduates are running clinical CAMH services in their countries, mostly pioneered by them. They are also conducting CAMH training, including as faculty on the programme, and some are in international CAMH leadership roles. Key success elements of the programme that can be replicated in other low- and middle-income countries include international partnership, adopting a train-the-trainer approach, using a curriculum that covers clinical aspects of CAMH while also developing leadership and research skills, use of free-access training resources, and access to seed funding.

The Dominican Republic is located in the Caribbean Sea and comprises three-quarters of the island Hispaniola, which it shares with Haiti. According to the 2002 census, approximately 8.5 million people live in the Republic, with 64% residing in urban areas (Oficina Nacional Estadística, n.d.). During 1990 and 2000, the Dominican Republic was a leader in economic development for Latin America and the Caribbean; however, this was not reflected in the areas of human and social development (Pan American Health Organization & World Health Organization, 2007). Less than 1 % of the health budget administered by the Ministry of Public Health and Social Assistance (MISPAS) is allocated to mental health and the public system is generally underfunded (Pan American Health Organization & World Health Organization, 2008). However, there is an array of mental health services within the country when privately funded facilities are taken into account.

Bolivia's mental health plan is not currently embedded in mental health legislation or a legal framework, though in 2014 legislative change was proposed that would begin to provide protection and support for the hospital admission, treatment and care of people with mental disorders in Bolivia. Properly resourced, regulated and rights-based mental health practice is still required. Mental healthcare in the primary care setting should be prioritised, and safeguards are needed for the autonomy of all patients, including all those in vulnerable and cared-for groups, including those in prisons.

East Timor (the Democratic Republic of Timor-Leste) occupies the eastern half of the island of Timor, which lies between North Western Australia and the Indonesian archipelago. East Timor has a population of around 860 000. It is predominantly rural and there are few large towns. The country has a largely subsistence agricultural economy; coffee is the principal cash crop. The population is extremely poor, and transport and communications are primitive.

This paper describes the evaluation of a pilot e-supervision programme, with a focus on feasibility. The findings suggest that e-supervision in mental health using the World Health Organization (WHO) Mental Health Gap Action Programme (mhGAP) Intervention Guide and case-based discussions is valued by participants and can improve the knowledge, confidence and beliefs of primary care doctors in low- and middle-income countries.

Gypsy, Roma and Traveller (GRT) communities have considerably worse mental health outcomes than the general population and many other ethnic minority groups. We argue that there is a dynamic, interplaying ‘accessibility mismatch’, resulting in a failure of healthcare services to adequately understand and work with GRT communities in a meaningful way. The consequences are limited engagement and poor health outcomes. Contact with services is often at crisis points, such as in forensic services, which reinforces existing prejudice. Research is limited, and therefore so is the evidence base. It is critical that the UK's National Health Service takes a culturally informed approach to co-produce services that are accessible and responsive to GRT communities. Here we offer practical actions that healthcare organisations can undertake to help redress imbalances and increase equity of healthcare outcomes for these overlooked populations.