A set of principles which might underpin mental health law across the world is discussed, and one particular difficulty is highlighted.

For the past decade, overt unrest and danger have typified daily life for many families in Iraq and Afghanistan, while in Egypt under the former regime a superficial appearance of political stability lay over a sense of deep discontentment. What impact does living in those circumstances have on mental health? We asked psychiatrists with personal knowledge of events in three countries that have recently been riven by war and revolution to discuss their experiences. Because so few objective data are available on the impact of stress in any of the three regions reviewed, the authors have inevitably relied in large part upon anecdote and upon news reports from the internet.

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.

Since 2003 Iraq has experienced significant challenges in reforming and rebuilding its health services. A national mental health survey reported a high level of mental health problems consistent with a country that has experienced widespread violence and trauma. The survey also highlighted limited access to services. This paper outlines developments in and plans for mental health services in Iraq.

The 2011–12 Egyptian revolution (thawret 25 yanãyir, revolution of 25 January) took place following a popular uprising that began on Tuesday 25 January 2011 and is still continuing. The uprising was mainly a campaign of nonviolent civil resistance. In this revolution the participants have proved that if resistance begins with sincerity and unity, it may yet achieve victory.

Nigeria's current mental health legislation stems from a lunacy ordinance enacted in 1916 that assumed the status of a law in 1958. The most recent attempt to reform the law was with an unsuccessful Mental Health Bill in 2003. Currently, though, efforts are being made to represent it as an executive Bill sponsored by the Federal Ministry of Health. The present paper reviews this Bill, in particular in light of the World Health Organization's recommendations on mental health legislation.

This paper first briefly reviews the history of psychiatric services in Egypt. It then details the legislation in place during the last years of the Mubarak regime and goes on to set out recent developments, in particular the Code of Practice introduced for the Mental Health Act of 2009.

This paper reports admission rates within the acute service at a major South African tertiary psychiatric facility, Lentegeur Psychiatric Hospital (LPH) in Cape Town.

The authors wanted to learn whether it was possible to deliver cognitive-behavioural therapy (CBT) in a low-income country where English is neither the first nor the preferred spoken language and to evaluate the effectiveness of the training in terms of skills acquisition. Twenty participants attended a 3-day workshop on the technique. All had experience of communicating in Hindi with patients, although their medical training was in English. There is no manual for CBT in Hindi. Role-plays focused on basic CBT skills such as Socratic dialogue, the ‘five area’ approach, the use of the ‘downward arrow’, developing an automatic negative thought record and devising behavioural experiments, in Hindi. The findings suggested that it is feasible to train mental health professionals in CBT where English is not the first language.

To determine the rate of self-burning among all burns patients admitted to the Burns and Plastic Surgery Centre at Sulaimani University in Iraqi Kurdistan and to identify the risk factors and motives, all burns patients, aged 8 years and over, admitted between 1 September 2009 and 30 April 2010 were surveyed. Of the 200 patients interviewed, 54 (27%) reported self-burns and 146 (73%) reported accidental burns. The risk factors for self-burning included mental illness, female gender and younger age. Almost two-thirds of those who reported self-burns (32, 60.4%) had intended to kill themselves. The most commonly cited reasons for the act were family problems (24, 44%) and marital problems (13, 24%). Burns in the self-burning group were more severe and were associated with a higher mortality rate (34, 63%) than in the accidental burns group (29, 20%).