This book is a delight to read. By one of our leading international psychiatrists, it brings both wisdom and knowledge to bear on many key issues that the mental health movement currently faces. It is a collection of essays, some written especially for the book, others based on previous writings and lectures. The introduction gives us a fascinating insight into the development of Sartorius the psychiatrist – his desire to study medicine, to move into psychiatry and to include psychology in his portfolio; he describes a formative influence on his subsequent approach to mental health, and his desire to seek out a broader strategic role. ‘In order to make the best use of my working life’, he writes, ‘I applied myself to strengthen psychiatry, ethically and scientifically as a profession; I sought ways of bringing psychiatry closer to medicine for the benefit of both; and I tried to see ways in which political tools can be used to improve education, research and training in the field of mental health and in developing mental health programmes.’

The first group of essays examines the sociocultural context for mental health, including a discussion of social capital and the balance between rights and responsibilities, controversially challenging developmental dogmas such as concern about population growth in low-income countries, and the value of health services research in such countries. He tackles conceptual confusion vigorously. Instead of quailing before the problem he is intrigued by the health care possibilities that increasing urbanisation affords.

The second group of essays looks at the interface between mental health and general health care (there is some overlap between the chapter on primary health care and the chapter on general health care, but both chapters are well worth reading). Chapter 10 is an engrossing inside history of the mental health division of the World Health Organization (WHO) and a reminder of our loss with Sartorius's departure from the WHO.

The third group focuses on psychiatry, and one chapter asks why we are not doing more on prevention. Sartorius did much to stimulate conceptual thinking on prevention in the 1980s when it was deeply unfashionable. He is also passionate about the need to tackle stigma, which occurs with surprising intensity at all levels of social structures. I particularly liked the chapter on research in psychiatry where he points out that the current emphasis on operational criteria has prematurely reified our classification systems and their reliability at the expense of enhancing validity in relation to phenomenology, laboratory findings and epidemiology.

This is a book to savour: it is enjoyable as a straight read, perhaps on a long flight, but is also a book for the bedside, to dip into from time to time. There is plenty to agree with, some things to disagree with; but above all this book is contemporary and inspiring, challenging psychiatrists to become more involved with the wider contextual milieu in which we operate.