Intellectual disability was recognised in ancient Indian literature, but organised services have a history of just five decades. India shares many features of low- and middle-income (LAMI) countries regarding intellectual disability. There is a low level of awareness about its nature, causes and interventions. One can come across many superstitions, myths and misconceptions about intellectual disability. In general, services are inadequate, being concentrated in big cities and urban areas. There is generally limited access to support services and few government benefits, and these, in any case, are often of little value (World Health Organization, 2007). Locally and nationally, there are few relevant and reliable epidemiological data on the prevalence of intellectual disability. However, there have been some positive developments within the past three decades, and they are the focus of this paper.

Aboriginal Australians have relatively high rates of intellectual disability, a situation that is probably due mainly to poor health and social disadvantage. Populations with high rates of intellectual disability are more at risk of developmental disorders and mental ill health. We explore the training needs for psychiatrists working with indigenous people and how they can be met.

We have conducted a qualitative study to collect information about services for adults and older adolescents with intellectual disability in Mexico, as part of ongoing research on intellectual disability from a public health and rights-oriented perspective. Our focus is on existing services and outstanding needs. One of our main goals is to provide an opportunity for people with intellectual disability to convey their experiences and express their opinions about the additional services they require. Three types of service are included: those supporting autonomy or independence (personal and economic); those enhancing community inclusion; and those providing vocational opportunities.

The National Health Service (NHS) serves the UK through four devolved organisations for England, Scotland, Wales and Northern Ireland. It is one of the largest public healthcare systems in the world, universal and free at the point of delivery. Its key challenge is to maintain this approach within tight financial constraints, while embracing new technologies, treatments and styles of service delivery, as well as meeting the health needs of an ageing population.

The Solomon Islands is situated in the South Pacific Ocean and is a low-income country. It comprises nearly 1000 islands with a total land area of 304 000 km2 spread over a sea area of about 1 500 000 km2, making communications, travel and service delivery difficult and creating inequities in access. The population of the Solomon Islands was estimated to be just over 580 000 in 2008, and is young, with 42% aged under 15 years (Solomon Islands Ministry of Health, 2006). The majority of the people are Melanesian (93%) and 98% of the population belong to a Christian church. The population is, though, extremely diverse, with 91 indigenous languages and dialects being spoken, in addition to the Solomon Islands pijin (the most common language) and English (the official national language). Over 83% of the population live in rural areas, where subsistence agriculture, fishing and food gathering are the main sources of income. There is no substantial tourist industry. The gross domestic product (GDP) is US$1.5 billion and annual per capita income is approximately US$2800 (International Monetary Fund, 2009). Total expenditure on health represented 5.6% of GDP but only 1% of the total health budget is allocated to mental health (World Health Organization, 2005).

Working in psychiatry is generally rewarding. However, it can also lack job satisfaction and be detrimental to personal life. Research findings indicate high rates of burnout (Kumar et al, 2007), impaired health status of practitioners (Korkeila et al, 2003), negative effects of violence in the workplace (Inoue et al, 2006) and lack of job satisfaction (Fischer et al, 2007; Bressi et al, 2009).

In 2006, the Azerbaijan Ministry of Health and the World Bank launched the 6-year Health Sector Reform Project (HSRP). The principal goal of the Project is to prepare and implement a fundamental and comprehensive reform of the health system in Azerbaijan, including a major emphasis on strengthening the primary care system (Ministry of Health Project Implementation Unit, 2007). The project envisions the development of a new optimised system of services, with the integration of mental health into general healthcare. In the line of this process, the Public Health and Reform Centre (PHRC) of the Ministry of Health has developed evidence-based clinical practice guidelines on depression, for implementation within primary care (Ministry of Health, 2009). At the same time, representatives from the PHRC and the Departments of Psychiatry and Family Medicine of Azerbaijan Medical University, as well as the State Institute for Advanced Training of Physicians (in cooperation with the World Health Organization Country Office), formed a task force to carry out a survey to assess the need for education in mental health for primary care doctors. A total of 308 primary care doctors (see Table 1) working in 14 settings in different regions of the country were randomly selected and interviewed by the research team.

In 1977 the World Health Organization recommended that every country throughout the world should have a national plan for child mental health. The United Nations Convention on the Rights of the Child has been another important stimulus for child mental health policies and services in many countries. Adopted unanimously by the United Nations General Assembly in 1989 and instituted as international law in 1990, the Convention is an agreement on the basic protections that should be accorded to children. Adopted in 1961, the European Social Charter is the major European treaty that secures children's rights. In 1996 the Charter was revised and expanded to include a list of core obligations of the contracting parties relating to the recognition of social, legal and economic rights for children and young persons.