Nigeria, like other African countries, is short of personnel trained in mental healthcare. Efforts to tackle the problem have often focused on increasing the numbers of psychiatrists and nurses in the field. These efforts, over the past 20 years, have not appeared to have greatly improved service delivery at the grass roots. Most of the specialist centres where such highly trained personnel work are in urban areas and for a large part of the population access to them is limited by distance and cost.

In this narrative review we consider what is known about mental health conditions in the prison system in Bangladesh and describe the current provision of mental health services for prisoners with mental health needs. We contextualise this within the literature on mental health conditions in correctional settings in the wider sub-continental region and low- and middle-income countries (LMICs) more broadly. We augment findings from the literature with information from unstructured interviews with local experts, and offer recommendations for research, policy and practice.

Mental health legislation protects the rights of people with mental illnesses. However, despite major social, political and cultural changes, Sri Lankan mental health services still operate on laws enacted mostly during the British rule more than a century ago, in the pre-psychotropics era, and focusing more on the detention of people with mental illnesses than on their treatment. It is high time all stakeholders made efforts for the much-awaited new Mental Health Act to pass through parliament urgently to meet the needs and protect the rights of patients, their caregivers and service providers.

An understanding of the current state of mental health services in the United Arab Emirates (UAE) from a clinical perspective is an important step in advising government and stakeholders on addressing the mental health needs of the fast-growing population. We conducted a retrospective study of data on all patients admitted to a regional psychiatric in-patient unit between June 2012 and May 2015. More Emiratis (UAE nationals) were admitted compared with expatriates. Emiratis were diagnosed more frequently with substance use disorders and expatriates with stress-related conditions. Psychotic and bipolar disorders were the most common causes for admission and had the longest in-patient stays; advancing age was associated with longer duration of in-patient stay.

In this issue, three papers discuss the issue of the brain drain: of psychiatrists from Egypt and Nigeria, and of nurses from East Africa. They explore the complexities of professional migration and its impact on the health of populations in source and recipient countries; they also review how recommendations for changes in policy and practice might influence the so-called ‘push’ and ‘pull’ factors that aggravate the brain drain.

Many patients in Nigeria consult traditional healers before, or in parallel with, modern psychiatric services. Part of the attraction of traditional medicine for the populace, apart from its lower cost and easier accessibility, may lie in its ‘cultural’ explanatory concepts of the nature and course of mental disorder.

When Thomas Szasz summed up his philosophical principles at the Royal College of Psychiatrists' annual meeting in Edinburgh in 2010, he declared that ‘freedom is more important than health’. Psychiatry is the arena in which the conflict between freedom and health comes most sharply into focus, according to Szasz. This paper proposes some parallels with medicine in low-income countries for pointers towards a resolution of this conflict.

The importance of traditional healing in low- and middle-income countries cannot be under estimated. It is generally perceived as part of the prevailing belief system and traditional healers are often seen as the primary agents for psychosocial problems in these countries; estimates of their service share range from 45% to 60% (World Health Organization, 1992). The World Health Organization (2000) estimated that 80% of people living in rural areas in low- and middle-income countries depend on traditional medicine for their health needs.

The European Psychiatric Association (EPA), the main association in the field of mental health in Europe, has long been supporting the development of early career psychiatrists. The EPA Early Career Psychiatrists Committee (ECPC) and its core task forces promote research activities among young psychiatrists, contribute to their professional development through organising courses and other educational events, prepare online educational materials and publications, and actively collaborate with other organisations. The EPA ECPC is always open to fostering cooperation on new professional, educational or research initiatives with early career psychiatrists from different countries.

Sri Lanka ranks highest in the region for human development. Despite producing the first female head of state in the world, the country has failed to achieve substantial gains in the gender inequality indices in the past decade. In recent years, the proportion of females in secondary education has equalled that of males, and young women have become the majority among the university entrants. These educated young women are likely to face psychosocial distress in a patriarchal society where they would be expected to fulfil traditional gender roles. This article describes gender disparities that could affect the mental well-being of young Sri Lankan women and the need for awareness among mental health professionals in the country.

Stigma attaching to mental illness has been considered a major challenge to public policies, to the provision of care and to the well-being of people who live with the experience of mental illness worldwide. Here we discuss narratives from peer support workers which we obtained during the assessment of a new psychosocial intervention programme in Rio de Janeiro. We used a range of focus groups, in-depth interviews and clinical supervision notes to derive these narratives, which covered topics such as the peer support workers' perceptions of family and social views, their sense of self and the experience of being stigmatised. We conclude that stigma appears to be a barrier to recovery. Peer support work for people with severe mental illness is a strategy that may help them to overcome stigma and discrimination. Fostering mutuality and hope in the context of peer support helps affected individuals to make sense of their being in the world and can facilitate their recovery.

The paper describes the current provision of psychiatric services in Algeria – in particular, in-patient and out-patient facilities, child psychiatry and human resources. Education, training, associations and research in the field of mental health are also briefly presented. The challenges that must dealt with to improve psychiatric care and to comply with international standards are listed, by way of conclusion.

The profound political, social and economic changes that occurred after the end of communist rule in Central Europe in 1989 had a profound influence on Czech psychiatry. In the socialist Czechoslovakia the healthcare system was fully owned, financed and organised by the state, in so-called regional institutes of healthcare. These had obligatory catchment areas of about 100 000 inhabitants and comprised in-patient as well as out-patient care facilities, including psychiatry. The main trends after 1989 were decentralisation of the healthcare system, rapid privatisation, especially of out-patient services, and financing through the newly established health insurance corporations.

The International Health Partnership (‘the Link’) between the East London NHS Foundation Trust and Butabika Hospital in Uganda was set up in 2005. It has facilitated staff exchanges and set up many workstreams (e.g. in child and adolescent psychiatry, nursing and psychology) and projects (e.g. a peer support worker project and a violence reduction programme). The Link has been collaborative and mutually beneficial. The authors describe benefits and challenges at individual and organisational levels. Notably, the Link has achieved a commitment to service user involvement and an increasingly central involvement of the Ugandan diaspora working in mental health in the UK.

The article describes the changes that have taken place in the mental healthcare system in Russia since a new mental health law came into force. The focus is on involuntary hospitalisation and the guarantee of patients' rights.

Stress and burnout are major issues affecting medical trainees, especially psychiatry trainees, throughout the world. Stress and burnout were studied using an online survey among psychiatry trainees of the National Institute of Mental Health and Neurosciences (NIMHANS) which is one of the oldest and largest training centers in India. Postgraduate training in academic institutions like NIMHANS, while offering excellent teaching experience, may impact the mental and physical health of trainees due to complex clinical challenges and academic pressure. Measures need to be taken to enhance trainee well-being by ensuring support from colleagues and seniors, allowing for an adequate work–life balance, introducing departmental level committees to address grievances and providing therapy and mentorship. Providing safe and non-stigmatizing spaces to seek help in workplace promotes whole-person growth and well being.

This article briefly assesses the historical trajectory of psychiatric institutions in the Middle East. It underlines a key observation: the persistence and expansion of psychiatric institutionalisation, specifically in the Arab world. In contrast to the deinstitutionalisation that eventually closed large psychiatric hospitals in the 1960s and 1970s, notably in Europe and North America, psychiatric hospitals have continued to grow in size in the Arab world. This absence of deinstitutionalisation marks a major departure from how psychiatry developed in the West, which is worth reflecting on if we are to understand the current crumbling infrastructure of in-patient psychiatric facilities in the Arab region.

The Republic of Yemen, on the south-western coast of the Arabian Peninsula, was formed in 1990 when North and South Yemen united. Yemen covers 527 970 km2. The capital is Sana'a. The country is divided into 20 governorates and one municipality. It has an elected president, an elected House of Representatives, and an appointed Shura Council. The president is head of state, and the prime minister is head of government. Suffrage is universal for people aged 18 and older. The population of Yemen according to the 2004 census is about 20 million, but recent years have seen the arrival of many refugees.

Singapore is a modern city state and the smallest nation (land area of 699 km2) in South East Asia. Its population of over 4 million is multiracial, with the Chinese (76.8%) constituting the majority of the population, followed by the Malays (13.9%) and the Indians (7.9%). The present health system is one that stresses individual responsibility, based on a system of compulsory medical saving accounts and on market mechanisms for the allocation of scarce healthcare resources. There are both public and private healthcare sectors. Since 1985, every public sector hospital has been ‘restructured’ — to grant some degree of autonomy in operational matters, with the intention of creating competition and financial discipline, although the government still retains 100% ownership of the hospitals.

Education in modern medicine in India began in 1835 with the establishment of the Madras Medical College, in what is now Chennai. Initially the growth of new medical schools was slow but it gathered pace after independence in 1947. In the past decade or so, the growth in terms of the creation of new medical schools has been phenomenal.