It has been recognised that work is a positive factor for mental health since the days of Galen (2nd century CE). It was central to the theories and practice of William Tuke at the Retreat in York (founded 1796) and has continued in different forms as a therapy and/or a form of rehabilitation ever since. These forms can be usefully divided into four main categories: sheltered work, vocational training, transitional employment (or work experience) and supported employment. These broad categories have been adapted to different cultures and economic circumstances across the world. There are advantages and disadvantages to all forms, but the burgeoning research literature of the past 20 years does show that when it comes to finding people paid work in the open labour market, supported employment is markedly more successful than other methods.

The availability and use of mental health treatments are influenced by many different factors. Prominent among these are scientific evidence, cost, ethics and politics. However, the social sustainability of treatments can also have a considerable influence on their use.

Psychiatric sequelae may occur following traumatic injury irrespective of whether an insult has been caused to the brain. A range of psychiatric illnesses have been either causative of or associated with road traffic accidents and traumatic injuries, including depression, anxiety, post-traumatic stress disorder, substance use disorder and attention-deficit hyperactivity disorder. Despite literature on such associations, psychiatric intervention in the treatment of patients following traumatic injury is limited. The authors share their experience of challenges in addressing mental health problems in a tertiary care trauma centre located in North India. Steps in overcoming those challenges included: developing a semi-structured form to be completed for referrals and consultations, a psychiatrist attending weekly rounds with the surgeons, and initiating a psychiatry out-patient clinic for patients discharged from the trauma centre. It may be worthwhile in the future to set up a trauma psychiatry unit at the centre, involving a clinical psychologist, a psychiatric social worker and an occupational therapist for the comprehensive care of patients.

The challenges besetting the Philippine mental health system demand multifaceted, strategic responses to ensure the holistic well-being of Filipino youth. Through the integration of mental health into primary care, augmentation of the professional workforce, bolstering information infrastructure, reforming medication accessibility, augmenting budgetary allocations and invigorating governance, the Philippines can pave the way for an inclusive mental health system that adequately addresses the exigencies of its younger demographic. In doing so, the nation can make substantial strides towards alleviating the negative impacts of adverse social conditions, such as the COVID-19 pandemic, on the mental well-being of its youth.

Phallometry is an objective method of assessing male sexual arousal. The main applications in forensic psychiatry concern the evaluation of men charged with or convicted of sexual offences, the evaluation of those with suspected paraphilias not subject to the criminal justice system, risk assessment and measurement of response to sex offender treatment. In some jurisdictions, phallometry is incorporated into legal decisions about release from custody or discharge from secure hospitals. This paper provides a brief overview of the international development of phallometry, considers challenges to its broader adoption and discusses future directions for research and clinical practice.

The mission to find ‘the secret of the village’ is one attraction of engaging in mental health services in Bangladesh. Over the last 15 years much attention in world psychiatry has been given to the fairly robust finding that the prognosis of people with established and severe mental illness is better in ‘developing countries’ than in ‘developed’ ones (e.g. World Health Organization, 1979; Leff et al, 1990; Jablensky et al, 1992). Earlier assumptions that ‘developing’ is a simple variable were almost certainly a result of racist ignorance (Kulhara, 1994). Developing countries are not homogeneous. The variation in mental health outcomes seems to be clearer in more remote villages and tribal areas (Chatterjee et al, 2003), especially those that have less contact with Western (colonial) models of psychiatry and ways of life. More studies on this topic across a wider range of rural and urban settings would have much to offer. Is there something poisonous that comes with lots of expensive services? Or is there something missing?

Australia, a vast continent of 7 700 000 km2 (including the island state of Tasmania), is roughly the size of Western Europe or mainland USA, but with a population of only 20.2 million (2004 estimate), mainly concentrated in coastal areas.

This article is a summary of perspectives on training curricula from child and adolescent psychiatry trainees globally. We aimed to identify the relative strengths, weaknesses and gaps in learning needs from a trainee's perspective. The 20 early-career child psychiatrists who contributed are from 16 countries and represent all the five continents. We could identify some global challenges as well as local/regional challenges that need to be addressed to develop competent child psychiatrists.

The relationship between spirituality and behavioural addictions is complex. Although some studies have suggested spirituality to be a protective factor helping in recovery from addictive behaviours, others have found spirituality to be a potential risk factor. To better understand the relationship between spirituality and various behavioural addictions, this review summarises the literature on the association between spirituality and the following behavioural addictions: gaming disorder, gambling disorder, problematic internet use, problematic smartphone use, compulsive sexual behaviour disorder and compulsive buying/shopping disorder. Implications for clinical practice and future research are discussed.

At the turn of a new decade how might the futures of psychiatrists look? Here we address issues of social inclusion and, also, the professional identity and relationships of psychiatrists.

Lebanon is a western Asian country with an area of 10 452 km2 and a population of around 4 million (excluding the 10 million Lebanese immigrants worldwide). It has approximately 60 psychiatrists, mostly concentrated in the capital, Beirut, although a trend for decentralisation is currently observed. The number of psychiatrists is steadily increasing as postgraduate training centres have been established during the past decade. There are, however, few sub-specialists, owing to a lack of adequate training programmes.

The mental health of military veterans has been, and continues to be, a topic of heated political and journalistic debate. There is a well-documented impact of conflict upon the mental health of service personnel, and most nations have aimed to provide effective care for individuals who have fought for their country. However, as the three thematic papers in this issue demonstrate, the realities of service-related mental health are rather more complex than they initially appear.

Demographic ageing proceeds apace in all world regions (United Nations, 2003). The proportion of older people increases as mortality falls and life expectancy increases. Population growth slows as fertility declines to replacement levels. Latin America, China and India are experiencing unprecedentedly rapid demographic ageing (Figs 1 and 2).

Over the past few decades there has been a growing interest in first-episode psychosis (FEP), help-seeking behaviour and pathways to care. Treating psychotic disorders in their earliest stages has become a key focus for research and clinical care (Yung & McGorry, 2007). FEP studies show that the average time between onset of symptoms and first effective treatment is often 1 year or more (McGlashan, 1987). This long duration of untreated psychosis (DUP) is undesirable. Early treatment helps minimise the risk of the serious consequences of untreated psychosis, in terms of changes in mental state and behaviour (Larsen et al, 1998; Wyatt et al, 1998) and can reduce suffering (Ho et al, 2003). Some early results suggested that an ‘early intervention in psychosis’ (EIP) service is more cost-effective than generic services (Mihalopoulos et al, 1999).

There is a perceived increase in incidents of rhetoric, legislation and vigilantism against sexual minorities and their allies across Africa. This ‘African homophobia’ is counter to human rights conventions, public health best practices and sound economic development. The paper reviews areas of progress as well as the broad economic and cultural contexts for the experiences of African sexual minorities.

Egypt and the Sudan have historically provided a continuum of social and cultural exchange. With the Nile valley providing the only route between the Mediterranean and sub-Saharan Africa, Egypt became the natural host for Sudanese refugees.

The Republic of Mauritius is a group of islands in the south-west of the Indian Ocean, consisting of the main island of Mauritius, Rodrigues and several outer islands, situated 900 km to the east of Madagascar. It has a total land area of 2040 km2 and a population of around 1.2 million. Mauritius has a multiracial population whose origins can be traced mainly to Asia, Africa and Europe. English is the official language but French remains the most widely spoken, along with the local dialect, Creole, which is derived from French. Mauritius is classified as an upper middle income country in sub-Saharan Africa by the World Bank. It has a per capita gross domestic product (GDP) of US$13 200.

The prevalence of attention-deficit hyperactivity disorder is consistent worldwide. Psychiatric comorbidities are common, although less is known about how those comorbidities affect utilisation of healthcare services. Access to paediatric mental healthcare is a challenge in many regions. However, access to care in the United Arab Emirates (UAE) is supported by a well-established healthcare infrastructure with widely available primary care physicians. A review of diagnosis codes suggests that a clear correlation exists between the number of comorbidities and increased utilisation of available mental health services. Infrastructure in the UAE may represent a successful model for paediatric mental healthcare.