With rapid growth and development in recent decades, the State of Qatar has been redefining strategies and policies towards building a world-class healthcare system. Mental health has emerged as a priority area for development. As a result, mental health services in the region are being redefined and expanded, and this was realised with the launching of the ambitious National Mental Health Strategy in 2013. Traditionally, mental healthcare in Qatar had been considered to be the remit of psychiatrists within secondary care. The new strategy supported the transition towards community-based care. It outlined a plan to design and build a comprehensive and integrated mental health system, offering treatment in a range of settings. In this article, we provide an overview of the advent of primary care mental health services in Qatar. We discuss the historical aspects of psychiatric care and development of primary care mental health services in Qatar.

This paper reflects on the development of a capacity-building programme to support a mental health service modernisation pilot project based in the Lviv region of Western Ukraine. National programmes that aim to modernise mental health services now have the experience of other countries on which to draw. The challenges faced by such modernisers have much in common. Nevertheless, although there are lessons to be learned from what has worked well elsewhere, we caution that the local context can have a profound effect on the successful implementation of plans based on best practice.

This paper summarises the impact of a new triage process on referral prioritisation and waiting times in a community specialist child and adolescent mental health service (CAMHS) in Qatar. The process involves initial review of referrals by a CAMHS nurse to ensure that there is adequate clinical information, obtaining additional information from patients/families and referring clinicians by the psychiatric triage team, when necessary, followed by prioritisation and allocation of accepted referrals. The new process reduced the acceptance of inappropriate referrals, ensured prioritisation of referrals and significantly improved the service's compliance with waiting-time deadlines.

Bangladesh is a densely populated emerging country in South Asia. Since its harsh independence war, it has suffered from repeated floods and other natural and man-inflicted disasters. Internal migration from rural areas to the urban centres has increased crowdedness, pollution and social conflicts. Furthermore, in recent years, the country has absorbed close to a million refugees from Myanmar. These stressors have been associated with an increase in mental disorders and symptoms with which the country is struggling. Lack of resources and a shortage of human capital have weakened the national capacity to efficiently respond to situational stressors or disasters. For assessment of stress-related mental health issues, information available from the Ministry of Health and the National Institute of Mental Health was collected and supplemented by external reports. It is promising that the government's approach of responding to mental health needs only after the occurrence of a crisis has recently been replaced by the concept of total management through primary healthcare. There is a need for development of adequate infrastructure, logistics and workforce support, as well as establishment of multidisciplinary teams of management and clinical services. Collaboration of all related sectors of the government and an overall increase in government funding for mental health are essential.

Primary care is geared to manage patients with mild to moderate presentations of common mental disorders and to refer patients with more severe mental disorders to specialist mental health services. With growing demand for specialty care, the quality of the referral is increasingly important to ensure efficient patient flow across the primary/secondary care interface and appropriate use of secondary services. We report on an initiative in a Qatari mental health clinic to improve the quality of referrals from primary care to specialist mental health services through an educational intervention for family physicians. We highlight the problem, the intervention and the outcome of our initiative, which was the first of its kind in the region. The number of inappropriate referrals fell by 93%, and the number of referrals with inadequate clinical information declined from 15 (January 2019) to 1 (September 2019). Feedback was very positive; respondents reported feeling supported, with better understanding of care pathways, the scope of primary care and mental health services.

The Mental Health Ordinance 2001 was the last comprehensive legislation on mental health policy in Pakistan, replacing the Lunacy Act 1912. Since then, most of the amendments to the act have only delineated the jurisdiction of the provincial governments. Failure to account for mental illness in Pakistan brings with it unique challenges, such as the criminalisation of suicide and exploitation of blasphemy laws. There is a need for organised efforts to promote awareness of mental illness, amend the obsolete legislation in conformity with the scientific evidence, implement mental health policy effectively and deal with sensitive issues that have a strong sociocultural or religious background.

The unique challenges of the correctional healthcare environment are well-documented. Access to community-equivalent care, voluntary informed consent of offenders with mental disorder, violence risk, suicide risk, medication misuse, and clinical seclusion, confinement and segregation are just a few of the challenges faced by correctional psychiatric services. This paper shares experiences for dealing with the ongoing challenges for psychiatrists working in the field. It provides an overview of the current state of mental healthcare in the federal correctional system in Canada, the legislative framework and initiatives aimed at addressing the healthcare needs of federal inmates.

People with common mental disorders often seek medical attention from their family doctors. Thus, it is essential for family doctors to possess primary mental health knowledge. The aim of this study was to understand whether psychiatrists endorse the primary mental health competencies identified by the World Organization of Family Doctors and whether they agree that family doctors are demonstrating these competencies. A questionnaire was constructed based on 32 core competencies. Presidents of all World Psychiatric Association member societies were invited to complete the questionnaire or to forward it to local experts. According to the respondents, these competencies are considered relevant yet not sufficiently possessed by typical primary care doctors. Proposals are made to bridge this assumed competency gap.

Mental health ecosystems research is an emerging discipline which takes a whole-systems approach to mental healthcare, facilitating analysis of the complex environment and context of mental health systems, and translation of this knowledge into policy and practice. Evidence from the local context is needed in the analysis of complex interventions and of geographic variations in the outcomes of care. Technical tools and support have been developed to gather and interpret evidence from the local context and translate it in a meaningful and relevant manner for planners and policy makers to guide their decision-making.

If you have started feeling your age or even older, stop right there! Feeling younger makes us feel better and healthier both physically and mentally; at least so say researchers from Germany. They examined longitudinal data collected over a period of three years (2014–2017) by the German Ageing Survey, with a mean age of 64 years (40–95). Controlling for baseline functional health and sociodemographic variables, they found that greater perceived stress was associated with a steeper decline in functional health, which increased with advancing chronological age. However, they also found that those who felt younger than their age showed a less steep decline in functional health and greater perceived stress was less strongly associated with functional health decline. Furthermore, they were less likely to feel stressed and this stress buffer effect was greater with increasing age.

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.

There is an increasing prevalence of mental disorders in Malaysia, with a growing need to improve access to timely and efficient mental healthcare to address this burden. This review outlines the current legislative framework and the challenges of delivering mental healthcare and treating mental disorders in Malaysia.

This study aims to assess the prevalence of depression and anxiety during the COVID-19 outbreak embedded within the war in Syria. A web-based cross-sectional survey design was employed. The 9-item Patient Health Questionnaire and the 7-item Generalized Anxiety Disorder scale revealed a high prevalence of depressive (n = 3326; 83.4%) and anxiety symptoms (n = 2777; 69.6%) among the 3989 participants. Multivariable logistic regression analysis was performed to identify factors associated with depression and anxiety. There is an urgent need within the healthcare system in Syria to provide mental healthcare to alleviate acute mental health disturbances and associated physical health perceptions among Syrians.

We humans thrive on social contact, and conversation is our main means of interaction. Many of us can recall long conversations and having difficulty putting an end to these, but also other times when we may feel aggrieved that the conversation has come to a premature end. We think we can read others’ facial expressions and body language, but perhaps we're not so good at this as we think.

Sri Lanka boasts of making significant strides in the indicators of maternal healthcare during the past few decades. However, these indicators mostly look only at the physical well-being of women. Lack of awareness regarding maternal mental health problems among grass-root level healthcare workers, poor integration of services, and the culture and stigma regarding perinatal mental disorders are barriers to improving services in maternal mental healthcare in Sri Lanka.

This paper describes the current state of mental health services in Nepal and reflects on the significant changes over the past decade. The main challenges to overcome are proper implementation of community-based services, the high suicide rate, stigma of mental illness, financial constraints, lack of mental health legislation and proper utilisation of human resources.

Despite the country's generous social welfare systems, perinatal mental health problems are prevalent in Norway. National guidelines recommend that health services identify women with perinatal mental conditions, but systematic screening and clear treatment pathways are not nationally endorsed, neither are recommendations for evaluating and treating possible parent–infant interaction difficulties of affected mothers. There are no subspecialties in perinatal psychiatry or psychology, hence healthcare personnel often lack expertise about perinatal mental health. To safeguard the mental health of infants and parents, we need to establish systematic communication between primary healthcare professionals, as well as between primary- and secondary-level professionals.

Healthcare workers employed in the COVID-19 emergency are at high risk of stress, burnout and post-traumatic stress disorders. The most important occupational risk factors that employers should address include insufficient staff training and resources available, and lack of training and treatment protocols. In Italy, recent guidelines were released for providing all healthcare workers who are employed in this emergency with psychological support services based on coping strategies for managing stress. We suggest that preventive measures and a psychological intervention plan should be framed within the mandatory occupational health surveillance programme, and carried out by occupational physicians in cooperation with mental healthcare providers in the workplace.

This article aims to explore the barriers and challenges of implementing psychiatric rehabilitation services at a psychiatric hospital in Iran. We performed an internal mixed-methods evaluation by adopting a multi-method approach. The data were organised, analysed and interpreted by the evaluation team. A low participation rate, administrative issues, low fidelity to protocols and incomplete documentation were the main findings.

Implementing and maintaining rehabilitation services in low- and middle-income country settings requires more than a mere transfer of models of psychiatric rehabilitation; it needs adaptation to the local context as well as continuous evaluation and quality improvement in an iterative fashion, given the rapidly changing contexts with scarce resources.