Humankind has been present on the Australian continent for at least 40 000, some say 60 000 years, remarkably adapted to the environment and having a cultural tradition appreciated by few Caucasians. White people have been here for only 200 years; and psychiatry for about half of that. We know nothing about the mental health of pre-contact indigenous peoples; but we now know a little about the ways in which mental disorders are explained and treated by traditional methods. In two centuries, the Aboriginal and Torres Strait Islands communities, which are very diverse, have been steadily reduced to become only 1.5% of the population. From settlement in 1788 until the 1950s, most non-aboriginal Australians were of Anglo-Saxon or Celtic origin. Since the Second World War, the pattern of immigration has greatly enriched Australian life, first through large numbers of people from the Mediterranean littoral, Western Europe and the Balkans, and more recently from south-east Asia. Ethnic diversity is now evident in most peoples' daily lives – whom you see in the street, whom you work alongside, who your friends are, what you eat and who you have as patients. So the present Australian population of 18 million has undergone a marked change in demography and lifestyle within only two generations. Like the people, psychiatry is also changing rapidly. Where are the changes taking place? What is it like to be a psychiatrist here at present? Where has there been success and where has there been failure? Where is there lots of action?