Through their study, George Ikkos & Nick Bouras reveal that the responsibilities of the psychiatric community are increasingly complex, especially amid the onslaught of globalisation and the confines of neoliberalism. ‘Metacommunity’ in this context refers not only to the history of psychiatrists but their role in strengthening and influencing mental health policies. A number of challenges continue to emerge in the public sphere, highlighting the need for psychiatry to adapt to society's evolving demands for inclusivity, equity and ethical governance. These challenges emphasise the importance of shaping the future of psychiatry that is responsive to the complexities of mental health care and aligned with democratic principles that prioritise transparency and social accountability. We have added several aspects that could complement psychiatrists' future theory and practice, including a more collaborative and evidence-based approach to dealing with increasingly complex mental health issues.

Under the circumstances of the current COVID-19 pandemic, videoconferencing applications (apps) have come into the mainstream across the world. Owing to their easy availability and cost-effectiveness, they are used in personal as well as professional lives to communicate. They have been very helpful for students and professionals to ensure that their routine work did not halt when various countries imposed lockdown rules restricting travel, social gatherings and other measures that resulted in reduced in-person meetings. However, they have their own set of disadvantages, aptly called ‘Zoom gloom/fatigue’, named after a popular videoconferencing platform. Users are also noted to have anxiety while using these apps. Therefore, immediate attention is warranted to ensure cautious usage and to reduce the distress associated with videoconferencing apps while maintaining the obvious advantages that these methods have rapidly spread all over the world.

During our routine work, we noticed an increased incidence of COVID-19 diagnoses among patients in the cardiac unit, which led to an exponential increase in COVID-19 cases among hospital staff. We found that patients hid their symptoms from the emergency doctors and attributed those symptoms to cardiac or other causes. Social stigmatisation appeared to be the root cause for hiding their symptoms. Hence, we recommended a strategy to introduce psychological counselling of patients who were suspected to be infected with COVID-19, with a normal cardiac workup to overcome social stigmatisation and save our general wards from COVID-19.

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.

Healthcare workers have faced an unprecedented workload in overstretched health facilities during the COVID-19 pandemic, and we describe various initiatives to support them. Psychological, financial and peer support, accommodation and meal services, proper personal protective equipment, applause and gratitude in the community, spiritual and religious life, child care and volunteering were identified. The potential effects of the COVID-19 pandemic – permanent stress, burnout and other mental health problems among healthcare professionals – can be expected to grow. Continued monitoring is essential to bolster resilience among healthcare workers and prevent the possible consequences for their mental health.

During a visit to Baghdad, I was able to visit several key centres in Iraqi psychiatry: the Ministry of Health, Baghdad General Hospital, Ibn Rushd Hospital and Al Rashad Hospital. This was my first experience of mental healthcare outside England, and it left me with a range of discussions and experiences to reflect on. I hope that this article offers a fair flavour of Iraqi psychiatry from the perspective of a UK-trained doctor.

The COVID-19 pandemic has resulted in unique challenges for in-patients across the National Health Service as visitors, both family and friends, are prevented from visiting patients owing to infection prevention and control measures. The Attend Anywhere platform was used as the basis of a quality improvement project to mitigate the detrimental effects of reduced social contact for patients. The use of video conferencing led to increased subjective satisfaction for both patients and healthcare professionals, thereby providing further evidence of the benefit that this emerging technology has on healthcare delivery.

A British general adult psychiatrist born and trained in the UK, who also considers himself Pakistani, had the opportunity to spend 2 weeks running a psychiatric clinic in a remote hospital in the Punjab province of Pakistan. In this article he offers some reflections on the unexpected culture shock he felt, on the hospital system, the patients he treated and their resilience in such a poor country.

This study provides an overview of the extent, nature and quality of reporting on mental health compared with physical health in Qatari newspapers. We analysed 1274 news reports from daily newspapers in Qatar. The majority of the articles provided general information and were either positive or neutral in tone, reporting purely on physical health matters. A small proportion made associations with violence or reported on suicide or substance use. Our results highlight the underrepresentation of mental health in Qatari newspapers. A collaboration between media and health professionals is recommended to improve reporting on mental health.

To address the growing need for good-quality mental health service provision to patients in Iraq, mhGAP-IG 2.0 training in mental, neurological and substance use (MNS) disorders was delivered for primary care physicians in May–June 2022 by the Royal College of Psychiatrists (RCPsych) volunteers scheme. An innovative hybrid model was used to deliver this training to improve engagement compared with virtual training alone. Pre- and post-training assessment tools showed a significant improvement in participants knowledge of MNS disorders. Follow-up fortnightly supervision sessions by RCPsych volunteers were planned to help participants consolidate their learning in managing MNS disorders.

We conducted an online questionnaire-based cross-sectional study to clarify psychiatrists’ perspectives on virtual networking events. We compared two groups of respondents: those who had participated in virtual networking events (experienced group, n = 85) and those who had not (inexperienced group, n = 13). The experienced group had a greater level of agreement than the inexperienced group that virtual events were generally useful and helped with forming professional relationships and improving professional skills. Respondents in the experienced group considered the ease of participation and low financial burden to be advantages of virtual networking meetings and difficulties in building friendships and socialising to be disadvantages.

A psychiatry trainee reflects on a period of work on the Greek island of Samos with the international medical non-governmental organisation Medécins Sans Frontières/Doctors Without Borders, providing mental health and psychosocial support to asylum seekers. The clinic provided services to asylum seekers who were living in a crowded refugee camp, many of whom were experiencing symptoms of severe mental illness. The author reflects on the nature and severity of these presentations, and questions the role of psychiatry in treating mental illness that is clearly exacerbated by circumstances resulting from European asylum policies.

This is a reflective essay about the time I spent volunteering in mental healthcare in Malawi, prior to commencing my psychiatry training. The burden of illness I saw was enormous and the resources very limited; however, I describe some particular experiences where we were able to deliver excellent care, and which made me reflect about mental health services in low-income countries in general. Details of the patients discussed in this essay have been fully anonymised.

Breathe is a student-led literary and arts magazine whose goal is to provide a platform for creative expression about mental health issues and promote mental wellness among trainee healthcare professionals using student-submitted art and written pieces. Select pieces were published to improve readers’ understanding of and self-reflection on mental health. Common themes among the submissions include life outside of healthcare, imposter syndrome and coping with stress. This novel project had high satisfaction reported by 87.5% of surveyed readers. We advocate for improved mental health awareness and increased use of artistic expression as a coping strategy against stressors in healthcare education worldwide.

In the wake of the COVID-19 pandemic, healthcare systems rapidly embraced technology as a means of providing care while adhering to social distancing protocols. In this brief article, we report on a new telehealth initiative recently implemented in an out-patient psychiatric setting and outline the novel role telehealth may serve in facilitating psychiatric care globally. The uptake of telehealth represents a new and exciting opportunity to increase both access to, and quality of, care for people with mental illness.

Amidst the current global surge in physician burnout, a compelling need arises for precisely targeted research and interventions that cater to specific contexts, illuminating a path towards professional well-being. This brief communication analyses recent studies on physician burnout in Oman, critically evaluating the findings, cultural factors, methodological limitations and future growth opportunities. Distinct elements of Omani culture, encompassing attitudes towards mental illness, gender roles and patient expectations, can distinctly influence how burnout presents in this population. Advanced mixed-methods research integrating cultural insights, biomarkers and longitudinal tracking is needed to characterise burnout in Omani physicians. The findings can play a significant role in developing comprehensive interventions, at both a systemic and an individual level, that promote well-being of physicians while specifically aligning with the cultural values of Oman.

Working as a foundation doctor in psychiatry I quickly noted the value of two things: the development of a strong therapeutic relationship and the importance of a detailed history. These two things are made much harder when your patient does not speak English and you do not speak their language. I present a reflection on my experiences with two patients who did not speak English, the role of interpreters and some common pitfalls when working with them.

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.

I visited Chile for the first time in 2003. Over the course of the 12 months during which the country became my home, I realised there was a secret side to the capital city, Santiago. Never was this clearer than when I witnessed a demonstration to mark the 30th anniversary of the 11 September 1973 coup, when General Pinochet took power. I watched tears stream down the cheeks of men and women as they sang along with the revolutionary Cuban folk singer Silvio Rodriguez, raising their fists in the air. I felt the distrust of and anger towards the police who lined rooftops with snipers and the military units which filled side streets with water cannons. It was a visceral experience, made more so by the contrast with day-to-day life on the city's streets. This was a boom town, proud of its malls and economic growth, and the residents of Santiago made every effort to remark upon their high standards of living.