We describe mental health services in Luxembourg and how they have evolved over the past 50 years. Health services in Luxembourg are provided through a social health insurance-based system and mental health services are no exception. Additional services are offered through mixed-funding avenues drawing on social care budgets in the main. Luxembourg is closely connected with neighbouring countries, where a large proportion of its workforce live. No run-through medical training exists and the entire medical workforce, including psychiatrists, have trained in other countries. This is reflected in a rich but often non-uniform approach to the provision of psychiatric care.

The Royal College of Psychiatrists’ Medical Training Initiative (MTI) enables qualified foreign-trained psychiatrists to gain further experience within the UK National Health Service (NHS). This article summarises the observations of two Nigerian psychiatrists during their forensic psychiatry placements on the MTI scheme and two of their UK supervisors. It discusses similarities and differences between Nigeria and the UK in forensic psychiatry, including the use of mental health legislation, the scope of forensic psychiatry and elements of the pathway to qualification in both countries. It concludes with recommendations that could improve the robustness of the MTI scheme.

In the majority of low- and middle-income countries, mental healthcare is delivered by primary care workers. Often, they are the only contact for patients and their families. Although their knowledge base can be limited, they are expected to manage complex cases with few resources. The authors describe their experience of partnership with mental health centres set up by the Nigeria Health Care Project, and training their primary care workers based on the World Health Organization's Mental Health Gap Action Programme. Although the programme was very effective in helping to upskill their knowledge and experience, a need for continued professional development was highlighted. Based on their feedback, multiple evidence-based options are explored, including the use of remote learning and social media (increased significantly around the world because of the COVID-19 pandemic), to help primary care workers improve their knowledge base and maintain their competencies with the limited resources available.

In-patient treatment is a complex system of recursively interacting components. Patient characteristics interact with caregiver characteristics, home context and ward factors. Quality improvement requires primary focus on the interacting factors over which the ward itself potentially has influence. Ward practice has to integrate the demands of the hospital owner, the legal framework for treatment and what we know facilitates effective treatment plans. We describe how we have implemented a quality improvement system that addresses these interplaying influences in acute adolescent psychiatry in Norway. The process involved with this system (developed in the UK for child and adolescent psychiatric units) is independent of the organisational structure of the department and which alternative resources it has to rely on. It is independent of the characteristics of the patient population, although specific standards can be developed for local requirements.

This report describes a pilot project which involved undergraduate medical students’ clinical competence in psychiatry assessed through objective structured clinical examinations for the first time in Zimbabwe. The pilot describes how gaps in medical education can be addressed by collaborative partnerships that allow sharing of knowledge by local institutions and international experts.

The Netherlands has an unique system of perinatal and postpartum healthcare. Pregnancy care is delivered predominantly by primary care midwives and childbirth services predominantly involve hospital care. The first week postpartum, all women receive daily care from maternity nurses. In addition, hospitals and out-patient clinics offer perinatal mental healthcare. More specifically, ‘POP care’ (psychiatry, obstetrics and paediatrics) was developed to promote multidisciplinary collaboration in this regard. Although clinical practices and government initiatives to improve pregnancy-related mental healthcare work well, they have yet to be fully described and evaluated. The current COVID-19 pandemic has an impact on health services and perinatal mental health.

This article describes the author's discovery of mindfulness and its method and describes the bias against mindfulness even at the beginning of the 21st century. The short essay also throws light on recent developments in mindfulness training and practice in the world and in the state of Kerala in South India.

An undercurrent of change is occurring in Qatar's approach towards mental healthcare. In the past 5 years, significant attention has been given to community care initiatives. There is much progress to be made, but the provision of psychiatric support outside of hospitals, the launch of several community services and the tackling of the associated social stigma represent a marked step away from the norm that has usually pervaded in the region. This article analyses these changes and identifies the challenges that remain.

Child labourers are at risk of poorer mental health and once rescued require urgent mental health interventions to ameliorate the long-term impact. In our review, only two published scientific studies evaluated custom-made interventions; other programmes were obtained from non-governmental organisations (NGOs), which need rigorous trial evaluation. We also sought the viewpoints of stakeholders working directly with rescued young people, as well as consulting young people with lived experiences of child labour. We propose that psychoeducational interventions aimed at employees working directly with young people could represent a fruitful approach for low- and middle-income countries in the Asia-Pacific region but also more generally.

Following the growing global focus on deinstitutionalisation in the past 50 years, accessible community mental health services was a highlighted commitment in the European Mental Health Action Plan 2013–2020 to improve well-being of patients and families. The progress of transition has been uneven in some Eastern European countries. This paper aims to update and reflect on the examples of five countries across the region.

Over half of doctors who joined the General Medical Council's (GMC) medical register in the UK in 2020 were from Black, Asian and minority ethnic (BAME) background, and I am one of them. Having experienced clinical settings across three different countries, I think my journey deserves to be shared with others as a unique experience. My story will help medical students and early career doctors have a general idea of different clinical settings and hopefully will encourage them to chase their dreams. I hope to inspire people.

Since 2018 Algeria has had a new mental health law intended to be more practical and in line with international standards for patients’ rights and supervision of coercive measures. Despite its simpler formulation compared with the previous law it remains far from what psychiatrists need and what patients hope for. Some chapters are confusing and difficult to grasp. Like previous mental health laws, it is unlikely that the current law will actually be applied, owing to the huge gap between the core text and the available services.

During the past three decades Nepal has gone through series of reforms to address the mental health needs of the Nepalese population by promulgation of an exclusive National Mental Health Policy and related Strategic Action Plan. Small but significant improvements have been achieved in Nepal with regard to mental health policies and plans. This article discusses the evolution of mental health policies in Nepal and analyses the challenges to be overcome for their effective implementation.

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.