Sierra Leone is a West African country with a population of just over 7 million. Many Sierra Leoneans lived through the psychologically distressing events of the civil war (1991–2002), the 2014 Ebola outbreak and frequent floods. Traditionally, mental health services have been delivered at the oldest mental health hospital in sub-Saharan Africa, with no services available anywhere else in the country. Mental illness remains highly stigmatised. Recent advances include revision of the Mental Health Policy and Strategic Plan and the strengthening of mental health governance and district services. Many challenges lie ahead, with the crucial next steps including securing a national budget line for mental health, reviewing mental health legislation, systematising training of mental health specialists and prioritising the procurement of psychotropic medications. National and international commitment must be made to reduce the treatment gap and provide quality care for people with mental illness in Sierra Leone.

Substance use disorders pose a significant global social and economic burden. Although effective interventions exist, treatment coverage remains limited. The lack of an adequately trained workforce is one of the prominent reasons. Recent initiatives have been taken worldwide to improve training, but further efforts are required to build curricula that are internationally applicable. We believe that the training needs of professionals in the area have not yet been explored in sufficient detail. We propose that a peer-led survey to assess those needs, using a standardised structured tool, would help to overcome this deficiency. The findings from such a survey could be used to develop a core set of competencies which is sufficiently flexible in its implementation to address the specific needs of the wide range of professionals working in addiction medicine worldwide.

The perinatal mental health field is growing rapidly, which has yielded innovations in both prevention and treatment. To realise the potential of these innovations to transform clinical practice, further investment in research and clinical service development is required. Clinical services must be expanded by providing increased access to specialty care and education for front-line clinicians. Research is needed to develop a personalised medicine approach to understanding the complex aetiologies of perinatal depression and optimising treatments to promote both remission and long-term recovery. Such initiatives will require policies to prioritise federal research funding and healthcare coverage for perinatal depression.

This paper describes a condition termed post-flight confusion using anecdotal and clinical observations. It reviews research from the fields of aviation and altitude medicine and how this could apply to some physiological changes that happen during commercial flights. The collection of symptoms observed is similar to those of delirium. More research is needed to validate these observations, to identify the risks of flying for older people and to consider not only how to minimise these risks but whether this situation contributes to our knowledge about the aetiologies of delirium and dementias.

We invited 108 psychiatrists of Sudanese origin, working in and outside Sudan, to take part in a study looking at the most appropriate method for scaling up mental health services in Sudan. Of those psychiatrists who were approached, 81 (75%) responded. Among the respondents, 30 (37%) resided and worked in Sudan, and 51 (63%) worked outside Sudan (mostly in the UK and Arab Gulf States). Most respondents preferred the lay counsellor model (43, 53.2%) to address the current shortage of human resources for scaling up mental health services.

This paper outlines the importance of person-centred approaches to the practice of contemporary medicine and psychiatry. In considering the many aspects of person-centred approaches it outlines some key perspectives, including freedom and human rights; improving individual practice and the quality of services; increasing clinicians’ work satisfaction; combining value-based and evidence-based practice; and the training of future generations of psychiatrists.

Brunei Darussalam is a small country in Southeast Asia with a conservative Islamic government and culture. Suicide is a criminal offence under the civil Penal Code and the newly implemented sharia Penal Code. Suicide and mental illness are associated with significant stigma. Public discussion about suicide and mental illness has been considered taboo for many years. Recently, increased rates of media-reported suicides caused significant public alarm. This paper describes the initial steps that have been taken and possible future strategies for suicide prevention. The complex issues affecting suicide prevention in the national context are discussed.

We used medical record abstraction to conduct research in a psychiatric hospital with paper-based medical records. The challenges we encountered included: the difficulty in retrieving files; the extensive effort and time needed to extract clinical information; the lack of a standardised documentation system of medical records; and the need for advanced computer literacy. To promote future research using electronic medical records, potential solutions include creating a registry of all patients receiving treatment, as well as equipping busy clinicians with computer skills.

This paper discusses the influence of the Mental Healthcare Act 2017 on mental healthcare in India. The new Act was introduced to meet the recommendations of the United Nations Convention on the Rights of Persons with Disabilities. Reforms proposed in the new legislation, challenges in their implementation and their effects on mental healthcare in the country are further discussed.

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 European Psychiatric Association (EPA), the main association in the field of mental health in Europe, has long been supporting the development of early career psychiatrists. The EPA Early Career Psychiatrists Committee (ECPC) and its core task forces promote research activities among young psychiatrists, contribute to their professional development through organising courses and other educational events, prepare online educational materials and publications, and actively collaborate with other organisations. The EPA ECPC is always open to fostering cooperation on new professional, educational or research initiatives with early career psychiatrists from different countries.

Dr Abdullahi was a Fellow of the Royal College of Psychiatrists’ Medical Training Initiative (MTI) scheme at Norfolk and Suffolk NHS Foundation Trust, East Anglia, between 2015 and 2017. He has adopted a comparative approach to share some salient observations and anecdotes from that time.

SKIP (Students for Kids International Projects) is a student-led global health charity; each university branch partners with a local non-governmental organisation in their branch country, where they run interventions identified by the local community. Research in these countries has identified an educational need for interventions around emotional well-being. In this article, we reflect on the process of creating culturally appropriate educational resources for children and young people in low- and middle-income countries, to be delivered by non-professionals. SKIP has a Research Ethics Policy. No external ethics approval was required.