Mental health advance directives are one mechanism to enable individuals to have a voice in their treatment at a time when most legislative systems would consider them to lack the capacity to make informed choices. This honours their will and preferences while at the same time recognising the difficulties of the legislative framework. In this review we consider the use of such advance directives in New Zealand, in the form of a specialised advance agreement known as a mental health advance preference statement (MAPS). By evaluating their development and considering their ethics and cultural components we offer insights into one approach to the creation and implementation of MAPS for other jurisdictions.

Mental health legislation in the Middle East varies significantly in terms of scope, content and implementation. Some countries have rights-based laws aligning with international standards, but others experience significant gaps in legal protections, regulatory oversight and the integration of community-based care. In conflict-affected regions, the disparity between legislative goals and the reality of functional mental health systems is even more pronounced. This paper examines the existing legal frameworks in Middle Eastern countries, emphasising the urgent need for harmonized, enforceable, and contextually relevant legal frameworks to promote equitable and rights-based psychiatric care throughout the region.

Suicide prevention is an under-prioritised public health issue in Bangladesh. Recently, it has received academic attention substantiated by an increasing number of publications. Along with that, the Mental Health Act (2018), National Mental Health Policy (2022) and National Mental Health Strategic Plan (2020–2030) have come out. There are many challenges facing suicide prevention efforts in the country, such as suicide’s criminal legal status and associated stigma, lack of a national suicide prevention programme, inadequate clinical services, and most important, the absence of a national database on suicide. This paper analyses documents critically considering initiatives for suicide prevention, highlights the urgent necessity for suicide prevention strategies in the country and identifies prominent stakeholders. A national suicide database in which law enforcement agencies have a prominent stake is urgently needed. In the long term, suicide prevention should be considered in the lens of public health.

Thailand’s first Mental Health Act was enacted on 20 February 2008, with an amendment enforced on 15 July 2019. The Act provides a framework for mental health professionals, aiming to protect patient rights and promote societal safety by minimising the risks associated with mental illness. This article highlights key practical aspects of the legislation and discusses issues regarding its real-life application.

Mental health apps (MHAs) are increasingly popular in India due to rising mental health awareness and app accessibility. Despite their benefits, like mood tracking, sleep tools and virtual therapy, MHAs lack regulatory oversight. India's framework, including the Central Drugs Standard Control Organization (CDSCO) and Medical Device Rules 2017, does not cover standalone health apps, raising concerns about data privacy and accuracy. Establishing a centralised regulatory body with guidelines for MHAs is essential for user safety and efficacy. This paper examines the current regulatory landscape, compares international approaches and proposes a tiered regulatory framework to foster responsible innovation while safeguarding user interests in digital mental health services.

Mental health legislation protects the rights of people with mental illnesses. However, despite major social, political and cultural changes, Sri Lankan mental health services still operate on laws enacted mostly during the British rule more than a century ago, in the pre-psychotropics era, and focusing more on the detention of people with mental illnesses than on their treatment. It is high time all stakeholders made efforts for the much-awaited new Mental Health Act to pass through parliament urgently to meet the needs and protect the rights of patients, their caregivers and service providers.

The article provides a brief overview of the legislation governing involuntary admissions to psychiatric hospitals in Luxembourg. The legislation was completely overhauled in 2009 and several human rights principles are enshrined into it. Emphasis is placed on voluntary, community-based treatment, and where compulsory treatment is required, it uses the least restrictive treatment option. Mentally ill offenders are dealt with through separate specialist legislation. Young people under the age of 18 are often detained using family law.

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.

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.

Mental health problems are almost ignored in Bangladesh, one of the most densely populated countries in the world. The lack of overall health literacy and human resources due to an ineffectively updated legal and regulatory framework, coupled with very limited but misused budget allocation, are some of the factors responsible for this. The country's Constitution recognises the importance of public health and stipulates the improvement of public health as an important primary duty of the state. Nevertheless, it is often compromised or neglected in favour of other socioeconomic development priorities. The Lunacy Act 1912 was recently repealed and substituted by the Mental Health Act 2018 to fill in various gaps in mental health law. This is a welcome development, but there remain limitations and scope for further improvement. We highlight some important provisions of this newly enacted law, identify some limitations and propose some issues for consideration in future policy reform.

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 first mental health act legislation in the history of the Philippines has been officially signed into law and was enacted as the Republic Act no. 11036 on 21 June 2018. It provides a rights-based mental health bill and a comprehensive framework for the implementation of optimal mental healthcare in the Philippines. We review the principles and provisions of the Mental Health Act of 2017 and the implications for mental healthcare in the Philippines.

The Mental Disorders Act of 1969 is the primary legislation relating to mental health in Botswana. Despite the country not being a signatory to the United Nations Convention on the Rights of Persons with Disabilities, its Act has a self-rated score of four out of five on compliance to human rights covenants. However, it can be argued that the Act does not adequately espouse a human rights- and patient-centred approach to legislation. It is hoped that ongoing efforts to revise the Act will address the limitations discussed in this article.

The current Law for Psychiatric Care in the Republic of Cyprus was enacted in 1997 with amendments made in 2003 and 2007. The mental health law makes provision for the development and function of Psychiatric Centres for the care of the mentally ill. In contrast to the old Mental Health Law there is a major shift from a custodial approach to community care. Compulsory admissions under the Act, which require a Court Order, are made to a designated secure psychiatric in-patient unit. The protection of patients' human rights is at the core of the Act.

The Mental Health Commission, a Supervisory Committee and designated body for the Protection of the Rights of the Mentally Ill, assists in the correct implementation of the Mental Health Law. The Commission has a primarily advisory role but it is actively involved in monitoring the implementation of the Mental Health Law.

Psychiatrists are often confronted with the problem of non-consensual treatment. This paper focuses on the rights of patients with mental health disorders in the Former Yugoslav Republic of Macedonia in relation to non-consensual treatment and deprivation of liberty. The current mental health legislation and its implementation in local services is described with an emphasis on the assessment and treatment of patients with mental disorders.

During the past 30 years the Kingdom of Saudi Arabia has developed an extensive hospital-based mental health system culminating in the passing of a mental health law in 2014. This legislation embodies many of the international standards promoted by the World Health Organization. However, the mechanisms for protecting the human rights of psychiatric patients are neither sufficiently independent nor adequately robust.

This article summarises the development of mental health legislation in Singapore in three distinctive periods: pre-1965; 1965–2007 and 2007 onwards. It highlights the origin of mental health legislation and the relationship between mental health services and legislation in Singapore. The Mental Health (Care and Treatment) Act 2008 and Mental Capacity Act 2008 are described in detail.

Australia has a generally progressive approach to mental health law, reflective of international trends in human rights. Responsibility for most legislation is vested in the six States and two Territories, a total of eight jurisdictions, such that at any given time several new mental health acts are in preparation. In addition there is a model mental health act that promotes common standards. Transfer of orders between jurisdictions relies on Memoranda of Understanding between them, and is patchy. State and Territory legislation is generally cognisant of international treaty obligations, which are themselves the preserve of the Federal Parliament and legislature. UK legislation has had a key influence in Australia, the 1959 Mental Health Act in particular, with its strong emphasis on voluntary hospitalisation, prefacing deinstitutionalisation.

Brunei's new mental health legislation was implemented on 1 November 2014. This is a much needed and long overdue development which has required significant multi-agency consultation and commitment. This paper describes how the 2014 Mental Health Order was prepared and provides a summary of its contents. The future direction and challenges facing its full implementation are discussed.

In Canada the ten provinces and three territories are responsible for their own health laws and services. The 13 mental health acts have core similarities, but there are clinically significant differences. In most Canadian jurisdictions legislation is based on common law; in Quebec, it is based on a civil code. Canadian jurisdictions favour voluntary admission and sometimes make this explicit in their mental health acts. For involuntary admission or compulsory in-patient or community treatment to be valid, three elements must be applied correctly: the process, the criteria and the rights procedures. These are reviewed in this paper.