The state of Kuwait is situated on the north-west coast of the Arabian Gulf. Its population is made up of approximately 3 millions; one third is Kuwaiti and the other two thirds are expatriates. Psychiatric services started in Kuwait in 1949 and developed over time. Although there is a mental health policy in Kuwait, there is no mental health legislation. The main and only psychiatric facility in Kuwait is the psychological Medicine Hospital, which is a large psychiatric facility with 650 beds. Until 2000 Medico-legal cases were admitted to a close ward. In 2000 a new forensic unit was opened. The unit consists of two male wards located within the ground of Psychological Medicine Hospital. It has 34 beds, and in practice it provides a level of security that is a mid-way between medium and maximum. Female medicolegal cases are few and are admitted to a general close female ward. Cases are referred for medicolegal assessment from Police stations, prisons and courts. The unit provides psychiatric services for mentally disordered prisoners. Involuntary admission of mental patients other than those referred from legal authorities depends on the agreement of their families whatever their conditions are dangerous or not. Management and regular follow up of mentally disordered patients at outpatient clinics faces many challenges. There is no legal mean to commit mentally disordered patients; found to be no guilty because of a mental disorder to attend outpatient psychiatric clinics. There is a need to have mental health legislation in Kuwait.