Over the past 2 years the Global Initiative on Psychiatry has developed a wide range of initiatives in the fields of prison mental health and forensic psychiatry in Eastern Europe and the former Soviet Union. Both areas, until recently, were either ignored or deliberately avoided. This is not coincidental. The prison systems in the former Eastern bloc are in essence military organisations with a strict hierarchy and a rather tarnished past. Although some reform programmes in this field were implemented or started during the past decade (e.g. by Prison Reform International and the London Institute for Prison Studies), none of these projects has involved mental health services within the penitentiary system. A society that often limits itself to locking away those who have committed crimes or are suspected of having committed them, and pays only little attention to the physical and emotional well-being of those imprisoned, does not see the mental health of these persons as a priority. Equally unimportant seems to be the mental health of those who guard the prisoners and who are under constant stress.