Our theme this month concerns the practice of psychiatry in Sri Lanka, with three related articles by Hapangama and colleagues. The first of these concerns the training of medical students and postgraduate education in psychiatry.^{Reference Hapangama, Kuruppuarachchi and Hanwella1} Throughout the world, as medicine advances, one might expect the attitude of medical students to have evolved towards greater interest in and empathy for mental illness, among their peers and patients. Recent research (e.g. Wang et al, 2016;^{Reference Wang, Ko, Chen, Yang, Lin and Cheng2} Pascucci et al, 2017^{Reference Pascucci, Ventriglio, Stella, Di Sabatino, La Montagna and Nicastro3}) suggests that negative attitudes persist. In Sri Lanka, the place of psychiatry in the medical school curriculum is not prominent, and the authors propose introducing a postgraduate internship in psychiatry as an option during foundation year training. It would be interesting to see how enthusiastically this option is selected.

A second article considers the need for an updated version of Sri Lanka's mental health legislation concerning the management of involuntary patients.^{Reference Hapangama, Mendis and Kuruppuarachchi4} Some elements of the existing law date back to the days of British governance in the 19th century, and reform has been pending for decades. It is concerning to learn that current official guidance mandates involuntary treatment in just one hospital, which is located in Colombo, so patients may be held ‘on remand’ for weeks in other parts of the country before their transfer can be arranged.

Finally, the authors draw our attention to the problem of drug misuse in Sri Lanka, with a focus on the ready availability of prescription drugs that are effectively unregulated.^{Reference Hapangama and Kuruppuarachchi5} As we know from the epidemic of misuse of drugs such as OxyContin in the USA and Europe, even if there are controls on who has a license to prescribe, these can easily be undermined. The concerns expressed here about the ready availability of mind-altering legal medications are not confined to Sri Lanka.^{Reference Morley, Ferris, Winstock and Lynskey6}