Owing to the relatively small population sizes and remoteness of the Small Island Development States (SIDS), their mental health systems face many common difficulties. These include having few mental health specialists per country, limited access to mental health services and low awareness. To overcome these limitations, the World Health Organization (WHO) Mental Health Gap Action Programme (mhGAP), which aims to decrease the treatment gap by training non-specialists, was implemented in more than 20 Pacific and English-speaking Caribbean countries. Many lessons were learnt from the experience. Mental health specialist support is crucial, and online training and supervision could be a solution. mhGAP training proved to be effective to improve knowledge and attitude, but close monitoring and supervision are needed to change clinical practice. Awareness raising and mental health service capacity building need to occur simultaneously. To realise sustainable development goals, countries need to invest more in mental health, especially in human resources; mhGAP will be one effective solution.

This article discusses the factors that have shaped the development of the new mental health legislation within the Falkland Islands. The process of implementing new legislation within this remote island community is discussed, including the aspirations underlying the new legislation, the management of psychiatric emergencies and the needs of the clinical team.

The Shetland Isles are a place of breathtaking landscapes and pristine wildlife. As harsh as the weather can be, so warm and welcoming are the people and their proud half-Scottish, half-Scandinavian culture. Practising psychiatry in this northernmost outpost of the UK involves significant challenges. The authors were the only two psychiatrists based on this remote island group, which is home to 23 000 people.

Nigeria has poorly structured services for correctional mental health driven by a mix of socioeconomic and legal factors. The archaic asylum systems established in the early part of the 20th century under the Lunacy ordinance of 1916 are no longer fit for purpose. The present strategy is to provide mental healthcare for mentally abnormal offenders within some prisons in the country. The current models for this are poorly staffed and underfunded. Adoption of task-shifting approaches based on evidence-based strategies within the context of professional innovation, government commitment and international collaboration should help to develop and sustain the needed correctional psychiatry services.

People with severe mental disorders in rural India have minimal access to mental health services. Project Shifa entails outreach to patients and families in 75 villages in rural central India. A team of local health workers led by one psychiatrist provide assessment, medications, education and follow-up services.

Our current understanding of autism and other developmental disorders is primarily based on research conducted in high-income countries, predominantly in North America and Europe. Even within high-income countries, White participants are overrepresented in autism research. There is now increased recognition that a more global and diverse research representation is warranted. This paper argues that in order for global and diverse research efforts to be effective, it is essential to collaborate and engage with local experts and stakeholders, including local researchers, clinicians and representatives from governmental and non-governmental organisations. Such collaborations ensure that studies use culturally appropriate methods and materials, and that research findings are interpreted taking local context into account. Ultimately, these collaborations build local capacity and foster the development of culturally and contextually appropriate interventions that address locally perceived needs. The adage ‘nothing about us without us’ is vital to global autism research.

Mental health information systems are increasingly being used to measure the effectiveness of mental health interventions. Little or no data is available for mental health service availability and service uptake in low- and middle-income countries. Through a narrative review, this paper illustrates the importance of routine monitoring data and suggests methods for developing, implementing and evaluating mental health indicators in low- and middle-income countries with a primary focus on India.