In late 2008, the Regional Office for Europe of the World Health Organization (WHO, 2008) issued a report based on a survey of the policies and practices for mental health within its area of operation. Forty-two European states were examined and a great diversity in practice was recorded. Almost everywhere, the report suggested, policy making and legislative initiatives were seen; since 2005, some 57% of the countries studied had adopted new mental health policies and 48% had introduced new legislation. Many countries were reported to be closing mental hospital beds and replacing them with community-based services. In some countries, however, the report suggested, desks in ministries were collapsing under the weight of policies that had never been implemented, and compliance with legislation by planners and psychiatrists was distinctly variable. The WHO felt that even the role that general practitioners played in treating people with mental illness was limited in many European states and that the availability of home treatment options, assertive outreach for people with complex mental health needs and community-based early intervention was not only variable but often severely limited. Given the wide discrepancies of procedure and practice, it was difficult for the WHO to gain any clear perspective on such legislative matters as arrangements for compulsory care in the community.

Compulsory admission to and treatment in psychiatric facilities have recently been brought into the spotlight by both psychiatrists and the media in Egypt. Interventions of this kind have always inherently involved deprivations of liberty and infringements on privacy. The debate around this issue acquired considerable heat after it was joined by the legislatures during the discussion of a Bill in Parliament. The Parliamentary Committee for Constitutional and Legislative Affairs questioned the constitutionality of the process of compulsory detention and requested more robust safeguards to protect the rights of persons with mental illness. The new Bill was passed by the Egyptian Parliament on 26 April 2009 and was due to come into force once ratified by the President and published in the Egyptian Gazette, expected in May.

Many legal mechanisms can be used to authorise compulsory community mental healthcare: leave or conditional discharge for compulsory in-patients; adult guardianship (or incapacity) legislation; treatment as a condition of a community-based criminal sentence, like probation, or of parole from imprisonment; or a full-fledged community treatment order (CTO) scheme. It is the specific mix of mechanisms employed in a particular jurisdiction that will characterise how that legal system manages the delivery of compulsory (or quasi-consensual) community psychiatric care.

Armenia is a landlocked mountainous country between the Black Sea and the Caspian Sea, in the southern Caucasus. It shares borders with Turkey to the west, Georgia to the north, Azerbaijan to the east, and Iran and the Nakhchivan exclave of Azerbaijan to the south. Its total area is 29 743 km2. A former republic of the Soviet Union, Armenia is a unitary, multi-party, democratic nation state with an ancient cultural heritage. Armenia prides itself on being the first nation formally to adopt Christianity (in the early 4th century).

The Republic of Niger is a large, landlocked west African country. Around 80% of its vast land mass (1 300 000 km2) is in the Sahara Desert. Its neighbours are Mali, Algeria, Libya and Chad to the north, and Nigeria, Benin and Burkina Faso to the south. The country came under French rule in the 1890s and gained its independence in 1960, but development has been slowed by political instability, lack of natural resources and drought. In 1999, voters overwhelmingly approved a new constitution, allowing for multi-party elections, which were held later that year. An ongoing rebellion in the north makes access to much of the country difficult.

Switzerland - officially the Swiss Confederation - is a federal republic situated in central Europe. It covers an area of 41 287 km2 and has a population of just over 7 600 000. Switzerland consists of 26 federated states, of which 20 are called cantons and 6 are called half-cantons. German, French and Italian are Switzerland's major and official languages.

The aims of this study were to establish the feasibility and effectiveness of training Ugandan mental health workers in the management of post-traumatic stress disorder (PTSD) based on guidelines from the UK National Institute of Health and Clinical Excellence (NICE). The Butabika Link is a mental health partnership between the East London Foundation NHS Trust (ELFT) and Butabika National Psychiatric Referral Hospital, Kampala, Uganda, supported by the Tropical Health Education Trust (THET), and based on the recommendations of the Crisp report (Crisp, 2007). The Link has worked on the principle that the most effective partnership between high-income and low- or middle-income countries is through organisations already delivering healthcare, that is, through the support of existing services. Butabika Hospital is a centre of excellence, serving an entire nation of 30 million people, many of them recovering from 20 years of armed conflict that took place mainly in the north of Uganda. In addition, Uganda has received refugees from conflicts in neighbouring states, including Congo, Rwanda, Kenya, Sudan and Burundi. The Ugandan Ministry of Health's Strategic Plan (2000) has prioritised post-conflict mental disorders and domestic violence, which is reflected in the vision of the Link's work.

Quality of prescribing is an important aspect of clinical practice. In a study of the effect of electronic prescriptions on prescription quality in the UK, Donyai et al (2008) found errors in 3.8% of their sample before the introduction of electronic prescription. In a psychiatric setting in Leeds in the UK, Nirodi & Mitchell (2002) found that 16.1% of prescriptions written for a cohort of elderly patients were illegible, and a third lacked information on dose, frequency or indication of use of medications. They found that only 18% were legible and free of all errors.

International medical graduates (IMGs) account for more than 30% of the first-year positions filled in US psychiatric residencies (Nation Residency Match Program, 2007). At the time of writing, the first author was 4 months away from finishing his residency at the University of Connecticut (UCONN) when the opportunity arose to turn the tables and use his fluency in French to complete a month-long elective in France. During this period, he spent time as an observer in the psychiatric service of a Parisian hospital, l'Hôtel-Dieu. The realisation of this elective was helped by the fourth author, who knew various members of World Psychiatric Association. This paper presents some comparative observations of the clinical milieus at UCONN and the Hôtel-Dieu.

The prevalence of HIV is high in the north-east Indian states of Manipur and Nagaland. The major route of HIV transmission is injecting drug use. Most injecting drug users (IDUs) are male and about 40% are married. The widows of IDUs are among the most disadvantaged people. Many are HIV-infected and experiencing poverty, poor health, social isolation and discrimination, all factors likely to compromise their mental health. Some widows are engaging in HIV risk behaviours, including alcohol and drug misuse, sex work and unprotected sex. There is increasing recognition of the links between poverty and mental health status and risk of HIV infection. People with poor mental health are more likely to engage in HIV risk behaviours.