The Alcohol Use Disorders Identification Test (AUDIT) is a ten-item standardised questionnaire to assess an individual's vulnerability to alcohol use disorders. Three of these ten questions are related to alcohol consumption. Nepal has a distinct alcohol culture, where alcohol use is socially and religiously acceptable in some caste/ethnic groups and is prohibited in others, thereby influencing the scores of AUDIT questions related to all three conceptual domains. Identifying and endorsing subsets of AUDIT questions relevant to different ethnic groups could be the way forward for effective screening of alcohol use disorders in Nepal.

Commonly occurring mental health disorders have been well studied in terms of epidemiology, presentation, risk factors and management. However, rare or uncommon mental health disorders and events are harder to study. One way to do this is active surveillance. This article summarises how the Royal College of Psychiatrists Child and Adolescent Psychiatry Surveillance System was developed, as well as the key studies that have used the system and their impact, to make the case for a wider international surveillance unit for child and adolescent psychiatry. Keeping this surveillance active in different populations across the globe will add to existing knowledge and understanding of these uncommon disorders and events. This will in turn help in developing better frameworks for the identification and management for these disorders and events. It will also facilitate the sharing of ideas regarding current methodology, ethics, the most appropriate means of evaluating units and their potential applications.

This paper reviews the development of Aotearoa-New Zealand’s (New Zealand’s) specialist Mental Health and Addiction Services (MH&A Services) and Mental Health and Addiction plans (MH&A Plans) to improve the mental well-being of all New Zealanders. It does so in the context of New Zealand’s 2022 health reforms, and the government’s response to its 2018 Inquiry into MH&A (He Ara Oranga). First, the context for reform is described, including New Zealand’s sociodemography, existing data monitoring systems, mental health epidemiology and a current overview of its specialist MH&A Services. The findings of the He Ara Oranga Inquiry and the goals of the MH&A plans are then outlined, along with progress in establishing new initiatives related to them. Finally, challenges to the new direction for New Zealand’s MH&A system are reviewed, with possible strategies to address them and other key implementation challenges involving the separation and operationalisation of the main strategies of MH&A plans. A high-level view of MH&A Services is taken, rather than one detailing speciality services such as age-related, cultural or addiction services.

Thailand’s first Mental Health Act was enacted on 20 February 2008, with an amendment enforced on 15 July 2019. The Act provides a framework for mental health professionals, aiming to protect patient rights and promote societal safety by minimising the risks associated with mental illness. This article highlights key practical aspects of the legislation and discusses issues regarding its real-life application.

The South Asian region, including India, faces an increased prevalence of illicit drug use. Key challenges include rising opioid use, injecting drug use and spread of stimulant use from some pockets to other regions of the country. Challenges faced are poor surveillance, lack of evidence-based and structured prevention programmes, wide treatment gaps and inadequate social capital for reintegration of substance users into society. The drug control efforts in India have resulted in an improved drug offence surveillance system, increased community awareness, a growing network of drug treatment centres and resource-building measures. India has made pioneering efforts in the field of harm reduction in the South Asian region. The steps taken have the potential of applicability across other South Asian, as well as most low- and middle-income, countries around the world.

Burnout is a common issue among healthcare professionals and can have a negative impact on both personal and professional well-being. This initiative follows a group of doctors working in Buckinghamshire, UK, who are at moderate to high risk of burnout, over 6 months to determine whether participation in a movie club, as a form of stress relief and social support, can have a positive impact on well-being. The aim of the project was to investigate the impact on doctors’ well-being by improving connectedness, reducing the feeling of isolation and encouraging face-to-face activities.

Suicide prevention is an under-prioritised public health issue in Bangladesh. Recently, it has received academic attention substantiated by an increasing number of publications. Along with that, the Mental Health Act (2018), National Mental Health Policy (2022) and National Mental Health Strategic Plan (2020–2030) have come out. There are many challenges facing suicide prevention efforts in the country, such as suicide’s criminal legal status and associated stigma, lack of a national suicide prevention programme, inadequate clinical services, and most important, the absence of a national database on suicide. This paper analyses documents critically considering initiatives for suicide prevention, highlights the urgent necessity for suicide prevention strategies in the country and identifies prominent stakeholders. A national suicide database in which law enforcement agencies have a prominent stake is urgently needed. In the long term, suicide prevention should be considered in the lens of public health.

Drug addiction is rife in Nepal, with a high relapse rate following treatment. Apart from basic psychosocial support, there are no evidence-based aftercare services for individuals in recovery. Recently, mindfulness-based interventions have shown promising results in preventing relapse. We discuss the context, challenges and opportunities of organising a 2-day intensive face-to-face mindfulness-based training for Nepalese mental health professionals to facilitate 8-week mindfulness-based relapse prevention (MBRP). Altogether, 24 participants completed the feedback questionnaire. Most were rehabilitation staff, along with a few psychologists and psychiatrists. Feedback suggested a high degree of satisfaction and provided comments to improve the programme. It has prompted us to design online MBRP training and set up a feasibility study for an MBRP programme in Nepal. If successful, this may help a huge number of individuals in recovery.

This article appraises cultural understanding and controversies regarding hikikomori (prolonged social withdrawal), with reference to research over the past 20 years. Initially viewed as a uniquely Japanese phenomenon, hikikomori is now recognised globally, prompting a re-evaluation of its cultural, psychological and socioeconomic demographics. A revision in lifestyle after the COVID-19 pandemic and ongoing technological advancements – particularly the rise of social media, gaming and the internet – have paradoxically both exacerbated isolation and provided new forms of social interaction for young adults who confine themselves at home. This phenomenon underlines the complex interplay between putative individual psychopathology, neurodiversity and broader societal shifts across the globe.

Decades of systemic oppression in Syria, from the 1963 state of emergency to the 2011–2024 conflict, have caused widespread psychological devastation. Arbitrary imprisonment, torture and sexual violence have been systematically weaponised. Following the fall of the Syrian regime in December 2024, freed political prisoners face severe mental health challenges due to years of inhumane conditions and trauma. This paper emphasises the urgent need for specialised mental health interventions and outlines evidence-based pathways to healing. A coordinated, multi-tiered response, integrating local and international efforts, is essential to prioritise mental health aid, restore dignity and support survivors in rebuilding their futures.