Most of the people who make decisions about global health are in the U.S. and Western Europe. There, the mental health care system is dominated by highly trained, expensive professionals in big hospitals, who often see patients over long periods of time. This simply can't be done in rural Africa or India. Who the hell can afford that kind of care?

The current approach that psychiatry takes almost ignores social worlds in which mental health problems arise and tries to become highly biomedical like other branches of medicine such as cardiology or oncology. But psychiatry has to be far more embedded in people's personal and social worlds.

I think the government must recognise that the wounds of conflict are even more grievous on the mind than the body, and indeed may even serve to fuel further conflict. Where conflict cannot be avoided, provision of adequate psychosocial services to prevent the adverse mental health consequences should take priority.

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