The effects of social development in the 21st century have affected different countries and different social groups differently. Although social development upgraded life standards of a sector of population, it has affected adversely on poor socioeconomic groups in different parts of the world. Even though the economic status of urban cities in developing countries has gone up, standards of living have not risen parallely. The social structure has changed and risk factors for common mental illness have increased whereas poorly developed mental health services remain unchanged. Resource allocation for the development of mental health services in developing countries still appears to be minimal.

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Mental health problems occur in a psychosocial context. Social dimensions significantly impact psychiatric practice and research. The twenty first century has seen dramatic urbanization, globalization, rapid advances in technology, and communications. These among several other social changes, such as nature and shift in family systems, newer patterns of relationships, migration, and social mobility will bring about novel challenges for diagnosing and managing mental health problems; nevertheless this may at the same time throw newer means and opportunities to intervene, particularly with the advancements in technology. There is likely to be greater awareness about mental health problems. The rights based and recovery oriented approaches will change the way psychiatry is practiced. Many of these changes will positively impact policies of the government and access to care. This article focuses on the social changes in the twenty first century and the impact this has had and will have on mental health, especially in India.

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2016 will mark as the year when commercially available virtual reality headsets first become available across the world. This is set to be a landmark development and will revolutionize the way we interact with technology, which is already eating up more and more of our time, and is now inextricable from day-to-day life. Adolescents, at a critical stage in both physical and psychological development, are often the first to adopt advances in technology, and therefore also any associated impact on health. We discuss some of the current and important research on the positive and negative implications of technology on the mental health of children and adolescents, and briefly outline how future technological advances may further affect how we diagnose, monitor, and manage our young patients in the psychiatric clinic.

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Psychiatric disorders cause significant burden to individuals and society across the world, accounting for nearly 13% of the global burden of disease. Eighty percent of people with mental disorders now live in low and middle-income countries. With one million deaths per year, suicide is the major reason for years of life lost due to mental illness. Estimates suggest that the burden due to mental illness is likely to increase over next decade and appropriate interventions are need of the hour. We discuss this increasing burden as a consequence of (1) lack of resources, (2) low budget for mental health in lower and middle income countries, and (3) under-utilization of services and stigma attached to mental illnesses.

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Social change is ubiquitous and associated with mental distress and illness worldwide. To argue that social change has a differential impact in low and middle-income countries requires evidence, yet unavailable. Any effort at serious comparison to obtain such evidence is limited by current psychiatric approaches, which have decontextualized psychiatric diagnosis. Current psychiatric diagnosis and classification do not take into consideration personal and social stressors as causal, even when present and contributory to distress and illness. Euro-American psychiatry has decontexualized psychiatric diagnosis, medicalized social and personal distress, focused on treating individuals and diminished the role public health approaches in keeping with capitalistic economic and political thought. The altered framework disregards social stressors and hence does not document the universality and impact of social and economic pressures on mental health. It paves the way for a shift of responsibility onto individuals and away from society and governments. International psychiatry has completely bought into their approach and to argue otherwise is considered “unscientific”. Social changes affect humans and most differences documented across countries are due to skewed measurement, decontextualized diagnostic systems and the biomedical theoretical frameworks employed.

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Telepsychiatry, the use of information and communication technologies to provide psychiatric services from a distance, has matured as a mode of service delivery and has expanded its reach since its inception. Telepsychiatry promotes equality of access to high-quality specialized care for underserved users. It enables, empowers and brings about high levels of satisfaction among users. Telepsychiatry can deliver a broad array of clinical services and support several other nonclinical activities. Accumulated evidence demonstrates that clinical outcomes of telepsychiatric interventions are comparable to conventional treatment among patients of all ages, ethnicities, cultures, and diagnostic groups across diverse clinical settings. However, negative attitudes, concerns about the quality of the evidence, doubts about cost-effectiveness, technological vagaries, uncertainty regarding the doctor–patient alliance, and a number of legal, ethical and regulatory hurdles continue to hinder the widespread implementation of telepsychiatric services. A particularly disappointing aspect has been the lack of development of telepsychiatric services in developing countries, where they are required the most because of the large mental-health gap in care with the more traditional forms of services. Problems of costs, lack of infrastructure and connectivity, shortage of trained personnel, sociocultural differences, limited data on effectiveness, and lack of institutional support are the principal challenges to the wider adoption of telepsychiatry in these resource-constrained countries. It is evident that much more effort by all stakeholders, innovative solutions, and hybrid models of care are required before telepsychiatry is able to fulfil its true potential and bring about the promised change in mental health outcomes in the developing world.

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The mental health of women and girls is closely connected with their status in society. Their empowerment and participation are important contributors to a safe and productive community life. Participation and the empowerment underlying it are in turn components of good mental health. This has special meaning for those living in poverty and those subject to violence in the home or displaced by conflict and natural disasters. The participation of these women and girls is critical for tackling social and health concerns - such as maternal and child health, violence at home and in the streets, substance abuse, prevention of HIV infection, and gender equity. The strategies for promoting the mental health of women and girls and for tackling their mental health problems are overlapping. The actions in each case include a strong focus on changing social attitudes and investment and the development of partnerships and local participation. For example, the maternal and child health problems relating to perinatal mental disorders potentially can be prevented and managed in low- and high-income settings by effective actions at individual and community level. Comprehensive approaches are needed to preventing suicidal behavior among women and girls, especially in low-income countries and communities. The World Psychiatric Association is working with partners to set priorities and develop a framework for action.

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The burden of mental, neurological, and substance use (MNS) disorders increased by 41% between 1990 and 2010 and now accounts for one in every 10 lost years of health globally. This sobering statistic does not take into account the substantial excess mortality associated with these disorders or the social and economic consequences of MNS disorders on affected persons, their caregivers, and society. A wide variety of effective interventions, including drugs, psychological treatments, and social interventions, can prevent and treat MNS disorders. At the population-level platform of service delivery, best practices include legislative measures to restrict access to means of self-harm or suicide and to reduce the availability of and demand for alcohol. At the community-level platform, best practices include life-skills training in schools to build social and emotional competencies. At the health-care-level platform, we identify three delivery channels. Two of these delivery channels are especially relevant from a public health perspective: self-management (eg, web-based psychological therapy for depression and anxiety disorders) and primary care and community outreach (eg, non-specialist health worker delivering psychological and pharmacological management of selected disorders). The third delivery channel, hospital care, which includes specialist services for MNS disorders and first-level hospitals providing other types of services (such as general medicine, HIV, or paediatric care), play an important part for a smaller proportion of cases with severe, refractory, or emergency presentations and for the integration of mental health care in other health-care channels, respectively. The costs of providing a significantly scaled up package of specified cost-effective interventions for prioritised MNS disorders in low-income and lower-middle-income countries is estimated at US$3-4 per head of population per year. Since a substantial proportion of MNS disorders run a chronic and disabling course and adversely affect household welfare, intervention costs should largely be met by government through increased resource allocation and financial protection measures (rather than leaving households to pay out-of-pocket). Moreover, a policy of moving towards universal public finance can also be expected to lead to a far more equitable allocation of public health resources across income groups. Despite this evidence, less than 1% of development assistance for health and government spending on health in low-income and middle-income countries is allocated to the care of people with these disorders. Achieving the health gains associated with prioritised interventions will require not just financial resources, but committed and sustained efforts to address a range of other barriers (such as paucity of human resources, weak governance, and stigma). Ultimately, the goal is to massively increase opportunities for people with MNS disorders to access services without the prospect of discrimination or impoverishment and with the hope of attaining optimal health and social outcomes.

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Introduction: Arising from the push for global health, the movement for global mental health has established itself as a distinct identity in the last few decades. Collaboration between donors, international agencies, institutions, and individuals of different countries has been an essential component in this endeavor. Methods: We review relevant reports in the literature that describe the process of collaboration between individuals and institutions in the area of mental health, in order to describe current patterns in international collaboration. Results and Discussion: In the last decade, international collaboration for mental health has increased substantially. Newer international professional associations; centers for global mental health at academic centers in Europe, USA, and Australia; and international health aid agencies have joined more established agencies, to provide platforms for collaboration. A number of priority-setting exercises have been undertaken that have stressed service development for mental health. International consortia for genetics and neuroimaging have demonstrated successful research collaboration. However, barriers to collaboration persist—these include a continuing failure to prioritize mental healthcare at a policy level, as well as difficulties in arriving at a consensus on conceptualization, transcultural issues, and priority-setting for mental health research. Going forward, the challenge for “global mental health” is to establish a framework that recognizes the unique contributions of all stakeholders and emphasizes equitable partnerships, while adapting knowledge across settings and health systems. Such an approach would be essential to achieve the stated aims of this movement.

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A sound and effective approach to psychiatry and medicine should prioritize the whole person. This implies an ethical commitment to the person behind the patient, and attention to the biological, psychological, social, cultural, and spiritual bases of illness and positive health. As part of this comprehensive approach, attention to values and context are required for an adequate diagnostic informational base and optimal planning of care. A model for person-centered and contextualized diagnosis of mental health has been developed under the name of Person-centered Integrative Diagnosis (PID) within the framework of person-centered psychiatry and medicine. It engages recent and evolving methodological approaches, which are addressed to enhancei the reliability and validity of diagnostic systems. Among the cardinal features of the PID model, are the diagnosis of a person’s whole health (both ill and positive health), considering diagnosis as both a formulation and an interactive process among clinicians, patients and families, and the use of categories, dimensions, and narratives as descriptive tools. Its multilevel informational structure encompasses health status, health contributors, and health experience and values. On the above bases, the PID contrasts with conventional diagnostic systems such as the DSM and ICD illness-classification models. Representing an application of the PID model, the GLADP-VR, a Latin American Guide of Psychiatric Diagnosis (using ICD-10 categories and codes of illness) has been recently published by the Latin American Psychiatric Association for the use of health professionals in the region. This paper identifies the thrusts and elements of the PID model, which represent attention to values and context. This includes ethical commitment through concern for the person's dignity, complexity, uniqueness and autonomy, and incorporation of the cross-sectional and historical context as well as the values, expectations, and preferences of the person presenting for care.

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Information technology (IT) has really made patient care much easier and available at door steps for the consumers. All latest information about any disease and its treatment is available to the patients with a click of mouse. Searching for a suitable doctor and fixing an appointment has become much easier with the health information technology(HIT).However the patient and caregiver are often al loss regarding which information to choose and discard. Therefore, information available often tend to mislead the patients.For an appropriate information regarding any health related event, contact with a trained physician seems indispensable. HIT is a boon for middle and low income countries where health care facilities are still inadequate. But all physicians and other health care workers do not find themselves at ease with the technology. A need of training regarding the same is repeatedly emphasized. Safety and confidentiality of the personal information on the electronic health records has emerged out to be another problem in use of IT even in the developed countries. Thus use of HIT is not only revolutionized health care delivery, but it has created new risk factors for doctor patient relationship too. Thus, without proper training and knowledge about the reliability of information and training of health care workers, it may not be feasible to get the expected advantage of HIT

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Development of mental health care for the total population is a challenge in all countries. Common challenges are accessibility, acceptability, affordability and stigma. There has been a progress in shifting the location of mental health services from jails, to asylums, to psychiatric hospitals, to general hospitals to community care facilities over the last three hundred years. Developing mental health services presents both universal and local challenges. There are advantages in collaboration across countries. Past efforts have taken advantage of collaboration to develop innovative approaches to care, tools for measuring impact of services, training methodology and evaluation of impact of interventions. Collaboration allows for bringing together wide ranging experiences and expertise, increase the size of the populations and understand the differences that influence development of mental health care. World Health Organization has pioneered collaborative projects in the past. The development of mhGAP Guidelines for non-specialists in recent times illustrates the value of collaboration. World Psychiatric Association promoted fighting stigma by bringing together over 20 countries. Grand Challenges Canada initiative is another example in this field. India has contributed to development of mental health services by focusing the importance of family in mental health care, integration of mental health with general health care, demonstrating the effectiveness of community care, revitalizing the traditional practices like yoga/meditation and presenting a different approach to psychotherapy. International collaboration for developing mental health services presents a win-win situation for all the partners and should be utilized to a greater extent.

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Scientific evidence in all sciences, inclusive of the brain and neurosciences as well as in assessing health systems’ performance is rapidly evolving in the 21st century. This new evidence is augmenting the understanding of the brain and its functions, its transactions with the human genome, the microbiome,Β the social determinantsΒ of health, and the dominant global burden of diseases presented by non-communicable diseases, inclusive of mental disorders, and their comorbidities. Together they are stimulating new research and innovation in addressing the challenges of primary, secondary and tertiary prevention continuum as well as the current health systems’ fragmentation. The author presents contemporary scientific evidence, its impact on developing Total Health models of integrated health systems, and its translation into global health policy to benefit individuals’ and populations’ health.

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Mental health promotion and prevention are increasingly recognized as having a vital role in public mental health around the world, and current evidence indicates various positive health and social outcomes. For this reason, the majority of national and international bodies have lent their support and advised their members to learn about, support, promote, and collaborate with others to instigate these strategies. The majority of health promotion strategies involve multiple and varied stakeholders, and therefore such interventions can prove challenging to organize. Improved infrastructure both regionally, nationally, and globally would help groups of stakeholders to collaborate even more efficiently. Conducting accurate and appropriate research can also prove difficult, and more data in terms of cost-effectiveness would be beneficial to prove the true cost-effectiveness of such collaborative interventions. Nonetheless, these are not insurmountable issues, and the future appears bright for collaborative health promotional interventions.

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Interventions for mental health promotion have to be initiated not just by the traditional mental health sector but by numerous other sectors and stakeholders who are involved in dealing with the social determinants of mental health. Collaboration would the most appropriate and effective approach to deal with social determinants of mental health. However, collaborative strategies are grossly underutilized or almost nonutilized at regional, national, and international levels. There are several reasons for this nonutilization. Foremost among them is the continuing struggle of mental health services all over the world, in both resource rich as well as resource poor settings, to effectively fill the treatment gap and provide services of adequate quality for the mentally unwell population. There is a need to expand the evidence base for mental health promotion and identify effective interventions which can be collaboratively implemented.

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Many societies around the world are experiencing a period of unprecedented change in traditional social roles and customs. Globalisation has contributed to materialism and a me-first individualism that heightens awareness of income inequality that itself is one of the most robust markers of unhappiness in society. Ever increasing urbanisation has driven an erosion of large ‘joint’ family arrangements to be replaced by smaller and relatively isolated nuclear families and single parent living. Mass migration has unmasked deep seated fear and prejudice towards the outsider in society. These global changes are fertile ground for the social conditions that have long been known to be risks for mental illness – poverty, poor quality child care, social isolation and the active discrimination and exclusion of the alien, the physically disabled and mentally ill. While there is little we can do to reverse global change, there is much a social psychiatrist can do to mitigate the effect, ensuring his/her voice is added to other calls for reducing discriminatory practice, promoting evidence-based social interventions such as parenting advice and peer support and ensuring that the success of a treatment is measured not just in terms of symptomatic improvement but in whether it results in an outcome that is valued by the patient.

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IT has revolutionized the way individuals carry on with their lives and has been harnessed for varied applications like business management, classroom teaching, online sales and ticketing, and so forth.^[1],[2] IT itself has seen development over the course of the last few decades and has seen greater access to the population, increase in computing power and speed, and enrichment in terms of content. The scope of IT has been appropriately recognized for health-care delivery and has led to the emergence of offshoot disciplines of eHealth and mHealth. Consequently, social psychiatry has also been favorably impacted, either directly or indirectly, by the ever expanding horizons of IT. This editorial discusses the application of IT in the realm of social psychiatry

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Modern technology (internet, smartphones, etc.) already has an impact on communication and health care services throughout the world. Evidently, everyone knows what it means to be able to better communicate with new technology (such as Facebook, Twitter, LinkedIn etc.). The problem is not here. It is evident that science advances quickly and turns peoples’ lives upside down, even if these advances have never had much of an impact on social, cultural, and psychological dimensions of the individual, the family, and the social group. At what point, then, do these advances in science have an impact for us, the mental health professionals? We will soon find ourselves in a situation where we will be obliged to accept the new methods of communication being presented to us, not only by policy makers, but also by patients and their families. Therefore, we must look at how we both have been integrating the advances of Information Technology into social psychiatry, but also how we can do so in the future.

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