Twenty years ago, a book was published entitled World mental health problems and priorities in low-income countries (1). A few years later in 2001, the World Health Organization (WHO) devoted its World Health Report to Mental health new understanding, new hope (2), and the Institute of Medicine in the United States of America brought out Neurological, psychiatric, and developmental disorders meeting the challenge in the developing world (3). These publications were among the first to seize upon the finding that, due to their chronic course and disabling nature, mental, neurological and substance use disorders contribute very significantly to the global burden of disease. Each report also drew strong attention to the desperate situation in most low- and middle-income countries regarding the availability, quality and range of treatment services, and produced a series of recommendations for research and training, service provision and policy.