Objective – 450 million people are estimated to suffer from neuropsychiatric conditions; approximately 10–20% of all children seem to have one or more mental or behavioural problems. Mental and neurological conditions account for 31% of all disability in the world. In epilepsy alone less than 25% of those affected receive treatment. In developing countries only a quarter of people suffering from schizophrenia receive treatment. Urgent action is needed to close the treatment gap and to overcome barriers. Governments need to take action with other partners to address these barriers and provide mental health services to those in need. Results – The World Health Report provides 10 recommendations for countries to begin taking action. These actions are divided into three scenarios: for countries with a very low level of mental health resources, for those with a medium level and for those with a high level of resources. Conclusions – The Report allows every nation to recognize itself in one of three scenarios and to adopt and implement die appropriate actions.

Objective – Even in countries whose mental health services are comparatively well resourced, the care offered to those in the early stages of psychotic illnesses is not what it could be. Patients often have to progress to chronicity before receiving adequate interventions, by which stage there has been great potential for harm, not only through the psychosis, but also to the quality of life of the individual who has often missed or not completed adequately, several important developmental tasks. Further, evidence indicates that delay in treatment is positively associated with poorer outcome. This paper puts the case for early intervention in psychosis. Method – Based on the experience of the Early Psychosis Prevention and Intervention Centre in Melbourne, the paper reviews the evidence for and the criticisms of, early intervention. Using the concept of indicated prevention, it suggests ways in which clinicians can improve the interventions available to those experiencing the onset of psychosis and suggests that prepsychotic intervention may be possible. Results – Evidence discussed in this paper indicates that the development of mental illness is a major health issue in young people; that there is a positive correlation between duration of untreated psychosis and outcome; that it is possible to identify a proportion of those at high risk of developing mental illness; that through intervention it may be possible to reduce the transition rate to illness. Conclusion – Primary prevention is beyond the capacity of our present knowledge. Indicated prevention in the form of early intervention and optimal, sustained treatment is a paradigm for which there is increasing supportive evidence. It is a paradigm which is appealing to clinicians, patients, families and which has the potential to reduce the secondary impact of serious mental illness such as suicide, stigma, isolation and reduction in social status.