Psychiatry across borders.

To gain an understanding of the challenges and opportunities confronting mental health professionals throughout the world, the author sent a brief questionnaire to psychiatric leaders in a diverse group of countries. Questions focused on patient care issues, education, and delivery systems. Responses from 13 countries indicated universal concern about the cost of psychiatric care and how it is delivered. Most countries consider health care a national responsibility and provide some form of universal insurance coverage. There is a lack of uniformity in resource distribution and use as well as in standards of care for acute and chronic patients. ICD-9 is the diagnostic classification system used in almost all responding countries, but use of DSM-III is increasing. The author emphasizes the importance of considering national differences and similarities in the delivery of psychiatric services so that professionals around the world can learn from each other's experiences.