The South Asian region, perhaps best captured by the political grouping of the South Asian Association for Regional Cooperation (SAARC), comprises eight nations which share a number of social and cultural characteristics, not least in terms of some of the major development challenges and opportunities facing these countries. Most notable amongst these, particularly from the perspective of public mental health, are rapid social change associated with urbanization and social networks, humanitarian crises and conflicts, the impact of climate change on livelihoods, and widespread social deprivation. On the other hand, the region is witnessing impressive levels of economic growth and a large youth population, sometimes referred to as an enormous demographic dividend. In all countries democracies are firmly in place, albeit with challenges in some.
Yet, despite these commonalities, the collection of papers in this themed issue of the International Review of Psychiatry bears testimony to the fabulous diversity of concerns, disciplines and contexts in which mental health research is being carried out in the region. The papers cover a range of mental health conditions across the life course, in a variety of settings, examining themes related to social and biological determinants and health care responses. The diversity extends to the professional backgrounds of the authors and to their institutional affiliations, demonstrating not only the globalization of the South Asian community to distant lands, but a continuing connection of these diaspora with the region and a commitment of scientists from other lands to South Asian concerns. One paper even addresses the concerns of the South Asian diaspora in a community living in the UK. With millions of people of South Asian origin living outside the region, the boundaries between the local and global blur even further. No doubt then that research from the region may also be relevant to the diaspora and vice versa.
While these diversities make it difficult to pull together a specific coherent thematic narrative arising from these papers, they leave us with a delectable taster menu which is likely to provide pleasure to a wide readership. The papers also speak to the capacity in the region to address one of the most marginalized issues in development and health, and are a timely addition to the evidence from this region in the context of the growing recognition of mental health as a public health priority both regionally and globally. Despite a body of evidence demonstrating the high burden of mental disorders, the strong associations between social disadvantage and mental health conditions, the high levels of unmet needs for care, and profoundly disturbing levels of discrimination and abuses of basic human rights, the response of governments has remained at best marginal, and with little population level impact. In this context, it is to be hoped that the papers in this collection serve not only to influence policy and practice in the region, but also provide a fillip for more research which is situated in the pathway to ultimately improving the quality of life of people with mental health problems around the world.