Brendan D. Kelly is Stanley Research Fellow in Psychiatry in Dublin (Department of Adult Psychiatry, Hospitaller Order of St John of God, Cluain Mhuire Service, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland. Tel.: +353 1 2833 766; fax: +353 1 2833 886; e-mail: brendankelly35{at}hotmail.com). His research interests include the epidemiology of psychosis and the relationship between mental illness and social factors. He was joint winner of the Gaskell medal and prize in 2003.
Globalisation means crossing borders. It is a complex, large-scale social phenomenon that presents to mental health services both challenges and opportunities. These relate to the increased cultural diversity of service users and service providers; the effects of migration on mental health; and the implementation of international protocols in relation to training, policy and education. In the aftermath of 11 September 2001 in the USA, the relationship between large-scale social change and mental health has also focused attention on the concepts of anomie and social capital. An explicit return to the principles of biopsychosocial psychiatry and a positive engagement with globalisation will advance the development of effective, evidence-based models of care appropriate to the changing needs of patients.
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