A recent training exchange visit to India posed several questions on the relevance of concepts such as child mental health and the applicability of western types of interventions and services.

Spending time with staff and clients was a privilege. They tested one's pre-conceived ideas on what constitute child mental health problems, why these develop, and how children with substantially different upbringing and experiences communicate them. This being my second attempt, following a similar visit to Gaza in Palestine, I was not very surprised by the similarities in the factors that lead to mental health problems.

Admittedly the presentation varied, but the underlying reasons for emotional and behavioural problems usually involved some kind of acute stressor or chronic adversity in the child's environment, accounting for what were accepted as the social, cultural and spiritual or religious norms (such as family roles, parenting or peer relationships).

This understanding and interpretation is important in deciding on the best way of developing realistic but effective mental health services for children and young people. There is no doubt that we should continue to strive towards redressing as much of the financial imbalance as possible, while supporting developing countries in establishing their own sustainable health and welfare systems.

However, one has to accept that there will be other urgent health priorities for years to come such as sanitation, nutrition and immunisations. Inevitably, the scope for specialist services will remain limited. It would also be wrong to drive national policies and limited resources simply by adapting western service models.

A recent review of health projects in the developing world indicated that the most successful ones acknowledged local societal strengths, and maximised the input of existing community supports and networks, for example by training volunteers in rural areas. A large proportion of these projects were steered by national or international NGOs and charities.

In relation to children, schools are another obvious focal point for mental health promotion and interventions. This was particularly obvious in India, as it was strengthened by parents' high value of education, even in very deprived areas.

The more we consider underlying principles such as family and community ties in enhancing children's emotional and social well-being in other countries, the more we might appreciate their value in western society, where the role of the public sector, mainly in urban areas, is often to compensate for or replace rather than complement such ties.

Panos Vostanis is consultant child and adolescent psychiatrist with the Leicestershire Partnership Trust's young people's team, and professor of child psychiatry at the University of Leicester.