As one article in a series on Global Mental Health Practice, Shoba Raja and colleagues provide a case study of BasicNeeds in Nepal, which emphases user empowerment, community development, health systems strengthening, and policy change to help socially disadvantaged individuals with mental health conditions.

As a result of our study, which was the first nationwide study in NZ to examine spirituality in hospice care, Hospice New Zealand has developed a spirituality professional development program. Given that spirituality was found to be important to the majority of our participants, it is hoped that the adoption of such an approach will impact on spiritual care for patients and families in NZ hospices.

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Background: Limited evidence about mental health finances in low and middle-income countries is a key challenge to mental health care policy initiatives. This study aimed to map mental health finances in Ghana, Uganda, India (Kerala state), Sri Lanka and Lao PDR focusing on how much money is available for mental health, how it is spent, and how this impacts mental health services. Methods:A researcher in each region reviewed public mental health-related budgets and interviewed key informants on government mental health financing. A total of 43 key informant interviews were conducted. Quantitative data was analyzed in an excel matrix using descriptive statistics. Key informant interviews were coded a priori against research questions.Results: National ring-fenced budgets for mental health as a percentage of national health spending for 2007-08 is 1.7% in Sri Lanka, 3.7% in Ghana, 2.0% in Kerala (India) and 6.6% in Uganda. Budgets were not available in Lao PDR. The majority of ring-fenced budgets (76% to 100%) is spent on psychiatric hospitals. Mental health spending could not be tracked beyond the psychiatric hospital level due to limited information at the health centre and community levels. Conclusions:Mental health budget information should be tracked and made publically accessible. Governments can adapt WHO AIMS indicators for reviewing national mental health finances. Funding allocations work more effectively through decentralization. Mental health financing should reflect new ideas emerging from community based practice in LMICs.

Authors' contributions: SR, CL, JK, MW, SKW and SM designed the study; VdM, MK, and DM proposed the framework for economic analysis; VdM conducted the analysis and drafted the article; all authors revised the article and approved the final version. Funding:The intervention was funded by the European Commission's Non-State Actor funding stream (DCI-NSAPVD/2008/156-918) and the UK Department for International Development's Civil Society Challenge Fund (CSCF 450).Competing Interests: Shoba Raja, Joyce Kingori, Milka Waruguru and Saju Mannarath are employees of BasicNeeds. Abstract (164 words)Background. The treatment gap for serious mental disorders across low-income countries is estimated to be 89%. The model for Mental Health and Development (MHD) offers community-based care for people with mental disorders in eleven low-and middle-income countries.