As Director of the Division of Mental Health at the World Health Organization, and President of the World Psychiatric Association, Norman Sartorius has surveyed the state of psychiatry worldwide and campaigned for greater equity and honesty in the clinical and research agenda. The essays collected here represent his latest thinking, and include some of his speeches and previously published articles. They range from trenchant critiques of mental health service delivery and prevention to more light-hearted, anecdotal pieces on language use and increasing productivity. All address core concerns for mental health programs today: the definition of needs; the role of psychiatry worldwide; and the challenges that urbanization presents for mental health.