The countries of the Eastern Mediterranean Region represent many challenges for the organization of mental health care. Many countries are in a state of rapid social change, some are in conflict or suffering the aftermath of conflict, while others are witnessing the growing problem of substance abuse, with associated HIV/AIDS rapidly becoming a public health priority. This publication addresses three aspects: the planning of mental health services; the current mental health situation in each of the countries of the Region, along with the innovative approaches developed during the past two decades; and the challenges and opportunities for addressing the mental health needs of the diverse populations. Bringing together the experiences of the Region provides an opportunity to learn from the past as well as for greater collaboration and cooperation in the future between countries facing similar problems.