Since the mid-1970s, World Health Organization policies have encouraged integrating mental health services into primary care settings. But no one knows what, if anything, might be working to help those who are suffering, says the author of a report reviewing mental health services — or rather, the lack of them — in developing countries. Alex Cohen, a Harvard Medical School instructor in social medicine, offers a bleak picture of mental health care in the developing world. “The problem facing poorer countries is to use limited resources to establish a range of strategies and actual service models that can extend mental health services most effectively,” writes Cohen. “It’s almost like making something out of nothing.” Developing nations face greater difficulties in providing appropriate mental health treatment. India, for example, has two to three psychiatrists per million inhabitants compared to 50 to 150 per million in developed countries. Depression, anxiety, and other mental disorders constitute more than 12 percent of the global burden of disease and affect about one quarter of all patients in primary care settings.