Abstract Since the World Health Report 2001 focused on mental health for the first time, the field of global mental health has seen unprecedented growth in policy commitments and research. Yet many challenges remain, including a lack of substantial new financial investments from governments, ongoing human rights abuses suffered by people living with mental illness, weak health systems in low resource settings and large gaps in our knowledge regarding aetiology, prevention of mental illness and mental health promotion. Stark inequalities persist between high-income countries and low- and middle-income countries (LMIC) in research knowledge and service resources. This editorial sets out to reflect on progress to date, and suggest priorities and possible future trends for research, policy and service implementation, especially in LMIC.