This chapter examines the current state of and issues related to mental health and welfare from an international social work perspective. It begins by outlining this global viewpoint and then situates international social work within the context of international development. The discussion proceeds to explore existing conditions and disparities in international social work across mental health, welfare, and development. Using a non-Western country as a case study, the chapter highlights key issues faced by mental health social workers in international development contexts. Rather than making a simplistic assertion that it is unconditionally good for social workers to be involved in international development, this chapter discusses that constant, reflective re-examination of practice is required through dialogue with people in the field. This process, in turn, offers insights for advancing the field of mental health social work.