The author makes an attempt at considering the most important achievements in psychiatry which have taken place in the global scale during the passing century, and the direction taken up by the development of global psychiatry in the coming century. The 20th century was characterised not only by the impressive development of science, thanks to which completely new possibilities opened up for global psychiatry, but also by the presence of extreme events that took place as a result of false ideologies such as fascism and communism. In the 20th century concepts like homicide, holocaust, the extermination of the mentally ill, experiments on people that are prohibited by the ethics of medicine and the elementary rules of humanity, etc. The paper includes the achievements of diagnosis and therapy of psychiatric disorders and the latest organisational solutions as well as the perspectives for further development of psychiatry. The author also implies the aims that psychiatry has to take up due to the numerous threats from our civilization: the technical-technological development, pollution of the natural environment, the negative changes in human values, the rising brutality in interhuman relations due to racial, national and religious conflicts and terrorism, the disappearing feeling of being safe in society, vision of hunger and poverty in many countries on a few continents, the danger of an epidemic outbreak of new unknown diseases caused by viral mutations, or genetics--the possible negative effects of genetic engineering (cloning of humans), etc. The author tries to define the role of psychiatry in preventing the threats of civilization.