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Lentegeur currently faces difficult challenges in both managing its workload and adapting to a variety of changes. Most importantly, these include population growth and epidemiological changes: mental illness is increasingly being recognized as one of the leading causes of global burden of disease, with a strong association to poverty. The communities served by the hospital, and particularly those in many of the areas surrounding it, are characterised by high levels of poverty, drug abuse, criminality and social fragmentation. Although climate change may not be a major concern within these communities, it is clear that its consequences, and particularly that of food-price inflation, will affect them most directly.