The Mental Health Act (1983) came into being eight years ago but few studies into its use have been reported (West, 1987; Sackett, 1987). The Act provided for the setting up of the Mental Health Act Commission to safeguard the interests of detained patients and to monitor the use of the Act. The Commission visits ordinary psychiatric hospitals on an annual basis and writes a report of the visit. The Commission also submits a Biennial Report to Parliament. These reports address important issues but do not provide detailed information on the use of the various sections of the Act in differing hospitals.

The Glasgow Media Group, through a combination of media watching and group interviews, has confirmed the importance of media representations of mental illness, with its finding that negative images can outweigh even an individual's direct experiences in this area (Philo, 1996). In one recent summary, Philo concludes: “the results show clearly that ill-informed beliefs on, for example, the association of schizophrenia with violence can be traced directly to media accounts” (Philo, 1997). The origins and strength of this association can be traced to cinema, where powerful images of violent ‘insanity’ endure today. In a questionnaire of 487 people who had a family member with severe mental illness, 85.6% identified “popular movies about mentally ill killers” as the largest single contributor to the stigma of that illness (Wahl & Harman, 1989).

Despite the increasingly widespread use of video consultations, there are very few documented descriptions of how to set up and implement video consultations in real-time practice. This step-by-step guide will describe the set-up process based on the authors’ experience of two real-time National Health Service (NHS) examples: a single health board use (delivered in normal time), and an All-Wales National Video Consultation Service roll-out (delivered during an emergency pandemic as part of the COVID-19 response). This paper provides a simple visual step-by-step guide for using telepsychiatry via the remote use of video consultations in mental health services, and outlines the mandatory steps to achieving a safe, successful and sustainable use of video consultations in the NHS by ensuring that video consultations fit into existing and new NHS workflow systems and adhere to legal and ethical guidelines.

In the next few months the London Region is expected to publish its strategy for learning disability services in the capital. This will inform the National Service Framework due in the autumn. At the same time, many trusts and health authorities are at various stages of reorganisation and reconfiguration. With the dawning of primary care trusts, single speciality mental health trusts and joint commissioning between health and social services, the debate over where learning disability services are best placed and their interface with mental health services has re-emerged (Barron et al, 2000).

Maurice Ravel (1875–1937), a musician of the highest order, died in a state of dementia. A genius of orchestration, a successful experimenter in musical forms and styles; he was at his best when given to composing small-scale constructions. His musical miniatures combine an extraordinary expressiveness with an unparalleled, almost mechanical precision. The latter quality provoked Stravinsky into calling him a “Swiss clock-maker of music”.

Clinical studies suggest that risperidone is an effective antipsychotic with a low incidence of extrapyramidal adverse effects. In a prescription survey of several trusts, we found that risperidone was widely prescribed at high doses alongside typical neuroleptics and anticholinergic drugs. We also demonstrated that prescribing in a single trust can be improved by simple interventions. Risperidone should be prescribed as the sole antipsychotic at doses below 8 mg/day to realise fully its clinical advantages. Few prescriptions met this standard.

Mental health services have been criticised for failing to respond to the needs of the rising number of homeless mentally ill. We report on the first year of referrals to a community mental health team established to meet the needs of the severely mentally ill homeless in Birmingham. Most users had a psychotic disorder and a lengthy history of unstable housing, and experienced a range of other disadvantages. Although the team is successfully reaching its priority group, examination of other characteristics of users has highlighted a number of issues which should inform the future planning and development of the service.

Questionnaire data are presented from a national multi-professional survey. Only 12% of respondents had local quantitative data on adults with learning disabilties (LD) and mental health needs (MHN). More described local provision as part of specialist LD services than integrated with generic mental health services. LD services were rated as more accessible and more available than generic mental health services. Clinicians agreed about the important elements of psychiatric assessment, treatment and their preference for using the ICD–9 and ICD–10 diagnostic classifications. The planning, delivery and evaluation implications for psychiatric services for adults with LD are outlined.

In 1978 the Section for Social and Community Psychiatry of the Royal College of Psychiatrists set up a working party to reconsider the DHSS guideline of 0.5 beds per 1,000 population for acute psychiatric units and to develop a new approach which would enable planners to adopt an appropriate bed provision figure according to the needs of different district psychiatric services. This followed the realisation that Health Authorities were beginning to set arbitrarily their own norms for bed provision, often based on one or two examples within their region, despite the fact that there is a two to three fold variation between districts in the number of beds provided for acute psychiatry. For example, in 1981 Worcester used 0.19 acute beds per 1,000 population and Camberwell used 0.76.

The nature, management and disposal of patients who present to casualty departments and receive psychiatric diagnoses by the assessing doctor are areas that have received scant attention by psychiatric researchers. The aim of this study was to analyse the records of such patients to see how they had been managed, in particular to document the degree of psychiatric intervention provided or offered, and to see what follow-up arrangements, if any, had been made.

People with the dual diagnosis of mental illness and mental retardation have proved difficult to resettle from hospital. Yet there is considerable evidence that, if diagnosed correctly, treatment for such patients can be effective (e.g. Matson, 1981; Welch ft Sigman, 1980). This paper describes the outcome of treatment at a specialist unit for patients with dual diagnosis.

Consensus is growing, in many areas of the humanities and social sciences, that aspects of the material world we live in have causal efficacy on our minds – the major dynamic being the plasticity of the brain linked to the affordances of our bodily engagements with things. The implications of that on how we approach and understand important mental health issues have not been adequately addressed. This paper proposes a material engagement approach to the study of the processes by which different forms of materiality achieve their effects. Focusing on the example of dementia, I propose that a collaboration between archaeology, anthropology, philosophy and psychiatry could help us to fill this gap in our knowledge, allowing us to understand the exact effects of everyday objects, personal possessions and forms of material engagement on people with dementia.