In a series of recent judgements the courts have authorised the treatment of adolescents against their will. What effect have these judgements and other legal developments had on the legal basis of medical treatment for children? How do they affect the professionals involved in decision- making? This article attempts to address the most commonly expressed concerns and queries about the changing legal context of work in the field of child mental health. It is based on the authors' discussions with professionals from backgrounds in health care, social care, and justice during training we have carried out with multidisciplinary and multiagency teams in England and Wales. For the purposes of this article, we will, in keeping with The Children Act 1989 (s105 (1)), use the term ‘child’ and ‘children’ to refer to everyone under 18 years old.