The human rights group Amnesty International has recently expanded the range of rights it promotes to include the right of persons with mental illness to enjoy the best available mental health care. The Irish section of Amnesty has launched a report and promotional campaign on the rights of persons with mental illness, using internationally recognised norms of best practice reflected in international conventions that generate binding legal obligations of the Irish state. The report is critical of piecemeal reforms and inadequate resourcing of mental health services, and calls for a more comprehensive implementation of the recommendations of domestic and international reports.

In autumn 1996, under the Presidency of Dr Robert Kendell, the College decided to mount a campaign to tackle the stigmatisation of people with mental illnesses. In 1997, a working party proposed goals, content, process and a 5-year governance. Other campaigns, both here and abroad, have either generically addressed ‘mental health problems' (e.g. Mind's ‘Respect’ Campaign) or targeted a specific mental illness, e.g. the World Psychiatric Association's anti-stigma campaign in respect of people with schizophrenia. Our working party decided that it might be timely to recognise the differences in public attitudes to the variety of mental illnesses. The campaign thus addressed six categories of mental illness: anxiety disorders, depressive disorders, schizophrenia, the dementias, eating disorders, and drug and alcohol misuse/addiction. Target populations were identified as doctors, children and adolescents, the workplace, the media and the general public. The working party had also secured funding and arranged for a survey, in July 1998, by the Office for National Statistics of opinions of the British public concerning people with these mental illnesses (Crisp et al, 2000). The Campaign started on 7 October 1998. Since that time, and drawing upon our survey findings within its initial literature review (Kelly, 1999) the Department of Health mounted its own anti-stigma campaign, ‘Mind Out for Mental Health’, which addressed a similar range of mental illnesses.

Self-harm is a major risk factor for suicide (Gunnell & Frankel, 1994) with around a quarter of suicides preceded by non-fatal self-harm in the previous year (Owens & House, 1994). Strategies for suicide prevention should include accurate monitoring of health service contacts due to self-harm. Unfortunately, the published literature points to few practical steps for ensuring this accuracy. We offer an account of running a database, to assist others who might be setting out on this monitoring process.

Robert Gardiner Hill, house surgeon, and Edward Charlesworth, physician and governor, at the Lincoln County Asylum are generally regarded as being the pioneers of the non-restraint movement in the UK, having totally abolished the use of mechanical restraints at that institution by 1838 (Lincolnshire Archives, 1838; Smith, 1999). John Connolly introduced non-restraint to the Hanwell Asylum in the summer of 1839, closely following Lincoln (Hunter & Macalpine, 1968). However, Gardiner Hill suggested the credit for introducing non-restraint in its full extent should go to Dr Thomas Prichard of the Northampton Asylum (Hill, 1857).

There is an increasing tendency in criminal, civil and family proceedings to rely on expert medical evidence. Within psychiatry, this role is traditionally regarded as falling within the remit of those specialising in forensic psychiatry. However, there is an increasing demand for psychiatrists working in other specialities to undertake this work.

It is a little-known fact that specialist registrar training allows an elective period of up to 3 months without affecting a trainee's Certificate of Completion of Specialist Training (CCST). The Postgraduate Dean for Oxford had discussed the idea of such an elective scheme with the military and I therefore saw in the elective an opportunity to do something different before becoming a consultant. As an ex-member of the Territorial Army, my wife was very supportive and encouraged me by telling me that I would never withstand the rigours of a military lifestyle.

There are major challenges in providing training for psychiatrists in the modern National Health Service (NHS). Senior house officer and specialist registrar training has been reorganised to focus on core skills and competencies, and is monitored through educational supervision and the Record of In-Training Assessment (RITA) process. For consultants, the development of appraisal and revalidation are linked to formalised approaches to continuing professional development and personal development (Royal College of Psychiatrists, 2001). Increasingly, training is self-directed and psychiatrists have to effectively evaluate and plan for their individual educational needs. They must be able to access good quality, structured training, to develop and maintain a range of specific and generic skills.