This is an important book. The editors are managers and directors of Home Counties-based children's and community services, respectively; and planners and providers of mental health, child mental health and child protection and placement services should have it on their bookshelves. This book should be part of relevant training programmes. It should be read and used for teaching and debate, not because it is perfect, but because it is almost the only publication of its kind in a field which deserves far more focused planning, audit and research. The range of contributors reflects this; they include adult and child psychiatrists, a policy director, psychologists, managers, the Chief Executive of the Central Council for Education and Training in Social Work, practitioners in that field and a director of housing and social services.

A recurrent theme is the need for multi-disciplinary planning for children and adolescents at risk of abuse or neglect, which evaluates the incidence and prevalence of mental health problems and needs in their care-givers, balancing respective needs and risks in a coherent, reasoned fashion enabling joint evaluation of each decision made.

Of course, this does not happen. At governmental level, mental health, social services and educational legislation have been enacted over the past decade without appropriate interdepartmental planning. The Children Act and mental health legislation lie in separate parts of the map, with few routes between them.

The same thing happens on the ground. Bernard (Chief Executive of the Central Council for Education and Training in Social Work) and Douglas (an executive director of community services) comment in Chapter 11 that mental health staff may be unable to obtain a quick response from a local child care team because “the mental health emergency may not appear to be a child protection issue. Similarly, a child care team may try to arrange for an approved social work assessment of a family member, believing that parental mental health problems are critical to family functioning. To the mental health team, these problems may seem minor and not constitute an emergency. At its worst, action can take days or even weeks to negotiate between the relevant teams”. Audit of such practices seems the bottom line in terms of future achievement, and this will be even more difficult to establish than is audit within individual overpressed agencies.

With regard to psychiatry, Lau (Chapter 9) writes of the need for service managers to address current splits in service delivery in which those for adult mental health and child and adolescent mental health services are often separate. This rings bells with anyone in the latter speciality: all of us work in services which at best obtain 5% of the adult mental health budget and which, although we try to embrace multi-disciplinary work, are hindered by the structural and legal anomalies in relation to social services. We are hindered even more by the lack of longitudinal training for psychiatrists across the age range of our patients. Lau writes: “Service specifications for mental health services must include screening and identification of the mental health needs of dependent children in a family where the parent is mentally ill”. This is hardly controversial: it is simply not addressed adequately in current practice and planning. There is a useful perspective from consumers, though this reflects adults rather than children; as ever, their voices remain distant and elusive.

There are a number of useful protocols, provided by specialist local services such as those in Bath, Lewisham and Hackney. Kumar provides an excellent chapter on the assessment of infants and mothers at the Maudsley Hospital.

All in all, it is extremely surprising to realise that this is a pioneering book which requires and advocates collaboration between professionals from the fields of health and social services. This is hardly an original message, given that it is writ large within every Part 8 inquiry on child deaths and serious injury as required by the Children Act 1989, and each inquiry into homicides by mental health patients. Nevertheless, the message needs repeating and this book is a refreshing contribution to a field of study which is aiming to improve audit practice rather than to learn from tragedies after the event.