The UK Mental Health Act 1983 does not apply in prison. The legal framework for the care and treatment of people with mental illness in prison is provided by the Mental Capacity Act 2005. We raise dilemmas about its use. We highlight how assessing best interests and defining harm involves making challenging judgements. How best interests and harm are interpreted has a potentially significant impact on clinical practice within a prison context.

I describe the needs for and impediments in provision of psychological support services for doctors. Morbidity and the resistance in the profession to addressing their own health needs are discussed. I also explore the principles of bespoke services for doctors, with particular emphasis on overcoming stigma and facilitating therapeutic engagement. I argue that triage is an inappropriate service model of care for doctors.

Planning for the future development of mental health services requires an understanding of the changing demographics of local populations. It is argued that the demographic transition faced by the UK requires mental health services to adopt an approach more typical of public health in responding to the needs of an increasingly ageing population.

Multiagency public protection arrangements (MAPPAs) were established in England and Wales 10 years ago to oversee statutory arrangements for public protection by the identification, assessment and management of high-risk offenders. This article reviews MAPPAs' relationship with mental health services over the past decade. Despite areas of progress in the management of mentally ill offenders, inconsistent practice persists regarding issues of confidentiality and information-sharing between agencies, which calls for clearer and more consistent guidance from the Royal College of Psychiatrists, the Ministry of Justice and the Department of Health.

The Health and Social Care Act 2012 brings in profound changes to the organisation of healthcare in England. These changes are briefly described and their implications for mental health services are explored. They occur as the National Health Service (NHS) and social care are experiencing significant financial cuts, the payment by results regime is being introduced for mental health and the NHS is pursuing the personalisation agenda. Psychiatrists have an opportunity to influence the commissioning of mental health services if they understand the organisational changes and work within the new commissioning structures.

The Coroners and Justice Act 2009 promised an overhaul of the coroners' service, introducing much needed efficiencies to benefit people bereaved by suicide and other sudden deaths. Central to these reforms was the introduction of a Chief Coroner to coordinate the system and exercise wider public health responsibilities. The coalition government's proposal to abolish the Chief Coroner's office on grounds of cost, ignoring the potential efficiency gains, has delayed implementation of coronial reforms significantly. With this proposal now abandoned, ministers are expected to appoint an independent Chief Coroner in early 2012. This article describes the intended benefits of the reforms for bereaved relatives, coroners' staff, public sector budgets, and the public health, and explores the reasons behind the delays.

The administrative imposition of new models of psychiatric care in the community has led to the fragmentation of services and a deteriorated experience for both service users and professionals. The author makes a plea for psychiatrists to reassert the principle of continuity of care, which has been all but lost from the practice of psychiatry during the past decade. It is possible to meet the clinical objectives of necessary support and treatment for service users within the community without the current multiplicity of team structures seen throughout England.

Child and adolescent mental health services (CAMHS) make an important contribution to the assessment and treatment of abuse and neglect in children. However, the provision of services is patchy and we see the present political and economic environment as providing opportunities but also threats. In this editorial we examine some of the barriers to CAMHS involvement, emphasise the potential public health benefits of improving the service, and provide some examples of how CAMHS could develop its involvement in partnership with Social Services and the family courts.

The host country's legacy after the Olympic Games is multifaceted. Alongside such diverse elements as tourism, commerce and transport sit the health benefits of increased participation in sports and provision of the highest quality medical support for the nation's elite sporting performers. Mental health, however, merits no specific mention. This could be a missed opportunity to create a legacy that promotes the mental health benefits of exercise as well as ensuring that the mental health needs of elite sportsmen and women are recognised and met in the same manner as their physical health needs.

This editorial offers an overview of mental health service provision across different languages and cultures in the UK. It is increasingly recognised that mental health service users with limited English proficiency are rendered doubly vulnerable by the combination of their illness and their language difficulties. Only recently has the importance of safe, coherent, nationally available interpreting, translation and language support (ITALS) been recognised by healthcare providers. We review the challenges within the interpreted interaction, some reasons for the scarcity of qualified and accredited ITALS suppliers, and some solutions to the ITALS problem.

The Equality Act 2010 should prevent age discrimination in the provision of healthcare and other services in the UK. The Royal College of Psychiatrists' Faculty of the Psychiatry of Old Age and General & Community Psychiatry Faculty have offered constructive guidance to help achieve this. However, there are pitfalls. First, legislation does not guarantee enforcement. Second, discrimination in the form of persisting negative attitudes of society towards older people and their ability to benefit from health interventions is associated with a deficit in funding old age services that has accumulated gradually during the 60 years of the National Health Service. These difficulties will need to be overcome to achieve effective implementation of the Act.

There is ambivalence about prosecuting psychiatric in-patients for violent offences. This ambivalence is reflected in the Memorandum of Understanding that exists between the Crown Prosecution Service and the NHS Security Management Service. This has led to an unwelcome change in practice when the police ask for information from an individual's consultant psychiatrist, the police requesting information about the individual's cognitive abilities at the time of the alleged offence and using this to make decisions about prosecution. However, there is also guidance on this area from other sources. We describe this and make further suggestions for dealing with these requests.

In this issue, Dr Lodge makes a plea for continuity of care in the face of the increased specialisation of mental healthcare over recent years. However, continuity of care is not a straightforward concept and its relationship to clinical outcome is not established. The increased specialisation of mental healthcare reflects an evolving evidence base that has increased our understanding of mental illness and the treatments and delivery systems that are most effective. In other words, specialisation is the sign of a progressive field.

It is generally stated that the Mental Health Act 1983 does not apply to prisoners, and this is a useful shorthand to remind those unfamiliar with British prisons that treatment cannot be administered under the Mental Health Act, even to the most severely mentally ill prisoners. However, the legal situation is actually more nuanced given that the Mental Health Act does make provision for prisoners – intending that they be promptly transferred to hospital for treatment. This does not happen in practice for service reasons. It is not clear whether the Mental Capacity Act 2005 applies to those falling through the cracks.