The Bethlem Royal and Maudsley Hospitals Item Sheet system for registering clinical data generated by psychiatric assessments is long established, with a proven track record as an instrument of scientific research. However, its use has not spread beyond the originating institution, despite being available in the public domain for many years. To address this problem we have designed a modified version of the Item Sheet. The new system has been simplified and improved to facilitate the use of this research aid in child guidance clinics and similar settings.

Health inequalities in psychiatry are well established, with people living in poverty and those from minoritised groups receiving different care and experiencing worse health outcomes. Psychiatric patients experience significant differences in life expectancy compared with the general population. This article explores changes within psychiatric services and public health interventions that could address health inequalities and asks why this has not happened yet.

In this article we give an alternative view of service provision for adolescents with emotional difficulties centred around four high schools. We believe that the service we offer differs in a number of ways and has a number of benefits for clients and other pupils and staff at the schools. We present this view of our service with some information about its historical context and as a snapshot of the current state of the service in the expectation that there will be further developments.

In recent years, the Royal College of Psychiatrists has been engaged in activities to ensure parity of esteem for mental health within the National Health Service, seeking to bring resources and services more in line with those available for physical health conditions. Central to this has been the promotion of psychiatry as a profession that takes a biopsychosocial approach, considering all aspects of the patient's presentation and history in the understanding and treatment of mental disorders. However, there has been a drift away from considering the psychological aspects of the patient's difficulties in recent years. This potentially has profoundly negative consequences for clinical care, training, workforce retention and the perception of our identity as psychiatrists by our colleagues, our patients and the general public. This editorial describes this issue, considers its causes and suggests potential remedies. It arises from an overarching strategy originating in the Royal College of Psychiatrists Medical Psychotherapy Faculty to ensure parity of esteem for the psychological within the biopsychosocial model.

This article describes the process of setting up a community support team for the severely mentally ill, and the challenges this posed. As this method of service delivery has been infrequently described, it is hoped our experience may be instructive to others.

The Stoke Park Hospital Group in Bristol has been providing a service to mentally handicapped people and their families since 1909. The nature and extent of the service has changed significantly between then and now, largely due to changes in Government policy, first laid out in the 1971 white paper Better Services for the Mentally Handicapped. The changing nature of the service was highlighted in Carter's paper in 1984, in which he examined all admissions to the Group over ten years. He found an increasing use of the hospitals for short-term care, particularly for those patients with a superimposed psychiatric disorder, and a continuing, albeit reducing, demand for long-term care for some patients. He concluded that the hospital would continue to have an important role to play in the evolving pattern of care.

The year 1991 will be emblazoned on our minds as the year of the Middle East War. Saddam Hussein gave more than a clue to his own psychopathology when he named this conflict “The Mother of All Wars”. All nations which actively participate in battle will lose troops and civilians. Physical damage, terror and distress are the immediate accompaniments of battle. Starvation, sub-standard living conditions and infectious disease often follow. Modern weapons and terrorism are capable of inflicting major damage on populations which are far away from the centre of the war.