Forthcoming changes to clozapine monitoring present an opportunity to expand, not dilute, specialist care for chronic schizophrenia. Reduced administrative burden should support timely clozapine use, structured assessment, access to psychological therapies and embedded physical health care. Experience from Cambridgeshire shows that secondary-plus clinics within community mental health teams can deliver sustained, equitable long-term care.

The National Institute for Health and Care Research has enabled the integration of world-leading science with clinical practice in the UK’s National Health Service, and has saved lives and improved lives as a result. However, this integration has not extended to mental health services. The case is made for a National Institute for Mental Health Research (NIMHR) to address this inequity.

Half a century of neuroimaging has transformed our understanding of psychiatric disorders but not our clinical practice. This piece examines why that promise remains unfulfilled and argues that the future lies not in ever newer tools but in rigorous, mechanistically grounded and clinically embedded imaging approaches that bridge brains, behaviours and treatments.

Censoring language in medical science enforces ideological conformity and political repression of marginalised groups through self-censorship. This editorial urges the scientific community to resist language control as a grave threat – not only to research freedom, but ultimately to human diversity and life itself.

Internationally, drug- and alcohol-related morbidity is at its highest recorded levels yet these modifiable risk factors often remain overlooked within systems of healthcare delivery and research. We seek to reaffirm the ongoing commitment of BJPsych to publishing and promoting drug and alcohol research and encourage submission of high-quality articles.

Psychiatry seems beleaguered: from underfunding of education, training, research and services to marginalisation within the healthcare world and even doubts about its relevance. Medical training, with advanced relational and formulation skills and a strong foundation of research, equips psychiatrists to exercise clinical leadership across the healthcare landscape. This expertise can and must be used to benefit patient care.

People with intellectual disability experience significant health inequality, and consequently poor health outcomes. Although research can facilitate change, there is a risk of researchers propagating inequity by selecting methods that exclude people with some forms of intellectual disability. We argue for participatory research methods that enable inclusion.

Cannabis use increases the risk of psychosis, but cannabis-based medicinal products may provide additional therapeutic opportunities. Decriminalisation of cannabis has led to wider availability in certain jurisdictions, while in the UK regulated medicinal preparations are not readily accessible. A more balanced approach could reduce harms while maximising potential therapeutic benefits.

This paper highlights systemic research and clinical deficiencies in addressing eating disorders among males and men, focusing on societal stigma, gender-biased diagnostics and barriers to care. It advocates for comprehensive reforms, including addressing systemic underfunding, closing research gaps, improving clinician training and tailored interventions to reduce disparities and improve outcomes.

It is often assumed that relapse leads to poor long-term outcomes, but new data question this in regard to symptoms, social function, quality of life and, possibly, employment. We consider this together with other impacts, risks and costs and how individual circumstances all influence decisions about antipsychotic maintenance treatment to prevent relapse.

Resource restrictions and changes to the ways in which psychiatrists are managed threaten professional autonomy and motivation. With examples from English National Health Service practice, maintaining knowledge and expertise, involvement in education and training, supporting research delivery and developing active followership skills represent transferable and realistic strategies that can improve psychiatrists’ autonomy wherever they work.

Lysenko was a powerful Soviet pseudoscientist, whose theories cost millions of lives. He died 50 years ago, but his legacy is highly salient. Anti-science and ideology come together slowly, and UK pseudoscience has had unforeseen consequences. Pseudoscience must be challenged even when this has repercussions for those who speak up.

Real-world studies provide valuable insights into long-term outcomes across diverse populations. Here, we contextualise recent findings on the association between antipsychotic use and breast cancer risk in women with schizophrenia. We discuss clinical implications and the strengths and limitations of real-world studies in psychiatry. We conclude with future perspectives.

Recent attention to diversity, equity and inclusion (DEI) has led to positionality wherein investigators and authors disclose their identity and social position, allowing readers to interpret findings through the lens of authors’ biases. This article describes positionality via meanings of identity and impact of positionality on readers and authors themselves.

The NHS 2025 Health Plan aims for radical reform but overlooks people with intellectual disability. This editorial highlights critical omissions in policy, services, research and rights protections. Without intentional inclusion, digital and community shifts risk deepening inequality. True progress demands co-produced strategies to ensure equitable care for this vulnerable population.

The ‘overview effect’ was described by astronauts who saw the earth from space and found this gave them a very different perspective. This effect is a shift in worldview, and it has been suggested that politicians be sent to space to change their narrow perspectives. In a similar vein, it is crucial that psychiatrists have an overview of their patients so that their perspectives on patient care enable them to deal with the patient from different angles. In this editorial, the overview effect is described in the context of clinical care.

The Royal College of Psychiatrists was established in 1971 with psychiatric training as its core business. Drawing on a feature written by a former president in 2000, this editorial is a reflection on how his predictions played out in the real-life practice of psychiatry and the suggested way forward.

A phenomenon distinctive to attention-deficit hyperactivity disorder (ADHD) is that the effects of stimulants are evident in domains of attention, mood, energy and focus, independent of the presence of an ADHD diagnosis. This reflects recreational use of stimulants for these and other effects. Perceived treatment response probably reinforces diagnosis, and hence diagnostic and prescribing habits.