Armed conflict devastates children across all regions and ideologies – inflicting profound and lasting harm on their bodies, minds, and developmental trajectories. While all sides may commit atrocities, the experience of children is tragically consistent: they are the least responsible, yet often the most harmed. This article traces the evolving global understanding of war’s impact on children, charting a journey in modern history to present-day realities. It begins with the landmark 1996 UN report by Graça Machel, which exposed the wide-ranging and systematic nature of the effects of war on children – where violence, displacement, and severed attachments force children into premature adulthood. Building on this, the 2009 and 2013 UN efforts codified the “Six Grave Violations” against children in armed conflict, now central to global monitoring and advocacy. Despite these frameworks and legal protections, including the Convention on the Rights of the Child, the 2024 UN Secretary-General’s report shows violations have surged – up 21% in the past year alone. To bring these patterns into focus, the article concludes with a case study of Gaza. Chosen for its immediacy and visibility, Gaza is emblematic of the ongoing failure to shield children from war’s worst impacts. Similar suffering persists in Sudan, Myanmar, and Ukraine. The article calls for an urgent, universal imperative: end hostilities to protect children. A trauma-informed, attachment-sensitive approach – grounded in lessons from Rwanda, Bosnia, and Syria – is essential. Clinicians, humanitarians, and policymakers must place children at the heart of all post-conflict recovery and accountability efforts.

In this article, I explore how the mental health and mental capacity laws in England and Wales can be used for suicide prevention. I criticise the use of compulsion for persons diagnosed with a mental disorder who nonetheless retain decision-making capacity and argue for a greater reliance upon capacity as a distinguisher between autonomous decision-making about the end of life and the risk to life posed by symptoms of mental illness. The label of ‘suicide’ is also criticised as an outdated legal notion carrying pejorative meaning. Although focused on the law in England and Wales, the arguments apply much more broadly to all jurisdictions seeking to reconcile the demands of respect for life and respect for autonomy.

This paper describes the 9-step Collaborative Care Pathway (CCP-9), an innovative approach to delivering recovery-focused community mental health care which has been piloted and implemented in a community-based secondary level service in Ireland over the past 14 years. Care planning is mandated in the Republic of Ireland by the Mental Health Act (2001). Subsequent public policy documents require care planning to have a recovery focus, as outlined in the Quality Framework Document (Mental Health Commission 2023). The CCP-9 is a novel approach to delivering community mental health care in which care planning is embedded as one of a sequence of nine steps in a complete pathway of care from referral to discharge, and which has been adapted over time in line with evolving public policy. The CCP-9 is innovative in explicitly taking a graded approach to assessment, in the emphasis placed on collaborative engagement of service users (SUs) and their families, in the detailed psychosocial assessment undertaken in parallel with diagnostic assessment and in the degree of multidisciplinary team (MDT) involvement. The CCP-9 is coordinated by a key worker, involves prospective identification of personal needs and goals by the SU and enhanced MDT involvement in review of assessments, case formulation, care planning and feedback to SUs and families. The CCP-9 emphasises sharing information, documentation and mental health education with SUs and family members throughout the process, as a necessary support for shared decision-making in developing and implementing the care plan. Challenges to the sustainability of the CCP-9 includes the significant time investment to complete the assessment, care planning and feedback.

The recent publication by the Mental Health Commission (MHC) constitutes a welcome acknowledgement of the unique challenges within mental health care delivery for LGBTQIA+ populations in Ireland. This timely guidance illustrates a comprehensive framework to tackle the entrenched disparities in mental health outcomes and service access challenges experienced by sexual and gender minorities in Ireland, aiming to align with international best practices of affirming and inclusive mental health care. The purpose of this critique is to situate the MHC guidance within the broader multimodal context of societal change and service provision, rather than to provide procedural or implementation instructions. For clinicians, this is an opportunity to reflect on the landscape in Ireland.

Substance use disorders and addictions are mental disorders deeply interconnected with other psychiatric conditions – and this connection is of fundamental importance. Although addictions are formally recognized as mental health disorders, they are often not addressed as such in research or clinical practice. Psychiatric research, clinical care, and treatment development remain largely organized along traditional diagnostic boundaries. While diagnostic classifications provide structure and clinical utility, it is increasingly evident that psychiatric diagnoses are neither fully separable nor independent entities. Despite extensive discussion on comorbidity, addictions are frequently excluded from broader conceptualizations of the intertwined nature of mental disorders. Yet, they share substantial commonalities with other psychiatric conditions across clinical presentation, psychopathology, genetic vulnerability, neurobiological mechanisms, socioenvironmental risk factors, and treatment strategies. Maintaining a conceptual divide between addictions and other psychiatric disorders reinforces diagnostic “tunnel vision,” constraining our understanding of neuropsychopathology and contributing to persistent gaps in care and treatment accessibility. This narrative review examines the overlapping risk factors, clinical features, and therapeutic approaches that link addictions with other mental disorders. We argue that advancing psychiatric research and nosology requires a deliberate acknowledgement of these transdiagnostic overlaps and shared mechanisms. The challenge is particularly evident in the understanding and treatment of dual disorders. Progress will depend on integrative, collaborative frameworks that bridge scientific and clinical perspectives and foster dynamic feedback between empirical research and clinical practice. Recognizing mental disorders as interdependent systems may offer a more coherent and effective foundation for understanding and treatment.

This paper outlines the experience of establishing a partnership for clinical services and academic training across two very different countries: Zambia and Ireland. Drawing upon the experience of setting up other similar international partnerships, the process of understanding the two very different cultural and clinical contexts has developed collaboratively over the course of the past 2 years, and has resulted in valuable insights and joint working. In line with local priorities, the Zambian colleagues in the partnership have prioritised the support for postgraduate training in psychiatry to enable the expansion of services, and allow greater population access. In particular, there is evidence of unmet need in the areas of substance use psychiatry, and child and adolescent psychiatry.

The collaboration will increase cultural awareness among psychiatrists and trainees in Ireland and deepen their knowledge and understanding of international psychiatry. This programme is mutually beneficial and has the potential to greatly improve relationships between the mental health service providers of the two nations.

Beliefs in evil spirits and the practice of deliverance from supernatural forces have been widespread throughout history. Many psychological and physical afflictions have been attributed to involuntary demonic possession. Traditional remedies, for those reporting inhabitation by evil spirits, can involve exorcism believed to expel such forces. Similar beliefs may be symptomatic of major mental illness and treatments namely medication and psychotherapy, are frequently recommended. An increasingly secular western world is also seeing growth in non-denominational Christian churches and other faiths, who accept spirit possession and exorcism. Culturally competent mental health professionals, seeking to understand their patients’ world view, may struggle with exorcism, seeing it as an interference to conventional treatment. They may be being unwilling thus to attempt differentiation between possession and mental illness. This paper explores the diversity of views on this topic and points of contention and overlap. The risks and cautions necessary in approaching this issue are stressed.

Individuals with mental health difficulties (MHD) have a substantial reduction in life expectancy compared to the general population. It is increasingly recognised that mental health services need to improve physical healthcare as a priority. Sexual health, including consideration of high-risk sexual behaviours, medication side effects, and challenges in romantic relationships, is a further important but under-recognised aspect of overall health. We discuss some of the current issues relating to physical and sexual health, with a particular focus on youth with MHD and how we might implement holistic care in Ireland. Prioritising the resourcing of these issues could facilitate the implementation of a Shared Model of Care as recommended in Ireland’s National Mental Health Policy, Sharing the Vision.

The position paper ‘The development of services for treatment of personality disorder in Adult Mental Health Services’ was published by the College of Psychiatrists of Ireland Personality Disorder Special Interest Group (PDSIG) in 2021. Following this, we are advocating for the development of a national treatment strategy for personality disorders in Ireland. As part of this process, we have examined international evidence and best practice guidelines for establishing personality disorder services. Key recommendations from the literature include access to services, continuity of care, a multidisciplinary approach, tiered models of care, collaboration with service users, staff training and supervision, and delivery of evidence-based interventions. These recommendations should form the backbone of a national personality disorder strategy for Ireland.

Consultation-liaison psychiatry (CLP) refers to the subspecialty of psychiatry and the specialist clinical services that deliver care at the intersection of mental and physical healthcare. CLP services provide specialist medical and multidisciplinary expertise for managing conditions in these areas of mental and physical healthcare overlap, and comorbidity. The Model of Care for CLP was identified as a key priority in Sharing the Vision, the 2020 national mental health policy in Ireland. Following four years of work by a writing group initiated by the Faculty of Liaison Psychiatry at the College of Psychiatrists of Ireland, the Model of Care for CLP in Ireland was launched in May 2025 (Cpsychi H (2025). Consultation-Liaison Psychiatry: A Model of Care for Ireland. Dublin: HSE.).). Consultation-Liaison Psychiatry: A Model of Care for Ireland. Dublin: HSE.). This reflects the collaborative efforts between the Liaison Faculty and the Irish Health Service Executive (HSE). This Model of Care, developed in collaboration with clinicians and patients, the College of Psychiatrists of Ireland, and the HSE, provides a potential template for future collaborations in the development and implementation of National Mental Health policy.