The Health of the Nation – A Strategy for England is a national response to WHO'S Health for All by the Year 2000 initiative. It has great importance both because it focuses on health outcomes and because it selects mental illness as one of five priority areas. This article traces the historical background to the development of the White Paper, summarises the content of the mental illness key area and current progress in improving information and understanding and developing comprehensive services, and improving good practice. It draws out the implications for individual practitioners, users and cares, and for the working arrangements between purchasers and providers.

The aim of this article is to promote a clearer understanding of the Mental Health Commission's development, structure and function. Over recent years, mental health professionals and patients have become more aware of the organisation and its work, although some may remain uncertain about its function and how it fits into the overall care of detained patients. The Commission's fundamental job is to safeguard the well-being and interests of patients detained under the Act. Its remit does not extend to informal patients. Unless otherwise indicated, all statutory references are to the 1983 Mental Health Act.

Forensic psychiatrists have particular ethical duties in relation to the protection of the public, which few other doctors have. Part of the fulfillment of that duty is the assessment of risk, upon which many ethical decisions rest. But comprehensive risk assessment may require information which is not available, leaving the forensic psychiatrist in a dilemma between her duty to the patient and to the public. This case history is based on a real case.

An anonymous questionnaire was sent to 67 senior and junior psychiatrists enquiring about their perception of equivalent antipsychotic dosages of three commonly used neuroleptic drugs. Thirty-one questionnaires were returned and revealed a wide variation in perceived potencies for the specific drugs. Increased experience in psychiatry was not associated with a decreased variation. On average clinicians saw haloperidol and flupenthixol decanoate as substantially less potent, relative to chlorpromazine, than the available literature would suggest.

Clinical experience suggested that between one tenth and one fifth of new referrals to a county-wide child and family service were referrals of children who had mental handicap. The purpose of this project was to establish the proportion prospectively with the clinical assessment used routinely by the service.

The effects of losing a loved one through death on the physical and mental health of both adults and children are well documented in the literature. Children are likely to be referred to mental health professionals for various behaviour and emotional problems which may have a causative link with a bereavement within the family. In this paper I discuss the need for preventive work and, propose a role for child psychiatric services in preventive work for bereaved families with surviving children and adolescents. A ten-point plan is suggested as a guideline.

Questionnaires exploring the attitudes of psychiatrists to philosophy were distributed at two meetings of the Royal College of Psychiatrists. Out of a possible 240, 126 questionnaires were returned (53%). The results showed a surprisingly high level of interest in and support for philosophy. Over 50% of respondents indicated that they considered conceptual analysis, ethics, jurisprudence, the philosophy of science and the philosophy of mind to be practically important in psychiatry. Similarly, 89% believed that ethics, and 72% that other areas of philosophy, should be included in the MRCPsych syllabus. The significance of the study is reviewed briefly.

A working party of the Collegiate Trainees' Committee of the Royal College of Psychiatrists sent a questionnaire to all trainees taking Part II of the MRCPsych examination in October 1992, asking about their satisfaction with various aspects of their training. Almost 70% rated their training as ‘good’ or ‘excellent’, but specific areas showed wide variation. Cognitive/behavioural psychotherapy, family therapy, research, the management of dangerous patients and the use of ECT were all highlighted as areas in need of Improvement. The working party make recommendations in the light of these findings.

The remit of our monthly training committee is to facilitate and audit postgraduate training. A clear remit, attention to the organisation and composition of the committee and clear links with other committees have helped us in our aims. Input to the committee from consultants, management and trainees are all essential to the maintenance of high training standards, particularly in a period of rapid change in the health service. The achievements and future plans of the committee are discussed.