This paper describes mental health services in the Lower North Shore (LNS) catchment area of Sydney, Australia, and is based on a visit made in early 1994. The local population of 170,000 is predominantly Caucasian, but there are also groups from other ethnic backgrounds. The mental health service has about 800 registered clients, with 60 new clients each month, the majority of whom have a serious mental illness. Since the service has won several awards, it may be instructive to review its structure and function.

The community psychiatry service in Bassetlaw District has been developing since 1984 and provision includes hospital hostels, supervised flatlets, nursing and rest homes, group homes, cluster flats and warden assisted accommodation. Close liaison with an enthusiastic Local Authority Housing Department has also led to the development of a new initiative, an unstaffed flat for use in crisis intervention and rehabilitation. Placements in the flat are described over the first 12 months of its existence.

This paper describes the process of involving mental health service users in the planning and running of a community service. PACT (Psychiatric Assertive Outreach and Continuing Care Team) is based in south London and provides care for people who have severe and enduring mental health problems. We present an approach based on three years of intensive collaboration with service users. Community services will only become effective if they respond to need and develop new partnerships with people in contact with them. People require the opportunity to experience new ways of becoming involved at all levels of service provision and, therefore, efforts need to be made to develop a variety of opportunities for people to put forward their views. This takes time and determination by all involved.

The law relating to consent to treatment in children can be confusing. It is made up of a patchwork of statutory and case law that reflects an ambivalence between respecting the rights and autonomy of the child and the pervading paternalism within the courts and society more generally. This has lead to an ebb and flow of these competing pressures over the years.

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.

The 40th anniversary celebrations at Keele are proving to be a lively acknowledgement that the University is now firmly back on its feet and has a renewed confidence in its baptismal vows. There has indeed been a recovery of Keele's raison d'être to provide multi-faculty education (all students study an arts and science subject), to pioneer a Foundation Year to allow more informed choice of Honours courses, and to accommodate undergraduates as well as many staff on its leafy 18th century estate. The Vice Chancellor has succeeded in putting Keele back in the black, and on the map, and now plans to increase the number of students to 6,000 in the next decade.

In the second of this occasional series, Mark Jones looks at Mozart and his 1788 masterpiece, Don Giovanni, and interviews Tom Sutcliffe, opera critic of The Guardian, about his views on this problematical work and its portrayal on the stage.

At its meeting in June 2004, the Court of Electors approved the proposals indicating changes in training and assessment in psychiatry to enable consultant psychiatrists to practise in 2020. The main recommendations are presented elsewhere in this issue (Bhugra & Holsgrove, pp. 49–52, this issue).

“Hogarth's Rakes's Progress paintings, which I saw in 1947 on a chance visit to the Chicago Art Institute, immediately suggested a series of operatic scenes to me.” (Stravinsky & Craft, 1960). By 1947 Stravinsky's career, which had started so brilliantly and stormily with the revolutionary Rite of Spring, was almost totally becalmed. Since emigrating from Paris to California in 1940, he had written a couple of untempestuous orchestral pieces, Circus Polka, “composed for a young elephant”, and little else. He was depressed by the lack of originality of his work and was eager to write an opera in English. When he saw the paintings of the Rake's Progress, he seized his opportunity.