Sir James Crichton-Browne (1840–1938) held a uniquely distinguished position in the British psychiatry of his time. Unburdened by false modesty, he called himself ‘the doyen of British medical psychology’ and, in the narrow sense, he was indeed its most senior practitioner. At the time of his death, he could reflect on almost half a century's service as Lord Chancellor's Visitor and a similar span as a Fellow of the Royal Society.

Service user memoirs are frequently reviewed in The Psychiatrist and other related journals. Some academic publications include first-hand accounts of mental ill health, and there is a lively market for autobiographical books and articles about mental illness. But clinicians already have extensive contact with service users and it might seem unlikely that they have much to gain from reading memoirs. In this article I suggest that the greater depth of reflection in published memoirs means clinicians do in fact have something to learn. I illustrate my argument by showing how memoirs cast a light on the world of information and conclude by suggesting reasons why memoirs raise issues that are of increasing clinical importance.

As an expatriate psychiatrist, working in a new culture has exposed me to the difficulties in practising my profession, and in particular, its limitations. In search of understanding common psychosocial distress in the communities we serve, I have sought to work with traditional healers in the high-density suburbs of Harare city.

About 45% of foundation doctors in the UK now have a placement in psychiatry. However, the current UK Foundation Programme Curriculum states that all foundation doctors need to demonstrate basic mental health-related capabilities. To address this we developed a novel teaching approach to cover these new capabilities using principles of team-based learning (TBL). This can be delivered to all foundation doctors both face to face and online using case scenarios and in no more than 4 hours over the 2-year foundation programme. The approach can be easily be replicated, but collaboration between mental health and acute trusts is essential for delivery.

Although the research base on mental health in intellectual disabilities is advancing, there are long-standing barriers that hinder successful completion of funded studies. A variety of stakeholders hold the key to mitigating the challenges and arriving at sustainable solutions that involve researchers, experts by experience, clinicians and many others in the research pathway. Lessons learned during the COVID-19 pandemic can also contribute to improvements in the conduct of research in the medium to long term. People with an intellectual disability and mental health conditions deserve high standards of evidence-based care.

A useful part of the MRCPsych residential revision course at the University of Surrey in Guildford is the mock clinical examination. One of the peculiarities of the mock examination for the Membership course which I attended was that all examinees interviewed patients in one large hall. I found it intriguing to observe the note-taking techniques of my equally nervous colleagues. It seemed to me that there was little organisation in the way candidates wrote down the information acquired from their interviews. Most people left the hall clutching a jumble of disjointed sheets of paper to start a scrambled five minutes of hasty preparation before presenting the case. Much of this precious time was then spent attempting to decipher and organise their notes, when clearly it would have been better employed in thinking and trying to anticipate likely questions.

The clinical management of a mother who has a severe puerperal mental disorder is complicated by the fact that her baby is not ill and does not need to be in hospital—especially a psychiatric one. On the other hand, separating babies from their mothers can have adverse effects upon their relationship and upon the psychological development of the infant, although much depends upon the timing, nature and duration of the separation as well as on the quality and stability of the family background.

A Confidential Enquiry has been set up to review cases of homicides and suicides by mentally ill people. It is appreciated that those looking after people with psychiatric illnesses have always been alert to the need to protect those in their care. However, the objective of the enquiry is to discover whether some of these distressing deaths might have been prevented by different approaches to clinical management or by different provision of care.

The aftercare of psychiatric patients discharged from hospital is currently under debate among clinicians and in the media. Our study audited the planning of aftercare for detained patients discharged under section 117 of the 1983 Mental Health Act. Our completed audit cycle showed how discharge planning can be improved yet underlines the difficulties encountered in providing for this vulnerable patient group.

Rotational training schemes are now well established as appropriate means of organising psychiatric training in the UK. There are already a number of good descriptions of how schemes are organised and managed (Soni et al, 1987; Davies, 1990) and one report of the experiences of trainees in a particular scheme (Fahy & Beats, 1990).

The strong recent public interest in attention deficit disorder and its drug treatment has led to the need for, and development of, guidelines for clinical practice. As a first step in this process our aim was to ascertain the current level of professional consensus on certain points regarding the use of medication in attention deficit disorder. Although a high level of consensus was found in relation to indications and prescribing issues, opinion was divided on details of how the treatment should be delivered – including the role of paediatricians, and the use of psychological treatments.