This editorial launches the new culture section in the journal. Without any unchallengeable definition of ‘culture’, potential contributors may consider submissions under four headings: the arts and humanities relating to practice; regulatory culture; becoming a cultured practitioner; and psychiatry's cultural context. A new article type, ‘Cultural reflections’, has been created, and submissions may reflect any appropriate methodology, including those from the arts. Peer review (from methodologies outside psychiatry if appropriate) will assure quality. Our objectives are to establish BJPsych Bulletin as the ‘journal of record’ for cultural studies relevant to psychiatric service delivery and demonstrate equivalent quality between them and scientific studies.

For several decades, mental health services within the UK's National Health Service were provided by specialist mental health trusts. More recently many of these trusts have integrated community physical health services into their operations. We describe here how two integrated mental health trusts in England were able to make an enhanced response to the COVID-19 pandemic.

The climate crisis is a health crisis; it demands the urgent attention and action of healthcare professionals and organisations. In this issue of the BJPsych Bulletin, we consider what the destructive effects of the climate and ecological crisis entail for the mental health of populations, and what the response of psychiatrists, both individual and collective, must be. We also highlight the opportunities and benefits a more sustainable and preventative approach could offer individuals, communities and the planet.

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.

Growing student numbers are producing greater demand for teaching, and resources allocated for education are being placed under increasing strain. The need for more student clinical placements and more clinician teaching time is expanding. Psychiatrists have successfully drawn attention to the importance of parity between mental and physical illness. We now have a responsibility to ensure enhanced opportunities to teach psychiatry to our medical students. This is set against a background of an increasing number of psychiatry consultants leaving the profession and an already stretched National Health Service environment. Many consultants contribute to teaching but do not have this activity included in their job plans. Although clinics and clinical meetings are inevitably slower when students are present, there is often no backfill provided. As outlined below, trusts receive substantial funding to cover costs related to the teaching of medical students, but most of us don't know what actually happens to this money. Here, we discuss how teaching is currently funded and make recommendations regarding improving accountability.

Two recent papers on a controversial topic in this journal attracted significant criticism from readers. This editorial addresses these criticisms and describes changes to be made to the journal's editorial and review procedures in light of the complaints received.

The COVID-19 pandemic has put the UK's National Health Service under extreme pressure, and acute psychiatric services have had to rapidly adapt to a new way of working. This editorial describes the experience of a London psychiatric intensive care unit (PICU) where all nine in-patients ultimately tested COVID-19 positive.

This editorial is co-written by a developmental psychologist and a young climate activist. We start by showing how the climate crisis is imposing a heavy psychological burden on children and youth, both from experiencing climate-related disasters and from the knowledge that worse is to come. We then describe the global movement of youth demanding urgent climate action. We conclude that health professionals can support young people in many ways, but particularly by supporting their capacity to take action, raising awareness about the impact of the climate crisis on youth mental and physical health, and taking action themselves to work for a secure climate future.

The COVID-19 pandemic has brought untold tragedies. However, one outcome has been the dramatically rapid replacement of face-to-face consultations and other meetings, including clinical multidisciplinary team meetings, with telephone calls or videoconferencing. By and large this form of remote consultation has received a warm welcome from both patients and clinicians. To date, human, technological and institutional barriers may have held back the integration of such approaches in routine clinical practice, particularly in the UK. As we move into the post-pandemic phase, it is vital that academic, educational and clinical leadership builds on this positive legacy of the COVID crisis. Telepsychiatry may be but one component of ‘digital psychiatry’ but its seismic evolution in the pandemic offers a possible opportunity to embrace and develop ‘digital psychiatry’ as a whole.

Self-harm is a major international public health concern and is especially prevalent among prisoners. In this editorial, we explore recent trends in prisoner self-harm during the coronavirus lockdown, and consider strategies for improving the prevention and management of self-harm in prisons as we emerge from the pandemic.

There is scientific consensus that anthropogenic climate change is real and that it provides an existential threat to humanity and the planet. In this article, we focus on climate change conspiracy theories and the impact of such beliefs on mental health. We discuss the psychiatric disorders that might be relevant to conspiracy belief endorsement and we present the underlying psychological mechanisms. We note that there is little to no literature to associate beliefs about climate change with serious mental health conditions. However, we anticipate that such beliefs may manifest pathologically in psychiatric presentations as climate change becomes increasingly at the forefront of the global agenda.

The climate crisis poses the greatest threat to human health this century. Mental health services will be called on to address the psychological consequences of its effects on peoples’ lives, particularly the socially disadvantaged and those on low incomes. However, healthcare systems are also contributors to the climate crisis. This editorial discusses how services can continue to provide care while contributing less to climate change. Specifically, it suggests what services such as forensic mental healthcare, which is constrained by legal, political and resourcing concerns, can do differently.

Summer schools are traditionally used to encourage sixth form students to consider a career in medicine. Is it worth attracting students earlier in their school career, concentrating on psychiatry? Wyke et al describe an innovative project attempting to do just that.

Over the past few years the term ‘service users’ has been increasingly used to describe patients in mental healthcare. This paper argues that the term ‘service user’ in this context should be avoided and outlines four reasons: the term is discriminating, cynical, patronising and detrimental. Of course, none of these effects is intentional, but that does not change them. The term ‘patient’, however, describes appropriately a temporary role in healthcare, provides parity of esteem with patients in physical healthcare and reflects the reasons why large parts of society are willing to fund healthcare, in solidarity with those who are sick.

Within paediatrics, young children experiencing physical and emotional distress are admitted to hospital with their parents as a matter of course, recognising the trauma associated with parting children from their carers. Much of this practice is underpinned by our understanding of attachment theory, which also sits as a fundamental tenet of child psychiatry. Yet the culture in psychiatric in-patient hospitals remains to admit young children without their parents, often to units that are geographically distant from the family home. We argue that the practice of admitting lone children to psychiatric in-patient units is likely to be traumatising as well as less effective. We believe this culture requires challenge and change.