Comprehend, Cope and Connect (CCC) is a trauma-informed, transdiagnostic and evidence-based psychological intervention for mental health crises that can be applied cross-culturally. CCC has been implemented in acute and crisis mental health settings across the South of England and in services elsewhere in the UK. More recently, it has been taken up and adapted for specialist community settings, including perinatal services, addiction services and primary care settings. A continuously growing evidence base indicates that CCC could be the next step towards solving the national problem of mental health crises. It is now time for CCC to be piloted and researched nationally.

Bessel van der Kolk’s book The Body Keeps the Score has maintained exceptional cultural and clinical influence since its publication in 2014, remaining a best-seller and shaping public discourse on trauma. Its central claims – that trauma causes lasting neurobiological damage and that body-based treatments are uniquely effective – have been widely embraced but seldom subjected to systematic critical evaluation in peer-reviewed literature. This commentary synthesises the evidentiary basis for these claims as a counterweight to an influential narrative. It situates these findings within broader discussions of neuroscience framing, cultural appeal and evidence-based communication, underscoring the need for rigorous, balanced engagement with widely disseminated mental health narratives.

Debate about borderline personality disorder (BPD) has intensified, with some proposing its absorption into complex post-traumatic stress disorder and others questioning whether the diagnosis is harmful. These debates often obscure the central issue of construct validity. This paper evaluates whether BPD constitutes a coherent clinical entity. Drawing on Robins and Guze’s classic diagnostic validators – symptom specificity, heritability, course of illness, biological markers and treatment response – the evidence demonstrates that BPD is a robustly validated psychiatric disorder that should be retained in future classification systems. Concerns about stigma and dimensional models are considered but do not undermine its empirical grounding.

Summary Despite co-produced guidelines and actions recommended by statutory bodies, there has been a persistent lack of progress in improving the quality of healthcare for those with eating disorders in the UK. Drawing on multiple evidence sources, including lived experience, the author analyses reasons for this. The concept of an ‘ignorance culture’ is theorised as a key barrier, defined as cultural practices that uphold systemic failures by ignoring concerns that harm clinicians, patients, caregivers and wider society. A shift towards a ‘responsibility culture’ is proposed, with recommendations aimed at creating greater accountability, shared learning, transparency and reflexivity. Prioritising cultural change is central to improving the quality of care for everyone affected by eating disorders.

The Mental Health Act perpetuates the harmful and misguided detention of individuals with personality disorders. The outdated practice lacks ethical, legal or clinical justification. Coercion is mistaken for care, and detention often exacerbates distress, retraumatises patients and increases suicide risk. Despite its promises, the new Mental Health Bill fails to address these systemic failures, continuing the cycle of risk-driven, defensive psychiatry. It is time to abandon compulsory detention for this patient group, redirect resources toward evidence-based, relational interventions, and move toward a capacity-based, trauma-informed legal framework that aligns with contemporary psychiatric understanding of these conditions and fundamental human rights.

We consider that the current National Institute for Health and Care Excellence (NICE) guideline CG185 on bipolar disorder does not provide sufficiently specific guidance for the safe monitoring of plasma lithium levels in older people. We feel this needs correction, and laboratories across the UK should lower the range recommended for monitoring older people’s lithium levels in line with guidelines from the International Society for Bipolar Disorder. This would provide a safety net in older people in order to prevent lithium toxicity without compromising efficacy.

The diagnosis and treatment of personality disorder are both highly contentious subjects. It is argued in this article that we have misunderstood personality pathology as yet another form of mental illness that should require treatment for its alleviation or removal. But it is not a typical mental illness; personality is a stable persistent component of the self and needs a different treatment approach based on adaptation.

Patient involvement in psychiatry education struggles to be representative of the patients that doctors will treat once qualified. The issues of mental health stigma, cultural perspectives of mental health and the unique role of teaching, required exploring to establish the barriers and facilitators to increasing the diversity of patients involved in psychiatry education. To explore the causes of this lack of representation, a roundtable event with 34 delegates composed of people with lived experience of mental health issues, people from underserved communities, academics, mental health professionals and charity representatives met to discuss the barriers to involvement in psychiatry education and possible solutions. Themes were further developed in a context expert focus group. Notes from the roundtable and focus group were analysed and developed into recommendations for medical schools and mental health professional teaching departments.

Heated online communication reveals global challenges in the digital age, often fuelled by collective outrage. This article investigates how Buddhist network perspectives, paralleling digital reality, can inform mental health. Avatamsaka philosophy provides practical ways to navigate web complexities, suggesting that individual actions ripple across society. Recognising our interdependence and the impermanence of social responses deepens understanding of communication’s broader impact and dynamic interconnected worldviews. These perspectives support relational balance and cognitive flexibility, essential for alleviating online distress and conflicts, including acceptance of present circumstances and fostering motivation for positive change. Valuing connectedness while respecting individuality helps cultivate resilience, enriching therapeutic practices.

Many people experiencing mental ill health are trapped in cycles of worsening social exclusion. Individual Placement and Support (IPS) is being implemented to support those with mental ill health into employment. However, this intervention does not address the many challenges faced by those who are more vulnerable and is less effective for those with more severe clinical presentations. Although National Health Service (NHS) guidance suggests broader support is needed, there is little clarity over what this should look like. We discuss one model, drawing on years of experience facilitating user-led services at Lambeth Vocational Services, implementing a genuinely person-centred, trust-based approach to facilitate social inclusion.

The importance of art and humanities in mental health is widely recognised, and consumption and creation of poetry, prose, drama and the plastic arts are now considered to be relevant knowledge-generating and therapeutic activities. However, literary and art criticism remain at the margins. By contrast, in his two ‘Logics of Discovery’ papers, psychiatrist, psychopathologist and psychotherapist Giovanni Stanghellini brings to bear on clinical discovery and the healing alliance cultural historian Aby Warburg's approach to images (specifically, his Atlas of Mnemosyne) and philosopher Giorgio Agamben's analysis of the linguistic phenomenon of parataxis in Friedrich Hölderlin's poetry. Both Warburg and Hölderlin experienced severe mental disorders, and Stanghellini's analysis is notable for its potential to contribute to co-creation in a wide range of clinical settings. We suggest that this work may help to address some key sources of dissatisfaction among mental health patients and thus improve patient experience and clinical outcomes. We also comment on issues regarding implementation of Stanghellini's proposals and conclude with discussion of an example of the severe loosening of associations originally reported by Eugen Bleuler.

Welfare assessments can harm the mental health of neurodivergent individuals and people with intellectual disabilities, yet this remains under-recognised in clinical practice. This article integrates three perspectives: media reporting on private profit in UK disability assessments; a clinical case of an autistic man whose deterioration was triggered by Personal Independence Payment and Universal Credit reassessment; and research on the experiences of people with learning disabilities. Common themes include fear, shame, loss of agency and reactivated trauma. Psychiatrists should view welfare systems as determinants of mental health, adopt trauma-informed, neurodiversity-aware approaches and support patients through advocacy and interdisciplinary collaboration.