Reduced access to dementia healthcare services by elders from ethnic minority backgrounds is often a manifestation of underlying systemic disadvantages within dementia assessment and treatment services. In this narrative review of current literature on UK dementia healthcare services we identify risk factors contributing to the inequalities faced by people with dementia from ethnic minorities, point to major knowledge gaps in dementia diagnosis, management and long-term care for these groups and highlight clinical challenges arising in delivering services to them. We describe the inequity in diagnostic rates, their poorer treatment outcomes and the lack of culture-specific support for people from ethnic minority communities. We present proposals for South Asian and the Black ethnic minority groups by which local healthcare systems may minimise some of these disadvantages. This will enhance our understanding of the aetiology and management of long-term conditions such as dementia by improving access to and dialogue with ethnic minority communities and healthcare providers.

The Bell Jar (1963) is a semi-autobiographical novel written by the confessional poet, novelist and short-story writer Sylvia Plath (1932–1963). It has been often cited as a recommended reading within the medical humanities, because of its powerful description of depression and the understanding-by-experience of the related psychiatric treatments. This brief article, primarily directed at the clinically oriented reader, presents a selection of excerpts from The Bell Jar to illustrate the main diagnostic features of clinical depression and the vital role of therapeutic relationship quality in hindering or facilitating treatment outcomes and recovery.

This article reviews the seminal work of Jaak Panksepp: Affective Neuroscience: The Foundations of Human and Animal Emotions. It outlines the basis of his theory of Basic Emotional Command Systems as common to all mammals and goes on to specify some of the key fields that have grown out of his research.

Essays on Partial Derangement of the Mind in Supposed Connection with Religion, written amidst the illness of its author almost two centuries ago, was the little-known work of a distinguished physician. Seeking to rebut the argument that religion is causative of ‘derangement of the mind’ it takes a surprisingly biological view of such conditions while, at the same time, affirming the importance of faith, hope and love in human well-being. Despite its limitations, it makes observations that remain relevant to debates about religion and psychiatry today.

Cognitive–behavioural therapy (CBT) has been widely used for a broad range of mental health problems for several decades and has been researched extensively. Its techniques are relatively easy to learn and follow in treatment protocols. Many new CBT-based psychotherapies have been developed that go further than traditional CBT, some specifically addressing personality disorders. These so-called third-wave approaches target emotional responses to situations by using strategies such as mindfulness exercises and acceptance of unpleasant thoughts and feelings (observing thoughts as ‘from afar’). In this article, we discuss the historical context of these therapies, dissect common and specific factors in some treatment modalities often used to treat personality disorders, and suggest potential future directions for research and treatment.

John Thomas Perceval (1803–1876) was confined first to Dr Fox's private madhouse (asylum) in 1830 and transferred to Mr Newington's madhouse at Ticehurst, Sussex, in 1832 until his release in 1834. His account of his incarceration and treatment was published in two versions, the first in 1838 and the second in 1840. In this article I describe Perceval's psychosis, his treatment and management at Dr Fox's madhouse and his reforming and advocating contributions to psychiatry in the period following his release.

This commentary responds to Carona & Atanázio's discussion of Sylvia Plath's novel The Bell Jar in this issue of BJPsych Advances. Although I agree with their emphasis on empathy and sensitivity in medical practice, I argue that they overlook the broader insights of the medical humanities. By examining themes of suicide and patriarchy in The Bell Jar, I highlight how the novel itself, and the humanities scholars who have studied it, provide a counternarrative to the biomedical model, urging a more holistic understanding of psychological distress. I advocate engaging with Plath's work beyond diagnostic criteria, appreciating its cultural and structural dimensions.

The interface between the Mental Health Act 1983 (MHA) and the Mental Capacity Act 2005 (MCA) can throw up complex issues. This article reviews a Court of Protection case that considered this interface specifically in the context of physical healthcare for a patient detained under the MHA. The court analysis also included consideration of the European Convention on Human Rights, the Mental Health Units (Use of Force) Act 2018 and the concept of residual liberty. The judgment describes principles to be applied when considering whether non-consensual physical health treatment for detained patients could result in a further deprivation of liberty. Discussion of other Court of Protection cases considers the issue of communication during a capacity assessment, the MHA/MCA interface in obstetric cases and what test to apply in determining whether a patient could be detained under the MHA. Such principles and guidance are helpful in clinical practice for healthcare professionals who deal with the MHA/MCA interface.

Quality improvement (QI) is an evidence-based approach to analysing and improving healthcare systems. QI's success has led it to become a required competency expected of medical professionals in several countries. However, much of the QI literature to date has not focused on mental health. Moreover, many psychiatrists have no formal training in QI. To address this gap, this article introduces key QI concepts, including six dimensions of quality care, the Model for Improvement and plan–do–study–act cycles. Each QI concept is illustrated using a fictitious case study of an out-patient psychiatrist reducing chronic benzodiazepine use in their clinic.

Medical dramas such as Grey's Anatomy influence young people's career aspirations, creating unrealistic expectations. This article examines the gap between these portrayals and the reality of medical practice, highlighting challenges such as rigorous training and high stress. Using Italy's ‘numero chiuso’ (‘closed number’) system as a case study, it addresses the global issue of intense competition in medical school admissions. The article advocates for realistic education and better support to prepare future healthcare professionals.

Nidumolu et al’s article in BJPsych Advances illustrates how psychiatrists might use the key concepts of quality improvement (QI) to analyse and improve mental healthcare systems. This commentary on the article points out the importance of recognising the type of problem for which QI is best suited and the role of softer, relational approaches alongside the technical tools of improvement. It also highlights that QI can bring broader benefits to a team and organisation, including improvements in staff engagement and well-being. In mental health services, psychiatrists can play a key role in enabling and role-modelling this approach to problem-solving, as their extensive experience of leading multidisciplinary teams and shared decision-making with patients can be a great asset in QI.