The 2023 Barbie movie became an unexpected touchstone in my clinical practice. In the months after the film’s general release, children, young people and adults quoted from the film’s comedic moments and inspirational monologues, using them as a shorthand for complex emotional experiences, and to identify struggles and experiences of care and recovery. The film’s playful tone and layered themes allowed for moments of humour alongside serious introspection. This paper describes an exploration of the Barbie movie as a shared cultural language that facilitated therapeutic conversations and provided a narrative framework for self-exploration. Drawing upon concepts from narrative medicine, psychoanalytic theory and the enduring cultural symbolism of Barbie, this discussion positions the Barbie film as a displacement object, a transitional space, a narrative tool and a fitting metaphor for adolescent development as well as recovery. I consider the impact of the film’s rich cineliteracy on clinical practice, against a background of historical psychiatric discourses around the Barbie doll, and her enduring cultural symbolism. Fictionalised clinical encounters illustrate how young people engaged with Barbie to explore issues of gender, trauma and institutional structures. This paper argues that an openness to integrating popular media into psychiatric practice expands the scope of assessment and therapeutic engagement, allowing children, young people and adults to express their experiences through culturally familiar, accessible narratives.

Functional neurological disorder (FND) presents with a range of neurological symptoms. Therefore, these patients are usually referred to the neurology team, although mental health liaison teams are also commonly involved in their care as in-patients. This article gives an overview of FND in adults, its diagnosis and management strategies, in the acute hospital. It discusses the common diagnoses it can be mistaken for, some techniques for psychoeducation and the value of the patient perspective. It emphasises the significance of clear communication, appropriate use of resources and considerate discharge planning. The role of liaison psychiatry is key, as an advocate for an improved multidisciplinary approach, establishment of local integrated multidisciplinary pathways, enhanced education for all clinicians and ongoing research to optimise treatment. FND needs an individualised, patient-centred approach to address the complex needs of this patient cohort.

The NHS 2025 Health Plan aims for radical reform but overlooks people with intellectual disability. This editorial highlights critical omissions in policy, services, research and rights protections. Without intentional inclusion, digital and community shifts risk deepening inequality. True progress demands co-produced strategies to ensure equitable care for this vulnerable population.

Attention to human rights as a central pillar of global mental health work has shifted from a focus on the right to healthcare to a deeper examination of the quality of care received, and to the way in which people with mental health conditions are treated in all aspects of life. The QualityRights programme is the World Health Organization’s flagship guidance for promotion of rights-based approaches to mental healthcare, and a means of holding service providers to account for quality of care provided. A recent evaluation of the QualityRights e-training package demonstrates promising impact on attitude change of participants, raising the prospect of an efficient scale-up of efforts to improve dignity in services and reduce stigma and discrimination.

This article discusses sceptical arguments about measurement scales. Measurement scales are part of a promising agenda of openness, transparency and patient and public involvement (PPI) in medical research, but have received critical, sometimes hostile attention from anthropologists. This is because scales repackage localised cultural assumptions about distress as something universal and pan-human and have the capacity to reshape people's interior lives in unhelpful, possibly harmful ways. We take as an example the Patient Health Questionnaire-9 (PHQ-9). Use of the PHQ-9 is currently mandated by major funders. But its history suggests flawed PPI and a lack of openness. The article suggests a constructive role for anthropology in mental health research, using ethnographic evidence and theory to show how, although they have their uses, mental health scales should not be regarded as inert or harmless.

Mental health services in Japan are fully integrated into the broader healthcare system, and patients have access to a wide range of services and specialists. In addition, psychiatry services are part of comprehensive mental healthcare that provides social support to address the whole person's needs. However, there are still challenges in the mental health system in Japan, including overuse of hospital beds and coercive practices such as involuntary admission, restraint and seclusion. This article will explore the current state of mental health services, the challenges the country still faces and the efforts being made to address these challenges.

A national study in the UK has shown that perpetration of intimate partner violence is common for men and women attending mental health settings. People who perpetrated intimate partner violence were more likely to have experienced intimate partner violence, particularly for women. Perpetrators who were men were more likely to also perpetrate non-partner violence against family, friends or strangers. Mental health clinicians require training in identification, risk assessment and response, including referrals to behavioural programmes. More research is required to inform such responses; however, the need to address this common hidden problem in mental health settings is urgent.

Borderline personality disorder (BPD) has been a controversial diagnosis for over 40 years. It was to be removed from the latest version of the ICD, only to be reintroduced as a trait qualifier as a result of last-minute lobbying. Retaining BPD as a de facto diagnosis keeps us stuck at a deadlock that undermines the voices of patients who have persistently told us this label adds ‘insult to injury’. Miranda Fricker's concept of epistemic injustice helps illuminate how this affects subjectivity and speech, hermeneutically sealing patients in ways of thinking that are not evidence-based, resulting in testimonial smothering (altering or withholding one's narratives) and testimonial quieting (dismissing a speaker's capacity to provide worthy testimony) that prevent more affirmative explanations.

The relationship between spirituality and behavioural addictions is complex. Although some studies have suggested spirituality to be a protective factor helping in recovery from addictive behaviours, others have found spirituality to be a potential risk factor. To better understand the relationship between spirituality and various behavioural addictions, this review summarises the literature on the association between spirituality and the following behavioural addictions: gaming disorder, gambling disorder, problematic internet use, problematic smartphone use, compulsive sexual behaviour disorder and compulsive buying/shopping disorder. Implications for clinical practice and future research are discussed.

Doctors’ typical reaction to patients’ suffering is to alleviate it when clinically appropriate. This has been described as a negative model of suffering, in contrast to the positive model of suffering. In the positive model, suffering can contain an important message of needed change, indicate a response to a psychosocial predicament or be a route to spiritual enlightenment. This approach is briefly critiqued, and circumstances where patients might prefer this approach are described. Doctors can work alongside professionals using this approach while also trying to alleviate suffering if indicated (such as if a patient wishes less suffering or if risk is involved).