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All human rights organisations set forth codes by which they align their purposes and activities. The Mental Health Declaration of Human Rights articulates the guiding principles of the Citizens Commission on Human Rights and the standards against which human rights violations by psychiatry are relentlessly investigated and exposed. The Mental Health Declaration of Human Rights was created by Citizens Commission on Human Rights (CCHR) International, a mental health watchdog based in Los Angeles. CCHR is responsible for helping to enact more than 180 laws protecting individuals from abusive or coercive practices. CCHR has long fought to restore basic inalienable human rights to the field of mental health, including, but not limited to, full informed consent regarding the medical legitimacy of psychiatric diagnosis, the risks of psychiatric treatments, the right to all available medical alternatives and the right to refuse any treatment considered harmful. The Mental Health Declaration of Human Rights is found online at https://www.cchr.org/about-us/mental-health-declaration-of-human-rights.html. Under the banner of the Mental Health Declaration of Human Rights, tens of thousands of people around the globe have joined CCHR and taken to the streets to protest psychiatric drugging and other inhumane mental health practices. Find out more about CCHR and its work to investigate and expose psychiatric fraud and abuse.

Research clearly demonstrates that from conception onwards, rapid brain development influences the cognitive, emotional and social development of babies and young children. Pre-conception to five years is an important time in a child’s life and critical for brain and psychological development, the formation of enduring relationship patterns, and emotional, social and cognitive functioning – all of which are foundations for healthy development, but which can also confer protection against mental health conditions. The establishment of sensitive, attuned and responsive relationships is essential for positive mental health and wellbeing and underpins interventions to address problems in social and emotional development, poor mental health and mental health conditions in under 5s. This report by the Royal College of Psychiatrists (RCPsych) aims to outline the importance of mental health in babies and young children under 5 to policy makers, commissioner and healthcare practitioners. Recommendations Government across the four nations of the UK to prioritise the mental health of under 5s through the delivery of a cross-government strategy with designated ministerial responsibility, an implementation plan underpinned by appropriate funding to meet the scale of need, a multi-agency workforce capacity and training strategy and a national, multi-agency shared outcomes framework. Government and multi-agency stakeholders to transparently agree on the level of population coverage of different public mental health interventions for under 5s and their families. Stakeholders should include children and young people, parents/carers, primary care, secondary care, secondary mental health care, social care, health and social care leaders, early years childcare, preschool and primary schools, public health, voluntary sectors and government. Provision of the resources and trained workforce required to deliver an agreed population scale, sustainable, integrated, multi-agency stepped care approach to mental health of under 5s, proportionately targeting higher risk groups. Introduction of routine, regular government-funded data collection on the mental health and wellbeing of under 5s and families, and on the level of provision of public mental health interventions, with a nationally agreed outcomes framework for early childhood development. This will inform regular assessment of the public mental health implementation gap for babies and young children, including for higher risk groups, in order to monitor progress towards agreed coverage targets and early childhood outcomes. Introduction of a national competencies framework for work with under 5s, and a national workforce training strategy. A multi-agency, multi-disciplinary workforce capacity and training strategy should support professionals from all sectors (psychiatrists, psychologists, psychotherapists, paediatricians, primary care professionals, social care professionals, health visitors, midwives, family hubs, early education and care practitioners, public health and policy makers) in their role with respect to the mental health needs of babies and young children. Development of an RCPsych training strategy for all psychiatrists. The Royal College of Psychiatrists will ensure that the Core Training Curriculum for all psychiatrists and the Higher Training Curriculum for general adult psychiatrists, includes basic training on assessment and interventions with respect to parent-infant relationships, attachment behaviours and the ways in which babies and young children can cue and/or miscue their needs. The Higher Training Curriculum for Child & Adolescent Psychiatrists and Perinatal Psychiatrists respectively, will include relevant specialist training in the assessment and intervention of parent-infant relationship difficulties and mental health conditions in under 5s, including neurodevelopmental disorders and the signs and symptoms of childhood adversity. The RCPsych will launch an online training programme in infant and family mental health for consultant grade and Specialty and Specialist (SAS) psychiatrists which can be accessed by practitioners from other sectors, including, for example, GPs, health visitors, and social workers. Services for babies, young children and their families to be co-produced with those with lived experience. This requires working in partnership with a range of individuals with intersecting identities across race, gender, ethnicity, sexual orientation, and disabilities (as outlined in equalities legislation) to ensure that the delivery of evidence-based interventions reflects the needs of the population it serves. Meaningful co-production in parent–infant work puts the voice of the child at its centre. Further research in a number of areas, including how to support improved implementation of evidence-based interventions for under 5s to treat mental health conditions, prevent mental health conditions from arising and promote mental wellbeing. Promote population understanding about the mental health and wellbeing of babies and young children. This would include actions to address societal stigma about mental health conditions in under 5s and include increased early years public mental health education that is family focused and highlights the importance of the prenatal care, child–parent relationships, the impact of adverse childhood experiences, and how parents and practitioners can access the relevant public mental health interventions at the right time.

Public and patient expectations of treatment influence health behaviours and decision-making. This study aimed to understand how the media has portrayed the therapeutic use of ketamine in psychiatry. It found that ketamine treatment was portrayed in an extremely positive light, with significant contributions of positive testimony from key opinion leaders (e.g. clinicians). Positive research results and ketamine's rapid antidepressant effec were frequently emphasised, with little reference to longer-term safety and efficacy. The study concluded that information pertinent to patient help-seeking and treatment expectations is being communicated through the media and supported by key opinion leaders, although some quotes go well beyond the evidence base. Clinicians should be aware of this and may need to address their patients’ beliefs directly.

Despite it being 20 years since the Institute of Medicine reported poor quality and high variability in healthcare delivery, there are still significant opportunities for clinical quality improvement (QI). As frontline clinicians and future healthcare leaders tasked with driving these changes, resident physicians are an important cohort to equip with knowledge, skills, and experience in QI and patient safety.  In this article, Mitchel and Li review the barriers to resident engagement, leadership and success with QI initiatives and propose potential solutions. Several barriers are unique to psychiatric training. The barriers described are broadly categorised as either structural or process-related, a distinction derived from Donabedian who described a framework for understanding the causal relationship between structures, processes, and outcomes in QI. In addition, the authors provide an example of a resident-led QI initiative to illustrate the proposed solutions.

This rapid response to the article 'What is a good doctor and how can we make one?', published on the BMJ website, discusses the background to the Biopsychosocial Model and it's implications in clinical practice today. The author highlights the importance of taking psychosocial factors into consideration, such as diet or loneliness, in order to improve individualised patient treatment.

Stopping antidepressants commonly causes withdrawal symptoms, which can be severe and long-lasting. This paper, published in Therapeutic Advances in Psychopharmacology, outlines the themes emerging from 158 respondents to an open invitation to describe the experience of prescribed psychotropic medication withdrawal for petitions sent to British parliaments.

This article, published in Social and Personality Psychology Compass, looks at the biopsychosocial model as a dynamic system of multiple contextual factors that influence health.

This collection of chapters surrounding the Biopsychosocial Model covers the background to the model and it's implications in areas of medicine as diverse as gastrointestinal diseases and mental health disorders. Chapters include: Bridging the gap between emotion and cognition Behavioural medicine Gastrointestinal diseases: psychosocial aspects Mental health and social work Respiratory disorders: psychosocial aspects Functioning, disability and health Geriatric psychiatry Cultural psychiatry.

Mental health nurses have a crucial role in preventing medical incidents and in promoting safety culture because they provide and coordinate most of patients' care. Therefore, they are able to enhance patients' outcomes and reduce nurses' injuries. The aims of this study from S H Hamaideh in International Nursing Review were to assess the perception of mental health nurses about patients' safety culture and to detect the factors which may affect patients' safety culture at psychiatric hospitals.

Steve Turner's blog discusses the use of psychotropic medicines for people with learning disabilities who show symptoms of distress. Steve offers a useful guide to help those prescribing these drugs consider all of the relevant factors so they can keep patients safe.

Patients in inpatient mental health settings face similar risks (eg, medication errors) to those in other areas of healthcare. In addition, some unsafe behaviours associated with serious mental health problems (eg, self-harm), and the measures taken to address these (eg, restraint), may result in further risks to patient safety. The objective of this review, published in BMJ Open, is to identify and synthesise the literature on patient safety within inpatient mental health settings using robust systematic methodology.

Radio 4's Women's Hour programme discusses coronavirus and the impact the current pandemic is having on access to cervical screening services. Later in the programme, the discussion turns to the topic of dealing with addiction during the lockdown. Cervical screening (listen from the start of the recording) Speakers, Kate Sanger, Head of Public Affairs at Jo's Cervical Cancer Trust, and consultant gynaecologist Dr Christine Ekechi stress that patients should not hesitate to contact their GP if they have any concerns or symptoms. Symptoms might include: abnormal bleeding, bleeding after sex, bleeding after the menopause, bleeding in between periods, unexplained pelvic pain and in some cases increased vaginal discharge. Addiction (21:45) According to the charity Action on Addiction, one in three people are addicted to something. How difficult can it be to remain sober or clean in lockdown, and what support can you still access? Speakers include Holly Sexton, Substance Misuse Practitioner at We Are With You, and Caroline Turriff, a freelance journalist who is 15 years in recovery. They discuss whether opiate painkillers and methadone being more easily available through pharmacies creates safety issues. Caroline argues that it will reduce the risk of people obtaining opiates online or heroin via street dealers which she says could enable them to obtain life-threatening amounts. 

Electroconvulsive therapy, or ECT, is still given to about 2,100 -2,700 people a year in England, about half of whom have not consented to it. This blog reports on a campaign for an independent review of this highly controversial procedure, and provides links to relevant articles.

Despite many investigations and inquiries into violent incidents in mental health settings, resulting in reports and guidelines, safety considerations for mental health staff continue to be an issue of serious concern. This report from the Royal College of Psychiatrists attempts to address the safety needs of psychiatrists. Psychiatrists from different disciplines are likely to be exposed to different degrees of threat to their safety, but no particular branch of psychiatry is immune. In the same vein, the context in which psychiatric practice is delivered will also have a bearing on the likelihood of violence, be it on in-patient units, in out-patient settings, in accident and emergency departments, in prisons and other custodial institutions, or in patients’ homes.

This article examines the lasting impact of the tragic case of Daksha Emson, a 34-year old psychiatrist who took her own life and that of her baby daughter in an episode of postpartum psychosis. Daksha had a history of bipolar disorder and had attempted suicide before, and the inquiry into her death found that she received “significantly poorer standard of care than that which her own patients might have expected.” The authors highlight the impact of her story on the development in the UK of both specialist perinatal mental health services and specialised confidential services for health professionals, which remove some of the stigma attached to help-seeking.

In 2020, 82 million people worldwide were forcibly displaced. In the same year, the UK received applications for asylum for over 37,500 people. Over 40% of those were women and children, and 8% were children who had arrived in the UK alone without a parent or guardian. This information produced by the Royal College of Psychiatry aims to support health and social care professionals in the UK coming into contact with displaced people. It provides information, guidance and support to ensure timely, high-quality care. This resource provides information on the following subjects: Experiences of mental illness in asylum seekers and refugees Distress and common mental illnesses in displaced people Approaches and principles Need for triage Barriers to accessing healthcare Safeguarding