Erving Goffman's Asylums: Essays on the Social Situation of Mental Patients and Other Inmates is a key text in the sociology of mental illness. It is sometimes seen simplistically as a paradigm of ‘antipsychiatry’, and as a key step in the triumph of community psychiatry over narrower, medical models of mental illness. Reading Asylums today, however, reveals that this portrayal does not capture the richness of the text. My argument is that, rather than being an opponent of biological psychiatry or medical models per se, Goffman's key role was in humanising patients and drawing attention to the patterns of interaction that dehumanised them.

The government's Public Health White Paper for England sets out a utopian vision of how to prevent and remedy mental health problems. The public health approach relies on primary prevention, promoting individual responsibilities and resilience, while also sustaining existing services and tackling inequalities. These ambitions are consistent with the preventive psychiatric paradigm, and with the best of evidence-based psychiatric practice. Although the evidence on cost-effectiveness of public mental health interventions is growing, the challenge is to ensure that specialist knowledge informs policy, practice and research so that inequalities are not compounded. Specialist mental health professionals are needed to inform and lead public health reforms.

There is an increasing appetite for a change in the law to allow assisted suicide. This editorial suggests that psychiatrists should engage in the debate because the issues at stake will affect us, and we are likely to have a significant part to play were the law to be changed. We suggest that there are three main areas where psychiatrists' expertise may be informative: (a) the extent to which safeguards to limit the availability of assisted dying to target groups can be applied safely and fairly, including to individuals with psychiatric disorders; (b) the complexities inherent in assessing mental capacity; and (c) the degree to which individuals adapt or change their desires, particularly in relation to suicidal behaviours.

Fifty years ago pharmacological discoveries transformed psychiatry but progress since then has been relatively slow and there is unease about the role of industry. Despite this, the possibilities of pharmacological treatment have improved in recent years but exploiting developments for the benefit of patients requires psychotherapeutic skill as well as a high level of scientific knowledge.

The prominence of risk in UK social and criminal justice policy creates opportunities, challenges and dangers for forensic psychiatry. The future standing of the specialty will depend not only on the practical utility of its responses to those opportunities and challenges, but also the ethical integrity of those responses.

Ways of working at the interface between primary and specialist care are considered with discussion of the limits of available evidence and the potential for a new role for psychiatrists in providing supervision and consultation in novel models of care.

Evidence concerning the superior efficacy and effectiveness of clozapine has not fully informed routine clinical practice. This is possibly because of the perception that clozapine is a dangerous therapeutic agent. Clozapine use may actually promote longevity, and earlier use of clozapine in adequate dosages represents a neglected therapeutic opportunity in this age of stagnated antipsychotic innovation.

The changing economic and social environment of Western nations is having a profound impact on men's lives. Men who assume a greater share of roles traditionally filled by women will experience challenges to traditional sources of male self-esteem, potentially heightening the risk for depressive disorders among men.

Cognitive impairment is a core feature of schizophrenia. Evidence in this Journal suggests that disrupted circadian synchronisation of sleep–wake phases may be one cause. Circadian synchronisation depends on the external input of light–dark cues and the integrity of central nervous system circadian oscillators; these may represent new interventional targets to improve cognition.

The idea that psychotic disorders are characterised by progressive neurodegeneration that can be reversed by drug treatment is used to justify early treatment of increasing numbers of mostly young people. I argue that there is little evidence to support the view that old- or new-generation antipsychotics are ‘neuroprotective’, and some evidence that the drugs themselves may be responsible for the decline in brain matter observed in some studies.