Editorial

One of the latest government policy documents, No health without mental health (2011), aptly reminds us not only that mind and body are closely related but that mental health is as vital as physical health. Investment in developing high quality services to help individuals with mental health problems should reflect this parity. The spirit of this document is commendable. However, despite its noble aspirations, we cannot help but be gravely concerned by the financial recession in which such ambitions will need to be realized. The efficiency savings that the NHS will have to make over the coming years are considerable and there are real risks to a range of mental health services, perhaps particularly to those offering psychoanalytic interventions. This is not just a potential threat. It's a reality: we know that in some services psychotherapy posts have already been cut or downgraded, and that long-established services are being decommissioned and closed down (e.g. the Cassel Families Unit).

The Improving Access to Psychological Therapies (IAPT) programme has now embraced brief dynamic therapy as one of the therapies it provides, but this welcome development appears to be contributing to the decommissioning of psychotherapy departments in some parts of the country. Brief dynamic therapy should not be seen as a replacement for long-term psychoanalytic psychotherapy: it should form part of a range of approaches provided so that we can meet the diverse needs of our patients.

Against this all-too-sobering backdrop the papers in this issue of the Journal serve to remind us of the vital contribution that clinicians informed by psychoanalytic thinking can make to helping individuals whose difficulties are complex and who most typically present for help in the public health sector (see Jones and Miller, Gloger, Wood, this issue). Complexity is hard to define. As some of the papers in this issue illustrate, it cannot be thought of solely as the property of an individual patient,