bluuebunny/crossref_metadata_2025 huggingface dataset:
Rejection of psychiatric treatment
Authors: Hillis Graham , Alexander David A.
Published: May 2008

The growing realisation that health care resources are limited has led to increasing concern about the wastage caused by the failure of patients to keep their psychiatric appointments. Generally, non-attendance following psychiatric referral is particularly high (e.g. Baekland & Lundwall, 1975), although in the north-east of Scotland the rate is roughly similar to those reported by other specialties (Alexander & Hillis, 1989). However, little effort has been made to elicit the views of non-attenders themselves or to consider what aspects of the referral system may contribute to this failure to attend.
The case for teaching and research experience and education within basic specialist training (registrar grade) in psychiatry
Authors: Crisp A. H.
Published: May 2008

Medical practice can be reframed in terms of research and teaching, possessing and using the relevant knowledge, skills and attitudes. The doctor's curiosity and the diagnostic challenges of medical practice (and in particular of psychiatry) demand a capacity to think systematically, measure comprehensively and accurately and analyse the information obtained within the consultation as a preamble to management and treatment. The word ‘doctor’ means ‘teacher’ and the same communication skills are essential to both professions. Psychiatric practice is especially dependent upon them. They are also often essential for good clinical research.
Undesirable reading: the real role of the clinical tutor
Authors: Walmsley Tom
Published: May 2008

I was appointed clinical tutor at Knowle Hospital seven years ago with little idea of what my responsibilities would be. From the College literature (which I have not found very helpful) it seemed I was responsible in a more or less indirect way for the psychiatric education of most of those working in the hospital as well as of those local general practitioners who might refer patients here. In addition, all medical students in the place are my responsibility – a considerable number of young people. To complicate this task, our academic unit had moved out of Knowle two years before my arrival and new trainees were advised that Knowle Hospital (usually described as a ‘traditional Victorian mental hospital’) would be closing in the near future as modern community services were provided. Finally, the advent of proper management, welcomed by me, was spoiled by an indifference to psychiatric education which bordered on absurdity.
Erotomania and Queen Victoria: or love among the assassins?
Authors: Turner Trevor
Published: May 2008

The issue of crime and insanity in Victorian Britain is dominated by the 1843 case of Daniel McNaughton. Hounded by paranoid delusions, about which he was relatively unforthcoming despite detailed questioning, he succeeded in shooting Henry Drummond, private secretary to the Prime Minister, Robert Peel. Thinking that it was Peel himself he had shot, McNaughton is quoted by the arresting policeman as stating “he shall break my peace of mind no longer”. The furore over his trial and non-execution filtered down the century, via the McNaughton rules. Daniel himself mouldered in Bethlem and Broadmoor for the rest of his days (West & Walk, 1977, esp. p. 93). But much more prevalent in the public's eye were the seven (at least) serious assaults on the Queen. Not only did they bring about a new criminal charge (vide infra) – but their recurrence tended to promote pro-royalist sympathies as well as pro-custodial attitudes towards “the insane”.
Field data capture
Authors: Macdonald A. J. D. , Simpson A.
Published: May 2008

The process of psychiatric research, as distinct from its content, has been the subject of little comment. Central to present-day techniques are the use of questionnaires and more or less structured interviews. Pre-coded data are preferred, and even if there are few cases in any one study, the quantity of data collected for each usually compensates for this and justifies computer analysis, using statistical packages such as SPSS∗. The days of punched cards have passed (only in the last eight years in one centre of excellence), so at least one of the error-prone steps (transfer of data from paper schedules by card-puncher) has been abolished, but the major chore is still this process, albeit direct to magnetic media (floppy or hard disk).
Psychiatry in Saudi Arabia: an overview
Authors: Al-Sabaie A.
Published: May 2008

The population of Saudi Arabia is about 10 million, 37% of whom live in the cities. Birth control is discouraged because of cultural and religious beliefs and the average size of the family unit is six people. Islam is the religion of the state and it is the source of its civil and criminal legislative systems. As a divine law it cannot be revoked in most instances.
A personal view
Authors: Jones Mark
Published: May 2008

That art is an expression of man's attempts to understand himself and his environment is as important as the purely aesthetic qualities of the piece, whatever it may be. Opera, together with the other performing arts, literature and painting, cannot simply be seen as pure entertainment. It is also a reflection of the society in which the composer and librettist lived, and the issues and values contemporary to those people. Opera with its fusion of words, music and theatre is able to delineate those issues involved and present them with an emotional intensity possibly unequalled elsewhere in art. Musical imagery is used to portray and develop the characters in opera by inflecting the librettist's words and embedding them in a sound world. This is how we can gain access to those characters' thoughts and emotions. As psycho-dramas the works of the late 19th and the 20th centuries reach the greatest level of complexity.
Health Services Development Resource Assumptions and Planning Guidelines 1990/1991
Authors: Tannahill M. M.
Published: May 2008

In August 1989 the NHS Management Executive of the Department of Health issued Health Authorities with Circular HC(89)24 which lays down planning guidelines and resource assumptions for 1990/91. In five terse pages, the document sets the scene for the Government's priority health issues over the next two years. Several of these issues are of interest and importance to psychiatrists, as they are concerned with the implementation of the White Paper Caring for People: Community Care in the Next Decade and Beyond. Health Authorities are asked to “identify the health care needs of their populations” and to set targets, based on reports of their Directors of Public Health, to improve the overall health of their population.
Sincerely forward into the 1990s — a message from your District Chairperson
Authors: Rooth Graham
Published: May 2008

The 1980s have been a productive decade for the aptly re-named MHS (Managerial Health Services) nationally and locally. And here at District X, 1989 saw us exceed national norms for most of the usual indices of managerial activity, including bulletins and minutes at a staggering 6.2 metric equivalents per person per year of service.
The nuts and bolts of writing papers Number 6. The proof of the pudding
Authors: Footring Ralph
Published: May 2008

This is the last article in the series, and I might have to be allowed a little licence, as it is not strictly about writing papers. However, proofs are an important part of the publishing process, and I suspect not many authors appreciate what has been behind producing them.
A casualty of the ambulance dispute
Authors: Jones Gareth H.
Published: May 2008

As well as the more spectacular 999 calls to urgent road traffic accidents and myocardial infarction victims, the ambulance service provides a background care which allows people with chronic and recurring disabilities to remain in their own homes.
Community Treatment Orders in Victoria, Australia
Authors: Dedman Paul
Published: May 2008

It is one of the failures of contemporary psychiatry that many patients who respond well to neuroleptic medication given to them when they are in-patients relapse after discharge due to not taking any further medication. Those working closely with the acute psychiatric patient in the community are often forced to stand by powerlessly as a patient deteriorates, causing damage to himself and his social milieu until such a point is reached when he is again ill enough to warrant compulsory admission and treatment. This process is, of course, devastating for a patient's family and also disheartening for professionals involved, and is perhaps partly responsible for the high turnover of staff involved in front line services. Even if assertive outreach methods are employed such as those involved in a number of comprehensive community-based programmes (Stein & Test, 1980; Borland et al, 1989) so that contact with the patient is not lost, it is not possible without the necessary legislation to enforce treatment in the community.
Writing to the patient
Authors: Price John S. , Asch Rachel
Published: May 2008

In a recent study we compared writing to the patient with writing to the general practitioner after an initial psychiatric out-patient consultation. One of us (R.A.) interviewed the patients at home about two weeks after the consultation, and compared the two groups on satisfaction with the consultation, comprehension of information given by the psychiatrist, and compliance with advice. We felt that the comments of the patients might be of interest, particularly to those who might have considered (or done) something similar.
The savant syndrome
Authors: Schipperheijn J. A. M. , Dunne F. J.
Published: May 2008

Idiot-savants are people of low intelligence who have one or two outstanding talents such as calendar calculation, drawing, or musical performance. The syndrome occurs with high frequency among autistic children (autism is about four times commoner in boys), and the male to female ratio is about 6:1 suggesting a sex linked disorder (Hill, 1977). It is estimated to occur in 0.06% of the mentally handicapped population or about 1 in 2,000 of those living in institutions (Treffert, 1988). The gift starts apparently spontaneously between age 5 and 8 years. Frequently the parents claim that they themselves do not have the talent and know of no one in the family who has, but there is a tendency for savant skills to run in families, suggesting that genetic factors play a role.
Training primary care medical officers in mental health care: assessment using a structured clinical examination
Authors: Sriram T. G. , Chandrashekar C. R. , Isaac Mohan K. , Murthy R. Srinivasa
Published: May 2008

Mental health problems in primary care settings have received wider attention in recent years (Wilkinson, 1985). In India, the National Mental Health Programme (NMHP) was formulated with the purpose of promoting mental health care through primary health care (National Mental Health Programme, 1982). As part of the implementation of NMHP, training programmes for medical officers and health workers have been initiated in a number of centres in the country (National Mental Health Programme for India, Progress Report, 1988). At the National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, a monthly training programme for doctors and health workers of primary health centres has been carried out since 1982. In order to evaluate the gain in knowledge and clinical skills, a multiple-choice questionnaire and case vignettes have been standardised (Sriram et al, in press). The doctors are also evaluated through a structured clinical examination which is carried out on the last training day. The focus of the present report is to evaluate the clinical skills of medical officers using the structured clinical examination.
Extending management training for senior registrars
Authors: Gadd Elaine M.
Published: May 2008

It is recognised that the consultants of the future will have a greater management role than those of the past. The Griffiths report (1983) regarded doctors as ‘natural managers’, although this has been challenged by some authors. They suggest that medical training, with its emphasis on the individual case and rapid decision-making (Higgins, 1989), leads to a very different perspective from the manager considering the often competing long-term needs of many individuals.
Psychiatry at Keele: germination of a new department
Authors: Cox John L.
Published: May 2008

The 40th anniversary celebrations at Keele are proving to be a lively acknowledgement that the University is now firmly back on its feet and has a renewed confidence in its baptismal vows. There has indeed been a recovery of Keele's raison d'être to provide multi-faculty education (all students study an arts and science subject), to pioneer a Foundation Year to allow more informed choice of Honours courses, and to accommodate undergraduates as well as many staff on its leafy 18th century estate. The Vice Chancellor has succeeded in putting Keele back in the black, and on the map, and now plans to increase the number of students to 6,000 in the next decade.
The economic burden of schizophrenia
Authors: Davies Linda M. , Drummond Michael F.
Published: May 2008

Schizophrenia is an expensive disease. In the USA, it affects approximately 1% of the population but patients occupy 25% of all hospital beds. In Australia, schizophrenia was found to affect less than 10% of the number experiencing a myocardial infarction and yet the costs of medical services for treating schizophrenia are 75% of those for myocardial infarction.
Meetings for the relatives of refugees from Vietnam suffering from schizophrenia
Authors: Blackwell M. J.
Published: May 2008

The problems of diagnosis in transcultural psychiatry and the ideological and anthropological questions raised have received much attention in the psychiatric literature over the last 15 years. Even when the diagnosis is not in dispute, specific problems are encountered in the delivery of psychiatric care to patients from ethnic minorities (Littlewood & Lipsedge, 1989; Rack, 1982). Different explanatory models of illness and treatment, linguistic and cultural misunderstandings and numerous, apparently minor, practical difficulties bedevil treatment. Contributions to the psychiatric literature of practical use in management and service designs have been sparse.
Psychotherapy training as part of general psychiatry training
Authors: Bowen Joanna , Bremner Alexander
Published: May 2008

Training in psychotherapy for junior registrars is often piecemeal and relegated to an after hours out-patient and supervision. We are fortunate in having had the opportunity for a whole-time psychotherapy placement at the Cassel Hospital, Ham Common, Richmond, itself an internationally renowned clinical and training centre devoted to psychotherapeutic treatment of in-patients and out-patients.
The use of an unstaffed flat for crisis intervention and rehabilitation
Authors: Turkington Douglas , Kingdon David , Malcolm Katy
Published: May 2008

The community psychiatry service in Bassetlaw District has been developing since 1984 and provision includes hospital hostels, supervised flatlets, nursing and rest homes, group homes, cluster flats and warden assisted accommodation. Close liaison with an enthusiastic Local Authority Housing Department has also led to the development of a new initiative, an unstaffed flat for use in crisis intervention and rehabilitation. Placements in the flat are described over the first 12 months of its existence.
Senior registrar training in the psychiatry of old age in Scotland
Authors: Ballinger Brian R. , Eastwood Jenny , Hodge Grace , McIlwaine Ronald , Morrison Paul , Murphy J. Barrie , Olley Peter , Phanjoo Andre L.
Published: May 2008

The psychiatry of old age has come to occupy an increasingly prominent role in psychiatry, because of demographic trends, and also because of service developments. About a third of referrals to most psychiatric services are for the over-65s and a high proportion of beds are occupied by this age group. Recently the training recommendations for senior registrars in the psychiatry of old age have been revised and clarified (Royal College of Psychiatrists, 1989) and old age psychiatry is now recognised as a specialty within psychiatry. Nevertheless there is continued concern about the training opportunities available in this field (Wattis, 1988), reports of difficulties in filling consultant posts, and evidence that the present guidelines for consultant staffing levels are inadequate (Ballinger et al, 1989). It has recently been recommended that one-third of senior registrar posts in general and old age psychiatry should be assigned to the psychiatry of old age (Sims, 1990).
Clozapine
Authors: Cutting J. , Reveley A.
Published: May 2008

On several occasions in the last ten years, when interviewed by a market researcher about future developments in the treatment of schizophrenia, we have said that the biggest problem in the drug management of schizophrenia is compliance. We believed that if drug companies could manufacture an injectable neuroleptic lasting six months, then many of our problems would be over. Compared with this, the benefits of a new neuroleptic preparation appeared to be trivial.
Ernest Matsner Gruenberg
Authors: Brandon Sydney
Published: May 2008

Ernest (Ernie) Gruenberg was born in New York City on 2 December 1915 and died in Washington on 2 July 1991. He was the second son of Ben, an educator, and Sidonie, founder of the Child Study Association of America, who together produced one of the earliest books for the sex education of children.
The second Residential Scientific Conference for Senior Registrars in Psychiatry
Authors: Junaid O.
Published: May 2008

About 70 senior registrars from the United Kingdom and the Republic of Ireland spent a weekend at the Manchester Business School. The weekend started with a ‘keynote’ address by Professor John Wing on Measuring Psychiatric Morbidity: symptoms, diagnosis, handicaps, needs and outcomes. This lecture introduced us to the conceptual issues surrounding the ICD-10 classification and the need for sensitive and valid research criteria and instruments.
The ‘evil’ psychiatrist and modern cinema
Authors: Haddad Peter
Published: May 2008

Celluloid psychiatrists tend to fall into a limited number of stereotypes (Schneider, 1987). ‘Dr Evil’ is the unscrupulous psychiatrist who harms others, often his patients. Although common throughout cinema history, this stereotype appears to be becoming more extreme. Recent examples from mainstream cinema, many of which have been shown on British television, and possible clinical implications are discussed.
The mental state of detained asylum seekers
Authors: Bracken Patrick , Gorst-Unsworth Caroline
Published: May 2008

The persecution of civilians by the Iraqi forces in Kuwait and subsequent acts of revenge on the Palestinian population have caused widespread revulsion throughout the world. Stories of torture and rape have been described in the Western media and issues of human rights have gained considerable prominence of late. Perhaps now is a good time to examine how Britain responds to the needs of survivors of torture who seek asylum here.
A district's view of regional in-patient units for children and adolescents
Authors: Basu Robin , Griffiths Mary Ann , Parker Yvette
Published: May 2008

Recommendations in the White Paper Working for Patients will have a major influence in the field of child health. District consultants have been asked by colleagues and managers to explain and account for current practice in child and adolescent psychiatry, and to plan for the future against a background of serious financial constraint. Similarly, child and adolescent psychiatrists will need to evaluate current levels of use of regional services and consider a relationship where these services may have to be bought from a limited child and adolescent psychiatry budget.
The residuum of a traditional psychiatric hospital
Authors: Anstee Bryan H.
Published: May 2008

It is known that in most traditional psychiatric hospitals a significant minority of patients can have a better quality of life in hospital-hostels. With ample hospital-hostel places it was decided to interview and/or review the notes of all the non-demented Gloucestershire patients under 75 years whose stay in psychiatric hospitals exceeded one year on a census date of 26 September 1990. The characteristics of these long stay or residual patients are described.
Are your casenotes perfect?
Authors: Cunningham Sara
Published: May 2008

Working for Patients (1989) demonstrates the Government's intention to “encourage all Royal Colleges to make participation in medical audit a condition of a hospital unit being allowed to train doctors”, suggesting this may also become a requirement for psychiatric trainees. The Psychiatry Department at Fazakerley Hospital moved into the rather uncharted territory of clinical audit with monthly unit audit meetings in 1989. At each meeting randomly selected cases are reviewed and data presented which are relevant to clinical practice on the unit. The majority of topic audits have been presented by trainees with support from consultants. Most Colleges agree that casenotes should be available for scrutiny (Warden, 1988). Consequently I undertook a casenote audit.
Conference presentation techniques
Authors: Dayson David , Anderson Jeremy
Published: May 2008

The presentation of factual material to an audience has become a routine part of psychiatric training, be it a case presentation, a journal article or original data. It can be seen as an anxiety-provoking task that bears little relevance to everyday practice. But it can become a creative endeavour with its own reward. Organising the material so that it can be easily understood clarifies your own thinking on the subject. The medium of a presentation both passes on information and enables quick and useful feedback. And, most importantly, it provides a deadline to work towards. Over the year a tradition of oral advice about conference presentation technique has been built up among research workers with the Team for the Assessment of Psychiatric Services. This team is evaluating the closure of Friern and Claybury Hospitals and has presented preliminary work at a yearly conference since 1986. This advice has usually been passed on during the frantic weeks that build up to our annual conference. This essay is an attempt to set down in writing some of those guidelines.
Absconders from a district general hospital
Authors: Farid B. T.
Published: May 2008

The patient absconding without leave (AWOL) produces considerable anxiety to staff, relatives and the public, and involves a great deal of staff time in notification, search and enquiry to the detriment of the care of other patients. Incidents of AWOL are potentially dangerous and all efforts to predict these incidents and to deal with them appropriately should be made.
Archives of General Psychiatry, June 1991
Authors: Kerwin Robert , Bailey Paul
Published: May 2008

We were recently asked by one of the editors of the Psychiatric Bulletin to comment on the June 1991 issue of the Archives of General Psychiatry because of its exclusive neurobiological approach that month. Having thus been given our brief and now having carefully read the issue, we feel obliged to warmly congratulate the Archives for a superb issue and a superb Journal that has consistently set high standards for the reporting of neurobiological research as applied to psychiatry. The June issue this year was the first to report the use of magnetic resonance spectroscopy (as opposed to imaging) in vivo (more of this later) and had many more excellent contributions on the action of lithium on neurotransmiter and second messenger systems and papers on the role of serotonin and endorphins in a variety of conditions.
The community and asylum care: plus ça change
Authors: Turner Trevor
Published: May 2008

Is it reasonable for mentally ill people to “do nothing”? At a recent meeting of the Social, Community and Rehabilitation Section of the College, there was some discussion of this in the context of the influential ‘Three Hospitals’ study. The assumption of those researchers had been to view such non-activity in a pejorative light. Some members of the audience considered this simply reflected the “class norms and value preferences of the professionals”, a phrase used by Jones et al in relation to modern attitudes towards community care. Developing a thoughtful and historical perspective, based on their own continuing work in the Friern/Claybury TAPS (Team for Assessment of Psychiatric Services) research project, these authors have highlighted several key weaknesses of the modern non-asylum movement.
Management and leadership training: the need for an educational strategy
Authors: McClelland R. J.
Published: May 2008

It is increasingly recognised that effectiveness and efficiency of health care delivery depends on sound clinical leadership. Few would now disagree that if doctors are to carry out their clinical and management roles effectively within the NHS they must have a full appreciation of the organisation within which they work and possess the necessary management and leadership skills. Good management is an integral part of good clinical practice.
Current affairs group: a clinical tool!
Authors: Sheikh A. Jawad , Caesar Elizabeth , Williams Karen
Published: May 2008

Current affairs groups are run informally in a number of psychiatric wards, both acute and chronic. They are mostly arranged by the nursing staff and occasionally by an enthusiastic senior house officer or registrar. The goals may be positive such as to stimulate, generate discussion, and encourage understanding and tolerance. Sadly, some groups develop with the negative aim of ‘just having to do it’, as a ‘traditional’ part of the ward programme. We realised from our training years that a current affairs group could be a clinical asset on an acute admission ward if it was run with the following objectives: improved clinical assessment, especially of patients' mental state, and improved understanding and better relationship between patients and doctors.
Psychiatrists and the public
Authors: Ramsay Rosalind
Published: May 2008

One hundred and fifty years on, how, Professor Clare asked an invited audience of eminent non-psychiatrists at the Royal Society of Medicine, do we fare? Is there really a more positive attitude to mental illness, now than in the nineteenth century, or even the 1960s? The Victorian public image of madness was characterised by ignorance, intolerance and fear and the mentally ill regarded as less than human, available to be exploited or used to entertain; and also, dangerous and incurable, best put away in large mental hospitals or ‘bins’. The media colluded in maintaining such attitudes: a leader in The Times in 1900, commenting on the 30-fold increase in the mental hospital population, was anxious that soon the mad might outnumber the sane!
A short series of short pieces (with questions)
Authors: Culliford Larry
Published: May 2008

“Suppose you and I argue. If you win and I lose, are you indeed right and I wrong? And if I win and you lose, am I right and you wrong? Are we both partly right and partly wrong? Are we both all right or both all wrong? If you and I cannot see the truth, other people will find it even harder.”
Choosing trust status: should we trust it?
Authors: Dick D. H.
Published: May 2008

The proposals outlined in the White Paper, Caring for People, are now law and were little affected by the wave of protest which greeted them when they were first published. So the time has probably come to see what can be made of them and how they might be turned to advantage, rather than continuing to worry about the politics of whether change was necessary at all.
Developing therapeutic interview skills in medical students
Authors: Green Ben , Gopfert Michael , Dickinson Paul , Abou-Saleh M. T.
Published: May 2008

There has been considerable interest in doctors' interviewing skills during the last few decades (Nuffield Working Party, 1978). Despite this interest, there has been no consensus as to how these skills may be taught to medical students. We describe the ongoing evolution of a teaching package for these skills as taught by the Liverpool University Department of Psychiatry.
The psychiatrist and war
Authors: Haig Robin
Published: May 2008

The year 1991 will be emblazoned on our minds as the year of the Middle East War. Saddam Hussein gave more than a clue to his own psychopathology when he named this conflict “The Mother of All Wars”. All nations which actively participate in battle will lose troops and civilians. Physical damage, terror and distress are the immediate accompaniments of battle. Starvation, sub-standard living conditions and infectious disease often follow. Modern weapons and terrorism are capable of inflicting major damage on populations which are far away from the centre of the war.
Non-attendance at a psychiatric clinic
Authors: Thapar Anita , Ghosh Anindya
Published: May 2008

High attrition rates in psychiatric out-patient departments are well documented in the literature (Baekeland & Lundwall, 1975; Gillis & Egert, 1973). Non-attenders' attitudes and beliefs about their illness and treatment may provide valuable insight into reasons for not attending. This consumer orientated approach could enable clinicians not only to improve clinic attendance but to assess their treatment efficacy.
Neural networks and psychiatry
Authors: McDonald Carrick , McDonald Simon
Published: May 2008

This paper draws the attention of psychiatrists to the developing field of neural networking in the belief that the models created in this discipline demonstrate several functions central to cerebral performance.
Community treatment teams in New Zealand – are they suitable for Britain?
Authors: Cape Gavin
Published: May 2008

The run-down of the psychiatric institutions has led to innovative and novel methods of treatment of the mentally ill in the community. In New Zealand, as in other countries, deinstitutionalisation of the more traditional psychiatric services is proceeding rapidly and the statutory and non-statutory community services are straining under the burden. Amid the turmoil of change and the crying out for alternative provisions, a pilot scheme was proposed to serve the mentally ill in the population of West Auckland. In early 1988 the Extended Hours Team (EHT) was born. It is based on the model used in North Sydney, Australia (Hoult, 1986) and Madison, Wisconsin (Stein & Test, 1980). At the time of conception of the EHT, cost cutting was the rule which led to a difficult gestation but a surprisingly easy delivery and subsequent development over the first year.
Psychiatric discharge summaries in the South East Thames region
Authors: Essex B. , Rosenthal J.
Published: May 2008

Patients discharged after acute psychiatric admission are vulnerable, and need continuing care in the community. For these people and their families, the first two weeks after discharge is a critical time. This is when problems arise, support is needed, drugs run out, and default most likely. Care may be shared between psychiatrist, community psychiatric nurse, general practitioner and other health personnel. It is therefore essential to identify the roles and responsibilities of all involved in follow-up care. Studies have shown that information needed by general practitioners includes differential diagnosis, management, treatment on discharge, prognosis, what patient and relatives were told, future plans which specify the roles and responsibilities of all involved, as well as the date of any follow-up appointment. Moreover this information is needed within two weeks of discharge. Without this information effective follow-up is unlikely to occur. The early discharge summary provides this vital information in the immediate post-discharge period. This is quite distinct from the final report which usually takes a few weeks to be sent. It is therefore important to identify current psychiatric practice relating to the initial discharge summary.
The changes in the education of psychiatric nurses: do psychiatrists have a role?
Authors: Jorsh Michael S.
Published: May 2008

The new syllabus for both general and psychiatric nurses, Project 2000, is a manifestation of the gradual revolution taking place in nursing. It attempts to address some long-standing issues which have concerned the profession in several countries. The resolution of these issues will determine the role of nurses as members of the multidisciplinary team and effect cooperation and interactions therein.
Music groups for psychiatric patients
Authors: Brown Máirín , Schofield Ann
Published: May 2008

Music therapy is a non-analytic therapy concerned with the creative process in which an attempt is made to reach the emotions of the patient without recourse to verbal means. It should in theory be suitable for chronic psychotic patients and all whose verbal ability is minimal. The ability to appreciate music may persist despite psychotic disintegration and provides one way, maybe the only way, into a patient's inner life. Music is one aspect of the aesthetic or creative experience that neurotic patients often lack and for this group music may provide a broader view of emotional life than their own more narrow previous experience.
Outcome of psychiatric training – the Liverpool training scheme
Authors: Birchall Eric , Higgins James
Published: May 2008

The Liverpool training scheme in psychiatry began in August 1985 and at the time of writing is five years old. During this time 73 trainees have left the scheme; some having completed four years training in psychiatry, some completing a much shorter time. We thought, therefore, that it would be interesting to consider the posts trainees took on leaving.
The physical health of old long stay in-patients in one psychiatric hospital
Authors: Stewart Mary
Published: May 2008

The provision of care for patients with chronic mental illness is changing with the gradual closure of mental hospitals and the expectation that this group will be largely cared for in the community. In Scotland the process is only beginning. A recent Scottish survey examined the demographic, social and clinical characteristics of 2605 “old long-stay” in-patients, defined as those in hospital more than six years and under 65 years of age at the time of last admission (McCreadie et al, 1991). Patients in 18 psychiatric hospitals serving 83% of the Scottish population were studied. Results showed the population was elderly, 70% being over 60 years of age, and nearly 40% over 70 years. The aim of the present study was to look at the physical health of the old long-stay population in one hospital, namely Crichton Royal, Dumfries, because of the implications of physical health care needs for the management of this group in the community.
An aspect of community psychiatry training: a senior registrar's experience
Authors: Shah A. K.
Published: May 2008

With the closure of large mental hospitals there is increasing emphasis on community psychiatry (Thornicroft & Bebbington, 1989) and a need for experience and training at all grades in this speciality. Some training aspects of an area of community psychiatry as experienced by a senior registrar are detailed.
The Psychiatric Bulletin: some background notes
Authors: Kerr Alan
Published: May 2008

The British Journal of Psychiatry, the title it has enjoyed since 1963, can claim descent in direct line from three earlier journals, entitled in chronological order, The Asylum Journal from 1853; The Asylum Journal of Mental Science from 1855; and The Journal of Mental Science from 1858.
New publications
Authors: Simpson C. J.
Published: May 2008

The world of the media is alien to most psychiatrists although we are frequently portrayed in different ways, but rarely are the portrayals close to real life (Clare, 1990). These media portrayals help determine public attitudes towards outselves and also our patients. It has been argued that psychiatrists should be involved in a “serious, concerted, and professional effort to educate the public about the prevalence of serious and chronic mental illnesses” through the media (Talbot, 1985). There are some noticeable exponents of this view whom we often hear, read, and see.
Quality thinking and a formula they can't refuse
Authors: Child Nick
Published: May 2008

In the peripheries of excellence, providing a service is the main task. Professor Nichol says that describing a child psychiatry service to managers is easy (Third Section Newsletter). I say it is and it is not. The way he does it follows the traditional bioscientific medical pattern and logic - number and range of cases and diagnoses etc. Health managers at a first glance may be quite happy with this ‘biomedical’-looking picture. But I believe that in their second glance they can tell that these expensive child psychiatrists, who just sit in rooms talking, are not dealing with the same thing as surgeons and physicians.
The moral case against psychotherapy
Authors: Charlton Bruce G.
Published: May 2008

First of all, some definitions. In general, psychotherapy is what happens when a doctor speaks to a patient. More specifically, psychotherapy is talk as therapy: it involves the physician assuming a role of expertise in talking.
The impact of the Mental Health (Amendment) Act 1983 on admissions to an interim regional secure unit for mentally handicapped offenders
Authors: Hoare Sudip , O'Brien Gregory
Published: May 2008

The management of mentally handicapped offenders has long been problematic. Three misconceptions of the relationship between mental handicap and criminality have been widely held since the turn of the century, despite there being no conclusive evidence in their support (Jackson, 1983). These are: that mentally handicapped people are more likely than others to commit antisocial acts in general; that they have a particular predisposition to commit serious crime, especially sexual crime (Robertson, 1981); and that they are unlikely to be deterred by normal sanctions. Misunderstanding breeds misapprehension. Sadly, in the past, many mentally handicapped people were admitted to hospital after committing only trivial offences. Moreover, one Special Hospital study (Parker, 1974) found that most “severely subnormal and subnormal” detained patients actually had IQs above the category to which they had been assigned.
A lesson from the history of psychiatry: competitive tendering for services and defective central heating systems in Georgian New Bethlem
Authors: Howard Robert
Published: May 2008

Entries in the minute books of the New Bethlem Hospital Building Committee from 1813–1816 contain details of the commissioning, installation and subsequent extensive modification of a system for heating the hospital. The system adopted was chosen principally for its cheapness, but in a manner that may seem familiar in the current climate of competitive tendering, with adoption of the cheapest proposal; through the incompetence of its manufacturer it was to prove problematic and dangerous.
Senior registrars in the psychiatry of old age: a new group within the College
Authors: Rands Gianetta
Published: May 2008

The Senior Registrars (SRs) in the Psychiatry of Old Age (POA) group was formed in June 1990. This is an account of our creation, structure, and development and is followed by our ‘policy statement’.
Training aspects of the Birmingham court diversion scheme
Authors: Kennedy N. M. J. , Ward M.
Published: May 2008

Recent developments in the criminal justice system (Home Office, 1990) have highlighted the need to divert the mentally disordered offender away from custody whenever practical. To this end a number of pilot schemes have been developed within the National Health Service. The West Midlands Regional Forensic Service, together with the West Midlands Probation Service Court Liaison Team recently initiated a project based in the Central Police “lock up” in Birmingham. This scheme differs from others in that defendants are screened prior to their appearance before the court (James & Hamilton, 1991; Joseph & Potter, 1990).
The organisation of general psychiatric care in France and the development of the ‘Secteur’
Authors: Lloyd Margaret Gwynne , Bénézech Michel
Published: May 2008

In 1945 general psychiatric care in France was still mainly centred on large public and private institutions built, for the most part, in the 19th century and which had embodied, as their basic philosophy, the isolation and detention of the mentally ill.
Are psychiatric case-notes offensive?
Authors: Crichton Paul , Douzenis Athanassios , Leggatt Claire , Hughes Timothy , Lewis Shôn
Published: May 2008

During the last decade there have been a number of legislative changes establishing and extending the rights of patients to have access to their own medical and social service records. The Data Protection Act 1984, as modified by the Subject Access Modification Order 1987, gave patients access to computerised medical records with certain restrictions, in particular for information thought to be harmful to patients. The Access to Personal Files Act of 1987 granted access to Social Services Records. Again there were restrictions, e.g. to protect clients from serious harm or to protect confidential staff judgements. Finally, the Access to Health Records Act of 1990, which took effect on 1 November 1991 gives patients access to their own medical records and enables them to correct inaccuracies which they may find. Information likely to cause serious harm to the physical or mental health of the patient or of any other individual who could be identified can be withheld.
The search for ‘the medical model’
Authors: Joyce Lionel
Published: May 2008

This article attempts to describe a senior manager's search for ‘the medical model’ in psychiatry in two large provincial teaching units. I was brought to a number of realisations and moved to write this article by watching the film ‘Awakenings’∗. This portrays with great sympathy and effectiveness the angst and real pain suffered by a neurologist watching his patients in relapse and being powerless to help them. This was reminiscent of many of my consultants describing their own feelings.
Services for families in crisis in Tower Hamlets: evaluations by general practitioners and social workers
Authors: Parkes Colin Murray
Published: May 2008

There is widespread recognition that many who seek or are referred for help to psychiatric and social services are acutely disturbed and require only short-term help if they are to come through a period of transient disruption in their lives. The frequency with which people in crisis consult their GP or visit a local Social Service Department is uncertain but suggests that the primary carers are the first port of call for most of them. Services developed to meet the needs of these people include traditional GPs and psychiatric services directed primarily at ‘patients’ (people who meet criteria for illness), but which often offer additional help to their families; traditional social services which place no such limitation on the individuals who seek their help but are directed mainly at people with problems in living, particularly with housing, employment and money; and counselling and advisory services (such as Relate – formerly Marriage Guidance) which focus on particular problems or client groups. A few special crisis services, most of which provide a multidisciplinary team, visit clients in crisis in their homes. These are usually psychiatric services for patients with acute mental illness (Cooper, 1979).
Perceptions of a crisis service by referrers and clients
Authors: Parkes Colin Murray
Published: May 2008

There are many kinds of crisis service. Most are open only to people who have been diagnosed as mentally ill. They facilitate rapid admission to short-stay in-patient services with the back-up of multidisciplinary teams working in the community. Others attempt to keep patients out of hospital by providing support to patients and their families in the community. Several have demonstrated striking reductions in the rate and duration of hospital admissions without detriment to the subsequent health or social adjustment of the patient.
Role of regional audit facilitators in psychiatry
Authors: Dwivedi Kedar N.
Published: May 2008

At most conferences on medical audit we are reminded that medical audit is centuries old. What is new is the push for medical audit as a formal activity in which each clinician must take part. This push came from Mrs Thatcher's NHS review in 1989, invoking the spirit of market forces in the NHS. Whether this spirit is that of a goddess or demon, it is perhaps too early to know. As many of the Royal Colleges (Hoffenberg, 1989; Royal College of Psychiatrists, 1989; Royal College of Surgeons of England, 1989) and the Standing Committee on Postgraduate Medical Education (1989) produced their guidelines, the push to make medical audit a formal activity in which each doctor should take part became reality in 1989.
An integrated service for mentally disordered offenders
Authors: Banerjee Sube , Exworthy Tim , O'Neill-Byrne Kiki , Parrott Janet
Published: May 2008

In recent years there has been increasing concern about the plight of the mentally ill in prisons, particularly those on remand. The 1976 Bail Act gives everyone the right to unconditional bail but mentally disordered offenders find themselves disadvantaged in that their right to bail can be set aside not only because of the gravity of the alleged offence but also for reasons consequent to their mental illness. These include lack of community ties, their own protection or most commonly for the preparation of psychiatric reports. The mentally disordered may thus be remanded in custody even if the charge against them is minor or not punishable by imprisonment.
Psychiatrists on bank-notes
Authors: Underwood R.
Published: May 2008

It has for many years been the custom for nations to commemorate their heroes and heroines by placing their features on bank-notes. Among these are four psychiatrists whose brief biographical details are given below.
“I mean to say …”
Authors: Footring Ralph
Published: May 2008

You might regard words as dependable things, that never do anything more tricksy than linger overly long on the tip of your tongue. But beware – don't let them gang up on you, or you'll be left with phrases.

George Orwell (1946) wrote in ‘Politics and the English language’ that:

“prose consists less and less of words chosen for the sake of their meaning, and more and more of phrases tacked together … the ready-made phrases come crowding in. They will construct your sentences for you – even think your thoughts for you, to a certain extent – and at need they will perform the important service of partially concealing your meaning even from yourself.”(pp. 145, 152, italics in original)
In conversation with Tom Lynch
Authors: Healy David
Published: May 2008

Professor Lynch was born in Dublin in 1922. From 1953 to 1961 he was Staff Psychiatrist, St Patrick's Hospital, Dublin, and Consultant Psychiatrist to Meath Hospital, Dublin. He was Resident Medical superintendent at St Otteran's Hospital, Waterford from 1961 to 1968. From 1968 to 1990 he was Professor of Psychiatry, Royal College of Surgeons in Ireland. He has been Chairman and Clinical Director of the Eastern Health Board, Chairman of the Irish Psychiatric Training Committee and Chairman of the Irish Division of the Royal College of Psychiatrists. He was a member of Council of the Royal College of Psychiatrists from 1980 to 1984, Junior Vice-President of the Royal College of Psychiatrists from 1981 to 1982 and Senior Vice-President from 1982 to 1983. He served on the College's Court of Electors from 1983 to 1988.
Prescribing community psychiatric nurses
Authors: Fear Chris , Wilkinson Greg
Published: May 2008

Community psychiatric nurses (CPNs) fulfil an important role in caring for people with mental disorders in the community. They provide a monitoring and information service for patients and relatives and form a link between general practitioners (GPs) and psychiatrists. Some CPNs provide advice to GPs about prescribing psychotropic drugs. We studied the extent of this activity in a geographically-defined district and the views of GPs, CPNs and psychiatrists towards it.