bluuebunny/crossref_metadata_2025 huggingface dataset:
Responsibility
Authors: Pond D. A.
Published: January 2018

Responsibility is an everyday word and an everyday concept, but for psychiatrists it poses special problems; firstly in relation to the behaviour of patients, especially when this is of an antisocial character, and secondly, even more closely and personally, in relation to our own responsibility in the everyday practice of psychiatry. I wish to discuss particularly the problems posed by situations in which psychiatrists apparently fail in their responsibilities, and I am thus attempting to link our own situation with that of our patients. In both situations, whether a patient has committed an offence or whether a psychiatrist is accused of failing in his job, the assessment largely turns upon deciding whether the lapse can be ascribed in some way to a mental disorder or to a personal ‘failure.’ To put it bluntly—is he mad or bad? Perhaps regrettably, a factor taken into account in making this decision is not only what has happened but what might happen as a consequence of this decision; that is, punishment or treatment, especially if one or the other might lead to the most serious long-term consequence, the permanent loss of employment.
The Short Report and its Implications
Authors: Caldicott Fiona
Published: January 2018

Members of the College will know that in the 1980–81 Parliamentary Session the Social Services Committee, chaired by Mrs Renée Short, examined the problem of achieving for hospital medical staff a proper balance between the number of doctors in training and the number in the career grades. In February 1982 the Government published its response to that Report as a White Paper, and stated its intent of seeking early discussion with the responsible bodies, which include the College, to promote action.
A Need for a Research Register?
Authors: Pippard John
Published: January 2018

The College ECT survey questionnaire in March 1980 asked ‘Are you doing research on any aspect of the use of ECT?’ From the 61 who replied ‘yes', it appears that there were 49 separate individuals or groups involved. By April 1982 I knew that 12 of these had published, or had had accepted, at least some of their work. A short questionnaire was sent to the other 37 to find out how their work was going on and to canvass opinion on the possible usefulness of the College setting up a Register of Research.
Forensic Psychiatry in the UK
Authors: McGrath Patrick
Published: January 2018

Here surely is the scriptural authority for the existence of forensic psychiatry, even though one interpretation of the text could be that medical care is a fate literally worse than death. In fact, however, forensic psychiatry grew up largely from the efforts of lawyers to use medical expertise to save their clients from the execution of a death sentence, and their efforts antedate the historic trial of Hadfield by many years, indeed centuries.
Further Comments on the Cambridge Conference on Recruitment
Authors: Wieselberg Michael , Hall Alyson , Hollyman Julie , Kaczmarczuk Madge , Thompson Chris
Published: January 2018

Faced with recruitment difficulties, financial stringency, changing public needs and important advances in clinical and academic psychiatry, the time is ripe for a re-evaluation of the education and training of psychiatrists and factors influencing recruitment to psychiatry. The Conference, held in Cambridge in March, providing a forum for the discussion of such issues involving the Royal College of Psychiatrists, the AUTP and APIT, was an imaginative concept which deserved widespread support within the specialty. However, the breadth of the conception meant that for some organizers and participants it was a conference on training, and for others it was mainly concerned with recruitment.
The Public Policy Committee—A Decade On
Authors: Levine Sidney
Published: January 2018

Following the establishment of the College, the Public Policy Committee held its first meeting in March 1972. It evolved from the Parliamentary Committee of the RMPA and at that meeting its terms of reference were agreed and are still current. They are: ‘That it shall take note of and consider legislation, existing and prospective, and departmental, regional and local administrative practice with a view to commenting on matters touching upon the affairs of the College. In this respect it is empowered to take immediate action, if public statements about psychiatric affairs are urgently required, but normally will report to Council any measures which it recommends. It shall concern itself with the education and enlightenment of the public in matters relating to the prevention and treatment of mental disorder and the work of the College and its members.’
Safe Prescribing of Drugs
Authors: Seager C. P.
Published: January 2018

Drugs are prescribed by doctors, dispensed by pharmacists and administered by nurses. Each profession has an obligation to the patient to ensure that the process is carried out safely, efficiently and accurately. A number of rules and guidelines have been formulated for each profession to ensure that this takes place, yet each profession does not work in isolation and it is important that nurses, doctors and pharmacists are aware of the obligations imposed on them and their colleagues to satisfy the requirements where this is law, and advice where the rules are not imposed by statute.
Cane Hill and ‘Mental Health’ Policy 1882
Authors: Walk Alexander
Published: January 2018

[As part of the Cane Hill Hospital Centenary celebrations, the Southern Division of the College held its 1982 Annual General Meeting there last June. Dr Alexander Walk was invited to prepare a paper to mark the occasion. Readers of the Bulletin will know that Dr Walk died in July last year. Poor health had prevented him from giving his paper, though it was read at the meeting.
Who Cares for the Adult Brain Damaged?
Authors: Newson-Smith Jane
Published: January 2018

There is increasing interest in services for younger brain damaged persons (acquired in adult life as a result of trauma or illness). However, there is uncertainty about the type of service needed and to whom the medical responsibility belongs.
Working Arrangements of Fifteen Child Psychiatrists in a Child Guidance Setting
Authors: Black Michael , Black Dora
Published: January 2018

A group of child and adolescent psychiatrists working in or near London has been meeting regularly for a number of years. There are places for about 20, and the composition of the group changes as old members leave and are replaced by new ones. In 1974 a pilot study was published on how members divided up their professional time.1 Seven years later the present group decided to examine this topic again,2 and also to explore other issues concerning their working arrangements.
Training in Psychiatry for Developing Countries (with special reference to Africa)
Authors: Cox John L.
Published: January 2018

It was bold, as well as shrewd, to have held the 4th Conference of the African Psychiatry Association in London (Institute of Psychiatry) rather than Lagos or Lusaka. Yet Dr A. C. Raman (Consultant, St Augustine's Hospital and Secretary General of the Association) should be well satisfied with the rewards for his hard work. There were about 100 participants (the majority from Africa) who debated with vigour and courtesy the diverse facets of the conference theme. To have discussed these controversial training matters at the institution which, together with the department of psychiatry in Edinburgh, had influenced considerably the development of psychiatry in Nigeria, as well as in other Anglophone African countries, could have misfired. However, for most participants the conference presented a rare opportunity for legitimate nostalgia, as well as the chance to contribute to discussion on the present training of psychiatrists in Africa.
Part-time Training in Psychiatry: A Personal View
Authors: Toms Rhinedd
Published: January 2018

In 1975, seven years after registration, I had two small children and a part-time post as Staff Medical Officer with an Area Health Authority in London. For various personal and medical reasons I had decided to have a family early in my marriage. I felt it right that their upbringing should be largely done by me, and the alternative, if I worked full time, would be to hand over their care to someone else. I knew, however, that I should not be satisfied with a purely domestic role and part-time work in occupational health provided a compromise at the time. But I was uneasily aware of the lack of a definite goal and of my own doubts about continuing long term in this type of work.
The Future of the Membership
Authors: Brandon Sydney
Published: January 2018

The question has been posed—is an examination necessary to admit to the membership of the Royal College of Psychiatrists? The College represents the views of psychiatrists, maintains the standards of the profession, regulates and monitors practise and accepts a broad overall responsibility for education. It should admit to its membership those who practice as psychiatrists. Who then are the psychiatrists? Should the membership be open to anyone who makes such a claim or should it be linked with appointment to specific jobs as a psychiatrist at a level yet to be determined? What of private practitioners, interested GPs? Surely anyone who wants to be a psychiatrist, to paraphrase Sam Goldwyn, ought to have his head examined by his peers to establish that his claim to be a psychiatrist is acceptable. It is the College which should regulate entry into the profession of psychiatry, not the National Health Service, an employing authority, or even the universities. Some membership entrance conditions are needed which lay down minimum requirements for becoming a psychiatrist and it is important to exclude or reject, in my view, before higher psychiatric training commences.
Exchanges with the Humanities
Authors: Davis Derek Russell
Published: January 2018

Psychiatrists, who in their treatment of mental disorder apply theories, concepts and method drawn from many branches of knowledge, have shown remarkably little interest in the humanities. Distinct from the natural and social sciences, these are concerned with human behaviour and culture. Their neglect contrasts with the keen interest in psychopathology shown in many humanities departments in universities, from which flows a stream of publications on the psychopathology of the famous, writers and artists, and the characters they create. The data on which such studies are based are similar to those making up case-histories, as Jaspers (1913–46; English translation 1963) pointed out, although the selection of the latter tends to be more focussed by a theory.
The Special Committee on the Political Abuse of Psychiatry
Authors: Levine Sidney
Published: January 2018

The aim of this article is to inform College members about the role and function of this important committee which has been in existence since July 1978. It is of interest to appreciate the events which led to its establishment.
What Should Psychiatrists Do?—A Personal View
Authors: Nunn C. M. H.
Published: January 2018

At one time, I knew what psychiatrists should do and it was very satisfying. They should, so far as humanly possible, restore the mad and the distressed to sanity and tranquillity. Now things are less clear, and there are three main reasons for this. First, many of the incurably mad are distressed because they live in conditions of unspeakable social squalor which one does not have the power to relieve. Second, most of the curably distressed are cured by time or their GPs and we see only a small proportion of them. Third, many of the people referred to us have personality or alcohol problems for which, in most cases, no effective treatment can be given.
Towards a New Mental Health Act: Mental Health Commissions for England and Wales
Authors: Bluglass Robert
Published: January 2018

The first step towards the establishment of an independent body to supervise standards of care for psychiatric patients was taken with the appointment in 1774 of Commissioners in Lunacy with the responsibility of licensing and inspecting private madhouses in London. It consisted of five physicians elected annually by the Royal College of Physicians. They were replaced in 1828 by a body of Metropolitan Commissions, consisting of fifteen members appointed by the Home Secretary, of whom only five were physicians and most of the rest were Members of Parliament. Their powers included (with respect to London) the supervision of 'subscription hospitals for the insane’ in addition to private madhouses (but with the exception of Bethlem). For a short period from 1842 their jurisdiction widened further to include provincial hospitals as well as those in the Metropolis.
The Dartford Training Scheme of the Joint Senior Registrar Appointment with King's College Hospital
Authors: Perinpanayagam M. S. , Sivakumar K.
Published: January 2018

Senior registrar training is a preparation for consultantship. The Royal College recommends that when selecting senior registrars ‘potential suitability for a consultant post’ should be the prime consideration (1). The trainee, having concentrated on the acquisition of theoretical knowledge and basic clinical experience, now sets out to learn further management skills, improves on his special interests and fills gaps in the experience he has so far gained (2). The emphasis during his senior registrar tenure is therefore on a different set of objectives.
Contracts in Underdeveloped Countries
Authors: Harris Brian
Published: January 2018

A number of schemes exist to provide aid from the developed countries to those countries which are less privileged and belong to the Third World. For example, the official Guide Book (1978) of the Inter-University Council states: The Inter-University Council for Higher Education (IUC) was established in 1946 by the Universities in the United Kingdom, at the request of the British Government, to assist the advancement of higher education in developing countries and, to this end, to encourage co-operation between Universities in those countries and Universities in the United Kingdom … In 1970 the IUC became a corporate, independent body and entered into a general agreement with the Ministry of Overseas Development which provided that all British official aid to the Universities with which it was associated should as soon as possible be co-ordinated by the Council.’
Senior Registrar On-Call Duties
Authors: Thomas P. C.
Published: January 2018

Much has been written concerning Higher Psychiatric Training, in respect of both the training and research opportunities which should be provided for senior registrars, and the degree of responsibility which should be expected of them. However, one area over which there is some dissension, and which appears in practice largely to be left to the discretion of the individual hospital, is the matter of on-call duties.
Psychiatry in the 1880s
Authors: Walk Alexander
Published: January 2018

The Annual Meeting of the MPA in 1881 was held at University College, London; it coincided with an International Congress of Medicine and so there were an exceptional number of foreign visitors. A group photograph of members and visitors was reproduced in the Journal for June 1978 (132, facing p. 530).
Management of Change in a Psychiatric Ward
Authors: Kennedy Peter
Published: January 2018

A psychiatric ward, like any organization, must be capable of changing to meet new demands. Undue conservatism has repeatedly been blamed for serious short-comings. Yet change can be dangerous, especially if it is rapid. Such a hiatus of experience may occur that disorganization results, or so much energy is diverted to those parts of the system being changed that vital routine tasks are neglected. Laudable endeavours in community psychiatry have got into difficulties when wards have quickly been depleted of experienced staff who have moved into community care, for which they have much enthusiasm but little experience.
Raising Standards in Psychiatry
Authors: Creed Francis H.
Published: January 2018

The title chosen by the Association of University Teachers of Psychiatry for their meeting was ‘Improving Higher Psychiatric Training—Roles and Responsibilities’. This title implies firstly that higher training needs to be improved and secondly that someone must take responsibility for doing so. The Joint Committee on Higher Psychiatric Training officially holds this responsibility, but the AUTP is obviously concerned to critically review the progress so far made.
The Year in Scotland Activities of the Scottish Division
Authors: Little Margaret
Published: January 2018

There are 352 College members north of the Border, a number close to the ideal village community—too small for impersonality, too large for boredom—and the activities of the Scottish Division are in consequence lively. About 50 members managed to attend each quarterly meeting during the 1979/80 season, with attendance rising to around 100 at our annual dinner in December.
A Contribution by John Bowlby
Authors: Pippard John
Published: January 2018

In giving a brief account of salient events in my professional life I will start in 1937 when I was aged 30 and had just completed my formal training as a child psychiatrist and psychoanalyst. Apart from a medical background and an interest in psychology, my choice of career had been determined by what I had seen and heard during the six months that I had spent in a school for disturbed children between my preclinical training at Cambridge, where I had also read natural sciences and psychology, and completing my medical qualification at University College Hospital. During my time at the school I had worked with children and adolescents whose difficulties I know now to be typical of much personality disorder, and had been exposed to hypotheses, derived from the ‘new psychology’ emanating from Vienna, regarding the role of childhood experience in their origin. Accordingly I had decided to train as a psychoanalyst. This I began before qualifying medically and continued whilst spending eighteen months at the Maudsley, learning the psychiatry of adults as one of Aubrey Lewis's early students. This proved a productive relationship, not least because on many questions we agreed to differ.
The Recruitment of Psychiatrists in Mental Handicap
Authors: Spencer D. A.
Published: January 2018

In most parts of the country today it is often difficult or impossible to fill consultant vacancies in mental handicap. According to the DHSS there were 146 consultants in mental handicap in post in 1978 compared with 102 in 1968, an overall growth of 43 per cent, compared with 34.7 per cent in general psychiatry. Nevertheless nearly one quarter of posts were vacant on 30 September 1978. The number of new consultants in mental handicap required to replace losses from death and retirement is about 6 to 10 per year. If an expansion of 10 is to be achieved some 16 to 20 fully trained senior registrars will be required each year. For this 60 senior registrar posts will be needed, assuming that senior registrars have three to four years training. At the end of September 1978 there were 34 established senior registrar posts of which 9 were vacant.
Daily Meetings Chaired by an Adolescent in a Psychiatric Ward
Authors: Bruggen Peter , Dunne Carol , O'Brian Charles
Published: January 2018

The reason for admission was early developed as a focus of work in Hill End Adolescent Unit (Bruggen et al, 1973). Boys and girls (they were all under 16) were admitted on the authority of those in parental charge, and the reason usually was that their parents needed a break from the anxiety of having them at home, or that their children's homes could no longer cope with them and that their social workers had nowhere else to place them.
Second Opinions for ECT and Extended Medication—Mental Health Act 1983: Attitudes of Consultant Psychiatrists and Analysis of 200 Second Opinion Visits
Authors: West Eric D.
Published: January 2018

The 1983 Mental Health Act made a requirement under Section 58 for a second opinion by an Appointed Doctor when a detained patient either did not understand the nature, purpose, and likely effects of a treatment or did not consent. The present study is confined to second opinions relating to ECT (electric convulsion therapy) and extended medication. It was noted in the Mental Health Act Commission's Biennial report that requests for second opinions varied in numbers between different hospitals and psychiatric units. In 200 personal visits by the author a Treatment Plan by the Responsible Medical Officer (RMO), which is an indication of good practice in the operation of the Act, was written in the case notes in only 66 cases (33%) and then most often by a junior doctor. This finding has been reported generally. It seemed appropriate, therefore, to explore the opinions of Consultant Psychiatrists on the legal requirement for second opinion.
Psychiatry Remembered
Authors: Valentine M.
Published: January 2018

In 1947 Britain had its severest winter since 1881, starving sheep came off the hills looking for sustenance in the towns, and the snow went on until April. That was when I boarded the MV Batory, later renowned or infamous for its espionage traffic, to be decanted into an early heat wave in New York. Times Square was hot and hectic, the steaks were two inches thick instead of two ounces a week, so my wife and I pushed on to our destination in Hartford, Connecticut where I had been appointed psychiatrist after an impressive series of transatlantic cablegrams. Hartford was a dignified and prosperous town, ‘the insurance city of the world.’ The Hartford Retreat had been founded in 1822, one of the earliest American hospitals to be devoted to mental illness; it had undergone a radical change in the 1930s under the entrepreneurial genius of Dr Charles C. Burlingame and was re-named the Institute of Living.
Meeting the Need—from Institutional to Community Care
Authors: Toms Rhinedd
Published: January 2018

Severalls Hospital is a large psychiatric hospital, established in 1913 and originally designed for about 2000 patients. With the changes in attitudes to mental health over the last 70 years the hospital's aims and objectives have altered several times. Now, with the number of in-patients already reduced to approximately 650 and the movement to run down large hospitals such as this, preparation needs to be made for the shift to the community as the main future base for psychiatric services. Over the years the hospital has recognised the importance of preserving close links with the patient's home and has always maintained that regular activity and work is vital in the process of re-establishing patients in the community and in employment.
The Oxford Service for the Young Adult Chronically Mentally Ill
Authors: Pullen G. P.
Published: January 2018

Oxfordshire is a pleasant, prosperous county dominated by the City where about one third of its 480,000 population lives. Oxford itself has nearly 15,000 students attending the University or Polytechnic. The active rehabilitation of long-stay patients was started in Oxford over 25 years ago, with the result that by 1986 there were only 40 non-dementing psychiatric-in-patients with a current admission of five or more years. This successful programme of rehabilitation, now virtually completed, was achieved by creating a wide range of sheltered work and other activities, and by the provision since 1963 of over 40 group homes and hostels by the Oxford Group Homes Organisation. However, many psychiatric illnesses still have a chronic and relapsing course; 65% of all admissions, aged 18 to 65 to the Oxford District mental illness units in 1982 and 1983, were readmissions. For those diagnosed as suffering from schizophrenia the figure rises to 80%. In 1972 and 1973 Mann & Cree surveyed 400 ‘new’ long-stay patients (current admission one to five years, aged 18 to 65) in 15 hospitals in England and Wales. They found a rate of 25 per 100,000 population and concluded that for about one third continuing hospital care was the only realistic option. If the remainder were to leave hospital, hostels providing a high level of support would be needed. The recent 1982 survey of ‘new chronic’ in-patients in 14 Scottish psychiatric hospitals still showed a rate of 17.2 per 100,000 population, of whom only 38% were not thought to be in need of continuing hospital care.
The Maudsley Daily Living Programme
Authors: Marks Isaac , Connolly Joe , Muijen Mattijs
Published: January 2018

This paper outlines a three-year controlled study, funded by the Department of Health and Social Security, which started at the Maudsley Hospital in October 1987. The research will compare seriously mentally ill patients maintained outside hospital on the daily living programme (DLP) with standard hospital-based care, and devise a multi-disciplinary training course in DLP for mental health care providers. It will be the first UK attempt at controlled replication of successful controlled studies from North America and Australia, and the first anywhere to devise systematic training in the approach.
Belgravian Bureaucracy
Authors: Kennedy Peter
Published: January 2018

In his Annual Report on the Health Advisory Service, Dr Peter Horrocks makes a statement that should worry all psychiatrists. He writes, “Participation and leadership in the process of change needs to be re-gained by the respective professional bodies, not least by the Royal College of Psychiatrists”.
Medical Refuseniks in the Soviet Union and Their Patients
Authors: Robinson Paul , Berger Mark
Published: January 2018

In July 1986 we went to Moscow and Leningrad to visit refusenik physicians and to learn about the medical and psychiatric problems of this community. Refuseniks, the several thousand Soviet Jews who have applied for—and been refused—permission to go to Israel, suffer considerable official and unofficial punishment. We were interested in the effects of this treatment on physical and mental health as well as in the experiences of Soviet Jewish physicians who apply for emigration. Our information comes from discussions with a number of doctors in both Moscow and Leningrad who gave us examples from their own experiences and those of their patients.
Consulting to a medium-term residential childrens' home: A proposed model
Authors: Isaacs Stephen
Published: January 2018

There is a trend for new consultant posts in child psychiatry to be linked to Social Services Departments. I recently took up such a post, with four of my sessions funded by the local Social Services Department. Training of child psychiatrists for such consultative posts is variable, but I was fortunate to have trained as a senior registrar at the Tavistock Clinic, where one of the training options was a link with Camden Social Services through a placement at Camden Assessment Centre.
The Role of the Psychiatrist in the Pain Clinic
Authors: Tyrer Stephen P.
Published: January 2018

In Britain there are almost 200 pain clinics concerned with the diagnosis and treatment of patients with chronic intractable pain. These patients have frequently run the gamut of medical and surgical services and they are referred to a pain clinic for further assessment and treatment, especially those cases where no organic basis can be found to account for the complaint of pain. Other reasons for referral include specialist treatment only available in a pain clinic, where conventional therapy has failed or where further surgical or medical treatment is not considered justifiable.
A Satisfactory Science of Mind, and the Connection Between Mind Science and Brain Science
Authors: O'Hara Peter
Published: January 2018

In this article, ‘mind science’ refers to any knowledge derived from the study of behaviour, in which I include self-reports of mental states. ‘Brain science’ refers to anatomy, physiology, and biochemistry. Psychiatrists have contact with both types of science, especially in helping to construct therapies. Some choose help more from the one or the other, but even those who make use of both rarely see any connection between the two sciences. There are also difficulties over what is truly scientific in the ‘mind science’ sector. This article looks at these two problems.
Community Psychiatry from Academia
Authors: Matthews B. J. , McLean E. K.
Published: January 2018

The community approaches which can be used in psychiatric practice are not so often in evidence in academic departments of psychiatry. One of us (BJM), on commencing as a Clinical Research Fellow within the Department of Psychiatry, St George's Hospital Medical School, was keen to spend his clinical time (set aside for training purposes) in a community-orientated way.
Network Community Mental Health Care in North-West Derbyshire
Authors: Peet Malcolm
Published: January 2018

The community mental health movement remains an important force in American psychiatry and a shift towards community orientated mental health care is now being actively promoted in Britain. Nevertheless, concepts of community mental health care are not clearly defined, and the term has been variously misused, as a label applied to existing facilities without real change in philosophy, as a political justification for closing large mental hospitals, and as a platform for the propagation of anti-medical ideology. The development of community orientated services involves a change in role for the psychiatrist, which many find difficult to accept. Psychiatrists have been warned that they are at risk of being left behind in the current moves towards community mental health care in Britain.
How Many Nurses do we Need—Standards or Pseudo Work Study?
Authors: Wattis John P. , Rix Keith J. B. , Collins David A.
Published: January 2018

In manufacturing industries, measuring productivity is relatively easy. In many service industries where the job is discrete (e.g. mowing a given area of grass or serving a number of cups of tea), work study methods are still easy to apply. In medicine and nursing where both the product and its process of ‘manufacture’ are hard to measure, things become more difficult. Nowhere is this more so than in psychiatry. Perhaps because of this, the standard often applied in the past has been professional judgement, and the Royal College of Psychiatrists, for example, has suggested appropriate levels of nurse staffing in psychiatry of old age. Such standards are now being questioned and an alternative is being propounded, at least in the Yorkshire Region, based loosely on work study methods. Psychiatry and psychiatric nursing have nothing to fear from work study, provided that acceptable standards of service are defined, and work study methods are properly applied. The first of these is partly a political task although it is to be hoped that the politicians would take guidance from patients, their relatives, and the appropriate professionals. Work study can ensure that such standards are achieved in the most economic way. It cannot set the standards. The authors are concerned because an exercise has recently been mounted throughout Yorkshire that purports to be a measure of nursing load, but which neither defines the standards of nursing care to be achieved, nor uses adequate methods to measure the work involved.
Workshop on Schizophrenia
Authors: Weller Malcolm P. I.
Published: January 2018

Representatives from 19 countries met by invitation to discuss their most recent research findings at the Third Biannual Workshop on Schizophrenia, Schladming, Austria 26–31 January 1986, organised by Dr T. J. Crow (MRC, Northwick Park Hospital) and Professor S. R. Hirsch (Charing Cross Hospital Medical School). The thrust was highly biological with biochemistry and brain structure much in the fore, assisted by much greater resolution of imageing techniques and the development of specific ligands for synaptic receptors.
Tread Softly (UK, 1985, 51 mins)
Authors: Garrett Elizabeth
Published: January 2018

ESCATA, the enterprising and innovative organisation which specialises in training material for health and social services professionals, does not claim mainly to produce educational films but rather, what it terms ‘video assisted workshops’. This is an important distinction and should be borne in mind when viewing the ‘Tread Softly’ video which looks at the transition from large psychiatric hospitals to local community services and is intended for practitioners, planners, managers and members from both voluntary and statutory mental health services.
Continuing Medical Education
Authors: Brook Peter , Wakeford Richard
Published: January 2018

Despite some general interest in the development and evaluation of continuing education for health professionals, the voluminous research literature on the subject is unfortunately equivocal as to exactly what approaches work and in which situations. In 1977, Bertram and Brookes-Bertram reviewed 113 studies of continuing medical education (CME): they found that three out of the eight studies which they judged as acceptably designed showed persistent positive effects. More recently, of six studies which examined the effect of CME upon the quality of care, half reported positive effects and half reported no effect, although all the studies demonstrated cognitive improvements.
Some Approaches to Employment Problems in Chronic Psychiatric Illness
Authors: Gloag Daphne
Published: January 2018

A personnel manager told me of a father who said of his son who had had some mental illness, “I didn't know what a nice son I had until he got a job.” Even the most apparently dreary work may be a life saver for someone with chronic psychiatric problems. On the other hand, an able young man in one of the work projects I discuss here was outraged by the boring packing work he had had earlier in his illness. But clearly a whole constellation of problems, stemming from the person concerned and from society, provides obstacles to getting work, interesting or otherwise, and keeping it. Many approaches have been evolved over the years in the provision of work as therapy, with graded work, detailed assessment, and perhaps psychological methods, and of later work with support as necessary. However, it is still all too common for these people to sit at home doing absolutely nothing.
Hospital Based Rape Crisis Programmes
Authors: Mezey Gill
Published: January 2018

The importance of rape crisis programmes in the United States is that they provide a service for rape victims that does not exist in Britain: a hospital-based service providing physical, psychological, emotional and practical help for the rape victim and which regards this work as a crucial part of health care provision.
Jobs and Computers
Authors: Lipsedge Maurice , Summerfield Angela B. , Lazzari G. , van Beeston M.
Published: January 2018

This is a report on a project which offers long-term day hospital patients a training which will lead to paid employment on the open market. Lack of work compounds the low self-esteem of chronic psychiatric patients. They experience multiple disadvantages, including loss of status, purpose, personal identity, social contacts outside the family, and a time structure to the day. Many of these disadvantages are known to be experienced by unemployed people in the general population. In most surveys, a fifth of the unemployed report a deterioration in their mental health since being unemployed, with an increased frequency of deterioration proportional to length of time without work. Work enhances self-esteem by decreasing the degree of dependency and by allowing identification with non-patients and may influence perceived locus of control. Work provides social participation and is ‘a visible measure of normality’ for former patients.
“Caesar of the Salpêtrière” J.-M. Charcot's impact on Psychological Medicine in the 1880s
Authors: Parry-Jones William
Published: January 2018

The year 1887 is memorable in medical history for the painting depicting ‘Une leçon du Docteur Charcot à la Salpêtrière’ by André Brouillet (1857–1914), a pupil of Gérôme. Lithographs by Eugene Pirodon of this painting were much reproduced and Sigmund Freud hung a copy in his consulting room. In fact, Freud had travelled from Vienna to Paris, in October 1885, to observe the work of Jean-Martin Charcot at the Salpêtrière. Charcot's views about hysteria and hypnosis were to have a formative and enduring influence on Freud, who returned home, four and a half months later, as one of Charcot's unqualified admirers and champions. It is timely, exactly a century later, to reflect on Charcot's work and influence, when his career was at its zenith and, in particular, to consider his impact on British psychological medicine.
A lack of direction
Authors: Dingwall J. M.
Published: January 2018

According to the recent Commons Report on Community Care, psychiatric patients are being discharged to inadequate community care. One of the reasons given for this situation is the lack of communication between professional groups, leading to bad planning of care.
PM Report
Authors: Flett S.
Published: January 2018

After the introductory talks and for the early part of the afternoon participants split into five speciality groups. All groups had one or two psychologists and psychiatrists acting as facilitators. Facilitators were given detailed briefs to encourage a structured and constructive response to certain themes across the groups. This brief is available from the College or the BPS. I was allowed a roving observer's role between the groups and was asked to report back on the final plenary session. The account which follows is a personal view intended to give the flavour of the proceedings.
Hospital Closures and Community Care: Correspondence between the National Schizophrenia Fellowship and the Minister for Health
Authors: Lines R. N. , Clarke Kenneth , Lines R. N.
Published: January 2018

Following the publication of correspondence between the then Minister for Health, Mr Kenneth Clarke, and the National Schizophrenia Fellowship (Bulletin, March 1985, 9, 49–55), we are now publishing the concluding letters in this exchange of correspondence. (Mrs Joyce Major has been succeeded by Mr R. N. Lines as Chairman of the NSF.)

We use the expression ‘long-term patient’ to describe one who, whether in hospital or elsewhere, needs a great deal of supervision and/or nursing care. We use ‘long-stay patient’ for the smaller category in hospital or equivalent health service institution. The great majority of long-term who are not long-stay are at present cared for by relatives, if at all; a small fraction are in staffed homes provided by the voluntary sector, or are in local authority hostels.
The first year of working as reported by consultants in child and adolescent psychiatry
Authors: Wardle Christopher
Published: January 2018

The Education Act (1981) was brought into effect on 1 September 1983. Explanatory and guidance documents were published in 1983. The Education Act has effects on the work of child and adolescent psychiatrists in two ways. Firstly it affects those in-patient and day units that have education on the premises. Secondly it affects the placement of children who have special educational needs because of emotional or behavioural problems, the children who in the past would have been deemed maladjusted. While child psychiatrists should be involved in all cases where emotional and behavioural problems are the main issue, they will also be involved with some of the children who have special educational needs because of intellectual and learning difficulties, children who in the past were deemed educationally subnormal. These children between them constitute a high proportion of those who will, under the new Act, be subjects of statements of need.
What Puts Medical Students off Psychiatry?
Authors: Scott Jan
Published: January 2018

At present about 4% of doctors opt for a career in psychiatry. Between 1974 and 1977 almost a quarter of the consultant posts in general psychiatry remained unfilled; in 1981 there were no less than 220 unfilled consultant vacancies. This shortage is regarded by many as representing a deficiency in quality as much as quantity of applicants. If the consultant grades are expanded in the future to the levels suggested by the Short Report these problems are likely to increase rather than decrease, unless recruitment into the speciality is enhanced.
What Makes Psychiatric Summaries Useful to General Practitioners?
Authors: Orrell M. W. , Greenberg M.
Published: January 2018

A general practitioner needs to be kept well-informed when a patient with a psychiatric disorder is admitted to hospital. This can be difficult because a number of professional workers, not all of whom are hospital based, become involved in management, and confusion over clinical responsibility may develop. In these circumstances communication usually depends upon the hospital discharge summary which should contain information that is relevant to the GP's requirements.
Liaison Psychiatry
Authors: Barczak Paul
Published: January 2018

A liaison is a union or effective conjunction with another unit or force. A liaison officer is seen as one who forms links or integrates such units or forces. This is a simple definition obtained from a standard dictionary but a further attempt at defining what is meant by liaison psychiatry is not so easy. This problem of definition and the lack of uniformity in such services in different settings may partly result in the marked under-utilisation of psychiatric expertise in dealing with the large number of medical patients who have a psychiatric disorder regardless of the presence or absence of a physical illness.
Training Psychiatrists in Behavioural Psychotherapy—Dispelling Myths
Authors: Farmer Roger , Miller David , Green John , Herzberg Joe
Published: January 2018

Behavioural psychotherapy is probably now the preferred treatment in as many as 25% of neurotic patients or 12% of adult psychiatric outpatients. It is, of course, part of some psychiatrists' therapeutic repertoire already. However, more widespread use of behavioural methods by psychiatrists would seem to be desirable and this is particularly so as clinical psychologists remain thin on the ground in many places. Indeed clinical psychology remains one of the smallest health-service professions. In 1981 there were 1,105.7 qualified clinical psychologists (whole time equivalents) in England. Moreover this overall figure conceals enormous disparities between Health Authorities, some of which provide good psychological services while others provide virtually nothing. In recognition of the importance of behavioural techniques, the Royal College of Psychiatrists has recommended that experience of them should be an integral part of any psychiatrist's training.
Health Care in a Destitute Population: Christmas 1985
Authors: Weller Ben G. A. , Weller Malcolm P. I.
Published: January 2018

The closure of the Camberwell Resettlement Centre, the largest in Europe, in September 1985, followed the closure of an estimated 2,000 common lodging houses and low cost accommodation in London between 1982 and 1984. Over a two year period only 14 out of the 25,000 who passed through the Centre had been rehoused. To aggravate the problem there had been a fall in local authority residential places in the six years up to 1982, accompanied by a decrease in the provision of home helps and meals on wheels, despite an increasing proportion of elderly in the community. of those who had utilised Camberwell Reception Centre 79% had slept rough and 19% had tuberculosis (personal communication of the staff).
“Marriages by the Petites Affiches”
Authors: Mansker Andrea
Published: January 2018

Founder of the most widely known matrimonial agency in postrevolutionary France, Claude Villiaume proved his talents as an enterprising ad man who exploited the uniquely commercial format of the Parisian Petites affiches to establish a virtual monopoly on the business under the Empire. Offering to serve as a conduit for men and women who pursued love anonymously in the Petites affiches, he skillfully marketed his “marriages by the classifieds” to lonely, uprooted individuals throughout imperial France. Villiaume pitched his unions as part of a new commercial and social world of movement in Paris. He sought to facilitate the circulation of capital and people by forging family alliances and love matches across multiple social and geographic borders. By linking marital choice and courtship to the vagaries of consumer capitalism, the agent transformed marriage into a form of commercial exchange associated with the new urban values of abundance, pleasure, and social mobility.

Fondateur du bureau des mariages le plus connu à l'époque de l'Empire, Claude Villiaume a fait preuve de son talent comme publicitaire dynamique qui se servait du format commercial des Petites Affiches de Paris afin d'établir un monopole sur la profession de courtier matrimonial. Il s'est proposé comme entremetteur pour les gens à la recherche d'un conjoint dans l'anonymat des petites annonces et il a mis en valeur ses « mariages par les petites affiches » aux personnes solitaires et déplacées dans la France impériale. Villiaume a proposé ses mariages dans le cadre d'un nouveau monde commercial et social marqué par la circulation rapide des personnes et des marchandises à Paris. Il a tenté de faciliter les alliances familiales et les liens amoureux au-delà des frontières géographiques et sociales. En associant le modèle du choix du conjoint et de la cour au capitalisme consumériste, l'agent a transformé le mariage en une espèce d'échange commercial lié aux valeurs urbaines de l'abondance, du plaisir, et de la mobilité sociale.
The Algerian War, European Integration, and the Decolonization of French Socialism
Authors: Shaev Brian
Published: January 2018

This article takes up Todd Shepard's call to “write together the history of the Algerian War and European integration” by examining the French Socialist Party. Socialist internationalism, built around an analysis of European history, abhorred nationalism and exalted supranational organization. Its principles were durable and firm. Socialist visions for French colonies, on the other hand, were fluid. The asymmetry of the party's European and colonial visions encouraged socialist leaders to apply their European doctrine to France's colonies during the Algerian War. The war split socialists who favored the European communities into multiple parties, in which they cooperated with allies who did not support European integration. French socialist internationalism became a casualty of the Algerian War. In the decolonization of the French Socialist Party, support for European integration declined and internationalism largely vanished as a guiding principle of French socialism.

Cet article répond à l'appel de Todd Shepard à « écrire à la fois l'histoire de la guerre d'Algérie et l'histoire de l'intégration européenne » en examinant le Parti socialiste. L'internationalisme socialiste, basé sur une analyse de l'histoire européenne, dénonça le nationalisme et exalta le supranationalisme. Ses principes furent durables et fermes. Par contre, sa politique concernant les colonies fut souple. L'asymétrie entre les visions européenne et coloniale du parti encouragea l'application de la doctrine européenne aux colonies françaises pendant la guerre d'Algérie. La guerre divisa les partisans socialistes des communautés européennes en multiples partis, dans lesquels ils coopérèrent avec des alliés qui ne soutenaient pas l'intégration européenne. L'internationalisme socialiste français fut une victime de la guerre d'Algérie. Dans la décolonisation du socialisme français, le soutien à l'intégration européenne recula et l'internationalisme disparut comme principe directeur.