The College motto is ‘Let Wisdom Guide’: but what is wisdom?

Wisdom is a recognizable attribute of human beings, reflected in their thoughts, words and actions, derived through intuition and through individual contemplation of ideas, knowledge and experience of all kinds. The definition is conventional, and says something. But what is wisdom?

In 1977 a number of considerations prompted a review of the facilities for the mentally ill of ‘no fixed abode’ in St Brendan's Hospital, Dublin. At that time the hospital had three clinical teams who serviced three geographically distinct catchment areas within the city and attended to the needs of patients with ‘no fixed abode’ on a rotational basis. There were complaints from community care agencies concerned with the care of the homeless which alleged that patients were discharged without adequate preparation or follow-up. However, this view was not shared by hospital staff, who instanced occasions when patients sought help in what seemed to be a psychiatric or social emergency, and then abused the service by discharging themselves shortly afterwards. The truth perhaps lay somewhere in between. Another complaint was that no single medical practitioner was clearly responsible for these disadvantaged individuals, thereby making it difficult for community care agencies to liaise with the hospital staff.

A survey of the views of consultant psychiatrists concerning possible difficulties for the practising clinician in the early aftermath of the Mental Health Act 1983 is presented. The number of consultant psychiatrists written to was 118 and the breakdown of responses was as follows: 37 of 79 general psychiatrists replied; 4 of 8 psychogeriatricians replied; 2 of 9 consultant adolescent psychiatrists replied; 2 of 4 forensic psychiatrists replied; and 5 of 18 consultants in mental handicap replied. The letter asked eight questions concerning specific aspects of the Act and invited any comment.

Travel has always been a part of medical education. Many of the great figures of British psychiatry seemed to have derived some of their inspiration from periods spent in European clinics, and more recently no c.v. seemed truly complete without the all important ‘Been to America’. Unfortunately, as the Atlantic has become cheaper to cross, the professional welcome at the other end has become increasingly lukewarm and the VQE and FLEX have proved substantial deterrents. There are, however, several alternatives which are worth considering. From 1980 to 1983 I worked as a psychiatrist in Africa, in the Republic of Botswana, and I thought a description of some of the practical aspects involved in making such a step might be of interest.

In 1981, the document Secure Facilities for Psychiatric Patients, a report of a Special Committee of Council of the Royal College of Psychiatrists, was published. Paragraph 12 of this document read as follows.

The College has been concerned to review the need for secure treatment facilities for all groups. Adolescents have been excluded from most proposals for secure units, but some believe that there is need for special units for them. The Child and Adolescent Psychiatry Specialist Section has been asked to examine this question in detail and lo report independently.

The 1984 North West Division Trainees Day took place at Prestwich Hospital on 29 February 1984. This was the first occasion on which it was held at a peripheral hospital.

Dr A. A. Campbell (Chairman, NW Division) welcomed trainees to the meeting. He outlined the current programme of the division and encouraged greater trainee participation. This was followed by an explanation of the structure and function of trainee representation, both centrally and locally, from Dr N. Simpson (Honorary Secretary, CTC), who also included a brief report on activities in the past year.

Reviving the title of Dr Derek Chiswick's article in an APIT Newsletter some five years ago, the second Trainee's Forum to be organized by the Collegiate Trainees Committee met to re-examine the question during the College's Winter Quarterly Meeting at Charing Cross Hospital Medical School in February 1984. The 40 tutors and trainees attending heard presentations by Dr Peter Kennedy (Psychiatric Tutor from York), Dr Jane Price (formerly Senior Registrar in Psychotherapy in Nottingham), and Dr Desmond Dunleavy (Course Organizer and College Convener from Newcastle).