In November 1997 a questionnaire was sent to a large random sample of members, fellows, affiliates and inceptors living in the UK or the Republic of Ireland.

One thousand four hundred and seventy-six completed questionnaires were available for analysis, a response rate of 63%. The College was complemented for raising standards of education and training in psychiatry and criticised for not trying hard enough, or failing, to influence the policies of the Department of Health. A high proportion of respondents highly valued the British Journal of Psychiatry and Psychiatric Bulletin but few made use of the library. A high percentage of Irish, Welsh and Scottish members, and of members of the five smaller faculties, participated in and expressed their appreciation of the activities of the College.

Whatever its other failings the College is not dominated by general psychiatrists and their interests, or by London-based psychiatrists. It is surprisingly successful at involving Scottish, Welsh and Irish psychiatrists, and members of the smaller faculties, in its activities. To some extent, however, the faculties are thriving at the expense of the English divisions.

To examine whether, 19 months after its introduction, the goals of the supervision register have been met. A matched case-control study of patients on the supervision register and Care Programme Approach was conducted.

Cases and controls demonstrated similar socio-demographic characteristics, primary diagnoses and community psychiatric care. The supervision register group were more likely to use concurrent alcohol and/or illicit drugs (P=0.001) or suffer with an accompanying personality disorder (P=0.0001), and were less likely to have experience of a long-term relationship (P=0.003). Nineteen months after registration, the supervision register group were more likely to be violent to others (P=0.002) or involved in serious threatening behaviour to others (P=0.0007). Relapse of mental illness was the only significant predictor of future violence in the supervision register group (P<0.01).

Patients with a history of violence to others were found to be appropriately placed on the supervision register but continued to demonstrate aggressive behaviour after registration, indicating that the goal of the supervision register to prioritise most appropriate care and treatment for this group of patients has not been met.

Health of the Nation Outcome Scales (HoNOS) were piloted in 248 patients with serious persistent mental health problems. Staff were trained by a cascade approach and rated patient outcome after six months.

There was poor interrater reliability between nurses and psychiatrists/psychologists. Outcome measured by HoNOS often contrasted with clinical experience.

HoNOS were not a reliable or valid measure of outcome. The scales are now completed only under supervision.

An audit was performed to look at how carefully anticholinergic medication was prescribed and monitored in a population of psychiatric patients on depot medication.

The mean duration of prescription was 47 months and 44% of patients' prescriptions went unaltered for over three years. Evidence was lacking for rational initial anticholinergic prescription.

Anticholinergic treatment needs to be prescribed more rationally with regular monitoring of extra-pyramidal symptoms.

Staff grade psychiatrists working in Scotland were surveyed by postal questionnaire in order to determine their demographic profile, career aspirations and experience of the grade.

A heterogeneous group of doctors was identified, from a variety of professional backgrounds, and with a range of ambitions. Respondents generally held a favourable view of the grade, but expressed concern over perceived lack of opportunities for training, education and career progression. This is despite considerable recent efforts by the College to include non-consultant career grades in its programme for Continuing Professional Development.

There remains scope for imaginative development of the grade. In particular, staff grade psychiatrists might benefit from a more individualised approach to, and support for, all areas of their professional development. Such ‘mentoring’ may be especially beneficial for staff grades in Scotland, for whom geographical, as well as professional isolation, can be problematic.

The study was undertaken to examine over the counter drug sales from hospital shops. One hundred hospital shops were sent a questionnaire asking for details of drugs sold and any policy to prevent sales to patients.

Seventy-three shops replied, 20 of which sold medication. Most had policies which would allow sales to patients. Three shops had sold medication which was subsequently used for self-poisoning by in-patients.

Hospital managers and clinicians should ensure hospital shops have effective policies to prevent medication sales to patients.

To describe one of the first psychiatric services in the inner-city especially designated for female psychiatric patients with severe mental illness.

The referral system, the staffing levels and the admission criteria have been established following needs of the patients, especially young women with perinatal problems and women from ethnic minorities.

This single gender acute psychiatric ward has received welcome attention from mental health professionals and management at every level, and it is hoped that further discussion will help to clarify future policies and guidelines on all aspects of this venture.

The aim of the study was to identify medical and socio-demographic characteristics of admissions considered inappropriate by psychiatrists. Appropriateness of admission was assessed by questionnaire. Medical and socio-demographic characteristics of each admission were obtained by case note review.

Twenty-five per cent of admissions were considered inappropriate. These patients showed high levels of adverse socio-demographic characteristics and commonly were diagnosed as personality disordered or as substance misusers. Junior doctors commonly admitted patients despite considering admission inappropriate.

Regular audit of the admission, process should be encouraged.

To set up a liaison psychiatry service for an obstetric department and review how much of the work involved in such a service can be undertaken by a senior registrar in two special interest sessions.

It was clear there was a demand for a service for women with psychiatric problems associated with childbirth. Referrals from colleagues in general psychiatry meant that the available time was soon used up. This did therefore not allow time to develop efficient systems for referral and management or to then see the extra referrals this would have produced. The limited and temporary service was well received by other professionals and by patients. The number of referrals received fell far short of the expected morbidity.

In an area with this number of births and its consequent level of psychiatric morbidity, it would not seem possible, within two special interest sessions, to develop a more formalised or comprehensive system.

All consultant psychotherapists should be sufficiently familiar with the three major branches of psychotherapy, to appropriately match therapy with their assessment of the patients' needs. This requires that specialist registrars training in psychotherapy acquire skills in psychodynamic/interpersonal, cognitive-behavioural and systems-based therapies.

While acknowledging the benefit for the trainee of being familiar with more than one model of psychotherapy the practicalities of incorporating different models in to training is likely to be problematic, at least initially, for both trainees and trainers.

Clinical implications In this article the experience of a senior registrar who completed a training in psycho-analyticpsychotherapy prior to gaining experience in cognitive-behaviour therapy is examined from the perspective of both the trainee and cognitive-behavioural trainer.