The current situation in Soviet psychiatry needs a surrealist of Kafka's skill to describe it. On the one hand, an increasing range of Soviet journals have, since last November, been forthrightly saying what Soviet dissidents and Western observers have said for 20 years. This is that politically motivated abuse of psychiatry has taken place in the USSR on a large scale for decades, causing enormous human suffering. Second, some of these journals point out that abuses, though much reduced in scale, continue to occur today.

The history of this East German plane flight to Moscow is interesting enough to record. In 1983 the All Union Association of Soviet Psychiatrists and Neurologists left the World Psychiatric Association, when it became clear that a resolution condemning the abuse of psychiatry in the USSR was about to be adopted.

The London-Berlin (GDR) Committee was established in June 1986, with the aim of encouraging cultural exchanges between Britain and the German Democratic Republic. This Committee organised a study tour of East Berlin for British health care workers in October 1988. This was the first exchange of this kind since the Second World War and the subsequent foundation of the modern Republic of East Germany.

The Department of Health and Social Security has designated eight services as ‘National Demonstration Services in Psychiatric Rehabilitation’. The aim of this was to identify services which would exemplify good practice in psychiatric rehabilitation and long-term care. In preparing his report Sir Roy Griffiths met with representatives from these services. It was felt appropriate that the National Demonstration Services should comment on the recommendations in so far as they are likely to affect those with long-term psychiatric problems.

Currently, resources for acute mental illness services are allocated on the basis of the age, sex and marital status profiles of the catchment population. However, it has been argued (Hirsch, 1988) that mental illness budgets and bed provision should also be weighted according to the socio-demographic characteristics of the local population.

Professionals dealing with young drug misusers, those providing mental health services for children, and those providing services for adult misusers have roles that converge and overlap (though occasionally diverge). While services for adult misusers may have been developing at a reasonable (though not to everyone's satisfaction) pace, those for adolescent misusers have not.

There is now an extensive literature on benzodiazepines (over 18,400 publications since 1966), particularly regarding their addictive potential (Feely, 1988). The importance of this finding lies in prescribing as well as in the treatment of existing addiction. However, psychological factors are also important in the maintenance of addictive behaviour and one should not assume that all are recognised. For example, it is known that drugs are used to reward children employed by the pornographic industry and that sexually abused children can develop drug addiction (Burgess et al., 1984). There are now over 300 publications on child sexual abuse but none linking it with benzodiazepine addiction specifically. This is the first one.

This century has been characterised by a substantial increase in the number of elderly residents in the community in the technologically advanced countries. One obvious consequence of this has been a pressure on existing mental and socio physical facilities that cater for the elderly. The medico-social factors responsible for this rise in the proportion of the elderly in advanced countries are subtly creeping into many developing countries like Nigeria (Lambo, 1966). It is with this perspective in view, coupled with the dearth of literature on psychogeriatrics in developing countries, that I decided to review the socio-demographic and clinical aspects of elderly (60 years and above) admissions to the Nigerian National Neuropsychiatric Hospital and WHO Collaborating Centre for Research and Training in Mental Health over a five year period (1 January 1982 to 31 December 1986). An attempt will also be made to draw comparisons with my experience of psychogeriatrics in the United Kingdom (I trained in psychiatry at the Royal Edinburgh Hospital in the early 1980s).

I have recently taken up a post as Senior Registrar in Psychotherapy in Leicester where about 20% of the citizens are Asian or Afro-Caribbean. For the rest of this article I shall use the term ‘black’ as synonymous with Asian and Afro-Caribbean. While realising this may offend some readers, I use it in a political sense and know that many prefer it to the equally inaccurate use of the term ‘ethnic minority’. Before being promoted, I was on the general psychiatry registrar rotation in the same city and not surprisingly had a large number of black patients. Now I have none; there are very few referred to the Department, and I gather this is typical of psychotherapy units across the country. I want to consider why this is so, and what, if anything, should be done about it.

Rarely in a lifetime do three people contribute to society in so many ways as the Burdens in Bristol. Here are some of their major achievements.

The Reverend Burden and his wifw Katharine opened ‘The Royal Victoria Home’, near Horfield Prison, for the care of inebriate women and girls in moral danger in 1895.

Although psychiatry's future looks less and less likely to be in large psychiatric hospitals, trainees at SHO/registrar level still spend nearly all their time in them. Although the White Paper looks set to dismember comprehensive provision as we know it, few psychiatrists have experienced self-employment, and most are untrained in practical management skills. Although our consumers – as we must now view them – are getting more discerning about what services we offer, psychiatrists only see them after they become ill, and less able to decide for themselves.

The declared aim of the World Health Organization, based on the Alma Ata declaration (1978), is to promote health care for all by the year 2000. It is recognised that this can be achieved only by the channelling of efforts into the development of primary health care, with medical care greatly augmented by the utilisation of non-medical carers, traditional healers and public health measures. As in more developed countries, where psychiatry struggles to maintain its share of national health resources against the ever increasing demand of technical advances in physical health care, so the mental health services of the less developed countries constantly are in danger of losing out to physical health in the battle against illness and natural disasters. To redress this balance and to meet the needs for mental health by the year 2000, the less developed world needs more psychiatrists (who are currently estimated to relate to the population at a rate of approximately only one per million) and these psychiatrists need to be appropriately trained to meet the challenges. How can the more developed nations help in this training of trainees from the less developed world? Can a partnership be formed between nations that ensures that trainees in psychiatry, in whichever country, are equipped as well as possible for the needs of their home country?

Views differ as to whether it is feasible – or indeed desirable – to agree on a Code of Practice with respect to the clinical management of suicidal patients in psychiatric units (Morgan, 1988). At Fulbourn Hospital (Gardner, 1988) we have developed some guidelines which might, if suitably modified, be used elsewhere; they are appended below.