When the Liverpool Daily Post, its sister paper, the Liverpool Echo, and the Daily Mail published inflammatory material about a restricted patient at Park Lane Special Hospital (now Ashworth (North) Special Hospital) their editors were strongly warned by the House of Lords that they would be well advised to exercise greater care in future, that they did not overstep the mark and find themselves in contempt of court. The newspapers won their appeal because the law allowed them to report the fact that a restricted patient had applied to a Mental Health Review Tribunal for his discharge, the date and place of the hearing of the application and any order made discharging the patient, absolutely or conditionally. But the law does not give the papers carte blanche to comment on a case in order to mount a campaign of public protest against the patient's release.

Depression is a very common disorder. It has been estimated that 20% of all women and 13% of all men will develop depression at some time during their lifetime, although much of the depression which exists in the community is unrecognised and untreated. Approximately 75% of the female population and over 50% of the male population attend their general practitioners at least once with a psychiatric complaint, of whom 70% of the women and 34% of the men have a depressive episode. While treatment for some patients will be successful following the acute phase of the depressive episode, it will generally take at least three months and in some instances six months or more to treat an episode. The risk of relapse following treatment is high, affecting approximately 50% of patients treated; furthermore, there is no evidence to suggest that those patients being treated for their first episode of depression are less vulnerable to relapse following response to treatment than those who have suffered previous episodes of depression.

Tardive dyskinesia (TD) is an involuntary movement disorder associated with long term neuroleptic exposure. Gerlach & Casey (1988) reported a 15% prevalence rate of TD among patients on neuroleptics, the rate increasing to 54% in patients over 60 years old.

The Chinese community in the UK has existed since the latter half of the 1800s and traditionally has been perceived as insular and self sufficient (Lynn, 1982). In the 1960s and ‘70s, there was a large influx of Chinese into the UK to work in catering businesses. Many of the children of this generation were born in this country; with this group now in their early adulthood, there is more integration into the indigenous population. However, there is still an impression that Chinese psychiatric patients are under-represented in the services, but as yet, there has been little psychiatric research carried out among the Chinese in the UK. This study examined briefly the level of contact with, and difficulties encountered in, managing Chinese patients by psychiatrists in Merseyside.

The compulsory treatment of addicts has always attracted controversy and even generates strong emotional responses from workers in the field. But the few projects which have been mounted have yielded results no less encouraging than voluntary approaches and in some instances report greater success. These schemes have already been subject to an international comparison (Webster, 1986).

In Southampton we have been carrying out audit that conforms to the Government's definition in the White Paper Working for Patients (1989) for over a decade. During the last six years the results of the audit have been presented in regular meetings, while the specific projects on procedures used for diagnosis and treatment, the use of resources and outcome that we have undertaken date back much longer than this.

Evidence bearing on the issue of what happens to patients from long-stay psychiatric wards in Britain is scarce. The results of a particularly well-planned resettlement programme may not be representative of the outcome from general policies of discharge from all psychiatric hospitals. The present study was undertaken in Sheffield to find the whereabouts of patients from long-stay wards after eight years, a longer period than usually studied previously. The expectation was that difficulties in tracing patients could be overcome with sufficient time and effort.

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.

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.

Professor Michael Peckham's appointment as Director of Research and Development for the National Health Service in England reflects a new phase in central government's concern to influence health care research. Responding to the House of Lords' 1988 report Priorities in Medical Research, and to continuing doubts about the effectiveness of the Department of Health's own research management division, Professor Peckham's remit is to control all the research and development activities funded through the NHS - estimated at over £200 million.

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.

The purpose of this paper is to examine existing information technology (IT) options for child and adolescent psychiatry (CAP) and to propose a strategy for continuing developments in the light of current NHS policy and priorities. It is the outcome of discussions among a group of colleagues within the South West Thames Association for Child and Adolescent Psychiatry. I offer it for discussion as the issues facing us have obvious wider relevance to the profession. The case for investment in health care IT systems has been made most recently in Working Paper 11: Framework for Information Systems (HMSO, 1989). The priorities spelled out in the paper are for management of contracts, measurement of quality of care, costing of services and management of resources.

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.

In 1987, 38% of Royal Free medical students answered the question “How could the child psychiatry course be improved?” by asking for “more”-in particular, they wanted more “hands on” experience.

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.

With a view to stimulating discussion on the subject of trainee's attitudes towards, and experience of teaching, at an informal meeting of members of the Association of University Teachers of Psychiatry held in Leicester last year, a survey of Trent Region Psychiatric Senior Registrars, as well as delegates to the first College Trainees' Conference (held at Warwick University), was undertaken.

Recent legislation, the Access to Health Records Act (1991), which came into force in November, will mean that patients will be able to apply for access to their written case file. This law will not be retrospective, and notes written before this date will not therefore fall under the scope of the act. Similar legislation has already been passed enabling access to Social Services case files (Access to Personal Files Act, 1987). The legislation follows increasing pressure for consumer rights in various areas and follows similar developments allowing access to health records in other countries.

Advertisements are biased. This is not a statement of ideology, but a statement of fact. They are neither public service announcements nor balanced debates. They exist solely to encourage the consumer to buy one product in preference to another. The importance of this is that, as clinicians, we often place ourselves apart from others when considering what influences our practice. On the one hand our training emphasises a combined approach of pharmacological, psychological, and social therapies, but on the other, it is only the pharmacological approach that has the ability to finance full-colour advertisements in learned journals. In 1982 the pharmaceutical industry spent £150 million on drug promotion in the UK (Medawar, 1984). We have attempted to take an objective view of drug advertisements by examining the words used in all advertisements that have appeared in the British Journal of Psychiatry over the last 30 years.

Of all the decisions taken by psychiatrists with or on behalf of their patients, few are as potentially far-reaching as the decision to repatriate a mentally ill person to his or her country of origin. Although many psychiatrists have anecdotal experience of individual cases, published research on repatriation is surprisingly sparse. Burke (1973) reported 66 persons repatriated from Britain to Jamaica over a four year period, and Asuni (1968) found 82 returning via Aro Hospital, Nigeria, over a similar period. Although it is difficult to extrapolate an estimate of the number leaving the UK each year, these figures suggest that the practice is not uncommon and that significant, possibly increasing, numbers of people are affected.