The following is the second part of Brian Barraclough's interview with Max Hamilton. Part I appeared in the March Bulletin.

The debate on the place of community psychiatry is conducted as if it were a matter of choosing between service in the community on one hand and hospitals on the other. When expressed as a dichotomy the question, as illustrated by Scull's Dilemma (Jones, 1982), may be unanswerable. Instead, should we not ask what range of co-ordinated services are required to provide a comprehensive service for the mentally disturbed in a geographically-defined community? The key word then becomes comprehensive with community, in the sense of extra-hospital, important but subordinate. The hospital is then seen as part of the service; it is of the community, not alien to it. Other service components need not be anti-hospital, but hospital staff will need to avoid institutionalism and live down prejudice. The debate about what we can afford, although relevant, is separate.

Psychiatry in a land of 7 1/2 million (National Census, August 1982) people with relatively advanced general medical services, but only eight psychiatrists, has great problems. The facilities have been described elsewhere (Murdoch, 1982). Historically poorly related to population needs, and with immense difficulties in serving the rural communities that still comprise over half the population (National Census), Zimbabwe has concentrated its post-independence effort on the development of primary health care in village, district and small town. With a medical school expanding (current intake 80 students per annum) and good central facilities for training and specialist care, primary care in public health and general medical services are developing on a sound basis. In psychiatry, a mere 1200 beds for the country (only 141 in the capital, Harare, which, with dormitory towns, has an ‘official’ population of 1.1 million and serves a further four million in remote rural areas) the training and specialist facilities are sketchy indeed.

One of the most valuable sources of psychiatric teaching films for many years has been the BMA/BLAT Film Library, which holds over 800 films on various topics relating to medicine. They may be hired for a £4 handling charge, and new productions are encouraged by the annual BMA film competition. A brief survey of borrowing during the period 1973–82, gives an indication of the use and value of film in the teaching of psychiatry.

This Notice notifies Health Authorities of the extension of the Legal Aid Scheme to include legal representation for all applicants to a Mental Health Review Tribunal (MHRT) from 1 December 1982 under the Assistance by Way of Representation (ABWOR) Scheme.

A course on ‘Psychiatry of Late Life’ for psychiatrists, geriatricians and community physicians will be held from 18 to 22 July 1983 at the University of Birmingham. Accommodation is available, but places are limited to 30. Information: Mrs V. Gilbert, Administrative Assistant, Board of Graduate Clinical Studies, Medical School, Vincent Drive, Birmingham 15.