Sir: It is with interest that we noted your publication of Ritchie et al's study ‘Patient or client? The opinions of people attending a psychiatric clinic’ (Psychiatric Bulletin, December 2000, 24, 447-450). As a community adolescent mental health team we wondered about the best way to address the people who were attending the unit. Between February 2000 and May 2000 we conducted a small survey and wrote to 133 people who had accessed the service and in response we received 42 replies. There were a number of questions on the survey, but in answer to the question about the preferred terminology to describe a patient/client the responses were as follows:

Servxice user	3
Patient	15
Customer	1
Client	16
Other	7

The preference was slightly in favour of the term ‘client’ as opposed to ‘patient’, with very little preference for service user or customer. It may be significant that our survey was only of clients between the ages of 16 and 19 years, whereas in the Ritchie et al's study the mean age was between 35 and 39 years. This might indicate a shift, which is influenced by age and points to an emerging change in culture. Perhaps the most significant finding was that only 42 clients out of 133 were sufficiently exercised by questions of this sort to return the questionnaire in its postage paid envelope. This question may be of more interest to professionals than clients.