This research aimed to explore the trainee perspective on factors affecting recruitment into old age psychiatry higher training in the UK. A qualitative survey was created by the Faculty of Old Age Psychiatry and distributed to current higher trainees in all psychiatric subspecialties. A total of 324 higher trainees responded to the survey, representing a broad demographic range. Thematic analysis was carried out, with sufficient responses to achieve saturation. Key themes included concerns about the future of the specialty, issues with social care, lack of support with patients’ physical health needs, issues with training posts, and workload. The need to improve core trainees’ experience of the specialty was highlighted. Many positive themes arose from the data; however, a number of barriers to recruitment were also identified. The findings have implications for recruitment to the specialty and should be used to inform recruitment strategy moving forward.

Assisted suicide is an emotive issue that will undoubtedly continue to grab media headlines, especially as medical science is able to prolong survival in chronic medical disorders. The law in the UK as applied under the Suicide Act 1961 is currently very sympathetic to cases of assisted suicide, whereby the individual has travelled abroad to a country where it is lawful to end their life, in that people assisting them and thus committing an offence have not been prosecuted. This article analyses a recent High Court case pertaining to the Suicide Act 1961 demonstrating the central importance of the Human Rights Act 1998 in such cases. It then discusses implications for clinicians and the future of the Suicide Act itself.

There is growing interest in music-based therapies for mental/behavioural disorders. We begin by reviewing the evolutionary and cultural origins of music, proceeding then to discuss the principles of evolutionary psychiatry, itself a growing a field, and how it may apply to music. Finally we offer some implications for the role of music and music-based therapies in clinical practice.

The Mental Health (Care and Treatment) (Scotland) Act 2003 contains major amendments to the Criminal Procedure (Scotland) Act 1995 that have a direct effect on the assessment and management of mentally disordered offenders. The major developments and provisions of this new legislation are described.

Three hundred randomly selected fund-holding general practitioners were sent a questionnaire that asked them to indicate their priorities for child mental hearth services. They were also asked to rate their local child mental health services; 210 (70%) returned completed questionnaires. Items accorded the highest priority by the largest number of GPs included written communication, short waiting time following referral, sensitivity to patient's cultural background, child sexual abuse services, and mental handicap services. Child psychiatrists were seen as the most essential members of multidisciplinary teams, and family therapy was the most popular choice of treatment. Financial considerations did not appear to dictate GPs' choices. About half of respondents rated their local services as barely satisfactory, unsatisfactory or extremely unsatisfactory.

On 30 November 1993 a nine year political debate on euthanasia closed; the first chamber of the Dutch parliament ratified the law on undertaking, including euthanasia regulations. This political step concluded, for the time being at least, a legal, public, political and medical debate, which started in 1973, when a medical doctor was convicted for performing euthanasia on her mother. In a first effort in 1983, parliament failed to legalise euthanasia. In 1989 a new government introduced an initiative to improve the existing law in this regard. As a part of the process, empirical data on the extent of euthanasia in The Netherlands were required. Therefore, the Minister of Justice installed a committee. Its findings have been reported nationally and internationally (van der Maas et al, 1991a, 1991b); about 2,300 euthanasia cases in 1990, being 1.8% of all deaths. These empirical findings reduced the uncertainties about the extent of euthanasia, thereby providing a sound basis for the parliamentary decision-making process. Although by the current law euthanasia and assisted suicide still remain illegal, under strict guidelines for behaviour provided by the Ministry of Justice in November 1990 and distributed among physicians in January 1991, euthanasia can be exempted by the public prosecutor from criminal punishment on the basis of the ‘opportunity’ principle, this being the opportunity for the public prosecutor not to bring all reported crimes to court (Letter of the Minister of Justice to Parliament, 1990).

The practice of psychiatry in the UK has for most of its existence been focused on the needs of adults, and it has been with this age group in mind that educational programmes and training needs have been formulated. It is not surprising, then, that the content and shape of psychiatric training programmes have followed this clinically-driven pattern. Trainees entering psychiatry begin their clinical careers working with adults or older people and are expected to obtain a grasp of the fundamental clinical tools of the trade working with these populations. Experience with younger people's mental health is explicitly excluded in the first year of training, emphasising the primacy of adulthood in the approach to learning clinical mental health skills.

There are two medical schools in Hong Kong, that of the University of Hong Kong and that of the Chinese University of Hong Kong. The former has a history of more than 100 years whereas the latter admitted its first batch of students only in 1981. Both use English as the teaching medium and both are recognised by the GMC. I received my undergraduate medical education in the former but have been teaching in the latter for seven years.

1. These recommendations are derived from the report of a working party on education and training set up by the Section for Social and Community Psychiatry in 1984. A companion paper deals with recommendations for Senior Registrar posts in Rehabilitation and in General Psychiatry. The recommendations for the most part do not represent new departures, but are mainly explicit descriptions of what is currently included in good training programmes, developments which are already increasing or recommendations made in previous documents. With the forthcoming expansion of psychiatric care in the community, appropriate training is increasingly required.

Treatment provision for individuals with gambling problems in Britain is at best inadequate. Here we call for gambling treatment provision to be integrated into mainstream drug and alcohol services, and for its commissioning responsibilities to fall under local public health departments.

The recent formation of a Liaison Psychiatry Group within the College reflects the growing integration of psychiatry with other medical specialties in the general hospital. The Group was established to foster the development of psychiatry in relation to medical and surgical patients, including its clinical, teaching and research components. The title, Liaison Psychiatry, is not an ideal term but has become firmly established in other countries to denote that area of psychiatry where the psychiatrist has particular skills to contribute to the care of the physically ill, and to those in whom psychiatric disorder presents in somatic terms.1

Air travel is now a common feature of most of our elderly population's lives. There is little by way of warnings, rules or recommendations for our patients with psychiatric diagnoses, in particular dementia, who intend to travel by plane, in contrast to other specialties. In this article I highlight an adverse outcome of long-haul air travel as a result of delirium and resulting accelerated decline in overall cognitive function. I review literature related to the topic and suggest ways to minimise precipitating factors for stressors prior to and during flights. This article suggests that more thought should be given to the title question.