This study evaluates the effects of moving an acute psychiatric ward from a psychiatric hospital to a district general hospital. A repeated measures design is used covering the three phases of shortly before and after the move and a follow-up 10 months after the move. Eleven measures were used including daily measures of patient disturbance and staff stress, length of stay, diagnosis and a consumer survey. Overall there was little change from before the move to follow-up. Two second-order variables relating to staff stress did, however, show a clear reduction.

Until recently, a doctor beginning a career in psychiatry would usually apply for a combined SHO/registrar rotation lasting approximately 3½ years. Trainees could expect promotion from SHO to registrar after about 18 months, subject to passing the Part I of the MRCPsych examination and also to their educational and clinical progress having been judged to be satisfactory by the scheme tutor and organising committee. Life has changed! The emergence of Achieving a Balance (Department of Health, 1988), the proposals of which are intended to be phased in over the next ten years, has meant that scheme organisers have had to quickly change the basis on which their rotations are run. This paper is an account of how this has been done in the SE Thames Region.

The host country's legacy after the Olympic Games is multifaceted. Alongside such diverse elements as tourism, commerce and transport sit the health benefits of increased participation in sports and provision of the highest quality medical support for the nation's elite sporting performers. Mental health, however, merits no specific mention. This could be a missed opportunity to create a legacy that promotes the mental health benefits of exercise as well as ensuring that the mental health needs of elite sportsmen and women are recognised and met in the same manner as their physical health needs.

There is an identified need for more psychiatrists who have been trained in cognitive-behavioural therapy (CBT). The Royal College of Psychiatrists' guidelines for psychotherapy training recommend that all psychiatric trainees receive CBT training. This paper describes a brief programme of CBT training for psychiatric senior house officers (SHO) which demonstrates a viable model achieving limited training objectives.

The adolescents (n=57, age 13–19 years) attending the special schools for moderate and severe learning disabilities in a South East London health district and their families were assessed. The mothers of adolescents with severe learning disabilities in the transitional stage to adult services and development reported greater behaviour problems in their offspring, greater stress, more negative psycho-social family effects and more negative attitudes. Implications of the results for interventions, needs assessment and future research in family and adolescent functioning and the origins of psychiatric morbidity in young people with learning disabilities were discussed.

The natural grouping of training rotations in psychiatry into those based on a central University Teaching Hospital and those in a peripheral location invites comparison between the two groups. Training perspectives in two neighbouring schemes, one in each category, have been explored recently (McWilliam & Morris, 1988). It was noticed that, although styles differ, resulting clinical competence is comparable. An important part of clinical training is out-of-hours experience. For approval of a rotational scheme, experience of on-call duties and emergencies is necessary (Royal College of Psychiatrists, 1987). We were interested in comparing on-call duties in two different types of scheme, one in Sheffield, the other in Chichester.

The recently published Count Me In 2007 census specifically reported age-standardised admission rates for individuals aged over 65 years from different Black and minority ethnic groups. the standardised admission ratio was higher in the White Irish, other White, White and Black Caribbean, other Asian, Black Caribbean, Black African and other Black ethnic groups; and lower in the White British and Chinese ethnic groups. As this census was undertaken on a single day for all psychiatric in-patients, it measured bed occupancy rather than admission rates and so it was actually referring to standardised bed occupancy ratios. Bed occupancy is a function of admission rates and length of stay. This editorial critically explores factors (including those related to institutional racism) that may affect both admission rates and length of stay, and ultimately bed occupancy, of Black and minority ethnic elders.

The Dutch have a tradition of tolerance and pragmatism in the fields of social policy, and nowhere is this better illustrated than in their policy and practice in the field of drug misuse. Indeed often exaggerated accounts of Dutch ‘liberalism’ are promulgated, and articles in the press have suggested a backlash is now occurring in Holland to these ‘progressive’ policies (Williams, 1989). The award of a Council of Europe Fellowship gave me the opportunity to spend two weeks in the Netherlands in October 1989, visiting drug services and talking to a wide range of people with responsibilities for such services. I was particularly interested to see how the Dutch were responding to the challenges of HIV infection in drug users (Fleming, 1989).

How relevant is the training which postgraduate psychiatrists from the developing world receive in the West? Are the investigations, treatment, and clinical practices taught in the UK transferable across widely disparate cultures? Should trainees be taught basic psychiatry or only sub-specialities? Should they come at all?

Community support teams are an important component of services for the chronically mentally ill who do not need to remain in hospital. In the autumn of 1989 the Department of Psychiatry in Central Manchester established a small team with a remit to develop such a service. The team is made up of four nursing staff (a charge nurse, staff nurse, SEN and a nursing auxiliary) with additional support provided by two occupational therapists, a clinical psychologist, consultant psychiatrist and senior registrar in rehabilitation psychiatry. This paper will briefly describe some of the experiences and problems that the service has encountered so far and some of the solutions that have been explored.