My paper deals with the provision of psychotherapy services for forensic patients and the training available to the would-be forensic psychotherapist. Psychotherapy in the context of this paper refers to psycho-analytically based psychotherapy, either individual or group, and not to behavioural or cognitive models. In addition, two aspects of psychotherapy should be borne in mind: supportive psychotherapy in the context of ongoing therapeutic relationships (e.g. patients suffering from chronic mental illness) and mutative psychotherapy, which aims to change some aspect of the person. Both aspects are important in the practice of forensic psychiatry, perhaps especially the latter.

The variations in structure and content between Masters degree courses offered to psychiatry trainees around the country are documented. Most courses are integrated to some degree with statutory Membership teaching. The extent to which courses differ is likely to surprise readers. The implications for the junior trainee as well as for consultant or senior registrar appointment committees is discussed. Universities act autonomously, hence a Masters degree awarded by one may bear no relation to that awarded by another.

Uganda has a rich history of medical education (Odonga, 1989) that was severely harmed by the rise of Idi Amin and the years of internal strife. It is only over recent years that the country has begun to rebuild itself (Boardman & Ovuga, 1997).

Of the very large sum of money spent on mental health services, almost all comes from the public directly in the form of central or local government taxation. In 1990, approximately £2 billion was spent in the National Health Service directly on mental health services. That represents 10% of total health service expenditure. In addition, local authority social services departments spend around £50 million annually on residential and day care services for people with mental problems. A further £100 million is spent on supplementary benefit for board and lodgings payments and a considerable amount expended by prisons, courts and the police. These figures omit the growing amount of money spent on supporting elderly people with senile dementia outside mental illness hospitals, in residential and nursing homes. Almost two thirds of all residential care for elderly people provide care for those with mental disorder, adding a further staggering £5–600 million by 1990. The current direct care costs of disabling mental disorder to the public purse is approximately £3,000 million (£3 billion). For all the huge amount of money, resources appear inadequate, ill-directed and uncoordinated. Several actions need to be taken to improve the use of these vast resources.

Convincing international evidence demonstrates that immigration detention adversely affects mental health. During the COVID-19 outbreak, additional concerns were raised about the safety and appropriateness of immigration detention. Consequently, several hundred migrants were released en masse from UK immigration detention centres, and few new detentions took place. Over 70% fewer migrants were held in detention centres in June 2020 compared with December 2019. This large ‘natural experiment’ has demonstrated that detaining fewer migrants is possible and it provides an opportunity to review the necessity for large-scale detention for the purpose of immigration control, as well as its impact on health inequalities. Additionally, given that detainee release arrangements had already been considered unsafe prior to the pandemic, clinicians and service providers should take into consideration that many of those released may not be receiving adequate post-release continuity of care.

As a relative newcomer to the medical undergraduate curriculum, child psychiatry is still looking for ways in which to best convey its message to students. There is fairly general agreement that this should combine opportunities to assess children or at least to observe the psychiatric assessment of problems and to impart basic information on child development and psychopathology.

Detention of general hospital in-patients under Section 5(2) is a rare occurrence. This study of the use of Section 5(2) in general hospitals uncovered a frequent neglect in following the guidelines of The Mental Health Act and The Code of Practice. Surprisingly the conversion rate of Section 5(2) to Section 2 or 3 was similar to that seen in a number of other studies conducted in the quite different setting of large psychiatric hospitals. A number of patient characteristics were identified that appeared to influence whether 5(2)s were converted to an admission Section. Each general hospital needs to develop guidelines to be followed when staff feel that a patient should be detained under Section 5(2) – an example of such a policy is included.

To date, there are few reports on the extent of elder abuse among patients referred to old age psychiatry services. This study examined suspected cases of abuse among new referrals to a community psychiatric team for the elderly, at a time when guidelines and procedures for the detection and management of elder abuse were about to be introduced. of 74 cases assessed, seven (almost 10%) were probably being abused. Several types of abuse were described, with no single pattern, and the professional responses therefore needed to be flexible. The impact of introducing the guidelines win be assessed later.

The views of referring general practitioners (GPs) on a psychogeriatric service were obtained through a questionnaire. Most GPs were satisfied with the service. A number of GPs wanted faster responses to referrals, telephone discussions after initial psychogeriatric assessments and more communication with consultants. In response to these findings, secretarial staff was increased and telephone discussions with referring GPs are to follow initial assessments of all urgent and emergency referrals.

Microcomputers are increasingly being used in psychiatry for a variety of purposes. When used in computer-patient ‘interviews’ they have generally proved acceptable—indeed popular—with psychiatric patients. Automated psychological assessment is one form of computer-patient interview that is attracting much interest. Some of the early applications were with elderly patients. Kendrick has expressed doubts regarding this application with the current generation of elderly people, suggesting that their relative unfamiliarity with computers and video games might cause difficulties.

We visited Italy in 1995 as part of a National Health Service management learning network. We visited Florence, Prato and Arezzo in Tuscany; before moving on to Rome and Milan. L.W. had completed psychiatric specialist training in Italy, prior to doing so in England.

This paper describes the implementation, merits and future potential of the eCPA – a computer-based Care Programme Approach (CPA) system for care planning. The system is designed to improve the quality of information in CPA care plans and, for the first time, to enable the rapid and standardised adoption of evidence-based good practice by all community mental health team (CMHT) staff.

Child and adolescent psychiatry training has progressed considerably in recent years. Additional training posts have been created, as well as senior academic appointments, and some pre-existing rotations have coalesced, allowing innovative schemes of high quality to evolve. CAPSAC (Child and Adolescent Psychiatry Specialist Advisory Sub-Committee) has continued to oversee established standards and encourage these changes.

A month's residence in an elegant stately home, situated among the manicured lawns and gardens of 150 acres of parkland, sounds ideal; when allied with comfortable accommodation, delicious food and thoroughly professional service, it sounds idyllic. When it is being paid for by Kenneth Clarke, it becomes irresistible.