Over many years and with various pieces of new legislation there are significant gaps in doctors' knowledge about mental health law. It is time to ensure that doctors know the law and can apply it to the patients they see. Practising legally and not detaining or allowing people to leave hospital inappropriately should be a mandatory part of training for every doctor no matter what the specialty. Medical schools, deaneries, training programme directors and the General Medical Council should take up the challenge and ensure good-quality training for all doctors to ensure good-quality care in this area is given to all patients.

The recent prominence of medical audit in psychiatry is due in large measure to the place given to the subject in the government's White Paper Working for Patients (DoH, 1989a). However, medical audit existed before the White Paper and covers a broader scope than the White Paper proposes. Thus in considering the introduction of audit into the mental health services it is important not to allow the White Paper to narrow the field of view.

In a rapidly changing NHS, there is a great awareness of the need to consult with general practitioners about their expectations of a service. A number of studies have looked at GPs' perceptions of psychological and psychiatric services (e.g. Eastman & McPherson, 1982; Whitfield & Winter, 1980) but to date little is known about how GPs view psychotherapy services. About 40% of the referrals to the Leicestershire psychotherapy department come directly from GPs and the present study aimed to ascertain local GPs' perceptions of the service. This was timely for the purpose of planning local development but clearly has important implications for psychotherapy services in general.

The patient absconding without leave (AWOL) produces considerable anxiety to staff, relatives and the public, and involves a great deal of staff time in notification, search and enquiry to the detriment of the care of other patients. Incidents of AWOL are potentially dangerous and all efforts to predict these incidents and to deal with them appropriately should be made.

The volume of literature on medical audit and the broader field of quality assurance is expanding rapidly. Medical audit is now a requirement for all medical practitioners; therefore, to perform it, they need to know something about it. There is a multitude of articles written in the journals, especially the British Medical Journal and the Journal of the Royal Society of Medicine. However, in this paper I intend concentrating on some of the many books pertaining to this field which have been published recently.

This is the second of two articles on GP referrals for compulsory admission, and seeks to examine the process and outcome of assessment by (a) comparing GP with other section assessment referrals and (b) comparing GP referrals who were compulsorily admitted to hospital with those not compulsorily admitted or voluntarily admitted. In relation to the law the main relevant sections for this article are sections 2, 3 and 4. There are two basic grounds for admission: that the patient is suffering from a mental disorder and that admission is in the interests of his/her own health or safety or for the protection of others. Section 4 requires one and sections 2 and 3, two medical recommendations, as well as an application by an approved social worker (ASW) or nearest relative. Section 2, admission for assessment, involves admission for up to 28 days; section 4, emergency admission for assessment, involves admission for up to 72 hours; and section 3, admission for treatment, allows admission for up to six months, and is renewable.

It has been recommended that child and adolescent mental health services operate on four tiers (NHS Health Advisory Service, 1995). Tier three represents specialist teams, where professionals work together to provide specialist services. Since additional resources have not been forthcoming to support such developments, existing teams frequently restructure themselves in order to operate in this way. One way of rationalising existing resources effectively is to establish interagency links so that multi-disciplinary working is not limited by professional boundaries. This can occur across as well as within teams.

The structure of mental illness services is changing rapidly. Large hospitals are closing or preparing to close and the service will be provided in other ways, partly by smaller units, partly by increased care in the community outside hospital and partly by amalgamations of two or more large hospitals. Smaller units allow closer working relationships with GPs, social workers and other professionals.

The David Lewis Centre for Epilepsy has approximately 300 adult residents. All have epilepsy, which is often only partly alleviated by available treatments; many have mental handicap or psychiatric illness, adding to their total disability. The Centre's explicit aim of understanding and caring for people with epilepsy implies concern not just for clinical measures such as seizure frequency, but for our residents' quality of life.