Recent attention has been focused on divergent practices in the implementation of Section 136, problems in its practice encountered by the police, and possible means of improving the service and reducing unnecessary detention. In these studies, doubts have been raised about the justness of the section, both in principle and in practice, and about the efficiency and efficacy of its implementation. In the context of the closure of the large psychiatric institutions it seems probable that these issues will become increasingly acute. The purpose of our brief study was therefore to investigate the trends of admissions to Friern Hospital, not only of patients under Section 136, but of all patients accompanied by the police.

Direct access residents in an inner London homeless women's hostel were interviewed and asked to provide information on medical, personal and social history. For each a DSM–III–R diagnosis, General Health Questionnaire, CAGE and Global Assessment Scale score was assigned, and their views on future housing were sought. The effect of severe mental illness (SMI) and age on dependent variables was examined. A third of the sample (n=14) suffered from SMI, and a further quarter from other mental illness (n=10). A quarter had a DSM–III–R substance misuse disorder. The prevalence of SMI was similar across age groups. Younger women had a different pattern of service needs, with greater levels of psychological distress, substance misuse and residential instability, than older residents.

Candidates' views regarding examinations in psychiatry have been highlighted in recent years. Few studies to date, however, have examined the views of the patients themselves toward the examination procedure. This study examines the knowledge and experience of a patient group participating in the College membership examinations. Providing patients with written information prior to the examinations significantly improves their knowledge and experience of the exam procedure.

The recent release of British and American hostages held by fundamentalist Islamic groups in Lebanon has received national and international publicity. The Psychiatric Division of the Royal Air Force Medical Service has been involved with the management of released British nationals and others but, in the interests of the hostages and their families, has delayed public discussion of the matter. From the British and American viewpoint the recent hostage crisis in the Lebanon has now resolved. It therefore now seems appropriate to describe in general terms the principles upon which early management was based.

The move towards community care essentially aims at the provision of a comprehensive psychiatric service in each District with facilities for the chronically disabled based outside the hospital for the greater part. Parallel with this move runs the aim to close all large mental hospitals. The present debate centres around the extent to which we can move towards a system of comprehensive District psychiatric services alone at this stage in time and the question of whether it is desirable to abandon totally the large psychiatric hospital style of care. The brief of this paper is to summarize the reasons for concern about a wholesale move towards District-based services from the large mental hospital from the psychiatrists' view-point. Unfortunately, much of the debate is based on speculation because of the experimental nature of this move and the fact that objective research is lacking on any changes already made in this country.

Few recent studies have investigated the prescription of electroconvulsive therapy (ECT) to depressed patients and their progress thereafter under ordinary clinical conditions. From case records, 412 courses of ECT were studied. ECT was efficacious in the short term, especially for patients with psychotic depression and for those over 65 years of age. Fifty-three per cent of patients required readmission in the six months following the index course. Neither age nor psychosis predicted whether readmission occurred. While short-term outcome is good, notably for the elderly and the psychotically depressed, patients are highly liable to relapse after ECT. High quality after-care is thus of paramount importance.

The question is often asked: “Does family therapy work?” This is an important but useless question. It is important because an enormous amount of time, energy and money is put into the clinical practice of family therapy. It is practised in every continent; there are many training courses and qualifications in very many countries, and there are over 40 journals devoted to families and family therapy. Yet there is a healthy and justified scepticism. So yes, we ought to ask whether it works.

HIV infection is a relatively new disease affecting families (Pizzo & Wilfert, 1994). As with other chronic and life-threatening illnesses, families are faced with many changes and losses as well as much uncertainty about the future (Eiser, 1990). Unlike most other conditions, however, there can be extra stigma-related stresses, such as fear and secrecy, which can compound existing burdens of illness and coping (Richmond & Ross, 1995). As further knowledge of the full impact on HIV on families evolves, there is a need to consider the effects of multiple loss and changes on the mental health and adjustment of the children as well as their parents (Melvin & Sherr, 1995; Reidy, 1995).