The community psychiatry service in Bassetlaw District has been developing since 1984 and provision includes hospital hostels, supervised flatlets, nursing and rest homes, group homes, cluster flats and warden assisted accommodation. Close liaison with an enthusiastic Local Authority Housing Department has also led to the development of a new initiative, an unstaffed flat for use in crisis intervention and rehabilitation. Placements in the flat are described over the first 12 months of its existence.

There has been much debate about effective treatments, service configurations and costs within Britain's mental health care system, but it has largely taken place in academic and management circles. We were interested in the views of those providing care. We organised a meeting of community psychiatric nurses, general practitioners and consultant psychiatrists (funded with an educational grant from Zeneca Pharmaceuticals). Participants worked in various parts of Great Britain, including rural and inner city areas. The authors facilitated the discussion, the emphasis of which was on participants' clinical experience.

With the implementation of community care and resettlement programmes, the extent, frequency and the management of emergencies in the mentally handicapped population have attracted a good deal of attention. Among the issues of importance are crisis in the community and unnecessary and repeated hospital admission; inappropriate emergency referrals leading to abuse of services; the need for emergency services and the importance of short term admission facilities (Nolan et al, 1992). While the number of psychiatric emergencies in people with mental handicap is not large, the trend towards living in the community has brought the need to monitor such referrals.

A previously unknown Spanish-language mutual aid resource for substance use and mental health concerns is available in Latino communities across the USA and much of Latin America. This kind of ‘4th and 5th step’ group is a ‘culturally adapted’ version of the 12-step programme and provides empirical grounds on which to re-theorise the importance of spirituality and culture in mutual aid recovery groups. This article presents ethnographic data on this organisation.

The Royal Society is the oldest scientific society in Great Britain and one of the earliest in Europe. It is usually considered to have been founded in 1660, though a nucleus had been in existence for several years before that date. From Charles II's reign onwards, British Governments have constantly appealed to the Royal Society for advice in connection with scientific undertakings. The Society elects some 32 Fellows annually, who have been proposed by six or more existing Fellows. Foreign Members, not exceeding 50 in all, may be selected by the Council from among “men of the greatest scientific eminence” abroad. From this it can be seen that Fellows of the Royal Society are among the most distinguished scientists in the country. It is not widely known that several psychiatrists have been Fellows of the Royal Society.

There hat boon until recently a dearth of descriptions of locally targeted community mental health services. Such a service, developed by changing a traditional psychiatric service in an inner setting, is described. The service addresses the needs of those with predominantly severe/enduring mental health problems, by increasingly using research based treatments in an ordinary district setting.

The current situation in Soviet psychiatry needs a surrealist of Kafka's skill to describe it. On the one hand, an increasing range of Soviet journals have, since last November, been forthrightly saying what Soviet dissidents and Western observers have said for 20 years. This is that politically motivated abuse of psychiatry has taken place in the USSR on a large scale for decades, causing enormous human suffering. Second, some of these journals point out that abuses, though much reduced in scale, continue to occur today.

British mental health trusts are trying to organise and deliver services based on recovery principles. Psychiatrists are perceived to be either reluctant or opposed to adopting these principles, although there is some support for recovery-oriented practice. In this paper we highlight the recovery needs of psychiatrists and propose a framework of internalising recovery principles in order to develop recovery-conducive habits based on Stephen Covey's popular book The 7 Habits of Highly Effective People.

We were interested to read J. J. Hutchinson and A. Puranik (1992) on journal clubs at St Edward's Hospital, and would like to share our experience of running journal clubs in Sheffield. As stated, the College does not provide guidelines on the format of journal clubs, but they do provide a suggested reading list. While this contains interesting and relevant papers, it does not provide a good basis for a journal club programme.

Conventional antipsychotics, historically the mainstay of schizophrenia treatment, were ineffective in many patients, at least 30% fitting treatment-resistance criteria (Kane & Lieberman, 1987). All had the same mechanism of action: none was any more effective in the individual than any other. Therapeutic nihilism accepted poorly controlled positive symptoms and disabling negative symptoms: nearly all patients suffered side-effects (Barnes & Edwards, 1993), particularly extrapyramidal side-effects (EPS) and hyperprolactinaemia. Conventional antipsychotics raise prolactin to a range associated with sexual dysfunction or even macroprolactinoma: effects in men include erectile dysfunction and hypospermatogenesis; in women, galactorrhoea, oligo- or amenorrhoea, hirsutism and increased risk of osteoporosis. In both men and women there is loss of libido, and a link between hyperprolactinaemia and weight gain.

Sir James Crichton-Browne (1840–1938) held a uniquely distinguished position in the British psychiatry of his time. Unburdened by false modesty, he called himself ‘the doyen of British medical psychology’ and, in the narrow sense, he was indeed its most senior practitioner. At the time of his death, he could reflect on almost half a century's service as Lord Chancellor's Visitor and a similar span as a Fellow of the Royal Society.

Service user memoirs are frequently reviewed in The Psychiatrist and other related journals. Some academic publications include first-hand accounts of mental ill health, and there is a lively market for autobiographical books and articles about mental illness. But clinicians already have extensive contact with service users and it might seem unlikely that they have much to gain from reading memoirs. In this article I suggest that the greater depth of reflection in published memoirs means clinicians do in fact have something to learn. I illustrate my argument by showing how memoirs cast a light on the world of information and conclude by suggesting reasons why memoirs raise issues that are of increasing clinical importance.