The main aim of this pilot study was to identify factors influencing acute psychiatry bed use. The reasons for occupying a bed vary with time, so patients in the study were assessed on a weekly basis to monitor the changes in the factors thought to be responsible for continued stay. The reasons for bed occupancy also are often only known to those professionals directly involved in day to day care of patients, and it is suspected that the reasons often have little to do with manifest psychiatric illness. The reason for this study was to investigate this question.

Literature searching has been revolutionised by the desktop computer. Today it is almost inconceivable to be without the tools to efficiently and comprehensively examine the medical literature. However, as this biomedical literature grows ever more vast, researchers and clinicians need to know which of the many biomedical and psychiatric databases will best cover their particular area of interest. No databases can cover everything. It is necessary to select the most appropriate source of information for the task at hand and for a literature review this will usually entail the use of multiple methods of data collection. In this brief review databases of particular interest to psychiatrists are discussed.

Preservation of the world's rainforests and other natural habitats can be argued for from several points of view. Maintaining biodiversity and preventing the ‘greenhouse effect’ are two commonly stated objectives. A less altruistic reason is that many of the floral species in such habitats remain unstudied and could yield new and important drugs to treat human diseases. Many of the drugs we use today are derived from plants or are their synthetic derivatives.

For many years, doctors in the staff grades, clinical assistants and associate specialists have made a substantial contribution to the care of psychiatric patients in the NHS but their position within the NHS and the College has been largely unrecognised. This article will describe recent attempts to remedy this situation. Numerically they comprise an important group of doctors (Table 1) and have always been more important in psychiatry than in other specialities, particularly in non-teaching districts where there are fewer consultants and junior doctors.

I have recently addressed myself to the problems of teaching medical students. In my case it is that of teaching the principles of psychotherapy. It is difficult to teach about the doctor–patient relationship in the normally accepted lecture form. Definitions of transference, psychological defence mechanisms or empathy can be given, but this gives no impression of what is meant at an experiential level.

The Centre Hospitalier Specialise de Ville-Evrard is situated 17 kms from the centre of Paris and serves an area of approximately a quarter of the north-eastern outskirts of the city. I visited as one of a multi-disciplinary party of 20. The visit took place over five days and returned their visit to Bexley Hospital, Kent in South East England, which took place in November 1989. English lessons take place in the hospital as part of the hospital's responsibility for continued education for its employees and they had initiated the visit to England to improve the standard of their English.

The DHSS/College recommended establishment for consultant posts in the psychiatry of mental handicap is one whole-time equivalent per 200,000 population.1 In 1982 the theoretical average in the English∗ regions was 1:321,000, varying between 1:153,000 (South West Thames) and 1:620,000 (North West). There were, however, 41 vacant posts, 19 of which were occupied by locums,2 so the actual substantive average was 1:612,000. By 1983 the number of vacant posts had risen to 49 and the substantive consultant/population ratios varied between 1:202,000 (South Western) and 1:2,170,000 (North Western).3

This study involved a case-note review of referrals to community psychiatric services in a university town in New Zealand. About one third of all 163 patients referred were taking antidepressants for depression; of these one third were taking therapeutic doses, with the remainder taking inadequate doses. This tends to confirm the findings of other studies that have identified problems relating to GP prescribing of antidepressants.

Although the process of psychiatric reform is taking place across Europe, national political, economic and historical factors determine to a large extent the manner and pace of its implementation as well as its final shape. The degree of centralisation of health care systems and the degree of prominence of primary care affect how efficiently change can be achieved. Various forms of professional resistance may, in different degrees in European countries, hamper the implementation of community care. The widely varying contexts in which psychiatric reform takes place throughout Europe, should provide a fertile area for future comparative research.