Sleep disorders are common in psychiatric and non psychiatric consultations. Yet there is very little education and training available to medical trainees in the UK. In this paper we describe our experience in a sleep laboratory during a part time six months attachment. We feel that a basic knowledge and experience in assessment, investigations and treatment of sleep disorders and involvement in academic and research activities in this field should be considered to be a part of the psychiatric training schemes.

The incoming editor Dr Norman Poole sets out a vision for his tenure at the helm of the BJPsych Bulletin. There will be redoubled focus on training and educational articles and an engagement with the cultural and social ramifications of this most vital of specialisms.

Night-time confinement, currently imposed as a blanket restriction on all patients on wards in UK high secure hospitals, constitutes an arbitrary restriction of liberty, not being based on any therapeutic purpose for those so restricted, nor serving a need for the protection of others. Its imposition constitutes a form of ‘degrading’ treatment as well as an unjustified restriction of ‘residual’ liberty. Persons who are vulnerable, especially those who are involuntarily detained as in this case, are particularly at risk of suffering human rights abuses. A compelling case can be made, based on ethics, law and accepted practice standards, for ruling out night-time confinement as an acceptable measure.

In this article we give an alternative view of service provision for adolescents with emotional difficulties centred around four high schools. We believe that the service we offer differs in a number of ways and has a number of benefits for clients and other pupils and staff at the schools. We present this view of our service with some information about its historical context and as a snapshot of the current state of the service in the expectation that there will be further developments.

In recent years, the Royal College of Psychiatrists has been engaged in activities to ensure parity of esteem for mental health within the National Health Service, seeking to bring resources and services more in line with those available for physical health conditions. Central to this has been the promotion of psychiatry as a profession that takes a biopsychosocial approach, considering all aspects of the patient's presentation and history in the understanding and treatment of mental disorders. However, there has been a drift away from considering the psychological aspects of the patient's difficulties in recent years. This potentially has profoundly negative consequences for clinical care, training, workforce retention and the perception of our identity as psychiatrists by our colleagues, our patients and the general public. This editorial describes this issue, considers its causes and suggests potential remedies. It arises from an overarching strategy originating in the Royal College of Psychiatrists Medical Psychotherapy Faculty to ensure parity of esteem for the psychological within the biopsychosocial model.

This study surveys the extent of substance misuse behaviour among secondary students in Hong Kong. One-fifth of the sample were misusing substances themselves and one-quarter had friends misusing substances. On seeking help regarding substance misuse, two-thirds would see the school social worker; the second preferred helper was a friend.

This very large training scheme was formed at the suggestion of the then newly appointed Professor of Psychiatry, Ian Brockington, who saw that in the existing rotations the balance between specialty and general posts was very uneven. He also argued convincingly that it would attract more trainees of high calibre and improve the morale and enthusiasm for training of the consultants, particularly in those rotations which had difficulty recruiting junior doctors or had failed to achieve more than provisional approval by the Royal College on repeated accreditation visits. The new scheme was launched in 1984 following the establishment of a Steering Committee including representatives of the psychiatric divisions of the five Birmingham Health Authorities and the adjacent Sandwell and Solihull Health Authorities, of the University Department and of the various specialties such as child psychiatry. All the Authorities agreed to pay jointly for a clerical officer to service the scheme and Solihull undertook to provide accommodation and a Medical Personnel Officer with specific responsibility for the scheme. A senior universally respected Clinical Tutor, Eddy Sethna, was elected Organising Tutor and given full authority to manage the rotation, reporting twice yearly to the Steering Committee which would advise on any difficulties which he could not resolve directly with trainees, trainers or divisions and would agree additions or modifications to the scheme.

The object of this paper is to set out some of the difficulties experienced in early training in Psychotherapy.