The participation of service users with intellectual disability and carers is essential in medical and psychiatric training at all levels. It validates the training experience provided by incorporating service users' and carers' perspectives and their experience of mental illness/challenging behaviour, anxieties, interactions and feelings generated when dealing with professionals involved in their care, and also provides an understanding of expectations, views on met and unmet needs and how management options are best explained and communicated for meaningful participation in providing consent and in making treatment decisions. This article brings together the benefits of involving service users with intellectual disability and carers in teaching, discussing their roles as trainers, and providing practical tips to plan sessions as well as recognise and overcome barriers.

This study addresses the perception among senior trainees that the lot of a consultant general psychiatrist is currently not a happy one and that transition from training to consultant grade can be difficult. Reasons for this are explored and alternatives suggested that might make the move from senior/ specialist registrar to consultant general psychiatrist a more rewarding and attractive proposition.

Over the past five decades, services for the mentally ill in India have steadily improved. From a predominantly mental hospital based service, provision has now moved to general hospitals and primary health centres. A variety of factors have contributed to changes in the quality of services. This paper briefly reviews the changes and discusses the relevance of some of them.

Huntington's disease is associated with a considerable psychiatric morbidity and mortality. These risks are not confined to the sufferer. The relations of victims, both biological and legal, are also at high risk for significant psychosocial dysfunction (O'Shea & Falvey, 1988). Despite recent advances in genetic research, there is still no cure for this chronic choreodementia syndrome. Medical management is confined to palliation of symptoms. The doctor and the patient's family, in the face of this unpleasant disease, are wont to exercise a variety of psychological defences which may hinder the delivery and receipt of adequate support (Martindale, 1987).

Units to admit psychiatrically ill mothers with their babies to psychiatric hospitals were pioneered follow ing Main's description (1958) of the treatment of mothers with their children at the Cassel Hospital. Particular interest in puerperal psychosis and dis orders of bonding and attachment led to units usually providing for babies below six or 12months. Suggesting older infants should also be admitted, Main referred to the benefits in admitting parents to paediatric wards with ill children, and described how toddlers had been admitted with their mothers at the Cassel. Another early unit at Banstead Hospital cared for schizophrenic mothers with their babies and found that joint admissions lead to faster recovery, lower relapse rates and more babies continuing to live with their mothers (Baker et al, 1961).

This paper highlights the role that the World Wide Web (WWW) has to play as an aid to psychiatry. A basic history of the WWW is provided as is an introduction to some search techniques involved with the WWW. The literature on applications potentially relevant to psychiatry is reviewed using computer search facilities (BIDS, PsychLit and Medline). The WWW is one of the aspects of the Internet that possesses a huge potential for exploitation, both the clinical and research psychiatrist are able to benefit from its use.

There are advantages to be gained from a knowledge of the patient casemix that psychiatric hospitals, and community services, are likely to encounter. In particular the efficient allocation of resources would be better achieved if individuals could be ‘placed’ into groups. These groups would need to be clinically distinct and contain similar members. Previous methods of defining casemix have focused upon clinical diagnosis. However, the effectiveness of diagnosis in predicting resource utilisation is limited. A range of other factors could be used, including comorbidity, severity of illness, and previous hospital contact.

The Third European Trainees Forum met in Copenhagen in May 1995. Twenty-nine delegates from fourteen countries came together to discuss training issues in the European context. Newcomers representing France, Spain and Italy joined representatives from the United Kingdom, Ireland, Norway, Denmark, Sweden, Finland, Greece, Switzerland, Germany, The Netherlands, Belgium, and Portugal. As in previous years, the Forum addressed a number of specific training topics and discussed furthering links with other European psychiatric bodies.

A study of all trusts in England and Wales providing specialist health services for people with learning disabilities attracted an 83.9% response rate. Considerable variation exists with regard to the quantity of services. The relationship between the learning disabilities psychiatrist and National Health Service learning disabilities bed-numbers and learning disabilities health professionals from other disciplines is explored. An appropriate balance needs to be kept in these ratios to reduce stress and burnout.

Most people with severe mental illness (SMI) may now live in the community, but few have jobs and many are socially isolated. Unemployment rates for people with serious mental health problems range from 60% to nearly 100%, and are particularly high if people have additional disadvantages in the labour market – being a member of an ethnic minority, having poor educational and employment history or possessing a criminal record. Unemployment is a cause of poverty, physical and mental ill health and is a cost to the community. Paid employment is central to human health and offers financial, psychological and social benefits to people with mental health problems: an income not derived from benefits, social contacts, a social role other than that of psychiatric patient, psychological recovery and possibly symptom reduction. These psychosocial and health gains may follow from any work – paid employment, low paid or unpaid work, training or education. Many mental health service users want jobs and alternatives to welfare dependency and traditional day centres. The Government wants to improve health and to reduce welfare spending and social exclusion. For deinstitutionalisation to achieve social integration and employment as well as relocation there is a need for a range of actions; public psycho-education, political reform and development and research of modern alternatives to sheltered work and industrial therapy.