To investigate the attitudes that psychiatrists hold towards people with mental illness. Each member of the Royal College of Psychiatrists in the UK was sent a questionnaire based on previous research in this area, supplemented with relevant questions on management.

2813 of 6524 questionnaires were returned (43%). Psychiatrists' attitudes compared favourably with those of the general population. Among other findings, they believed that the risk of dangerousness was overemphasised, that misdiagnosis of schizophrenia in Black people is common, and that polypharmacy and the use of antipsychotic medication above British National Formulary levels occurs too often.

Psychiatrists' attitudes are substantially more favourable towards people with mental illness than those of the general population with individual, but important, exceptions. Some aspects of psychiatric management, especially of antipsychotic medication, may undermine this, however. Comparison with other groups, e.g. general practitioners, nurses and social workers, would be useful in planning how to reduce the stigmatisation of people with mental illness.

A pilot study was set up to compare a symptom-triggered ‘front-loading’ detoxification technique with the usual fixed dosage method. A group of 23 in-patients with alcohol dependence were randomised to receive either the intervention technique using diazepam or the standard chlordiazepoxide taper over 10 days.

The intervention group received a mean dosage of 74 mg diazepam (equivalent to 222 mg chlordiazepoxide) compared with 700 mg chlordiazepoxide in those receiving usual treatment. There was no statistical difference in the severity of alcohol withdrawal symptoms in the two groups, and the intervention group were slightly more satisfied with their treatment than the group undergoing the usual detoxification treatment. Feedback from the nursing staff was positive towards the new approach but highlighted some potential problems for its wider implementation.

It was possible to use a simple randomised trial design to introduce a new technique for alcohol detoxification to a specialist unit. Symptom-triggered front-loading detoxification using diazepam was as effective as a standard taper technique in terms of withdrawal severity reduction, and was acceptable to both patients and staff. This is potentially a useful technique for busy acute psychiatric wards.

A questionnaire was sent to old age psychiatrists to ascertain their experience, views and clinical practice regarding psychological therapies in their services.

The provision of psychological treatments of all modalities to older people is widely varied in Britain. The main difficulty seems to be a lack of resources, but it would appear that inexperience with psychological therapies applied to older adults is also a factor. Most mental health teams (95%) provide anxiety management therapy, and cognitive–behavioural therapy is widely available (76% of teams), but areas such as training and staff supervision appear to be poorly provided.

Suggestions are made to increase provision and quality of service within existing resources; improving services to the standards of the National Service Framework would be a bigger challenge.

Computers and information technology (IT) play an increasingly important role in the working lives of psychiatrists. Previous studies have shown that computer access and skills among psychiatric trainees were inadequate. This survey aimed to assess the level of access to, and skill in, different IT applications among consultants and trainees in Northern Ireland, as well as what training is offered and needed.

Most doctors (91%) had access to the more basic applications, such as word processing, and most felt at least adequately skilled. However, access to and knowledge of statistical software was particularly poor. A minority of doctors were offered training in IT (39%), even though most employers provided this facility.

Psychiatrists need greater access to IT, and need to make greater use of available training. This is especially relevant in light of future policy directions and the trend for evidence-based practice.