Changes in the structure and organisation of health services are requiring clinicians to take on managerial and administrative responsibilities The need for training in managerial skills has, therefore, been endorsed by the College. This article discusses one of the key concepts in management, the business plan. We briefly describe the steps involved in writing a business plan, illustrated by a hypothetical example.

This paper describes a systematic, voluntary and confidential reporting scheme of new cases of occupational stress and mental illness in the UK (SOSMI). This scheme was designed to gather information on specific types and frequency of ill health seen by consultants within the specialty of psychiatric and psychological medicine. Information obtained from reporting schemes such as SOSMI is crucial in the recognition, understanding and prevention of work-related diseases, as this might come to the attention of specialists long after the patient has left the workplace responsible for the illness.

This paper aims to help trainees successfully negotiate the important ‘step up’ from senior house officer or equivalent grade to specialist registrar. It outlines the current structure of higher specialist training programmes in psychiatry, stresses the importance of early planning during basic specialist training and provides a guide to success in the shortlisting and interview stages.

In autumn 1996, under the Presidency of Dr Robert Kendell, the College decided to mount a campaign to tackle the stigmatisation of people with mental illnesses. In 1997, a working party proposed goals, content, process and a 5-year governance. Other campaigns, both here and abroad, have either generically addressed ‘mental health problems' (e.g. Mind's ‘Respect’ Campaign) or targeted a specific mental illness, e.g. the World Psychiatric Association's anti-stigma campaign in respect of people with schizophrenia. Our working party decided that it might be timely to recognise the differences in public attitudes to the variety of mental illnesses. The campaign thus addressed six categories of mental illness: anxiety disorders, depressive disorders, schizophrenia, the dementias, eating disorders, and drug and alcohol misuse/addiction. Target populations were identified as doctors, children and adolescents, the workplace, the media and the general public. The working party had also secured funding and arranged for a survey, in July 1998, by the Office for National Statistics of opinions of the British public concerning people with these mental illnesses (Crisp et al, 2000). The Campaign started on 7 October 1998. Since that time, and drawing upon our survey findings within its initial literature review (Kelly, 1999) the Department of Health mounted its own anti-stigma campaign, ‘Mind Out for Mental Health’, which addressed a similar range of mental illnesses.

Disenchantment with Santa Claus is a rite of passage that usually signals the adoption of an adult-defined reality. The ethics of the custom, which has been described as misleading, have recently been debated and there are suggestions that it is less well maintained than in previous years. This short article explores some of the sociocognitive benefits of promoting the Santa Claus tale and its associated customs. Sociological theories suggest benefits in family bonding and pro-social behaviour, including sharing. Cognitive theories describe enhanced fantastical thinking, expansion of the internal object world and purposeful play. Children may draw parallels between Santa Claus and God, although there is no current evidence that finding out he does not exist impairs their subsequent capacity for religious faith. Whether or not the fable is a threat to the child's trust is to be decided by each parent. On balance, the tale of Santa Claus is a powerful tool that may serve to nurture social and cognitive development, particularly in a technological society where children mature earlier.

Memory clinics have been in existence in the UK for over 15 years. Initially set up for research purposes, these clinics have been transformed by the advent of treatments for Alzheimer's disease. Clinics increasingly provide for early diagnosis, information dissemination, initiation and monitoring of treatment, and education and training. There are variations in clinic design, and availability nationally. There continue to be significant demands on existing services, which have traditionally offered domiciliary care. The valuable contribution of these traditional services deserves greater recognition, as do the benefits provided by memory clinics, which are often not fully appreciated by health care professionals or the public.

This article describes the establishment of a monthly meeting of a group of psychiatrists and other agencies involved in the delivery of emergency out-of-hours care in general adult and old age psychiatry. The meetings are a source of advice, information, opinion and support regarding on-call issues. The scheme has been running for over 2 years in the Portsmouth area, and has proved to be a valuable educational forum.

The Royal College of Psychiatrists is in the last year of its ‘Changing Minds' campaign to reduce the stigma of having schizophrenia, substance use problems, dementia, eating disorders, anxiety and depression. As a mental health service user with a diagnosis of schizophrenia, I have been involved in the campaign since its outset and have become used to blaming the media, especially the tabloid press, for a large part of the stigma that people with mental health problems encounter. However, recently while in hospital I re-read an Agatha Christie book and began to wonder whether crime novels, with their usual starting point of a murder, could actually contribute as much to such stigmatisation. As Agatha Christie was probably the most prolific crime writer in the English language, this article examines some of her novels with a view to discovering the extent to which she played a part in the perception of the ‘mad’ killer.

Access to medical information is going to be extended by recent Government proposals that patients who agree are sent copies of correspondence relevant to their illness and medical treatment. The National Health Service (NHS) Plan for England (Department of Health, 2000) has stated unequivocally that letters between clinicians about an individual patient's care will be copied to the patient as of right. No exceptions have been made and the plan did not suggest that patients suffering from a psychiatric illness are to be treated differently from any other group of patients. However, the Department of Health has recently stated its intention to fund a series of pilot projects to test some key concepts before the policy is fully implemented in 2004. A number of areas to be informed by pilot work have been identified. These include the style and content of letters, testing formats and language that patients find acceptable and particular issues concerning mental health, children and carers (www.doh.gov.uk/patientletters).

It is a stressful experience for parents and/or carers when their child is admitted to an in-patient unit because of severe mental illness.

From late October each year, bleary-eyed postal workers all over the UK sit in shifts, sifting through some 120 000 children's letters addressed to a rubicund, septuagenarian, airborne logistics expert living in the frozen Arctic. In accordance with guidelines, every letter is screened for signs of neglect, abuse or some other singularity. Every year, several escape the shredder. One year, a thoughtful 10-year-old wrote.

Air travel is a rapid and efficient mode of travel nationally and internationally. People with a psychiatric disorder can usually travel safely, but may at times require an escort. People whose mental state or behaviour are disturbed are not fit to travel until stability has been achieved. Suicidal or homicidal behaviour by those so disposed are fortunately rare, but can be catastrophic in outcome. Careful assessment is necessary, and psychiatrists are advised to be more aware of the possibility of liaison with airport medical services when appropriate.

A 19-year-old woman developed an immediate psychotic reaction following intravenous administration of clarithromycin. She responded to atypical antipsychotic drugs but needed psychiatric hospitalisation. She recovered after a year and is now symptom-free without any medication. This is a rare side-effect, but needs to be recognised.