“We have no credibility”. That was the response of a woman with a mental illness who put a complaint to the Health Service Ombudsman. Unlike many – not just patients but also a significant number of NHS staff – she had heard that the Ombudsman could carry out a completely independent investigation of complaints although she was not clear about the extent of his jurisdiction. Some people feel intimidated when trying to take on what they see as a powerful and defensive NHS and others experience a sense of despair that because of their illness their concerns have no validity. Those providing care and treatment generally do the best they can to attain high professional standards but delivery does not always match expectations and the outcome can be a complaint. Services for the mentally ill are not immune from shortcomings and, if local management fails to satisfy the complainant, the Ombudsman can step in.

Argentina, a country about the size of Europe, has a population of approximately 30 million people. Over 80% of the inhabitants occupy the few large cities. About 12 million people live in the neighbourhood of the capital, Buenos Aires. Unlike many other South American countries, it has a large middle-class population and a well developed social infrastructure and industry. However, the country has been the subject of considerable political instability with many recent changes in government including several revolutions. These have resulted in many changes of leaders of institutions including senior members of the medical profession. Psychiatry has been particularly vulnerable because of its social identity and social function. As a consequence most of the leaders of psychiatric institutions and services, including the Professor of Psychiatry, have been dismissed from office following changes in government. This has greatly impeded the development of psychiatric services and academic psychiatry. Despite many natural resources, the political upheavals have resulted in a considerable weakening in the economy with inevitable consequences on the funding of health care and the universities and the creation of a large poverty trap for the most vulnerable.

The National Schizophrenia Fellowship (NSF) was founded in 1972 following a period of correspondence in The Times initiated by John Pringle. It currently has a membership of around 7000 people linked to over 160 groups throughout England, Wales and Northern Ireland. The majority of the members are informal carers. The organisation provides direct care to about 3000 people each week.

German psychiatry is emerging from a black past to a challenging future. Under the Nazis it is thought that about 100,000 psychiatric patients were killed and 300,000 were compulsorily sterilised. Services for the mentally ill had also been adversely affected by two world wars and recession. For 50 years there was little progress. By the 1970s, the government and other institutions took more interest in mental health. Community facilities began to appear such as day centres. Long-stay patients are now being discharged from hospitals and asylums have closed in some states.

I am not a brave person. I have never been tempted to sign up for the armed forces, go parachuting or enrol on an Outward Bound course. It was therefore as much a surprise to me as anyone to find myself in January, travelling through central Bosnia, in flak jacket and helmet in an armoured personnel carrier. Together with my three female companions we had been despatched by the EC to investigate allegations of systematic rape and sexual abuse of Muslim women.

The vigorous public profile adopted by the College in the ‘Defeat Depression’ campaign (Psychiatric Bulletin, 1993, 17, 573–574) is to be welcomed, but the proposed educational programme is premature. The MORI poll is not an adequate basis for understanding how ‘depression’ is popularly conceived nor how people respond to it. The research report (Royal College of Psychiatrists, 1992) says little about the methods used in the qualitative part of the study: whether the researchers were properly trained in ethnographic field interviewing to elicit illness categorisations, and their ability to elicit the whole complex of ideas and actions, involving nomenclature, causation, agency, recognition and recourse to treatment.

Primor'e is a former Soviet colonial area in the Far East. It is now part of free Russia's national parkland, rich in flora and fauna. In the present chaotic period of transition to a market economy, business leaders from Japan, China and Korea have rushed in to develop its potential.

The annual meeting of the American Psychiatric Association is always something of a jamboree but this year its Sesquicentennial Celebration (1844–1994), held in its birthplace Philadelphia PA, was especially splendid with a birthday gala held in the elegant and richly endowed Art Gallery. However, attendance at the Philadelphia meeting was disappointing with only 15,000 delegates.

Jadhav & Littlewood make some interesting and thoughtful points, but I cannot agree with some of their syllogisms. I certainly do not sympathise with the pejorative tone of their comments (“to mount a glossy [sic] campaign … is frankly disturbing”) nor accept what appears to be their principal conclusion that “the proposed educational programme is premature”.