In 1987 the Charing Cross General Psychiatric Training Scheme incorporated an exchange with the National University Hospital, Singapore (NUH) sponsored by Glaxo Pharmaceuticals. Four selected UK trainees have now spent nine months at NUH as part of their general rotation. A description of psychiatric training based at NUH is outlined here.

The problem of geographical dispersion is common in clinical academic departments. Often there is a main departmental base in a teaching hospital with various smaller units either elsewhere on the same campus or based in other hospitals in the same city. In addition, staff may do their ward work, out-patient clinics and their associated clinical teaching scattered over a number of sites. Although these arrangements usually have some effects on departmental cohesion, problems can usually be overcome with a little effort and the traditional means of ensuring communication and developing common policies in teaching, research and service development has been to hold regular departmental meetings.

Imagine an “intelligent” sheet of paper, on which you could record data in an organised fashion, and format its appearance for publishing purposes, but which could also do it's own calculations, (with the answer appearing automatically), and draw graphs of the results. This is essentially what a spreadsheet does.

About five years ago I was seized by the idea of working in Africa. Now, nearing the end of a two year contract at the Department of Psychiatry, University of Zimbabwe, it is time to reflect.

Population movements away from large cities and congestion in urban areas create problems for the delivery of psychiatric care which are compounded by the move towards greater care in the community. These developing service patterns require adequate methods of communication between service components. There is a proliferation of new technology offering opportunities for improved national and international communication in psychiatry as in other branches of medicine. It will be important to decide which technological innovations will improve the efficiency of service delivery rather than end up as expensive ‘gadgets’, or solutions looking for problems to solve. In this paper the use of interactive television in psychiatry is reviewed and the implications for the evaluation of new communications technology are discussed.

An important emphasis in developing community psychiatric services has been to increase accessibility of psychiatric services to the public (Department of Health, 1989). This might mean not simply informing people about available services but also providing advice about mental illness and where individuals might seek further help, either for themselves or for others about particular problems.

Careers in psychiatry which commence straight after house jobs are now commonplace and an informal tradition by which future child psychiatrists worked in paediatrics before training in psychiatry is nowadays less rehearsed. Recently, one of the St George's psychiatric registrar rotations arranged a six month post as a community child health doctor (community clinical medical officer) for a psychiatric registrar (JD) who had expressed an interest in child psychiatry as a career but lacked experience in paediatrics.

Alzheimer's disease (AD) is the commonest form of dementia and affects about 6% of people over the age of 65. The aetiology is unknown and putative causes range from environmental toxins (Martyn et al, 1989) to chromosome abnormalities (St George Hyslop et al, 1987). Despite the extensive resources being channelled into AD research, it is surprising that no study has yet discussed the role of false teeth.

In recent years there has been increasing concern about the plight of the mentally ill in prisons, particularly those on remand. The 1976 Bail Act gives everyone the right to unconditional bail but mentally disordered offenders find themselves disadvantaged in that their right to bail can be set aside not only because of the gravity of the alleged offence but also for reasons consequent to their mental illness. These include lack of community ties, their own protection or most commonly for the preparation of psychiatric reports. The mentally disordered may thus be remanded in custody even if the charge against them is minor or not punishable by imprisonment.

The first meeting of the Violence Management Special Interest Group on 25 February 1992 drew a mixed group of delegates from three of the 15 Scottish Health Boards, three Regional Social Work Departments and several Education Departments, as well as the Scottish Prison Service. The majority of those who attended were actively engaged in designing training programmes for public sector staff.

It has for many years been the custom for nations to commemorate their heroes and heroines by placing their features on bank-notes. Among these are four psychiatrists whose brief biographical details are given below.

The EFPP is a British initiative concerned with public sector psychoanalytic psychotherapy that seems to have touched upon a recognised need in our European neighbours and colleagues. Its origins are inextricably linked with the development of the Association for Psychoanalytic Psychotherapy in the British Health Service (the APP).

This is the third and last in my series on recent changes incorporating the introduction of Disability Living Allowance in the allowances for the mentally ill. The Invalid Care Allowance is unusual in that it is paid to the person who does the caring and not the person being cared for.

The Jubilee Room at the House of Commons on November 5th would seem a suitably explosive venue to launch a campaign to obtain organised funding for trainee child psychotherapy posts. A working lunch was sponsored by the Child Psychotherapy Trust and the Association of Child Psychotherapists, and hosted by Emma Nicholson, MP, a Vice-Patron of the Trust.

Recent developments in the criminal justice system (Home Office, 1990) have highlighted the need to divert the mentally disordered offender away from custody whenever practical. To this end a number of pilot schemes have been developed within the National Health Service. The West Midlands Regional Forensic Service, together with the West Midlands Probation Service Court Liaison Team recently initiated a project based in the Central Police “lock up” in Birmingham. This scheme differs from others in that defendants are screened prior to their appearance before the court (James & Hamilton, 1991; Joseph & Potter, 1990).