“Little as we know about the way in which we are affected by form, by colour and light, we do know this, they have an actual physical effect.” Florence Nightingale, Notes on Nursing

The Audit Commission has drawn attention to local champions of change in mental health services. Good Practices in Mental Health (GPMH) (1985) has highlighted a district which has overcome some of the myths about the impossibility of transforming the service, and recently the Institute of Health Services Management (IHSM) Working Group (1991) has entered the debate with “good psychiatric services can be developed in areas where managers are determined to introduce improved services”. The Audit Commission singled out Torbay Health Authority, GPMH highlighted Exeter Health Authority, and the IHSM Working Group have listed 12 exemplary health authorities (including Torbay and Exeter) where good local services have been developed.

Physicians for Human Rights (PHR UK) is an independent group of doctors and health professionals launched two years ago by Drs Ian Munroe, former editor of the Lancet and Peter Kandela, a Middlesex GP. The group's aim is to direct the influence of the medical profession towards the defence of human rights, most immediately by bringing the skills of the medical profession to the aid of victims of human rights abuses (Hall, 1991).

Developments on the world political scene over the last year have had far-reaching effects on the lives of ordinary people in areas such as the Middle East and Eastern Europe. For the International Rehabilitation and Research Centre for Torture Victims (RCT) in Copenhagen these changes have led to a huge increase in calls on its service. In 1991, the continuing opening up of Eastern Europe made it possible to reach out to new countries where support is needed to establish centres offering training in RCT's treatment methods and information about torture, while the Gulf War created more urgent demands on its resources.

About a year after applying to come on the Overseas Doctors' Training Scheme (ODTS), I was offered a post. The letter arrived about two months before I was to start work in the UK; it contained pertinent information about my job, the training programme, and the community I would live in. The information and its early arrival enabled me to make adequate preparation for my trip.

Following the recommendations of the Butler Report (Home Office, 1975), there has been a slow growth in the number of Regional Secure Units (RSUs) (Snowden, 1985), which aim to assess and treat mentally disordered offenders in England and Wales in conditions of “medium security”. One particular recommendation of the Butler Report was that:

“The main emphasis in forensic psychiatric services … should be on community care and out-patient work.” (paragraph 20.14)

Computers are essential tools for medical research, communication and management. Informed choices require a basic knowledge of computers. Many doctors have, however, been frustrated by unnecessary jargon.

We decided to set up a short-term, closed group of mothers attending our local clinic, with the following questions in mind.

In February 1991 the Royal College of Physicians produced a report entitled ‘Fraud and Misconduct in Medical Research’. Most of the cases documented have come from the United States but by the end of 1988 five cases had been formally reported in Britain. One of these was a financial fraud perpetrated by a psychiatrist who worked in a district general hospital in the Northern Region and who forged data for a drug company. He was subsequently reported to the General Medical Council by the Association of the British Pharmaceutical Industry and had his name removed from the medical register. Informal investigations, however, suggest that fraudulent research might be more widespread and as a result the Royal College of Physicians established a working party to look at this issue in detail. They recommended that a twin track approach of prevention and thorough management of complaints of misconduct be adopted. The report was kindly forwarded to the Research Committee of the Royal College of Psychiatrists which felt that a summary of these recommendations should be widely published among researchers in psychiatry.

Psychiatry is much more community based than ten years ago. Despite this there is little specific research published on out-patient electroconvulsive therapy (ECT) and there is a lack of well-defined guidelines for its administration.

In 1987–88 I undertook a research project, to look at parental views on sterilisation for their mentally handicapped offspring. This project was prompted by the then recent decision of the High Court in the UK, which authorised the sterilisation of a 17-year-old girl with mental handicap, and created much controversy and debate at the time. Very little was known about the views of parents as a group in the UK on this issue, and hence the decision of our Department of Mental Handicap in Nottingham to explore this area (Bambrick & Roberts, in press).

In mid 1988 after Piper Alpha but before the Lockerbie disaster, the Social Work Department and the Mental Health Unit independently began to discuss plans for a post disaster counselling service. Over the next few months a joint working party was set up which during 1988 and early 1989 evolved the service described below.

Australia is a unique, geologically ancient island continent. Its flora and fauna are unlike those found anywhere else and the same may be said of its people, politics and health services. The population of 17.3 millions represents a multicultural mix, with an anglo-celtic core conflated by sustained post-war immigration from southern Europe, Turkey, southeast Asia and south America. One in five current Australians was born elsewhere, one in ten comes from a non-English speaking background, and a quarter of those born here have a parent who was born overseas. Aboriginals and Torres Strait Islanders form 1.4% of the total population. They have third world mortality figures but die of first world diseases, their life expectancy being 20 years less than that of other Australians. Two hundred and four years after what they see as the British invasion, their standard of living lags far behind all other socio-cultural groups in the country. Most members of the Aboriginal community do not live long enough to develop Alzheimer's disease, but it and other age-related diseases are emerging as the major determinants of health costs as Australia moves towards the 21st century.

In many parts of the country, child psychiatrists currently provide services on their own. This ‘unidisciplinary’ model of practice is out of step with College recommendations for multidisciplinary working in child and adolescent psychiatry (Royal College of Psychiatrists, 1990). The question arises whether one model is in fact superior to the other. In this article we look briefly at the history of the multidisciplinary team, describe our own experience of providing a unidisciplinary service and suggest a working model for the future.

How relevant is the training which postgraduate psychiatrists from the developing world receive in the West? Are the investigations, treatment, and clinical practices taught in the UK transferable across widely disparate cultures? Should trainees be taught basic psychiatry or only sub-specialities? Should they come at all?

Most medical researchers rely on computers to store their data, often many years of work. It is, however, surprising that many give little thought to protecting their machine from malicious damage caused by computer viruses. This article examines how to prevent, detect, and remove computer viruses.