In the last year or so the future of mental health services in this country has been intensively discussed. COHSE, MIND, and the Richmond Fellowship have produced their ‘blueprints', outlining details of the way they see services being organized. All variety of professional organizations have been busy presenting evidence to the House of Commons Social Services Committee which is specifically examining community care. The DHSS has committed more joint finance to ‘care in the community’ projects and Regional Health Authorities are examining the strategies to close large psychiatric hospitals. Consequently, District Health Authorities, in many cases, are planning the shape of a new mental health service which places increasingly less reliance on the large institution. The phrase ‘community care’ has now become so hackneyed in planning circles that for many it has lost whatever meaning it may have once had. However, despite all the rhetoric, and indeed all the planning activity, psychiatric nurses themselves have still to voice coherently their thoughts and fears about the shape of things to come.

The dramatic changes in Italian psychiatry since 1978 when the practice of Democratic Psychiatry was officially started has had a controversial response from both inside and outside Italy. In an attempt to know more about the system that made sweeping changes in Italian psychiatry, five Italian psychiatrists and psychologists were invited to Sheffield for a two-week exposition of films, paintings, photographs, lectures and meetings on the art of Democratic Psychiatry from Italy. This was the final leg of the visit to England, after London and Manchester. The events were organized in a truly varied and democratic manner by the University Department of Psychiatry, the Division of Continuing Education at Sheffield University, and the Graves Art Gallery, in co-operation with MIND, the District Health Authority, the Family and Community Services Department, and staff from hospitals in Chesterfield, Doncaster and Sheffield. The aim of the exposition was to provide an opportunity to discuss the prospects for changes in the mental health and mental handicap services in the light of the Italian experience.

The Marriage Guidance Council sets out. as the first of its objectives states: To provide a confidential counselling service for people who have difficulties or anxieties in their marriages or in other personal relationships. It offers other services too: education for young people, setting up training courses and conferences, and publishing and distributing literature. But the counselling of individuals and couples is the main activity of the Council and the one for which it is generally known.

Canada has a long history of recruiting overseas doctors, including those specializing in psychiatry, for services in their country. Today there is a strong nucleus of British trained psychiatrists, practising in Canada, in spite of which multiple vacant psychiatric positions still exist and Canadian recruitment drives for British psychiatrists continue. Approximately four years ago, following reading an advertisement in the Journal concerning opportunities for psychiatrists in Canada, I and my family emigrated. Since this time I have been active myself in the recruitment of British psychiatrists for positions in Canada and my experience, as a British psychiatrist in Canada, may be useful for colleagues who are themselves contemplating such a move.

In recent years there has been a move away from the purely literary to the numerically descriptive medical publications. This is largely attributable to a change in emphasis and direction in the medical sciences as practitioners become more ‘mathematically aware’. Sample populations are often described in terms of numbers, ratios, percentages or rates. All of these descriptors have merit in supporting the expression of methods and results in clinical trials, research and epidemiology. The application of rates can be most useful, particularly as results are not always considered in terms of simple numerical counts, but are often related to an underlying population.