The exclusion of services for older people from the Mental Health National Service Framework and the delays in publication of the National Service Framework for the elderly have caused many old age psychiatrists to be concerned that, as in many other areas of health service planning and provision, the needs of older people are not being adequately addressed by Government and health service planners. The recent Audit Commission Report, entitled Forget Me Not: Mental Health Services for Older People†, gives us much encouragement that the needs of older adults have not been forgotten. Its recent publication should provide an authoritative focus, which will help old age psychiatrists, their multi-disciplinary and management colleagues and commissioners of services to push forward improvements in services for older people with mental illnesses.

A questionnaire was sent to 200 psychiatrists asking them about their off-label prescribing in the preceding month. One hundred and sixteen replies (58%) were obtained. Seventy-six (65%) respondents had prescribed medication off-label within the past month. Only 5 (4%) had ever received a complaint from patients related to their off-label prescribing. If this region is typical, off-label prescribing is common amongst psychiatrists. No formal guidelines exist except for the use of high dose neuroleptics. A suggested guideline is given in this article.

The mythology of 19th-century asylums portrays them as dark and inhuman gothic institutions. Historical research is beginning to shed new light onto this world, however, forcing us to re-examine long-held beliefs. Case note analyses have consistently shown high levels of psychiatric morbidity in the patients admitted to these institutions (Turner, 1992; Beveridge, 1995; Doody et al, 1996). Patients' letters have been examined and confirm high levels of florid psychopathology (Beveridge, 1997), they also reveal some aspects of the rich social and cultural life available to patients at the Royal Edinburgh Asylum. Such studies add to our understanding of the culture of mental hospitals described by Jones (1991).

What follows is an attempt to summarise the current national approach to the management of information in mental health services. There are many different perspectives – mine is that of a member of the College Informatics Sub-Committee and lead psychiatrist for the NHS Information Authority.

The prospect of looking for a consultant post in child and adolescent psychiatry can be anxiety provoking. The ideal job should be balanced and fulfilling, with scope for personal and service development, and should minimise the likelihood of frustration and burn-out. It is not uncommon for newly appointed consultants to become dispirited by the discrepancy between the job description and the reality of the post.