Request for Agoraphobic Patients

A controlled trial of imipramine and behaviour therapy in the treatment of agoraphobia is being conducted at the Maudsley Hospital. We would be grateful for referral of patients suffering from agoraphobia who are able to attend on an out patient basis. The patients would be offered early assessment interviews, and those found suitable would begin treatment in the near future. Referral letters should be addressed to Dr I. M. Marks or Dr R. S. Stern, The Maudsley Hospital, Denmark Hill, London SE5 8AZ.

You are invited to give a 10-minute paper at the Annual General Meeting of the College in Exeter on 10–13 July 1979. There will be one or two special sessions at which anyone below the rank of consultant can speak; abstracts of the papers may later appear in the Journal or Bulletin.

The White Paper (HMSO Cmnd 7320) was published on 13 September, and its proposals are stated to be based on the need to strengthen the rights and safeguard the liberties of the mentally disordered, whilst retaining a proper regard for the rights and safety of the general public and staff.

My brief is to discuss the present and future relationships between clinical psychologists and psychiatrists. I shall be speaking from the, no doubt restricted, viewpoint of a Consultant in Adult Psychiatry working in a general hospital unit in a Teaching Area. My comments will not, therefore, apply to child psychiatry or mental handicap, and may well be received less than enthusiastically within mental hospitals. The highly efficient organizers of this conference, in their letter of invitation said, ‘We want a sensible, middle of the road view’. Did they realize, I wondered, that the middle of the road can be a rather dangerous position to occupy? I shall try very hard to avoid a head-on collision.

This article sets out the conclusions and recommendations of a multidisciplinary working party which from November 1975 considered ‘the extent to which psychiatric resources should be devoted to collaboration and consultation with other care givers rather than to the provision of direct clinical service, and to look at the implications of this for the planning of services and training of psychiatrists’. The working party comprised four sub-groups covering collaboration and consultation with the Community Psychiatric Team, with the Primary Care Team, with volunteers and with educational bodies. Reports from these sub-groups were subsequently collated and edited to make up this paper.