The views of psychiatric day hospital patients on the helpfulness of components of their treatment programme were surveyed. Ratings given to social activities were significantly higher than those given to therapeutic activities. Patients rated having a bus pass and access to hairdressing services as the most helpful parts of day hospital attendance while community meetings and ward round attendance were regarded as the least helpful. Ratings were, however, generally favourable. No significant effect of patient age, gender, or duration of attendance was found. Possible explanations for these preferences are discussed. Patient preferences such as these are likely to influence purchasers of care, and thus the use of resources by providers.

As mental health care services move increasingly into the community with staff working in more isolated settings, violence against staff is becoming an increasing health and safety issue. Education and training of staff to cope with potentially violent situations is a priority, equally important is the design and physical layout of the room in which potentially violent patients are seen. This audit looked at the safety features present in consulting rooms used daily, for interviewing patients, by mental health professionals. The study identified rooms which were judged unsuitable for interviewing potentially aggressive patients in, and as a result, several recommendations for safety improvements to these rooms were made.

The aftercare of psychiatric patients discharged from hospital is currently under debate among clinicians and in the media. Our study audited the planning of aftercare for detained patients discharged under section 117 of the 1983 Mental Health Act. Our completed audit cycle showed how discharge planning can be improved yet underlines the difficulties encountered in providing for this vulnerable patient group.

The notes of 24 individuals attending a clinic for people with learning disability and epilepsy were reviewed for all visits in the year preceding and following the Implementation of medical audit standards for out-patient review. There was no deterioration in any standard. A significant improvement was seen in recording of seizure frequency by seizure type, legibility of signatures, regular letters to general practitioners and the recording of seizure type and frequency in these. Medical audit can improve standards in epilepsy care, though its influence on outcome is not known.

Mental health promotion clinic funding was introduced with the new general practice 1990 contract and has been extensively used to fund counsellors and stress management clinics in primary care. This funding has been withdrawn. A postal survey was conducted on all 142 general practices in East Sussex in order to assess the impact of the introduction and withdrawal of mental health promotion clinic funding on the employment of counsellors and on stress management clinics. One hundred and forty practices participated and it was found that there was an increase from 33 to 70 counsellors employed and five to 36 stress management clinics run by January 1993. Many GPs did not know what would happen to their service and it was estimated that 44 (63%) of counsellors and 13 (36%) stress management clinics would be lost.

The clinical examination is the cornerstone of the MRCPsych Parts I and II. Trainees frequently prepare for the clinical by practising in a mock examination setting. One person's experience in examining candidates in mock clinical examinations is reported and an approach to the clinical examination is described. Some of the common pitfalls are highlighted.

Although pharmaceutical companies report side effects that may occur with use of their medications, little data on specific groups of patients that may be at risk of particular side effects is available (Katz et al, 1991). Patients with diabetes mellitus form an important group for psychiatrists since the occurrence of depression is relatively common with this group and guidance on its treatment is lacking.

A one year training post at senior registrar level in psychotherapy in a developing community mental health team is described, not only for its relevance to training at all levels but also as an example of how general psychiatry and psychotherapy can work together to promote good psychiatric practice in a community team.

It has been common knowledge that professional carers in the community, institutions, and perhaps also in hospitals lack appropriate training in issues related to mental health problems in the elderly. Many crises in the community appear to be precipitated not so much by the gravity of the problems the elderly pose, but by panic or the fear of the unknown among the carers. Arie et al (1985) postulate that the joint teaching of different professions can be a fruitful training for subsequent team work, while Beynon & Croker (1983) reported that shared tutorials in geriatrics at the Middlesex Hospital in London were very successful. The negative features of institutionalised care can be counteracted through training and management (Wilkin et al, 1985).

Recent surveys have shown that general practitioners have begun to employ practice counsellors. The recent establishment of fundholding practices has made it possible for general practitioners (GPs) to be direct purchasers of health services. The number and nature of counsellors and specialist mental health professionals directly employed by fundholding practices is reported.

A survey of psychiatrists was conducted to determine their current knowledge of the Driver and Vehicle Licensing Authority (DVLA) regulations and the advice they give to their patients regarding driving with psychiatric illness and/or medication. The results indicate that both knowledge and practices vary widely. In view of the potential risks of driving when not well or fully alert, information regarding driving should be a standard part of the advice given to all psychiatric patients.

Experience of psychiatry in a developing country is not generally regarded as pertinent to the training of the British psychiatrist. In this article I draw on my own experience of a psychiatric attachment in India to argue that such experience can be useful and relevant for British psychiatry trainees, and that it should be encouraged.

While conducting a study on the nature and extent of compulsory admissions to mental hospitals within the four London regional health authorities, discrepancies and inaccuracies were revealed in many of those mental hospital in-patient statistics. The nature and extent of some of these are examined. It is suggested that the value of such statistics for government planning must be questioned as is their value for research. It is recommended that a centralised system of collecting and collating such data be introduced as a matter of priority and that such a system be operated by the Mental Health Act Commission.

The variations in structure and content between Masters degree courses offered to psychiatry trainees around the country are documented. Most courses are integrated to some degree with statutory Membership teaching. The extent to which courses differ is likely to surprise readers. The implications for the junior trainee as well as for consultant or senior registrar appointment committees is discussed. Universities act autonomously, hence a Masters degree awarded by one may bear no relation to that awarded by another.

This article describes the process of setting up a community support team for the severely mentally ill, and the challenges this posed. As this method of service delivery has been infrequently described, it is hoped our experience may be instructive to others.

If psychoanalytic psychotherapy is to be part of the undergraduate medical curriculum, it must be well taught, and demonstrably relevant to the training of doctors. Psychotherapy teachers have a responsibility to devise a syllabus which is clear and relevant and to provide teaching which stimulates and engages the students so that they learn by thinking and understanding. An outline of a syllabus for medical students is included and one seminar as an illustration of interactive learning is described.

We have previously reported on the formation of a large regional registrar scheme covering 11 health districts in the South Thames region (Herzberg & Watson, 1991) and highlighted educational principles which we considered important for registrar training. The purpose of the present paper is to review those principles in the light of experience to date in running senior house officer (SHO) and registrar training schemes.