The shift of power from specialist services to the primary care teams has forced the former to examine the value of their hallowed traditions. In psychiatry, and geriatric medicine, the catchment area is a favoured restrictive practice, enabling demand to be regulated to suit the resources of each team. It is time to decide whether this is a practice to be defended and retained or whether, like many other restrictive practices, it is harmful to the consumer.

The establishment of mental health teams which take responsibility for small geographical catchment areas has been a fundamental element in the planning of community services in most Western European countries over the last decade. This idea is challenged in the companion paper in this issue of Psychiatric Bulletin which refers to catchment areas as a “relic of the past”. The case is put for catchment areas in terms of their planning, service delivery and quality advantages for the development of comprehensive inter-agency mental health services. In brief, it is argued that community mental health services are still in many areas poorly developed (Audit Commission, 1994; Faulkner et al, 1994), and that catchment areas are necessary but not sufficient for their fuller realisation.

The advantages and disadvantages of a mother and baby facility as part of a general hospital psychiatric admission unit were explored. A questionnaire was sent to 60 women who had been admitted to the unit with their babies over a ten-year period asking about their psychological health following discharge from hospital, the welfare of their family and their opinion of the facility. A 37% response rate was obtained. The patients' case-notes were studied for information on various items and the results for the response and nonresponse subgroups were compared.

The differences in attitudes to their illness between selected groups of medical and psychiatric in-patients admitted to units on the same hospital site were investigated. Patients new to the services were asked about their willingness to disclose information about their admission to hospital and their diagnosis to family members, friends and people at work. Psychiatric patients were more likely to want to keep their admission and diagnosis a secret. They were also less sure of the nature of their diagnosis and the necessity of their admission. The results suggest that wider public education is needed to reduce the stigma of mental Illness.

The case-notes of all patients in a district general adult psychiatric unit were assessed for standards of recording selected key items. The results were presented at a departmental audit meeting, and the assessment repeated after four months. Initial audit revealed poor standards of notekeeping in certain areas. On repeat assessment, standards of documentation had improved for all the key items assessed, and reached statistical significance for physical examination. This audit was quick, easy and cheap, revealed unexpectedly poor standards of notekeeping, and evidently produced a measurable and significant improvement in practice.

Seizures are a serious adverse effect of many antidepressants: most, if not all, tricyclics (TCAs) lower the seizure threshold, some atypicals (e.g. maprotiline) are known to cause convulsions and seizures have been reported to occur with all selective serotonin reuptake inhibitors (SSRIs). Opinions vary on which is the safest antidepressant to use in epilepsy.

This is the second in a short series of articles on portraits of children from the point of view of a child psychiatrist.

‘Induction days' are becoming more popular for trainees and are a useful way of communicating important local information to the new intake. The authors feel that a handbook given out during the induction can serve as an aide-memoire, and have provided a suggested layout which they themselves have used in preparing several such books.

Femi Oyebode and Christina Pourgourides show how Greek tragedy tests established morality and helps an audience resolve its own emotional conflicts.

‘Welcome To Reality’ announces the bright orange graffito, in English, on the perimeter wall of The City Psychiatric Hospital Number 3. A superfluous arrow points to the gate house. This is a large general psychiatric hospital of 2150 beds serving a population of 1.7 million people and also providing my first experience of Russian psychiatry. The buildings, some wooden, date from 1870 onwards and are set in a large area of mature woodland enclosed by a high wall in the northern suburbs of the city.

Close links have developed between the Institute of Psychiatry at the University of Verona – a town in North-East Italy – and the Maudsley Hospital in South London. Reciprocal visits, exchanges and cooperation in clinical practice and research have led to interesting experiences and comparisons between the different cultural settings and mental health services. In 1993, one of us (MP) visited the South Verona Psychiatric Service for two weeks, and a year later VP spent six months attached to the South Camberwell Community Team and at PRISM (Psychiatric Research in Service Measurement), a research team at the Institute of Psychiatry. This paper records our impressions and observations during these visits. The two services are not representative of all services in the respective countries but the visits did give us the opportunity to consider details not revealed by formal comparative research studies.

This one day seminar was arranged by the King's Fund Organisational Audit team (KFOA), to take a multidisciplinary view of quality improvement in primary care. Despite the title of the day all the speakers were general practitioners and managers, and input from other professional groups was limited to questions and comments from the audience of nearly 200.