Prior to 1952 a Registrar was available at The Maudsley Hospital from 9.30 a.m. to 5.30 p.m. to see out-patients of the hospital who wished to consult a doctor outside the times of their routine appointments. In 1952 the necessity for a more extended service was recognized by the appointment of a Registrar to work whole-time in the Emergency Clinic. A special room and telephone were provided and in effect a psychiatric casualty department was established. The Hospital also offers an Emergency Service between 5.30 p.m. and 9.30 a.m., but this is not considered in the present study. With the change of policy towards more rapid discharge of patients from psychiatric hospitals and the care of the chronic mentally ill in the community, it seemed very probable that a psychiatric emergency clinic would be increasingly used for referral by family doctors and by patients spontaneously seeking advice, and in fact there were 1,830 attendances at the Clinic in 1958, 2,274 in 1960, and 3,377 in 1962.