Section 136 of the Mental Health Act 1983 is a controversial section. It authorises a police constable, often with no psychiatric training, to take a mentally disordered person from a public place to a place of safety, usually a hospital or a police station, so that he or she may be assessed by a doctor and a social worker within a 72 hour period. There have been several studies looking at this section from the point of view of psychiatrists, social workers, and other interested parties, in particular MIND. The aim of this study was to find out from the police whether or not problems arose during their dealings with people whom they had placed on section 136.

On several occasions in 1979 a GP member was consulted by the father and brother of a young man because they were concerned about his violent and aggressive behaviour. The GP arranged for a consultant psychiatrist to visit the patient at home on three occasions, although once he was not in and on the other two refused to see the psychiatrist and threatened him with violence.

Selective abstraction of information and good communication are essential in the practice of psychiatry. A good psychiatric discharge summary performs both these functions and can therefore be a significant aid in patient management. The need for a good psychiatric discharge summary is no less necessary in the psychiatry of mental handicap than in general adult psychiatry. However, the psychiatry of mental handicap does differ in some respects from that of general adult psychiatry. This difference therefore should be reflected in the psychiatric discharge summary in mental handicap settings if the summary is to represent accurately the clinical process. This fact was recognised by the Medical Executive Committee of Leavesden Hospital and it was therefore decided to provide specific guidelines on the writing of discharge summaries in a mental handicap in-patient setting to junior trainees in that hospital. Below is a document which I prepared at the request of the Medical Executive Committee, and which has now been officially accepted by them. It is hoped that its publication will be of interest to readers working in other mental handicap hospitals.

Chance meetings in public between psychiatrists and their clients are not usually relished by either. At its least embarrassing, the encounter can pose to both parties the dilemma: Should we greet each other and risk revealing to the public our special, but stigmatised, relationship? Or, should we ignore one another and risk one (or both) of us feeling rejected? The more embarrassing encounters are well known in psychiatric covens and sometimes even revealed to outsiders in the course of ethanolic abreaction at intimate dinner parties. However, hitherto they have not found a place in conventional psychiatric literature, with its scientific emphasis and basic assumptions in the journals of smoothly flowing professionalism and the normality of the psychiatrist.