Over recent years attention has been directed towards providing appropriate facilities for the mentally abnormal offender. In the past such individuals were probably absorbed into the hospital system. However, the open door policy of the 1960s and 1970s, together with hospital closures and reduced bed numbers, has meant that this invisible absorption has been unable to continue. It has been suggested that many of these mentally abnormal offenders are inappropriately placed within the penal system, thus contributing to prison overcrowding. The Butler and Glancy Reports recommended Regional Secure Units as a possible solution. At the beginning of 1987, 14 of these had opened. The tendency has been for Regional Secure Units to deal mainly with the mentally ill offenders and the needs of the mentally impaired have been largely overlooked. The literature on the subject of this latter group has been sparse. Craft described an isolated unit in Wales, which dealt with mentally abnormal offenders, and there are hospitals which provide secure facilities for the mentally handicapped. The purpose of this study is to describe the characteristics of the patients admitted to an open forensic unit in order to assess the suitability of the facilities and the outcome of the treatment provided.

This paper aims to compare two SHO/registrar training schemes, both of which have grade ‘A’ approval from the Royal College of Psychiatrists but have differences in character and content. We intend to present an overview of current general training in psychiatry by focusing on these rotations. We would like to point out that these are personal views based on our own experiences, but hope that this paper will stimulate discussion.

We were asked to do some research into the needs of people with long-term mental health problems who were living in the community. The main questions which sprang to mind were WHO, WHAT, and HOW to approach this.

This paper outlines a three-year controlled study, funded by the Department of Health and Social Security, which started at the Maudsley Hospital in October 1987. The research will compare seriously mentally ill patients maintained outside hospital on the daily living programme (DLP) with standard hospital-based care, and devise a multi-disciplinary training course in DLP for mental health care providers. It will be the first UK attempt at controlled replication of successful controlled studies from North America and Australia, and the first anywhere to devise systematic training in the approach.