The gradual transition from unqualified attendant to the trained psychiatric nurse of the present day was described in detail by Walk. A key turning point in this story occurred at the Quarterly Meeting of the Medico-Psychological Association in Edinburgh on 16 November 1883, when Dr A. Campbell Clark, Medical Superintendent of the Glasgow District Asylum, read a paper entitled ‘The special training of asylum attendants'. This paper was published in the Journal of Mental Science in January 1884. Whilst attention had been given by many other asylum doctors to the training of attendants, Clark's experience of organizing attendant training courses and his firm recommendations opened the way to practical steps which set training on a new footing. Clark acknowledged the work of Dr T. S. Clouston, Physician Superintendent of the Royal Edinburgh Asylum, who read a paper to the annual meeting of the Association in 1876 entitled ‘On the question of getting, training, and retaining the services of good asylum attendants'. This paper aroused a good deal of interest amongst members of the Association, and a small committee was formed to report ‘on the advisability of the formation of an association or registry of attendants in connection with this Association and the best manner of carrying it into effect’. However, there is no record of any report by this committee.

The mental handicap scene is changing but not as quickly as some would like. A constant stream of letters, consultative documents and booklets remind us of the various ways in which we can work together to create a service where the health care component is rationalized and the large hospitals are reduced in size. The services are changing, but there is variation in the pace of change and in the commitment to the joint planning process involved in such change.

Developments in preventive psychiatry should occur as a result of new knowledge of the psychiatry of infancy as presented at recent conferences: the International Conference of Child and Adolescent Psychiatry, Dublin 1982; the World Infant Psychiatry Congress at Cannes, March 1983; and the Child and Adolescent Psychiatry Congress in July 1983 at Lausanne.

A symposium on Expatriate Stress and Breakdown was held on 27 October 1983 in London under the auspices of Guy's Hospital and Charter Medical to bring together psychiatrists, psychologists, sociologists and physicians with an interest in occupational health. Since the 1920s, when one-fifth of the British employees of the Anglo-Persian Oil Company suffered from ‘tropical neurasthenia’, little has been published on this topic.

There are now six psychiatric case-registers covering areas in England, two in Scotland and one in Wales. All record the contacts made by patients or clients from a defined geographical area with specified medical and social services. This information is stored in a linked and cumulative file so that the care of any individual or group can be followed over time and the patterns of care established. The geographical base allows rates to be calculated and epidemiological research to be conducted.

Participation in a sensitivity group as part of the general training of a psychiatrist is recommended.1,2 There are, however, obstacles to obtaining this experience, which may be practical or personal. Particularly in a peripheral hospital, there may be no such group available. A conductor should have sufficient experience as well as enthusiasm, and if the conductor is well known to the trainees or perhaps a member of the consultant staff, this may provoke personal anxieties in the participants. Finding a time in the widely differing schedules of participants, when all are free to attend is a problem, and further difficulties are presented by duty rotas and trainee rotations.

The Annual Meeting of the Irish Division took place at James Connolly Memorial Hospital, Blanchardstown, Dublin on 21 October 1983. This year our clinical section was on the theme ‘Liaison Psychiatry’. An attendance far exceeding expectations turned up to hear three stimulating and thought-provoking papers from Drs Rachel Rosser, David Sturgeon and Richard Mayou. Professor Noel Walsh performed the difficult task of summarizing the proceedings with his usual competence.