SummaryThe administrative imposition of new models of psychiatric care in the community has led to the fragmentation of services and a deteriorated experience for both service users and professionals. The author makes a plea for psychiatrists to reassert the principle of continuity of care, which has been all but lost from the practice of psychiatry during the past decade. It is possible to meet the clinical objectives of necessary support and treatment for service users within the community without the current multiplicity of team structures seen throughout England.

No abstract

The function of the mental health review tribunal is defined in Part V of the Mental Health Act 1983. Together with statute and Common Law, it provides safeguards to those detained under the Act. The provisions of the Human Rights Act 1998 have strengthened these safeguards. The key articles in Schedule 1 of the Human Rights Act are 5(1)(e), relating to the lawful detention of persons of unsound mind; 5(4), providing that the lawfulness of such detention shall be decided speedily by a court; 6, providing for a fair and public hearing within a reasonable time by an independent and impartial tribunal established by law; and 8, establishing the right to respect for a private and family life. The latter is relevant to disclosure, nearest relatives' rights, and treatment.

All British mental health professionals will be aware of several highly publicised deaths at the hands of mentally ill people and will have seen the conclusions of inquiries and government reactions. To reduce the risk of future tragedies effective methods of risk assessment and prediction are needed.

Clovoxamine, an inhibitor of neuronal uptake of both serotin and noradrenaline, was compared with doxepin in depressed patients over four weeks. Antidepressant efficacy was comparable for both drugs, but clovoxamine might have a special degree of efficacy for patients with more severe depressive illnesses.