Many needs were identified, all of which could be addressed using the existing skills of local health and social care professionals. The investigation raises serious concerns about standards of hospital and community care for elderly patients with schizophrenia. The findings may be unique, reflecting long-standing problems within a particularly hard-pressed part of the NHS. However, it is not known whether a similar situation exists in other parts of the UK.

A review of the drug treatment of 163patients attending two old age psychiatric day hospitals showed that 29 received medication from the day hospital, 44 from general practitioners and 60 from both sources. Many of the patients' knowledge of their drug treatment was incomplete. Of those individuals interviewed, approxi mately equal numbers expressed a preference for day hospital and general practitioner prescriptions. The origin of the prescription did not bear any obvious relationship to subsequent admission to hospital or continued attendance at the day hospital.Patients attending old age psychiatry day hos pitals may receive prescribed drugs from both the hospital and their general practitioners (GPs). The practice followed varies from centre to centre, and may not always be based on a systematic analysis of patients' needs and wishes. Non-compliance can be a problem (Ballard et al, 1991).The aim of this study was to analyse the prescribing of drugs in two day hospitals and compare them with reports of GP prescribing. Patients' preferences were sought and the out come of care is also reviewed. The studyThe study was carried out in two old age psychiatric day hospitals, Menzieshill (DH1) and Ashludie (DH2), serving the city of Dundee. The day hospitals had a total of 50 places per day and a total of 163 patients attending (120 female, 43 male). DH1 treated women from the west side of the city while DH2 treated women from the east side of the city and the men from the entire city. The study was completed in a seven month period from July 1991 to January 1992. Information about GP prescribing was collected routinely at the start of day hospital attendance using a standard form and this was repeated during the study period.Information about day hospital prescribing was collected on a standard form, noting drug doses, times of administration and date of initial prescription. Drugs supplied to take away were recorded. When a drug was prescribed by the day hospital the staff were asked for the reason.Information was collected from the patients' case records and included age, duration and frequency of attendance and diagnosis. The Information/Orien tation section of the Clifton Assessment Procedures for the Elderly scale (McPherson et al, 1985) was completed by one of the authors. Patients were interviewed about their views using a structured questionnaire.The outcome of treatment was defined in terms of continued attendance at six months after the initial part of the study. Findings Patients studiedThe age range of the 163 patients was from 57 to 93 years, with a mean of 76.6 years (s.d.=8.17). There were 14 (9%) people under 65 and these included seven men. The primary diagnosis in 107 (66%) of these patients was dementia and the others suffered from affective psychosis, other depressive disorders, neurotic disorders, para noid states, alcohol dependence, schizophrenia, alcoholic psychosis, organic psychosis, other psychoses and mild mental retardation.In the whole group, 133 (82%) were on medication at the time ...

The advantages and disadvantages of a mother and baby facility as part of a general hospital psychiatric admission unit were explored. A questionnaire was sent to 60 women who had been admitted to the unit with their babies over a ten-year period asking about their psychological health following discharge from hospital, the welfare of their family and their opinion of the facility. A 37% response rate was obtained. The patients' case-notes were studied for information on various items and the results for the response and nonresponse subgroups were compared.

Of 299 referrals to the Dundee general psychiatry liaison service over a six month period, deliberate self-harm (DSH) was the reason in 83%. An overdose was used in 94%, and alcohol misuse occurred in 56% of DSH episodes. Fifty-two per cent of referrals were followed up by the general psychiatry service; 31% of these were admitted directly to a psychiatric ward, 10% on a compulsory basis. At follow-up, 23% remained in contact with the Dundee psychiatric service. Twentythree per cent of all patients referred to the Area Alcohol Service (AAS) were in contact with it six months later. Clearly, liaison psychiatry has a role in detection and management of significant mental disorder.

There is now an increasing emphasis on the views of the consumers of health care, but little is known of psychiatric patients' opinions on their care and treatment. This may be due to an assumption that their reports are unreliable. Much of the research in this area has been carried out in the USA, although there have been reports from the UK and elsewhere (Freeman & Kendall, Hansson et al, 1985; Lazare et al, 1975; McIntyre et al, 1989; Weinstein, 1981).