Abstract
Demand for psychiatric services is rising in part because many former patients are now in the community and the development of community services has not kept pace. Needs perceived by psychiatrists and family physicians are congruent with each other and with the many job opportunities for psychiatrists which now exist. In five years there will be an increase in attrition of psychiatrists by retirement at the same time as the demand for service by the high utilizers — the young middle age group — will increase. The number of psychiatric training positions funded by the Ministry of Health has diminished. The influx of foreign medical graduates on whom one-third of services depend has been severely curtailed. The net result of these trends, if unmodified, will be higher population-to-psychiatrist ratios, decline in quality, decline in effectiveness, and a decline in the availability of services.