Australasian Psychiatry

It is the start of the academic year 2020. The Techno Mac Casino University Inc. which last year successfully bid for the government tender to run medical education in Australia announced today that psychiatry has been deleted as a medical specialty. As part of the restructuring and rationalisation of psychiatry its domains of thought and clinical practice are to be divided between TechnoMac's School of Neuro-pharmacology in Geneva and its California Academy of Evidence-based Counselling, each of which offers a (part-time) diploma course on the Internet to any subscriber who owns more than ten thousand shares in TechnoMac or its subsidiary healthinsurance or pharmaceutical companies.

The plight of the deaf person who has been admitted to or assessed by a mental health service has been recognised for over 30 years [1,3–6]. Even though studies have been carried out, recommendations made, and in some areas of the world, units set up specifically for the deaf, Australia is still far behind other countries in assisting our members of the deaf community, having only one assessment unit for the deaf in Sydney.

Clinical supervision is a very important component of psychiatric training. For the trainee, formal supervision process presents an opportunity to develop an understanding of psychopathology and the theoretical underpinnings of therapeutic interventions in addition to the acquisition of clinical skills. During this time the supervisor acts as a clinical role model, teacher and examiner, administrator and often the trainee's manager within the mental health service. The supervisor also models for the trainee the personalsocial components of clinical practice, such as professional and ethical standards of conduct and the management of work-related tensions.

A new community mental health service, the Mobile Assertive Care (MAC) team, offering intensive community based treatment for people with severe and persistent mental illnesses was evaluated twelve months after its commencement. Of the sixty-three clients referred within the first twelve months of operation, twelve-monthly outcome data was available for 54 clients at the time of this study. Results indicated clinically significant reductions in days spent in hospital, and statistically significant improvements in clinical and functional status.

The Second National Mental Health Plan [1] has as one of its key themes, a focus on the quality and effectiveness of services with an emphasis on outcomes for consumers and carers. This focus on quality and outcomes results in an increasing interest in clinical practice guidelines, benchmarking of services and the development and evaluation of models of best practice. One way to progress these issues within clinical services is to develop clinical pathways for groups of patients with similar conditions.

The nature of healthcare provision in Australia in both the private and public sectors is changing rapidly. In the mental health area there has been a dearth of studies examining what actually occurs within the two sectors, and few direct comparisons have been made. Such a lack of data has not prevented suggestions that private psychiatric hospitals ‘skim the cream’ off the market for acute health care, by providing the most profitable services for the best-paying patients [1].

The connection between substance abuse and self-harm has been well recognized in the literature for some time, and may even be the basis for rising youth suicide rates [1]. However, this knowledge is not always reflected in clinical practice. When psychiatric assessments are made of suicide attempters the contribution of substance abuse is often passed over quite lightly. Of even greater concern is the general lack of skills and focus on management of self-harm in specialized drug and alcohol services, despite their high-risk clientele. Furthermore, these services often experience difficulty in accessing psychiatric support.

Interpersonal Psychotherapy (IPT) (Klerman and Weissmann [1]) is currently enjoying increasing popularity in North American and European psychiatry. The modality is a brief and highly structured manualbased psychotherapy that addresses interpersonal issues to the exclusion of all other foci of clinical attention. This approach has allowed ready modification of the original treatment manual for depression to a variety of illnesses[2]. Rather than paraphrasing the original IPT manual, this article aims to serve as an introduction of IPT for the general clinician in the hope of encouraging its utilisation as another treatment modality in the everincreasing number of options for brief psychotherapy.

The training for Fellowship of the Royal Australian and New Zealand College of Psychiatrists (FRANZCP) provides a very sound base for not only passing the Section I FRANZCP examinations, but also for working in other environments. This paper describes how I planned and completed a Fellowship in Forensic Psychiatry in Calgary, Alberta, Canada, during the 5th year of training for the FRANZCP.

Since the first day of IYOP (International Year of Older Persons, 1999) the College has had a Faculty of Psychiatry of Old Age. A submission from the Section in Psychiatry of Old Age for a change to Faculty status was considered and approved by our College Council in late 1998.

Nineteen ninety-nine has started as a year of high achievements for a number of Fellows and colleagues associated with the College in both Australia and New Zealand.

Hello everyone! After more than a month in the College secretariat now, I feel quite at home. This is largely due to the warm welcome that I have received from everyone here and also from those Fellows and other staff members with whom I've had contact so far. I can't even claim the title of newest arrival in the office any more, so it must be time to get down to work.