Abstract

I was surprised to read that heroin prescribing was considered controversial ([Luty, 2005][1]). In the 1970s my colleague and I had no serious problems prescribing heroin and cocaine. In the 1980s and’90s Dr John Marks successfully prescribed heroin in Widnes but there was great hostility to his

Highlights

  • The divide between services for children and adults with mental health problems continues, so I was pleased to read the article by Singh et al (Psychiatric Bulletin, August 2005, 29, 292-294) which draws our attention to this matter again

  • I think that more emphasis should have been placed on the important role of training, for junior psychiatrists and general practitioners (GPs) who will be in the vanguard of developing or commissioning services in the future

  • Foreman (2001), for example, found that 47% of GPs sampled had no undergraduate training in child and adolescent mental health service (CAMHS) and 93% had negligible postgraduate experience

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Summary

Gaps in adolescent services

Singh et al (Psychiatric Bulletin, August 2005, 29, 292-294) highlighted problems at the interface between adolescent and adult mental health services. As an adult community service provider I encountered a young lady in crisis whom I considered required adolescent services - she was 15 and still at school. She was 15 and at school, but she had left home so she did not qualify for their service, despite the fact that the reason she left home that morning was because she had discovered that her mother was having sex with her boyfriend! That can’t be right as we have more ‘non-service’ delivery scandals than ever. Perhaps this wouldn’t happen in the UK? Perhaps this wouldn’t happen in the UK? Perhaps I’m just naive?

The interface between child and adult mental health services
Findings
Guidelines for prescribing injectable heroin and methadone

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