by chronically disturbed mentally ill patients. The south west has not experienced the latter problem and has therefore virtually always been able to admit prisoners in urgent need of psychiatric treatment. This would appear to be an extremely important use of the regional secure unit, and therefore the ability to run at just below full capacity, thus allowing for emergency admissions from prison, may be desirable. Nevertheless, there are less favourable interpre? tations of the data. The increasing use of section 48 may indicate larger numbers of severely mentally ill prisoners on remand. Could this in turn reflect a failure of community psychiatric services and a lack of longer term facilities for the severely mentally ill? Table I shows that both in the south west and nationally the increased use of section 48 has been associated with more than a 30% reduction in the number of psychiatric beds. Interestingly, nearly all of the section 48 patients in the present series were already known to the psychiatric services. It could be argued that those regions with few section 48 admissions are providing a superior service for this group of patients compared with regions that make greater use of the section 48 provision. Clearly more detailed studies are required to clarify this. It is unlikely that any straightforward conclusions can be drawn from these data. The relation between the use of section 48 and other factors such as the availability of general psychiatric facilities, secure beds, and the recognition of the need to treat mentally ill offenders outside the prison system is a complex equation. Nevertheless, the use of section 48 should be included as one of the parameters by which the psychiatric services are monitored and should be subject to regular audit. For more serious offenders suffering from mental illness who cannot be diverted from the criminal justice system at an early stage the use of section 48 should be encouraged.