In the centre of Norwich stands a red brick building which has a rare place in psychiatry. Its history began on 12 December 1712 when a lease on a small piece of waste ground was granted by the Corporation of the City of Norwich to four men. The men were acting as trustees for an elderly widow, and the deed specified the purpose of the lease: it was to build a house, or houses for “the benefit and use of such as are lunatics.” The term of the lease was 1,000 years at an annual rent of one peppercorn. The widow was one Mary Chapman. Born in 1647, she was the daughter of Thomas Mann, Mayor of the city and one of the richest and most influential men in Norwich. It is thought that she grew up close to the city's Bridewell, where many difficult lunatics would have been housed, and she is known to have had immediate experience of mental illness in her own, and her husband's families. In 1682 she married a widowed cleric, Samuel Chapman, some years her senior and the vicar of a local parish. Together they made plans for the Bethel but in 1700 she was widowed and left childless. Despite this she continued to develop her charitable project. The final choice of name, Bethel, or house of God, was her husband's.

Music therapy is a non-analytic therapy concerned with the creative process in which an attempt is made to reach the emotions of the patient without recourse to verbal means. It should in theory be suitable for chronic psychotic patients and all whose verbal ability is minimal. The ability to appreciate music may persist despite psychotic disintegration and provides one way, maybe the only way, into a patient's inner life. Music is one aspect of the aesthetic or creative experience that neurotic patients often lack and for this group music may provide a broader view of emotional life than their own more narrow previous experience.

The 1983 Mental Health Act gave increased responsibility to the Mental Health Act Commission and the Mental Health Review Tribunal to ensure safeguards in the treatment and detention of patients compulsorily admitted to hospital. Although most are agreed that the civil rights of patients admitted to hospital against their will are better protected under the new Act, some psychiatrists are irritated by the necessity to involve these bodies in what they regard as primarily clinical management. The North-East Division of the Royal College of Psychiatrists believed that debate on this issue might benefit both psychiatrists and others involved and this topic was chosen for the Annual Meeting of the Division in York on 28 September 1990. The meeting attracted other mental health care professionals and of the 144 participants almost one-third were not psychiatrists, but mainly social workers and psychologists. The sessions were chaired by the President of the College and Professor Donald Eccleston.

Ernest (Ernie) Gruenberg was born in New York City on 2 December 1915 and died in Washington on 2 July 1991. He was the second son of Ben, an educator, and Sidonie, founder of the Child Study Association of America, who together produced one of the earliest books for the sex education of children.

Recent legislation, the Access to Health Records Act (1991), which came into force in November, will mean that patients will be able to apply for access to their written case file. This law will not be retrospective, and notes written before this date will not therefore fall under the scope of the act. Similar legislation has already been passed enabling access to Social Services case files (Access to Personal Files Act, 1987). The legislation follows increasing pressure for consumer rights in various areas and follows similar developments allowing access to health records in other countries.

Sir Robert Armstrong-Jones was President of the Medico-Psychological Association in 1906.

The Royal College of Psychiatrists (1989) has recently produced its own preliminary report on medical audit. It defines medical audit as: “The systematic, critical analysis of the quality of medical care, including the procedures used for diagnosis and treatment, the use of resources and the resulting outcome and quality of life for the patients.” This definition is in essence similar to that of the Royal College of Physicians.

Exchange visits with Soviet colleagues are being encouraged. I recently had the opportunity of spending two weeks visiting services for drug misusers in the Soviet Union with two colleagues, a visit sponsored by the British Council as a UK/USSR collaborative project. We spent most of our time in Leningrad and the surrounding region, and a short time in Moscow. Since then a party of Russian specialists has visited the Wessex Region to see drug and alcohol services.

The Matthew Trust has argued that ex-offenders and ex-patients of the special hospitals should not be allowed to do jury service until they have had at least ten years without offending or have been out of an institution for at least ten years. Mr Peter Thompson, Director of the Matthew Trust, argues that this period is necessary, in order to overcome the effects of institutionalisation and adjust to life in the community. The ex-offender or patient is held to be under such psychological pressure during this ten years, largely as a result of society's prejudices, that he would be unable to perform objectively on a jury.

The NHS and community care reforms have implications for trainee psychiatrists, but many consultants are unable to instruct trainees in these areas.