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4 results

  • Clinical memory, functionalisation and fragmentation of care in UK psychiatry

  • Swaran P. Singh
  • Journal:
    BJPsych Bulletin , FirstView
    Published online by Cambridge University Press:
    20 July 2026, pp. 1-3
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  • Functionalisation – the separation of in-patient and community consultant roles – has eroded the longitudinal clinical memory of individual patients. Unlike specialisation, which deepens expertise, functionalisation has fragmented patient care. In functional models, critical decisions regarding admission, discharge and aftercare are often made without a comprehensive knowledge of the patient’s history. National inquiries highlight that risks cluster at these transition points, where information is fragmented and responsibility is unclear. Functional models fail to improve efficiency while significantly damaging continuity of care. Reform must become a proactive clinical priority rather than a reactive response to adverse events or inquiry findings.

  • General psychiatry, still in no-man's land after all these years: commentary, Deahl

  • Martin Deahl
  • Journal:
    The British Journal of Psychiatry / Volume 225 / Issue 1 / July 2024
    Published online by Cambridge University Press:
    02 September 2024, p. 294
    Print publication:
    July 2024
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  • General psychiatry, still in no-man's land after all these years

  • Martin Deahl
  • Journal:
    The British Journal of Psychiatry / Volume 224 / Issue 3 / March 2024
    Published online by Cambridge University Press:
    29 November 2023, pp. 86-88
    Print publication:
    March 2024
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  • Mental health services have changed beyond recognition in my 38-year career. In this editorial I reflect on those changes and highlight the issues that undermine patient care and damage staff morale. In particular, modern mental health services have undermined the therapeutic relationship, the bedrock underpinning all psychiatric treatment.