AIMS AND METHODTo study the attitudes and opinions of doctors and medical students with regard to psychiatric illness a questionnaire was sent to all medical students (832) and all doctors of all grades (441) at a London teaching hospital.RESULTSA total of 520 questionnaires were returned. More than 50% felt that people with schizophrenia and drug and alcohol addiction were dangerous and unpredictable. It was felt by the majority that people were not to blame for their conditions and there were low negative responses towards lack of treatability for a majority of conditions.CLINICAL IMPLICATIONSThere were more optimistic views with regard to treatment than the general population. There appeared to be a lessening in stigma as experience increased. This would suggest that early improved education and exposure in the future may lead to a greater decline in stigmatised attitudes.

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Within the UK, it is envisaged that Early Intervention Services will be developed nation‐wide by 2004 and these are expected to adhere to a strict model of service structure and provision. This uniform approach seems to lack the flexibility required to cater for local needs. Therefore, it would appear more appropriate to develop Early Intervention Services based on assessments of first‐episode psychosis (FEP) within the context of the local mental health economy and current service provision. A survey of FEP cases within South and West London revealed that existing mental health services were unable to adequately provide specialist care to this client group. As a result, it was decided to set up a tertiary service to provide comprehensive care to FEP patients based within the community. This package comprises assertive engagement, intensive keyworker support, atypical antipsychotics, psychosocial interventions, specialist psychological treatments, occupational therapy and educational/vocational rehabilitation. An ongoing evaluation of this specially tailored service is being conducted, focussing on patient characteristics, pathways to care, service delivery, patient outcomes and patient, carer and referrer satisfaction.