This book provides a practical guide to qualitative data analysis which, by using examples from comedy sketches and avoiding taking a theoretical perspective, is accessible to people from a range of backgrounds. It is intended to be a guide for people using computers in analysing their data and demonstrates the advantages of using computers as a tool for organizing and interrogating qualitative data.Most of the book is devoted to a step by step description of the process of analysing qualitative data, from reading and annotating the data through to producing an account of interpretations. Of particular use it details how (and why) to create and assign categories to the data, how to make links and associations between these categories, and how to test out emerging hypotheses. This process is in my experience often omitted or at best glossed over in many texts and courses on qualitative research, leaving the prospective researcher mystified as to how to get from some text and a few ideas to a grounded theory of the topic under investigation. This book provides the missing links which will be an invaluable aid to anyone intending to be personally involved in a qualitative data analysis.

GP recognition of psychological problems varies according to patient ethnicity but can be substantially masked by both the physical and social circumstances of patients at consultation.

Many people with psychiatric morbidity are not receiving treatment either from primary care or specialist services. High levels of severe morbidity and compulsory admissions highlight the pressures placed on inner-city psychiatric services.

In order to improve the uptake of mental health care, new initiatives should target those who are most likely to be unwell but least likely to access services. Purchasers and providers need to address differential patterns of use when developing and reviewing services.

The excess morbidity for alcohol use disorders reported in people born in Ireland is affirmed and the need for longitudinal and ethnographic research into this important public health issue emphasised.

Mental health services have a limited role in circumventing homelessness among people with psychotic disorders. An integrated approach involving other key agencies is required.

Ethnic diversity both in the characteristics of patients and their patterns of psychiatric care should be addressed when planning and developing services.

Mental health services have been criticised for failing to respond to the needs of the rising number of homeless mentally ill. We report on the first year of referrals to a community mental health team established to meet the needs of the severely mentally ill homeless in Birmingham. Most users had a psychotic disorder and a lengthy history of unstable housing, and experienced a range of other disadvantages. Although the team is successfully reaching its priority group, examination of other characteristics of users has highlighted a number of issues which should inform the future planning and development of the service.A sizeable proportion of the homeless population suffers from severe mental illness (Scott. 1993). There is growing recognition that these people are not adequately served by mainstream mental health services (House of Commons Health Committee. 1994; Mental Health Foundation. 1994; Health Advisory Service, 1995). They move frequently across community mental health team catchment area boundaries making it difficult to carry out comprehensive assessments and to provide adequate follow-up (Ritchie et al 1994) New approaches to service delivery are required if this situation is to improve (Dixon et al, 1995).Research in West Birmingham (a deprived multi ethnic inner-city area) estimated the six month prevalence of psychiatric morbidity among residents of communal establishments (defined as multi-occupancy accommodation for four or more people providing communal catering) at 42%, half of whom were suffering from a psychotic disorder (Sashidharan et al, 1995a). Of those with mental health problems only 58% were in contact with psychiatric services. Almost two-thirds of the 170 residents interviewed had been at their current address for six months or more and it was proposed that their needs could best be met by local community mental health teams (Sashidharan et al, 1995a). However, a substantial minority were highly mobile and likely to be excluded from services providing care to residents in defined geographical areas. Lar gely as a result of these findings, the city-wide community mental health team for the homeless was established. It was intended that the team should focus on itinerant single homeless people, prioritising those with severe and persistent mental health problems not in contact with mainstream services.For most of the year the team consisted of a consultant psychiatrist (0.5 FTE), three com munity psychiatric nurses and one resettlement officer. The service operates during office hours. Users requiring in-patient care are admitted under local consultants determined on a rota basis. Referrals are accepted from any source, but the team actively targets direct access hostels in the city. Interventions are broad based and include a strong emphasis on social aspects of care, especially assistance with finances and accommodation.The aim of the study was to assess the introduction of the new service, to determine whether or not the team was successfully reach ing its target group, and to c...