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Authors' reply
EDITOR,--We acknowledge the fears of Fred Kavalier and Raymond K Akwayena concerning the accuracy of our statement that there are a "considerable number" of overseas patients in London's acute psychiatric wards. Reliable data cannot be obtained, since London is a cosmopolitan city and many patients have temporary addresses. Patients who are psychotic, frightened, or confused by language difficulties enhance the problem. Patients' non-residential status may emerge only weeks after their admission. The key issue is one of resources for London; this is exacerbated by ignorance about its true population and highlighted by the current dangerous shortage of beds for mentally ill patients.
Our view is that such admissions are inevitable and that funding should be available to adjust for the demand. We enjoy the challenge of multicultural presentations, which make for a stimulating and diagnostically varied practice; that is why we work in London. Immense benefits can accrue in terms
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