Response

I must say how pleased I am to be here to celebrate with you - you, Joe, and you, the staff over the years, staff and ex-staff of the Crisis Centre - all your achievements. And to celebrate the reputation you've built up over that course of time. It is also, of course, an honour to be invited to respond to these interesting, elegant papers. In the short space of time each paper was given, they provide a particularly good, transparent window into what the Crisis Centre does.

One of my thoughts about the occasion was that it is a licence for a moment of idealization and self-idealization, which psychotherapists aren't particularly good at. But the occasion isn't for that. I know because Joe wrote me a letter telling me what I was supposed to do. I may as well tell you what he told me to do! His letter says, ‘I think we want you not just to praise us as a unique treatment facility, offering psychosocial interventions for borderline and psychotic people, but to place us professionally in terms of other treatment regimes.’ Well you are, of course, unique, and a moment of self-idealization is not out of place on the 25th anniversary. But I'm going to say a couple of serious things.

You are important for the psychotic people you try to help and treat, but I think there is now a real problem about the borderline side of your work. There are other units around - the Cassel, the Henderson and similar places - who can treat severe personality disorders, the narcissistic, and the borderline cases. And, as many of you may know, the Department of Health have produced money to create two more Hendersons, one in Birmingham and one in Manchester, and to run and research them. This is going to be an enormous increase in the rather small current provision. It is going to have a profound effect on all the other units that are going to be treating borderline patients, and I think the Crisis Centre will have to take account of that particular development.

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