Do Psychiatric Journals Have a Future in the Age of the Internet?

I write this piece as the editor of the British Journal of Psychiatry, which 2 years ago celebrated its 150th anniversary. It started its life in 1853, as the Asylum Journal of Mental Science, with fairly modest aims. Although it was originally meant to be an educational journal for architects, magistrates, and other professionals apart from psychiatrists, it rapidly became a house journal for asylum doctors, dealing not so much with the science of mental health as with all aspects of the conditions within asylums (1,2). In this form, it proved a valuable forum for the isolated doctors given the appropriate title of alienists and separated from the rest of the medical profession who enjoyed more constant peer review and support. Eventually, the journal escaped the asylum bond that constricted its development and became the Journal of Mental Science, surviving in this form until 1963, when it assumed its present name under the editorship of Eliot Slater. I wish The Canadian Journal of Psychiatry all the best as it enters the second half of its centenary-the first 50 years are always the worst-and would like to offer some observations on its future in the next few years, with particular reference to the influence of the Internet and its impact. Are Psychiatrists Computer Literate? The average psychiatrist is conventionally alleged to be highly competent when it comes to understanding words, feelings, and behaviour but generally incompetent when it comes to mastering technology. Like many stereotypes, this view is frequently inaccurate, but the notion of the psychiatrist in his or her library, surrounded by books, is much more tied to our work than the notion of the psychiatrist in a paperless office with sentinels of winking computers. There has, however, been no escaping the introduction of the Internet, which has led to many predictions about the ways in which it will change our lives, not always for the better. What is clear is that in 20 years' time it will be extremely rare for any individual in a well-resourced part of the world to be ignorant of the Internet. In 1996, Bill Clinton remarked that When I took office, only high-energy physicists had ever heard of what is called the Worldwide Web. Now even my cat has its own page. (3) If kittens of the future are computer literate, even the most uncool of psychiatrists will have to join them in padding about the Net. Indeed, they already seem to be. At a European conference on neuropharmacology, held in October 2004, 80% of the 545 delegates who completed assessments used on-line psychiatric journals (see www.cnsforum.com), and while they may not represent all psychiatrists, they are clearly using the medium in large numbers. In November 2004, all the journals published by the Royal College of Psychiatrists changed to on-line submission, so we have been able to monitor on-line use. Advances in Psychiatric Treatment, one of the journals that the Royal College of Psychiatrists publishes for postgraduate education, has had 12 000 downloads of full-text articles since it went on-line, and I know from conversations with other psychiatric editors that this is not an exceptional finding. We have also asked our readers their opinions about our new on-line system. Two-thirds of them are highly positive; only one-third grumble. We know there will always be a few-and they are not all grumpy old men-who will be reluctant to embrace this new technology, but it seems likely that their numbers will steadily diminish. What these data tell us is that the psychiatric fraternity is keener than might at first seem evident to embrace on-line technology and that this technology is perceived to have particular educational value. The growth of what has become known as distance learning is going to be especially important in large countries such as Canada. Simultaneously, the increasing sophistication of video and Internet conferencing, which I noted recently when I was speaking in Halifax, Nova Scotia, and St John's, Newfoundland, is going to be an enormous boon. …

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