By means of a postal survey of all consultant psychiatrists (n = 143) in the South East Thames Region, the authors examined factors associated with psychiatrists' decisions to impose restrictions on certain patients' access to admission. Twenty-two per cent of respondents reported the use of admission restrictions. Usage of this measure was associated with a local absence of psychotherapy services (OR 0.34; 95% CI 0.17-0.63) which might suggest that there is a need for more equal access to specialist psychiatric services across health districts.