We studied a representative cohort of 161 patients over 65 years of age, admitted non-electively to medical and geriatric wards of a large teaching hospital. Assessment for dementia was made using DSM–IV criteria. Psychiatric records were then examined, masked, to determine the involvement of psychogeriatric services.

There were 111 possible cases of dementia (69%), of which 30 (27%) had prior local psychogeriatric case notes; in 22 cases (20%) the patient had a prior psychiatric diagnosis of dementia. of 161 patients, 19 (12%) were seen by psychogeriatric services during their admission, of whom 12 (7%) were already known to psychiatric services. Dementia was diagnosed in 17 (complicated by delirium in 2), depression in 1 and hypomania in 1. Many patients with a possible diagnosis of dementia had no psychiatric assessment.

Psychogeriatric assessment was performed on a minority of older people admitted to medical care. This population may include older people with undiagnosed dementia and unmet psychiatric care needs.

The Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) were developed as a routine measure of outcomes in child and adolescent psychiatry. In a preliminary study we administered sub-scale 12 of HoNOSCA (Family Life and Relationships) to 20 families and compared the results with two well-established measures of family functioning and a measure of abnormal psychosocial situations associated with psychopathology.

Strong correlations were found between HoNOSCA sub-scale 12 and both self-assessed and clinician-assessed measures of family functioning. However, there was little relationship between HoNOSCA (12) and a measure of abnormal psychosocial situations.

HoNOSCA (12) appears to provide a quick and valid assessment of overall family dysfunction and can be used in a time-efficient manner as a means to assess where further more comprehensive family assessment or family therapy may be required.

In this paper an experience of facilitating a weekly support group for nursing staff on an oncology ward is described. A brief overview of burnout among oncology nurses is followed by a description of the processes by which the support group was established.

Some of the functions that the group has come to provide and recurring themes are highlighted along with a more theoretical understanding of the nature of groups within institutions.

Support groups can help prevent isolation and demoralisation.

Computers and information technology (IT) play an increasingly important role in the working lives of psychiatrists. Previous studies have shown that computer access and skills among psychiatric trainees were inadequate. This survey aimed to assess the level of access to, and skill in, different IT applications among consultants and trainees in Northern Ireland, as well as what training is offered and needed.

Most doctors (91%) had access to the more basic applications, such as word processing, and most felt at least adequately skilled. However, access to and knowledge of statistical software was particularly poor. A minority of doctors were offered training in IT (39%), even though most employers provided this facility.

Psychiatrists need greater access to IT, and need to make greater use of available training. This is especially relevant in light of future policy directions and the trend for evidence-based practice.

To establish the incidence of venous thromboembolism (VTE) in mental health services for older people (MHSOP) in-patient units, and investigate current practice in terms of assessment of risk of VTE and treatment given. We conducted an incidence survey of VTE on in-patient units in MHSOP in a National Health Service trust, searching data of in-patients discharged over a 2-year period.

Overall, 1495 individual patient records were searched. There were 17 confirmed VTEs, which is comparable with VTE incidence rates in general hospitals. There were no risk assessments done on admission and no thromboprophylaxis given. Use of compression stockings and mobilisation was limited.

The study confirmed a significant VTE incidence and the need for increased awareness among MHSOP staff. This can be met by improved training of VTE awareness and management for clinical staff and the use of a VTE assessment tool on MHSOP in-patient units.

This article considers the role that assessment of suicidal ideation may have in short-term prediction of suicide. Suicide risk assessment is a multifactorial process and it is assumed that assessment of suicidal ideation is one component. Denial that suicidal ideation has any useful role in risk assessment fails to allow for the marked ongoing short-term variability in severity of intent, which is a common feature of the suicidal state of mind. It is concluded that the assessment of suicidal ideation, provided it is carried out correctly and applied appropriately, should continue to be regarded as a central component of the overall prediction process. A ‘two-take’ approach to short-term risk assessment and mitigation is proposed that takes variability in severity of intent into account and includes anticipatory treatment planning for any problems that may occur in the near future.

To evaluate the feasibility of integrating a clinical librarian (CL) within four mental health teams. A CL was attached to three clinical teams and the Trustwide Psychology Research and Clinical Governance Structure for 12 months. Requests for evidence syntheses were recorded. The perceived impact of individual evidence summaries on staff activities was evaluated using a brief online questionnaire.

Overall, 82 requests for evidence summaries were received: 50% related to evidence for individual patient care, 23% to generic clinical issues and 27% were on management/corporate topics. In the questionnaires 105 participants indicated that the most common impact on their practice was advice given to colleagues (51 respondents), closely followed by the evidence summaries stimulating new ideas for patient care or treatment (50 respondents).

The integration of a CL into clinical and corporate teams is feasible and perceived as having an impact on staff activities. A CL may be able to collate ‘personalised evidence’ which may enhance individualised healthcare. In some cases the usual concept of a hierarchy of evidence may not easily apply, with case reports providing guidance which may be more applicable than population-based studies.

We surveyed old age psychiatrists in the north-east of England to determine what they considered relevant indicators of driving ability. The survey asked about their satisfaction with the current Driver and Vehicle Licensing Agency (DVLA) procedure of assessing competence to drive in patients with dementia and how they thought this could be improved.

Fifty-seven out of 76 psychiatrists (75%) responded; 26 (45%) respondents thought the forms issued by the DVLA were unsatisfactory but 32 (57%) were satisfied with the eventual decisions made about individual patients. Factors thought to be relevant indicators of driving ability were occupational therapy (n=46, 81%), neuropsychological assessments (n=43, 75%) and carer's report of driving (n=48, 84%). Factors thought not to be relevant were patient's report of driving ability (n=13, 23%) and the Mini Mental State Examination (n=21, 38%).

The current system for determining driving ability in people with cognitive impairment and dementia was felt to be unsatisfactory. A multidisciplinary approach and use of on-road driving assessments may improve decision-making.