We undertook an audit of hypnotic use on two functional older adult wards, followed by an educational intervention to all nursing staff and junior doctors. We then repeated the audit.

Our pre-intervention audit showed a hypnotic use of 48%. This decreased to 26% for the first month following the educational intervention. Usage increased gradually in proportion to time from intervention. However, over the 4-month post-intervention period hypnotic use remained significantly lower than pre-intervention throughout the time period studied.

As the study is an audit there is no control group, but our results suggest regular staff education is needed to sustain a reduction in hypnotic use.

This study describes residents in seven care homes, reviews their usage of mental health services and evaluates cost implications of psychiatric health care provision.

The patients are predominantly male with multiple diagnoses who are receiving psychiatric health care, but in general lack structured rehabilitation services. Forty-seven per cent of the residents moved into the trust catchment area in order to occupy the placement.The cost associated with the provision of differing models of out-patients care varies considerably.

These vulnerable residents are costing the mental health service relatively little, although the total cost to society is higher.This study points to the necessity of multiagency planning for 'new long-stay' patients.

The association in the media of mental illness with violence is well established. This study looks at whether there are differences in the portrayal of schizophrenia in the local newspapers of Nottingham, an area with a high crime rate and Dorset, an area with a low crime rate.

We analysed 98 newspaper articles, 55 from Nottingham and 43 from Dorset, and found no statistically significant difference in the portrayal of schizophrenia. Overall, 36.1% of articles were negative in tone, 56.7% were neutral and 7.2% were positive. In 6 of the 98 articles (6.1%) a person with schizophrenia or their carer was interviewed. These articles were either positive or neutral in tone. Schizophrenia has entered the language as a metaphor.

Local levels of crime do not appear to influence the portrayal of schizophrenia in local newspapers. Associations with dangerousness continue to predominate and the lay public continues to receive a distorted image of people living with schizophrenia. More interviews with patients and carers might help to address this imbalance. It is important to explore what the word schizophrenia means to patients and carers.

To describe one of the first psychiatric services in the inner-city especially designated for female psychiatric patients with severe mental illness.

The referral system, the staffing levels and the admission criteria have been established following needs of the patients, especially young women with perinatal problems and women from ethnic minorities.

This single gender acute psychiatric ward has received welcome attention from mental health professionals and management at every level, and it is hoped that further discussion will help to clarify future policies and guidelines on all aspects of this venture.

To implement the Royal College of Psychiatrists' guidelines for the practice of electroconvulsive therapy (ECT) and measure the impact of such implementation on the quality of treatment. Treatment of ECT for periods of six months before and after implementation of the guidelines were studied. The effect on producing adequate treatments and the actions taken by the administrating doctor were noted.

Once the guidelines were in place there was a slight improvement in the proportion of treatments considered therapeutic and the doctor was more likely to take appropriate action following an inadequate treatment. However, it was also clear that despite the guidelines being available they were not followed in a significant number of instances.

Implementation of the guidelines is not easy and there needs to be considerable effort to ensure they are used. When they are followed there is an improvement in the practice of ECT.

To generate a list of topics for ‘core curriculum’ that can be used as a guide for trainees and trainers carrying out workplace-based assessments (WPBAs). A three-stage Delphi consultation was carried out.

Generation of a list of topics for WPBA appropriate for each year of core training with a mean rating of importance in curriculum.

In the absence of formal guidance, the list generated can serve as an informal guide.

We present two patients who developed refeeding syndrome following admission to a general psychiatry ward. The practical implications of assessing and managing medical consequences in patients with mental illness who start refeeding after a period of starvation are discussed.

Patients presented with overlapping clinical manifestations of mental illness and refeeding syndrome that were difficult to recognise and manage.

Awareness of refeeding syndrome in patients with mental illness may prevent fatal physical complications.

To assess the part that the 19th century asylums played in the development of the discipline of child psychiatry. Admissions to the Worcester County Asylum between the years 1854 and 1900 were screened to identify children aged 16 and under. An item sheet was used to record details of the admission.

One-hundred and ninety-five children were admitted. Risk of suicide and dangerousness were routinely recorded, family history rarely. It was not possible to make retrospective diagnoses. The death rate was high and contact with the family was minimal post admission.

Children were treated exactly like the adult patients, and therefore asylums did not contribute significantly to the development of the discipline of child psychiatry.