Following recommendations made by our 2004–2005 audit, we carried out a re-audit of the local Section 297 protocol in 2007–2008. Our aim was to establish the quality of documented information provided by the police; adherence to the protocol; completion rates of documentation; and rates of notification to the Mental Welfare Commission for Scotland, in keeping with the standards set in the Code of Practice of the Mental Health (Care and Treatment) (Scotland) Act 2003.

We reliably traced 84 POS1 forms completed in accordance with the protocol. The audit identified a rate of 74–89% notification to the Mental Welfare Commission for Scotland. By comparison, there is a surprisingly wide variation in notification rates across Scotland. Good-quality information was given by the police, despite receiving no additional training.

This audit highlights a serious lack of information about place-of-safety legislation in Scotland. For patients in the catchment area, the joint protocol and use of standard documentation has significantly standardised patient care. Other health boards and police forces should consider this as they implement legislation.

The use of the Royal College of Psychiatrists' trainee's log book was evaluated by a cross-sectional survey of psychiatric trainees and their consultant trainers.

One-quarter of trainees had not received a log book. There was a lack of mutual commitment to using the log book, with fewer than 45% of trainees believing their trainers were committed to its use. There had been little use of the log book beyond the setting of educational objectives. However, concern that trainees would be against using the log book for formative assessment was not observed.

More work needs to be done by the College to promote the use of the log book to both trainees and trainers.

Following concerns over recruitment into general adult psychiatry, this study was undertaken to determine which factors influence senior trainees in psychiatry with regard to whether or not they choose a career in general adult psychiatry. The method used was by postal survey of all senior and specialist registrars in the UK.

Of those responding, 32.6% had chosen a career in general adult psychiatry, while 38.9% had actively rejected such a career. Twenty-six per cent of respondents had chosen another speciality without actively rejecting general adult psychiatry. For those actively rejecting general adult psychiatry, the top three factors cited were poor resources (57.6%), high workload (43.2%) and poor working conditions (30.7%).

Through an awareness of why senior trainees reject general adult psychiatry as a possible career, resources can be targeted more specifically in the future at the factors responsible, and thereby improve recruitment into this speciality.

Safeguarding adults is everybody's business, and it is now standard practice for clinicians to undertake safeguarding training as part of their mandatory training in the UK. Nevertheless, safeguarding work is complex and can involve significant dilemmas for professionals. The Care Act 2014 has introduced a number of differences in the way safeguarding is approached, emphasising the overall well-being and choice of the patient rather than merely focusing on their safety. This paper sets out to illustrate evolving safeguarding demand and practice, and aid clinicians in protecting people at risk by describing how they can approach challenging presentations.

None.

We conducted a secondary analysis of data from the National Audit of Psychosis to identify factors associated with use of community treatment orders (CTOs) and assess the quality of care that people on CTOs receive.

Between 1.1 and 20.2% of patients in each trust were being treated on a CTO. Male gender, younger age, greater use of in-patient services, coexisting substance misuse and problems with cognition predicted use of CTOs. Patients on CTOs were more likely to be screened for physical health, have a current care plan, be given contact details for crisis support, and be offered cognitive–behavioural therapy.

CTOs appear to be used as a framework for delivering higher-quality care to people with more complex needs. High levels of variation in the use of CTOs indicate a need for better evidence about the effects of this approach to patient care.

The aim of this survey was to determine attitudes among consultants in different specialities towards the development of a reciprocal liaison service providing access for psychiatric patients to medical and surgical liaison services equal to the access of medical and surgical patients to psychiatric liaison services. All medical, surgical and psychiatric consultants in a district health service were surveyed, with a total response rate of 48%.

The mean number of medical and surgical patients requiring a psychiatric liaison service was 6%. The mean number of psychiatric patients requiring medical and surgical liaison services was 11%. Ratings overall for various components of the two types of liaison service were generally similar, with acute assessments and follow-up being given a high priority for both types.

As liaison services are developed, the notion of equity of access for all patients is paramount. Commissioning of such services should thereby specify the reciprocal nature of development. This survey shows that generally there is a positive attitude to the development of such a service.

Critical psychiatry takes the position that ‘mental illness’ should not be reduced to ‘brain disease’. Here I consider whether this particular stance is outdated in light of more recent exchanges on reductionism, which consider questions raised by new mental health sciences that seek truly integrative and specific biopsychosocial models of illness.

To select staff for a personality disorder service by exposing applicants to anticipated challenges. Applicants took part in a role play, an unstructured group with fellow applicants and numbers of the interviewing panel, and a panel interview. A service user representative was involved from the initial planning stage.

Multiple assessment methods enabled fine discrimination between applicants. Appointed staff said they felt the interviews were a valid test of required skills and have been well regarded by patients in the programme.

Selecting staff for a personality disorder service benefits from using multiple interview methods. The service user representative and role-play actor can contribute crucially by representing the patient's perspective. Key domains to assess include the applicant's psychological qualities, psychiatric skills and ability to work in a team.

Informed consent was obtained from the patient for publication of Box 1.

None.

There is poorer control of hyperactivity symptoms in community clinics than research settings, and difficulty in detecting such symptoms without standardised measures. Hyperkinetic children (n=29) were evaluated at follow-up using the parental version of the Strengths and Difficulties Questionnaire (SDQ) and, independently, routine clinic reports to test the value of a parental questionnaire.

The parental SDQ identified symptoms in more patients (25, 86% v. 13, 45%), but high levels of symptoms did not necessarily imply impairment. Even clinically identified hyperactivity provoked no change in treatment.

Parental questionnaires alone are unlikely to improve clinic practice. Research is needed into what factors influence clinical decisions regarding treatment maintenance for hyperkinesis, and the adaptation of structured protocols from major research trials should be considered.

To support safe prescribing of antipsychotics in dementia, antipsychotic monitoring forms were embedded into our electronic health records. We present a review of the data collected on these forms to assess prescribing and identify areas for improvement in our practice and processes. Data were extracted from the structured fields of antipsychotic initiation and review forms completed between 1 January 2018 and 31 January 2020.

We identified gaps in practice where improvements could be made, mainly with regard to physical health monitoring (and particularly electrocardiograms, performed in only 50% of patients) and the low (less than 50%) recorded use of non-pharmacological interventions for behavioural and psychological symptoms of dementia. In addition, antipsychotic treatment was continued despite lack of benefit in almost 10% of reviews.

We advocate for recommendations on physical health monitoring of people with dementia taking antipsychotics to be added to the National Institute for Health and Care Excellence guidance on dementia and the Prescribing Observatory for Mental Health (POMH-UK) national audit.