The Child and Adolescent Psychiatry Section has agreed that a view should be formulated about the management of suicidal attempts in young people under sixteen. This report of the Section's Working Party is being published with Council's approval. (Members of the Working Party: Dr M. Black (Convener), Dr J. Erulkar, Mr M. Kerfoot, Professor R. Meadow and Dr H. Baderman.) A Working Party of the Public Policy Committee, which includes representatives of other professions, is continuing discussion of this topic.

I should like to draw to the attention of psychiatric colleagues the guidelines for the use of PPG assessments. These were produced by a working group of forensic psychologists drawn from the special hospitals, NHS regional and district forensic services, the Prison Department and youth treatment centres.

Some 40 years had passed since the death of Mozart, and Donizetti had made a name for himself with Anna Bolena and L'Elisir d'Amore. His music is certainly more fragile than Mozart's and his originality lies in his use of melody which is masterfully constructed to evoke humour, sentimentality and tragedy. In Lucia his musical canvass is, perhaps, the greatest he ever painted. Based on a story by Sir Walter Scott, it tells of the love of Lucia for Edgar of Ravenswood, who is the last of a rival household. In order that the Lammermoors' fortunes can be retrieved, Lucia's brother, Lord Henry Ashton, arranges for her to marry a politically influential figure, Lord Arturo Bucklaw. Ashton arranges that a forged paper indicating the infidelity of Lucia's lover is passed to her. She believes herself deserted and unwillingly consents to marriage with Bucklaw. On sealing the contract with her signature at the wedding, Edgar appears, having returned from France to claim his Lucia. Convinced that she has betrayed his love he damns her and throws the ring she gave him at her feet. The effect of this is to drive Lucia insane, she slays her husband and dies of her sorrows. Edgar waits to duel with Lord Ashton outside the castle. But Ashton flees, leaving Edgar in solitude. Edgar is then told by a procession of Lucia's death. He kills himself in sorrow.

Music therapy is a non-analytic therapy concerned with the creative process in which an attempt is made to reach the emotions of the patient without recourse to verbal means. It should in theory be suitable for chronic psychotic patients and all whose verbal ability is minimal. The ability to appreciate music may persist despite psychotic disintegration and provides one way, maybe the only way, into a patient's inner life. Music is one aspect of the aesthetic or creative experience that neurotic patients often lack and for this group music may provide a broader view of emotional life than their own more narrow previous experience.

This article explores some basic questions about management and reveals that psychiatrists may already have a head start in management. The aim is not to make good psychiatrists into managers, but to enable good psychiatrists to provide good mental health care.

Up to one third of patients referred for psychotherapy fail to attend for their first appointment (O'Loughlin, 1990). Psychotherapy assessments are usually allocated a considerable portion of uninterrupted time, and an unexpected non-attendance wastes significant clinical resources. A variety of strategies have been used to ensure that assessors are not left waiting for a patient who never comes. One method is to send out forms which must be completed and returned before a first appointment date is given. In O'Loughlin's study, in which a similar questionnaire to that detailed in this paper was used, it was suggested that sending a pre-appointment questionnaire reduced the default rate.

The above quotation comes from the general public group discussions which were part of MORI's survey on public attitudes to mental health. This investigation was commissioned by the Mental Health Foundation as part of the events making the charity's 40th anniversary appeal.

Following the recommendations of the Butler Report (Home Office, 1975), there has been a slow growth in the number of Regional Secure Units (RSUs) (Snowden, 1985), which aim to assess and treat mentally disordered offenders in England and Wales in conditions of “medium security”. One particular recommendation of the Butler Report was that:

“The main emphasis in forensic psychiatric services … should be on community care and out-patient work.” (paragraph 20.14)

A generation of digital natives are living their lives in fundamentally different ways from previous generations. The rapid advance of the internet and mobile telephones, and the adoption of online social media, mean that substantial parts of the social lives of young people are played out in online settings. This has implications for how young people discuss and seek help for mental health problems. This commentary discusses the role of online forums for young people who self-harm. Practitioners need to understand the potential harms and benefits, and explore how benefits can be harnessed and harms minimised.

The life of an institution may come to an end. The closure of a large mental hospital is an event of great emotional importance analogous to the death of an individual. Man has developed a set of rituals to help him cope with emotional turmoil released by bereavement. Since the death of an institution is not common the need for mourning rituals is not so generally acknowledged. We describe a ceremony to mark the closure of Cane Hill Hospital, Surrey.