The patient's experience of the clinician is an increasingly important area in time of ‘consumer choice’ and appraisal of the individual practitioner. Validated, easy-to-use scales are scarce. The aim was to validate a user-friendly, brief scale measuring patient satisfaction (PatSat scale). Over three phases, patients were involved in developing and validating the scale against the Verona satisfaction subscale.

A highly significant correlation was found between the two scales (Spearman's correlation coefficient 0.97, two-tailed P <0.001).

The PatSat is a new patient satisfaction scale validated in a psychiatric out-patient population. It appeared popular with patients and took less than 1 minute to fill in. The use of validated scales measuring patient satisfaction is a pivotal part of mental health delivery and advancing overall quality of care.

To detail changes in the use of place of safety orders in England, including the outcome of these detentions, using publicly available data.

There was a sixfold increase in the rate of the Mental Health Act Section 136 detentions to places of safety in hospitals between 1984 and 2011. The use of Section 135 and the rate of subsequent detention under Section 2 or 3 also increased, but the proportion of people detained fell as the absolute rate of detention increased. There was a wide variation between regions in the use of hospitals or police stations as places of safety. The change in the annual rate of detention under Section 136 was associated with the annual change in the population of England.

The increase in detentions to places of safety in hospitals may in part reflect their move from police cells. It may also reflect a real increase in overall rate of detention and possibly a change in the threshold for the use of Section 136 detentions.

To describe patient characteristics and clinical activities at a British military department of community mental health (DCMH). Data were drawn from a clinical database over a 1-year period (n=409).

Mean age was 29 years, 50% were single and 76% were from the junior ranks. Women were over-represented compared with the wider military population. Mean length of service prior to presentation was 5 years. The main presenting problem was alcohol misuse (33%) followed by depression (19%). Twenty-five per cent were referred for psychotherapy and 68% returned to full employment after treatment.

Patient characteristics of those treated at a DCMH differ from those in the wider military. An out-patient occupational mental health service returns a substantial number of patients to occupational fitness within the Armed Forces.

We examined the prescribing practices concerning benzodiazepine and hypnotic medications at a university teaching hospital. Retrospective data from 74 consecutively admitted in-patients were analysed.

Benzodiazepines were prescribed to 51% of individuals on a routine basis and to 66% of individuals on an ‘as required’ basis. An indication was documented for 70% of individuals prescribed benzodiazepines routinely and for 29% of patients prescribed benzodiazepines ‘as required’. Hypnotic agents were administered to 24% of patients on a routine basis and 23% of individuals on an ‘as required’ basis. An indication was documented for 39% of patients prescribed hypnotic agents routinely and 12% of patients prescribed hypnotics ‘as required’.

Benzodiazepine and hypnotic agents are frequently prescribed without any clear reason provided in the patients' medical notes or prescription card.

To evaluate a comprehensive risk management programme. A Risk Assessment and Management Self-Efficacy Scale (RAMSES) was used to evaluate the impact of a clinical guideline and training course. Fifty-three psychological therapists were randomly allocated to training v. waiting list in a controlled, delayed-intervention design. Differences in mean self-efficacy scores between groups were examined using analysis of covariance (ANCOVA).

The RAMSES measure had adequate factor structure, internal consistency and construct validity. When adjusting for baseline scores and cluster design, the group exposed to training had a higher mean self-efficacy score than controls. Mean differences between groups were not significant after the control group received training, nor at 6 months' follow-up.

Exposure to training and clinical guidelines can improve self-efficacy in risk assessment and management. An important advance put forward by this study is the specification of areas of competence in risk assessment and management, which can be measured using a psychometrically sound tool.

General practitioners (GPs) were surveyed on their experience of and attitudes towards attention-deficit hyperactivity disorder (ADHD) treatment using methylphenidate, and asked about prescribing practice.

Most GPs have experience of children with ADHD and the use of methylphenidate. The majority felt that it was a drug that should be initiated by a specialist who should continue to provide clinical monitoring, but that primary care could provide ongoing prescribing and physical monitoring. There was a lack of training in this area, with most GPs requesting further training both on ADHD and its management.

ADHD is a topical issue both in the health service and with the public. This survey suggests that GPs may be willing to play a role in the management of ADHD once the child has seen a specialist, but that child and adolescent mental health services need to consider how training will be provided.

We aimed to examine variations in clozapine prescribing in all 12 NHS trusts with catchment area mental health services in one English county, over a 2-year period. We tested a series of hypotheses to explain the variation in prescribing of clozapine.

A 34-fold variation between trusts in rates of clozapine provision was found after adjusting for measures of local population need. This variation did not change over the 2 years examined. It was not explained by differences in resource level.

The evidence base is strong for the effectiveness and likely cost-effectiveness of clozapine in severe schizophrenia. Our data indicate that variations in evidence-based clinical practice at the provider level led to the wide variation in clozapine prescribing.