New collaborative care models with an emphasis on primary care are required for long-term management of patients with severe and enduring mental illness (SMI). We conducted a descriptive evaluation of clinical outcomes of the first 3 years of a novel enhanced primary care (EPC) service. Data from 2818 patients and staff survey results were analysed.

2310 patients were discharged to EPC (508 not assessed as clinically suitable or patients/general practitioners declined the transfer); mean length of stay with secondary care service of the cohort was 9.8 years (range 0–24). 717 patients (31%) have been discharged to primary care only out of the EPC services and 233 patients (10%) have been transferred back to secondary care. Patient and staff satisfaction with the new EPC model was high. No severe untoward incidents were recorded.

The data suggest that EPC can be safely provided for a significant proportion of patients with SMI, who traditionally received long-term secondary care support. The novel EPC model can be utilised as a template for the provision of cost-effective, recovery-oriented and non-stigmatising care in the community.

To compare attitudes towards mental disorders in professionals working in mental health and professionals working in different areas of medicine. Levels of emotional empathy in both groups were also investigated. In total, 58 mental healthcare professionals and 60 non-mental healthcare professionals completed our attitudes towards mental disorders questionnaire and Balanced Emotional Empathy Scale.

The results reveal generally positive attitudes towards people with mental disorders in both groups. Non-mental healthcare professionals regarded people with a mental disorder as significantly more dangerous and unpredictable than did mental healthcare professionals. There was no statistically significant difference in emotional empathy between the two groups. Both groups cited illicit drug use as one of the most significant causes of mental disorder.

Mental healthcare professionals and non-mental healthcare professionals show broadly similar attitudes and a similar degree of empathy towards people with a mental disorder. However, non-mental healthcare professionals regard people with mental health problems as significantly more dangerous and unpredictable. There is scope for further research including examining the effects of educational interventions.

The impact of flexible assertive community treatment (FACT) has been observed in people previously supported by assertive community treatment (ACT) teams, but its effect on those previously with a community mental health team (CMHT) has not been studied in the UK. An observational study was conducted of 380 people from 3 CMHTs and 95 people from an ACT team, all with a history of psychosis, following service reconfiguration to 3 FACT teams.

People previously with a CMHT required less time in hospital when the FACT model was introduced. A smaller reduction was observed in people coming from the ACT team. Both groups required less crisis resolution home treatment (CRHT) team input.

FACT may be a better model than standard CMHT care for people with a history of psychosis, as a result of reduced need for acute (CRHT and inpatient) services.

None.

To investigate the effect of the 2004 tsunami on suicide rates in Sri Lanka. the number of suicides in the 2 years prior to and 1 year after the tsunami were considered for the study. Data from districts affected by the tsunami were compared with those from unaffected districts.

No significant differences were found between the number of suicides before and following the disaster or between areas affected and unaffected by the tsunami.

Worldwise, the impact of disasters upon suicide rates is variable. It is possible that the tsunami failed to have any profound effect on societal forces affecting suicide rates in Sri Lanka.

This study explores the economic cost and carbon footprint associated with current patterns of prescribing long-term flupentixol decanoate long-acting injections. We conducted an analysis of prescription data from a mental health trust followed by economic and carbon cost projections using local and national data.

A reduction of £300 000 could be achieved across England by improving prescribing behaviour, which equates to £250 per patient per year and 170 000 kg CO2e. These savings are unlikely to be released as cash from the service, but will lead to higher-value service provision at the same or lower cost. Most of these carbon emissions are attributable to the carbon footprint of the appointment – 88000 kg CO2e (including energy use and materials used) and the overprescribing of medication – 66000kg CO2e.

Psychiatrists need to review their prescribing practice of long-acting injections to reduce their impact on the National Health Service financial budget and the environment.

Relational security is an important component of care and risk assessment in mental health services, but the utility of available measures remains under-researched. This study analysed the psychometric properties of two relational security tools, the See Think Act (STA) scale and the Relational Security Explorer (RSE).

The STA scale had good internal consistency and could highlight differences between occupational groups, whereas the RSE did not perform well as a psychometric measure.

The measures provide unique and complimentary perspectives on the quality of relational security within secure services, but have some limitations. Use of the RSE should be restricted to its intended purpose; to guide team discussions about relational security, and services should refrain from collecting and aggregating this data. Until further research validates their use, relational security measurement should be multidimensional and form part of a wider process of service quality assessment.

To survey current specialist perinatal psychiatric provisions and opinion about these services in England. A brief semi-structured confidential questionnaire was circulated to the lead clinician or manager responsible for perinatal services of the 78 mental health trusts in England.

Fifty-seven trusts (73%) responded. In 26 trusts (46%), availability of either specialist in-patient facilities and/or intensive home treatment facilities were reported. In only 13 trusts (23%) was there evidence of provision of services covering both in-patient and community components. The number of mother and baby units or their equivalents has reduced in the past decade. The services were generally considered to be inadequate nationwide and opinion remains divided about the best approach for providing them.

There is a need for a recommendation of a national standard provision of perinatal services by mental health trusts.

Many studies report prescribing preferences for antipsychotics but few have examined what professionals would choose for themselves if they were diagnosed with schizophrenia. We asked 188 nurses, pharmacists and doctors which antipsychotic they would prefer to be prescribed.

Risperidone (n=49, 26.1%), olanzapine (n=49, 26.1%) and aripiprazole (n=35, 18.6%) were the most popular choices.

Professionals' choice was in line with the latest evidence on comparative effectiveness of atypical antipsychotics and therefore might be a sensitive indicator of the most effective antipsychotic.