To ascertain current levels of access to home treatment for those with acute mental illness and future plans of trusts and purchasing authorities to provide such services. Also, to assess the attitudes of these organisations towards this form of treatment. A postal survey of all mental health trusts and purchasing authorities within the UK was carried out.

One hundred and seventy-two trusts and 82 health authorities returned questionnaires, representing a response rate of 75% and 67% respectively. Only 27 (16%) of trusts provided home treatment but 58 (40%) had plans to do so. All health authorities and 97% of trusts were in favour of the principle of providing home treatment.

Despite the low levels of provision of home treatment trusts and health authorities were strongly in favourof it. There is likely to be a large increase in its availability over the next 12 months.

Although the Health of the Nation Outcome Scales (HoNOS) were designed for routine clinical use, completion rates in clinical settings rarely exceed 60%. We evaluated two initiatives to increase completion rates: timely feedback to clinicians, useful at individual, team and service levels, and improved supporting materials (tabulated glossaries for all versions covering the life-span).

Clinicians in South Shore Health district provided ratings on all outpatient referrals over 12 months as part of routine care. Data were captured using the Nova Scotia routine administrative data system. Completion rates rose from 61% to 86% (n=1190). Clinicians' ratings of the instrument's ease of use were significantly improved.

Use of a tabulated glossary and enhanced feedback of clinically useful information improved clinician support for the routine measurement of health outcomes with HoNOS.

To identify the questions patients most commonly ask their psychiatrist. For 200 consecutive psychiatric patient consultations, answers to the invitation, “Do you have any questions you wish to ask me?” were recorded along with diagnosis. The most frequently asked questions were noted and compared across patient groups.

Most patients wanted to know when medication could be reduced or stopped. Some patients asked for more medication. Concerns about side-effects and fitness to drive were also common. A high proportion of patients (21–57%) asked no questions.

Psychiatrists must be prepared to answer questions effectively on the necessity and benefits of long term medication. These may be useful facts to include in a patient information leaflet. Side-effects of medication should also be taken seriously. Many patients lead impoverished social lives, with low levels of interpersonal interaction. This may be a barrier to participation in the clinical interview, and diminish the likelihood of posing questions.

To determine values for reliable change and clinically significant change for the Leeds Dependence Questionnaire (LDQ) and Social Satisfaction Questionnaire (SSQ). The performance of these two measures with the Clinical Outcomes in Routine Evaluation (CORE-10) as three dimension measures of addiction was then explored.

The reliable change statistic for both LDQ and SSQ was ≥4; the cut-offs for clinically significant change were LDQ 410 males, ≤5 females, and SSQ ≥16. There was no overlap of 95% CIs for means by gender between ‘well-functioning’ and pre- and post-treatment populations.

These data enable the measurement of clinically significant change using the LDQ and SSQ and add to the evidence for the performance of the LDQ, CORE-10 and SSQ as dimension measures of addiction. The CORE-10 and SSQ can be used as treatment outcome measures for mental health problems other than addiction.

This article examines mental health disorders as individuals transition from adolescence to adulthood. Data were collected from clinical records of patients who had transitioned from child and adolescent mental health services to adult mental health services in a region in South Wales. Demographics and clinical diagnoses under both services were recorded. Patterns between adolescent and adult disorders as well as comorbidities were investigated using Pearson's χ2-test and Fisher's exact test.

Of the 98 patients that transitioned from one service to the other, 74 had changes to their diagnoses. There were 164 total changes to diagnoses, with patients no longer meeting diagnostic criteria for 64 disorders and 100 new disorders being diagnosed. Comorbidity increased in adulthood.

Diagnoses can evolve, particularly during adolescence and early adulthood. Therefore regular reassessment is paramount for successful treatment.

None.

We surveyed the views and experiences of all mental health professionals in adult community mental health teams and approved mental health professionals in 2Gether and Oxford Health NHS Foundation Trusts, regarding the use of community treatment orders (CTOs).

A total of 288 surveys were completed (response rate 48%). Forty-eight (83%) psychiatrists and 142 (67%) non-psychiatrist mental health professionals were in favour of CTOs. The decision-making regarding CTOs was overwhelmingly clinically oriented for all professional groups. However, there were significant differences in views between groups regarding the effects of bureaucracy, the infringement of human rights and coercion.

Multidisciplinary team involvement is crucial in decisions regarding CTOs and may protect against idiosyncratic or unhelpful practice. Further training for staff is urgently required and there may be a case for creating small local reference groups that can develop expertise and provide advice and support for clinical teams.

To ascertain the prevalence of metabolic syndrome in individuals with chronic enduring mental illness attending community psychiatric day centres, and to identify the prevalence of individual cardiometabolic risk factors and the rate of screening for these abnormalities. One hundred participants with chronic enduring mental illness were recruited and investigated using physical assessments and comprehensive laboratory testing.

Of the 100 participants recruited, 55% met the criteria for metabolic syndrome. There were similar prevalence rates between those with psychotic and non-psychotic disorders. Forty-four per cent of the patients had not been screened for metabolic parameters in the previous 12 months, and 43% of these met criteria for metabolic syndrome.

Chronic enduring mental illness is associated with high prevalence rates of metabolic syndrome regardless of diagnosis or use of antipsychotic medication. A substantial proportion of this standard cohort of patients attending day centres carry cardiovascular risk factors that remain unidentified, but should be screened for and intensively managed.

This study was conducted to ascertain the clinical characteristics of patients who repeatedly attend accident and emergency (A&E) department seeking psychiatric assessment and care. We identified 24 individuals who attended frequently and compared them with 72 matched single attenders using data abstracted by chart review.

Individuals who attended frequently made up 5.3% of all patients who attended the A&E department for psychiatric care but accounted for 19% of all such presentations. Compared with controls, they were younger at first psychiatric contact and had higher rates of schizophrenia and psychiatric admissions.

A small but distinctive group of patients repeatedly seek and obtain hospital-based psychiatric care. Early identification of these patients and targeting them with effective, community-oriented strategies, such as home treatment, could improve their quality of life and prognoses as well as reduce the cost of their care.

The aim of the study was to determine whether diagnostic case-mix influenced the distribution of clinical activity within the community mental health team (CMHT). Information concerning every patient involved with the CMHT and every episode of clinical activity was collected over a 2-week period.

Data were obtained concerning 417 patients and 1744 corresponding episodes of clinical activity. Diagnostic case-mix significantly differed between the professions. The duration of episodes of clinical activity varied significantly according to the type of patients involved and whether or not direct face to face contact occurred.

Diagnostic case-mix, in addition to absolute numbers, should be considered when estimating the actual work generated by the different professions' case-loads. Patients with psychosis may place an increased time burden upon CMHT members.