While Youth Access attempts to organise voluntary counselling services for young people on a national level research describing such agencies is lacking. In order to investigate their activity with a view to multi-agency collaboration, a questionnaire was distributed to eight agencies in Hampshire.

The responses demonstrate a strong emphasis on accessibility and informality. Although agencies have reported increasing numbers of service user contacts little attempt has been made to quantify and evaluate the service provided.

Efforts to organise, evaluate and improve accountability in the voluntary sector might spoil these fundamental components for the disaffected adolescent.

To introduce a monthly screening clinic for new patients referred to the community mental health team with less severe mental health problems.

Sixty patients were selected for screening in the first year. Their non-attendance rate of 48% was more than double the rate for all new patients. We did not diagnose severe mental illness in any patients on first assessment or during the 6 months of follow-up.

Patients referred from general practice with minor psychiatric morbidity may have particularly high rates of non-attendance. The brief screening clinic model offered us considerable savings in consulting time. The outcome for our service is shorter waiting times for patients with more severe mental health problems.

To examine trends in appeals to mental health review tribunals and hospital managers' panels in a hospital covering two outer London boroughs from 1997 to 2007. Data were also used to explore associations between demographic variables, including ethnicity, and the results of appeal hearings.

The number of detentions under Mental Health Act Sections 2, 3 and 37 rose from 203 in 1996 to 279 in 2006. the percentage of these that went to appeal increased from 34% to 81% during the same period. However, there was no observed trend in the result of the appeals. the results were not associated with gender, ethnicity, marital status, age or the section involved; 12% of appeals were successful.

The study shows rising use of the Mental Health Act over the past 10 years and an increasing volume of appeals against its use. Since appeals are no more likely to result in discharge, the increased use of the Mental Health Act is not balanced by increased rates of discharge by review hearings. the study also demonstrates the rising workload for all involved in appeal hearings.

The Community Care Act came into effect in April 1993. In order to see what impact this would have on the discharge profile of dementia inpatients, prospective studies of inpatient discharges from a dementia assessment ward before the Act, and five and 41 months after the Act were conducted.

The proportion of patients discharged to their own homes and to residential/nursing homecare remained unaffected by the Act. Duration of hospital stay increased after the Act in 1993 and 1996 (P=O.02) largely due to delays in placement into care homes. Placement delay was increased both in 1993 and 1996, but by 1996 the difference was no longer statistically significant. Duration of hospital stay was unaffected by the Act for those patients discharged to their own homes.

The new care management process by social services was found to be associated with delayed discharges for people with dementia requiring residential/nursing home placements, thus causing pressures on beds and hig her in-patient costs.

Atypical antipsychotics have less neurological side-effects than the older drugs but are only available as oral preparations. This may limit their use in forensic patients. We sent a postal questionnaire to all consultant psychiatrists working in forensic settings in the UK to determine their views.

The response rate was 60%. Respondents tended to overestimate the benefits and underestimate the side-effects of the atypical antipsychotics. The majority often prescribed atypical antipsychotics and depots together. Psychoeducation and serum level monitoring were used to optimise/monitor compliance by 50%.

Using atypical antipsychotics as monotherapy is problematic in forensic settings. The extent of polypharmacy means that patients may experience the side-effects of both typical and atypical antipsychotics. More could be done to facilitate and monitor compliance.

To assess safe practice in psychiatry and self-perceptions of safety among trainees (Senior House Officers (SHOs) and Specialist Registrars (SpRs)) and consultants, a questionnaire was sent out to all general adult and old age psychiatrists, including trainees, in a teaching hospital and a district general hospital in East Anglia.

A total of 29 SHOs, 11 SpRs and 27 consultants were approached (response rate 92%). In the past year 69% SHOs, 45% SpRs and 11% consultants attended breakaway training. Interview rooms were frequently below the Royal College of Psychiatrists' standards; 87% of the rooms did not have a panic button and 62% were isolated. Most doctors had felt threatened over the past 6 months but only 31% carried a personal alarm. Despite similar frequencies of assaults, consultants felt safer at work than trainees.

Safety is important for doctors throughout their careers and should be regularly reviewed by individuals as well as audited by hospital trusts.

To evaluate the introduction of service user-led teaching on experiences of psychiatric services and interview style into the educational programme of trainee psychiatrists. A ten-session programme was devised and delivered in conjunction with a local service user organisation. Twelve trainees underwent the training programme. Evaluation was undertaken through analysis of the feedback forms completed by the trainees.

No significant difference was found between service user-led and psychiatrist-led sessions in content, relevance or presentation.

The study demonstrated that service user-led teaching can be integrated into a trainee's education programme without reducing the perceived quality or relevance of their education.

A retrospective case note study provided data on the service consumption and outcome of treatment for a cohort of adult anorexia nervosa sufferers treated in a specialised secondary service.

A cohort of 106 patients was studied. Only just over a quarter were ever admitted. Of a subset of 78 patients, first seen before 1994, nearly one-fifth failed to engage in treatment. Those who were admitted spent on average a total of 10 months in hospital, were in touch for four years and had over 100 therapy sessions. The majority who were treated solely as out-patients remained in touch with the service on average for over two years.

Services for anorexia nervosa sufferers need to plan for prolonged contact with their patients and high rates of service consumption.