Access describes factors that influence the initial contact or use of services, emphasising both the characteristics of patients and the health resources that influence the use of health services.

To compare Mexican boys and girls with mental disorders, with respect to primary diagnosis, symptom onset, and seeking and accessing specialised mental health services (SMHS).

Longitudinal data were collected from primary caregiver-reported assessments of 397 child–caretaker dyads (child mean age 12.17 years, range 5–18 years, 63% male) that were obtained in two psychiatric hospitals specialising in child mental healthcare. Student t-tests and χ2-tests were applied to compare boys and girls regarding their diagnosis and variables associated with the seeking of and access to SMHS.

Hyperkinetic disorder was the most prevalent diagnosis in boys, whereas depressive disorder and anxiety disorder were most prevalent in girls. The mean age at symptom onset for boys was 7 years, compared with 10 years for girls. Hyperkinetic disorder had the earliest symptom onset (mean 5.9 years), followed by depressive disorder (mean 9.8 years) and anxiety disorder (mean 12 years). Delayed access to SMHS was associated with initially seeking care from a psychologist, whereas quicker access was associated with affiliation with the (now defunct) Popular Insurance, a programme that served low-income and uninsured individuals.

Programmes aimed at children's mental health education and early intervention should consider gender- and diagnosis-related differences in symptom onset and trajectory. Access to SMHS might be improved by rapid identification by parents, educators, primary-care physicians and psychologists.

Psychodynamic psychiatry training seminars are a blended supervision and experiential style approach to training health care professionals in reflective practice and formulation. They apply psychodynamic theory through case formulations, seminars, and Balint groups so that health care staff can improve their communication style, formulation skills and enhance their appreciation for patients with complex mental health problems. Our aim is to evaluate the provision of our psychodynamic psychiatry training sessions for psychiatry trainees in the Cambridgeshire and Peterborough NHS Foundation Trust, and to evaluate the perceived benefits of attending in terms of personal and professional development.

The evaluation used a standardized mixed-methods approach, with the sample consisting of psychiatry core trainees as part of the regional MRCPsych course. Sessions were delivered via an online format. The evaluation period was between November 2021 and January 2023. Data were gathered via a survey tool, adapted from the literature using Likert scales and free text questions to identify barriers and facilitators to the sessions.

The survey collated data from thirty-seven core trainees ranging between CT1 to CT3. The majority of participants (> 90%) scored the sessions positively across the board in terms of the content of session material, length of training, and quality of delivery. The majority of attendees felt the sessions focused on the relevant clinical issues (97%), were relevant to their training (95%), and felt the group was a safe place to express and process anxieties and frustrations about their work (89%). Notably, the majority either agreed or strongly agreed the group had changed the way they think and practice (91%), including an appreciation of the emotional and symbolic aspects of patients' presentations (89%).

This evaluation reports early findings on psychodynamic psychiatry teaching for psychiatry trainees. Overall, the participants felt the sessions were relevant to their training and improved their personal and professional development. Key benefits of the sessions included increased insight into the emotional and symbolic aspects of the patient's symptoms and clinical issues, team working through cohesion, and the humanity of the doctor in the clinical relationship with the patient. This suggests that the sessions provide a much-needed space to process and reflect on the often-intense demands of clinical work and training. The main theme within barriers to the group processes was external in terms of other clinical demands requiring prioritization.

The aim of this project was to construct and deliver an educational session for general practitioners (GPs) in local Primary Care Networks on challenging child and adolescent mental health conditions. It was hypothesized that delivering targeted teaching sessions, supported by the same quiz applied before and after, would demonstrate an effective and repeatable method of improving GPs’ knowledge about these conditions. Since the COVID-19 pandemic, demand on both Child and Adolescent Mental Health Services (CAMHS) and GPs has reached unprecedented levels. Compounding this load, half of all referrals written by GPs to CAMHS are rejected, which prolongs the time a young person is under GP care, delaying specialist intervention. Unfortunately, during GP training exposure to CAMHS is limited and dedicated teaching is often insufficient. As a step towards addressing this challenge, a comprehensive teaching session combining didactic and socratic methods was devised and tested.

The teaching session comprised the presentation, diagnosis, and first steps in management of four challenging conditions in children: autism, eating disorders, depression, and emotional dysregulation. A quiz with multiple-choice answers was administered before and after the presentation, addressing each of the four conditions. The data collection took place between December 2022 and January 2023. A total of 29 pairs of quizzes were completed by GPs. Due to the type and size of data collected, a non-parametric bootstrap resampling method was used to compare the before-and-after scores for each topic and overall score.

For the 29 pairs of quizzes, mean differences and 95% confidence intervals (CIs) were calculated between before-and-after scores, for each topic and for the total. All 4 topics showed statistically significant mean improvements: autism 1.3 CI: [0.9 , 1.8 ], eating disorder 1.8 CI: [1.4 , 2.3 ], depression 1.4 CI: [1.0 , 1.7 ] and emotional dysregulation 1.7 CI: [1.4 , 2.0 ]. The total mean improvement was 6.2 CI: [5.5 , 6.8 ] out of a maximum 16 points.

These targeted educational sessions suggest it is possible to make reliable improvements in GP knowledge across a variety of topics. With child and adolescent mental health demands at record levels, a more focused approach of the kind considered here may offer a model for training elsewhere. As an indication of the impact of this approach, further sessions on other topics have been requested by the GP teaching leads.

Major depressive disorder (MDD) is a serious psychiatric disorder marked by low mood and anhedonia. Understanding the neural mechanism of MDD is essential for the treatment of depression. White matter fibres, connecting different computational units in the brain, have an important effect on brain function; however, the mechanism of white matter fibre abnormality in MDD is still unclear.

Our study expected to find white matter abnormalities associated with the frontal lobe and hippocampus in individuals with MDD.

Using diffusion tensor imaging data and tract-based spatial statistics, we investigated the microstructural differences in white matter fibre tracts between 30 adults with MDD compared with 31 healthy controls, and calculated the association between MDD-related microstructural changes and illness duration.

It was found that patients with MDD showed reduced fractional anisotropy in the genu and body of the corpus callosum, right corona radiata and part of the thalamic radiations, suggesting lower fibrous myelination levels in these regions; the decreased fractional anisotropy in these regions was associated with longer illness duration.

Our results suggest that MDD may be associated with microstructural damage of key fibre tracts, which could provide insights into the understanding and treatment of MDD.

Older adults in mental health services often have complex physical health needs, due to multimorbidity and frailty. Staff working in these services may not feel well-equipped to manage these needs, leading to symptoms being missed or unnecessary investigations. The authors designed written educational resources for healthcare professionals working across older adult services, both in hospital and the community. The Postcard Project aimed to improve staff knowledge of the physical health needs of older adults and encourage good quality, evidence-based care.

Twelve postcards were created focusing on twelve concepts of caring for the physical health needs of older adults within psychiatry services. These topics were highlighted as potential areas of staff weakness, the staff themselves, and a survey conducted prior to the project. The postcards contained key evidence-based information about the chosen topic, summarised in less than 7 bullet points, and provided links to relevant, digestible resources, such as up-to-date guideline summaries and podcasts. The postcards were released monthly and distributed via email and physical copies. A survey was carried out before the project via a Microsoft Form, where respondents ranked their confidence in their knowledge on different topics relating to the care of physical health in older patients, with 1 being not confident at all and 5 being very confident.

57 people responded to this survey, including nurses, doctors, and other members of the multidisciplinary team. This survey showed a large discrepancy between different topics and staff's confidence. Staff were confident in identifying the symptoms of a UTI (83% confident) and fall prevention (79%). However, they were less confident with their understanding of CRP blood results (46%) and their ability to identify an Acute Kidney Injury (23%). Data are still being collected as to whether this project improved staff knowledge of these key concepts.

Staff in older adult mental health and community services were not confident with certain key aspects of good quality medical care of elderly patients before this project. The level of confidence varied between topic and profession. This project aimed to improve staff knowledge on the weaker topics, however, without the post-project survey data, it is not yet clear as to whether this project improved the knowledge of staff.

Medical Emergencies in A Mental Health Setting (MEAMS) was a proposed high-fidelity simulation training course specifically designed for the mental health multidisciplinary team (MDT). A team of resus officers, mental health nurses and psychiatric doctors worked to create scenarios reflecting the emergencies encountered in mental health. It aimed to gives staff simulated experience in approaching and managing a verity of complex emergencies, including physical health, as well as communication scenarios. Specifically the aims were: (1) Determine if course was perceived to benefit staff, (2) Determine if course subjectively increased staff knowledge and confidence in mental health emergencies, (3) Review for continued areas of improvement

The full day sessions were carried out in the Electroconvulsive therapy (ECT) suite, with it being modified into an immersive environment similar to wards or clinics. The faculty of medical resus officers, mental health nurses and psychiatric consultants ran the courses, with participants joining from across the MDT including nursing staff, junior doctors, consultants, students and nursing assistants.

The morning program, run by resus officers, provided education in life support, initial assessment of the unwell patient and intraosseous access. The afternoon contained various scenarios, including for example managing neuroleptic malignant syndrome. Scenarios were observed via video link by faculty, with constructive feedback and debriefs provided.

Quantitative data of knowledge and confidence was obtained pre and post sessions using Likert scales. Qualitative information regarding future proposed scenarios, areas of improvement and areas of notable value was gathered.

36 staff attended the program, run over 4 days. Average knowledge and confidence (scored out of 10) improved from 4.9 pre-session to 8.1 post-session. All 36 staff felt the session was beneficial. Particular positive feedback on scenario realism, MDT working, safe/ supportive teaching and the resus faculty teaching was highlighted.

Areas for improvement highlighted included running sessions more often, widening accessibility to more staff and teaching on resus medications and fluids. A variety of further scenarios were suggested, for example management of withdrawal seizure.

MEAMS was felt to achieve its aims, and demonstrated clear subjective increase in staff knowledge and confidence regarding common emergencies seen in mental health settings. Further sessions and wider accessibility to the mental health MDT is anticipated to continually benefit staff. Taking on qualitative feedback, the faculty aims to continually adapt the program to provide the best possible training and education, adapting and creating new relevant scenarios.

The Scottish psychiatric workforce has remained largely static; in June 2022, there were 1,164.7 whole-time equivalent (WTE) psychiatrists across all grades. RCPsych In Scotland recognise the importance of focussing on, and improving, the recruitment and retention of trainees in Psychiatry in Scotland by undertaking a number of different projects.

We understand that trainees have differing needs and therefore since 2018 have looked at different ways to attract and retain trainees using different mediums. These included membership benefits, written information, policy work, and events.

With funding from NHS Education for Scotland we focussed on undergraduate students creating bursaries, a new RCPsych In Scotland welcome pack and ran summer schools.

Focussing on existing trainees we had a stand at the virtual international congress, training events including ST4 interview skills webinars, bursaries for trainees to attend conferences and a workforce report to illustrate the likely gaps in future consultant posts as well as barriers to recruitment and retention throughout the work span.

Due to the lengthy duration of psychiatric training it is not possible to evaluate an immediate impact of the campaign on Scotland's workforce however we have seen benefit by looking at other measurable objectives. The work focussing on undergraduates had led to a 333% increase in student associate membership of RCPsych in Scotland.

In 2018 there was a 63.08% fill rate for core psychiatry posts compared to 100% in 2022. As recruitment is now national, it is not possible to get Scotland only data for competition ratios however the 2021 competition ratio for the UK was 2.99 compared to 1.48 in 2018.

We are starting to see a change in higher training fill rates. In 2022 there was a 69% fill rate over all specialties with Psychiatry of Older Adults and Medical Psychotherapy both having a 100% fill rate. This is a slight improvement from 2019 where there was a 61% fill rate.

The work undertaken by RCPscyh in Scotland has increased interest in psychiatry both at an undergraduate and post graduate level although there is still work to be done with regards to retention, both into higher training and also to consultant level posts. The work we are currently undertaking with the workforce report hopes to focus on the reasons that trainees leave training and we aim to use it to advocate for policy change with regards to training numbers and pathways in Scotland.

Population mental health relies on retention of a skilled mental health workforce, including consultant psychiatrists. The purpose of this study was to explore UK psychiatrists’ experiences, expectations, and reflections about the transition from trainee to consultant. By exploring the transition experience, it was hoped that ideas could be generated which might inform ways of supporting psychiatrists during this period.

A qualitative approach was used to gather rich, detailed data about individuals’ experiences. The sample population was a large NHS mental health trust in the South West of the UK. Stratified purposeful sampling was used, allowing focus on three distinct groups of psychiatrists at different stages of transition. Four trainees, four Specialty Doctors and nine new consultant psychiatrists were interviewed 1-1 by the lead researcher. Qualitative data were analysed using thematic analysis.

Psychiatrists’ experiences of transition centred on three major themes: Facing the Real World, Learning from Others, and Being Myself. These themes were connected by central concepts of belonging and identity. New consultants must survive the challenges associated with transition, and establish professional identity as a consultant; an authentic sense of self-in-role. This relied on the psychiatrist's establishment of a sense of identity, industry and belonging within professional communities.

Transition is unique for each individual but there are common aspects, and study of seventeen individuals’ experiences enriched understanding of the transition period. Clinicians and managers must not underestimate the challenges faced at transition. This matters for the specialty; consultants form a small proportion of the workforce, but their functioning has a major impact. It would be detrimental to care provision if difficulties at consultant transition resulted in attrition of psychiatrists. The main recommendation is development of a trust-level transition programme to provide support to individuals, which could also be of value to the organisation and wider profession.

Television is a medium through which an audience can gain insight into the nuances of psychiatric practice. Nonetheless, the psychoeducational benefits are dependent on accurate portrayals. “The Sopranos” has received critical acclaim from various professional psychiatric bodies for its artistic depiction of psychoanalysis and the psychotherapeutic relationship. The series follows Tony Soprano, a middle-aged Italian-American male engaged in organized crime. He is referred to his psychiatrist, Dr Melfi, by his family physician after suffering debilitating panic attacks. Melfi accepts the referral despite Tony's chequered past, employing a holistic approach to his care. We aimed to analyse the psychotherapeutic relationship between Tony Soprano and his psychiatrist, using a biopsychosocial approach.

Season 1 of “The Sopranos” was identified by a facilitator and utilized for discussion. The season was viewed individually and virtual case-based dialogues took place between the author and facilitator examining the psychotherapeutic relationship using the biopsychosocial model.

The Sopranos coincided with the popularity of the serotonin theory of depression in the US, promoted by the pharmaceutical industry. Tony Soprano is pharmacologically treated for panic attacks, anxiety and depression. This sparked thematic discussion around symptom control, medication efficacy and adverse effects. Melfi balances the application of medication alongside understanding the psychological roots of symptoms, deprescribing when necessary.

Themes pertaining to conflict between Freud's id, ego and superego persisted, manifesting cognitive dissonance most prominently in relation to Tony's line of work. Symbolism of ducks guided understanding of Tony's biggest fear – losing his family. Projective testing was explored, alluding to the Rorschach test. Scenes depicting transference and countertransference were present, the former representing Tony's unmet needs from female figures in his life. Eventually, Tony's distress induces internally generated pseudohallucinations.

Tony's tender treatment of his children offsets his volatile relationship with his parents, particularly his mother who habitually antagonizes her son. His personal and professional life are intertwined, with mental health stigma evident in both realms as Tony seeks help surreptitiously to maintain his credibility.

“The Sopranos” depicts the psychotherapeutic relationship between a man suffering from mental illness and his therapist. This layered and accurate portrayal can provide a case-based reference for psychoeducational discussion, and give rise to further discussions of psychiatric themes within film and television.

‘The Sopranos’ is a well known television show, following the life of an Italian-American mobster suffering from anxiety and depression. Despite the overarching theme of mental well-being, elements of racism still feature within the show. These elements are ever-present throughout society and can act as an additional stressor for black minorities, who have an increased risk of suffering from mental health problems compared to their counterparts. Racism has also been linked with an increased probability of developing depression. This qualitative study aims to look at the portrayal of black characters in Season One episodes 1 and 2, to identify themes and psychiatric associations with black mental health. It identifies negative portrayals and conceptualises how these impact black mental health in the real world. Finally, it aims to use these results to propose ways of engaging with the media and the self, to improve negative stereotyping and bias.

This qualitative study was performed using thematic analysis via a deductive approach. This included creating themes, to then apply to depictions and interactions of black characters who featured within episodes 1 and 2 of the first season of The Sopranos.

Themes included: occupation, social network, verbal negative connotations, derogatory language, physical appearance.

Three online databases were used: Google Scholar, PubMed and BMJ Journals to identify literature ranging from 1999–2023. This focused on literature exploring relationships between media, cognition, society and/or racism.

Literature of the most recent mental health data collected within the UK Survey featuring Black Caribbean/British/African was also analysed.

Several depictions of negative stereotypes and behaviours of both black men and women were present in both episodes. These were in the forms of: derogatory language, pacification and code-switching and negative interactions with other characters.

Literature has established that negative presentations within media can result in marginalisation of ethnic groups, which can be extrapolated here.

Negative depictions and stereotypes of black minorities may be having an impact on their mental health and could explain finding of mental health within Black minorities. It could affect the way they interact with the world and apply additional stressors via unconscious bias.

To resolve this, changes within social media and self-awareness should be promoted, so this is less likely to happen.

Preparing for postgraduate examinations is stressful for many doctors, with psychological, financial, and social impacts. Ensuring that doctors feel supported with exam preparation is likely to improve their well-being and performance, whilst also potentially addressing workforce retention and differential attainment. This quality improvement project aimed to improve the confidence and preparedness of trainees taking the MRCPsych Paper A exam in the North West School of Psychiatry.

Six weekly online revision sessions were held for trainees preparing for the MRCPsych Paper A examination. One session was devoted to each major curriculum topic, whilst two covered neurosciences. The sessions were held over Microsoft Teams for 1 hour and chaired by senior trainees and Consultant Psychiatrists. The sessions incorporated a combination of PowerPoint slides, discussion about relevant theory, and interactive practice questions using Slido. A baseline survey was completed to ascertain trainees current levels of exam preparation and confidence. Questionnaires were administered at the end of each revision session to measure their impact and gather feedback. Trainees indicated the extent to which they felt confident with each curriculum topic and their responses were compared, at group level, before and after the revision sessions (1 = strongly disagree with feeling confident, 5 = strongly agree with feeling confident).

40 trainees completed pre-session feedback and 56 trainees completed post-session feedback. The mean confidence scores of trainees improved by between 25.4% to 51.5% after the revision sessions, with the lowest pre-session mean confidence score being observed for neuroscience and the greatest improvement being observed for psychopharmacology. 77.8% of trainees rated the revision sessions as ‘extremely useful’ and 22.2% perceived them as ‘useful’. All trainees agreed (43.4%) or strongly agreed (56.6%) that their knowledge improved after attending the sessions, and all trainees agreed (23.6%) or strongly agreed (76.4%) that they would recommend them to colleagues. Trainees favourite aspects of the revision sessions included completing multiple choice questions, combining Slido polling with PowerPoint slides, and the speakers explanations of difficult concepts. Suggestions for improvement included offering more frequent and longer revision sessions, concealing group voting choices on Slido until revealing the correct answers, and teaching more relevant theory alongside practice questions.

Online group revision sessions combining interactive polling and didactic teaching are popular and useful amongst trainees preparing for MRCPsych Paper A. These sessions appear to improve trainees' self-reported confidence with exam curricula content, although further evaluation is required to determine whether they improve examination pass rates.

Everyone in the NHS deserves to work in an environment that is safe, welcoming, and free from discrimination, however recent surveys have highlighted that this is often not the case. Alarmingly, it has been recognised that few psychiatrists report any forms of discrimination and of those who have, there is often dissatisfaction with the response received from their employer. Due to a paucity of data relating to the experiences of psychiatry trainees in the North West, we sought to understand their lived experience and to co-design proposals for future work that may improve the status quo.

All psychiatry trainees across the North West of England in 2022 and early 2023 have been invited to complete an electronic, core training or sub-specialty specific higher training survey. Basic demographic details were collected. Respondents were asked a range of questions around their experience of discrimination in the workplace and good practice observed in managing this. Subsequently, each group of higher sub-specialty trainees were invited to a two-hour reflective session held face-to-face or via an online platform. Two further reflective sessions were arranged in Liverpool and Manchester for core trainees. During reflective sessions, attendees were presented with vignettes of workplace discrimination, developed from the results of the initial survey. Session facilitators guided a discussion on the feelings evoked by each vignette, whether attendees wanted to discuss their lived experience of similar incidents and to consider ideas for what may be done to support a trainee in these situations. A post session questionnaire was circulated.

Over 100 individuals have completed the pre-session survey and attended a reflective session. Survey respondents were predominantly trainees who identified as Asian, Asian British, Black, Black British, Caribbean or African ethnicity, with a roughly 50:50 split between Male and Female.

Themes highlighted include:

That the vignettes used in the reflective sessions are representative of everyday workplace discrimination.

That training in microaggressions should be given to trainers, trainees and other clinical staff on a regular basis.

That the burden of managing discriminatory behaviour should be on the institution and not the trainee experiencing discrimination.

Many psychiatry trainees across the North West have lived experience of workplace discrimination and systems need to be implemented to improve trainees’ experience. Proposals for future improvements; such as the formation of a deanery wide reporting and management system for trainees who have faced workplace discrimination; are being co-developed to address current challenges.

Sierra Leone has a 98% mental health treatment gap. This has been attributed to lack of resources and attitudinal/cultural barriers. Community health workers (CHWs) are the backbone of healthcare delivery in the country, constituting 1,500 of the general health workforce. The government has trained CHWs to improve mental health care. However, evidence have shown that this training is inadequate, leading to poor mental health literacy among CHWs. Sierra Leonean CHWs' perceptions of mental health and experiences of mental healthcare delivery have not been investigated. Therefore, this study aims to assess CHWs' knowledge regarding depression and suicidality, as well as their perceptions of barriers to, and facilitators of, mental health care in Sierra Leone.

Purposive sampling and snowballing were used in this qualitative descriptive study (N = 10) to recruit CHWs in Kono and Freetown, Sierra Leone. Participants were interviewed remotely using Zoom. A short vignette on depression and suicidality was employed, together with remote semi-structured interviews exploring mental health literacy, perceptions of mental health care, and experiences in providing care during COVID-19. Thematic analysis was utilized.

Five themes and 10 subthemes were derived from the thematic analysis. More than two-thirds of the participants viewed the problem as 'depression', while none mentioned suicidal ideation. Life events were the most commonly identified causes of depression, with no mention of spiritual, supernatural or biological attribution as possible causes. The inductively coded themes include the need for change; barriers to mental health care; accessing care; and COVID-19-related mental health care challenges. All participants agree that seeking counselling or speaking with a mental health expert is preferred. Stigma, prejudice, misconceptions, religious and traditional beliefs and insufficient government support were perceived as key impediments to care. Community health workers' experiences during COVID-19 were mixed. Awareness campaigns, training, establishing mental health policies, and integrating mental health into communities were identified as facilitators of mental health care.

The findings have shown that developing and implementing a comprehensive multi-agency approach is fundamental in dealing with mental health problems in Sierra Leone. In addition, future larger-scale research should be conducted on the underlying cultural principles and traditions regarding mental illness and the status of mental health care provision in Sierra Leone.

‘Cynefin’ has many layers of meaning – it's a Welsh noun with no direct equivalent in English. The word conjures a very personal 'sense of place', belonging, familiarity, and relationship to the place of your birth or upbringing.The new school curriculum in Wales encourages young people to gain a fuller understanding of their identities, communities and histories that come together to form their 'cynefin'.Our aim was to develop a national and cultural programme of public education, co-produced with young people, that enabled them to explore issues that matter to them; whilst ensuring that these issues were at the heart of decision making in the national parliament of Wales ‘Senedd’.

Through a series of design workshops and evaluation, a diverse programme of public education was created by the Royal College of Psychiatrists Wales, Technology Enabled Care (TEC) Cymru, and co-produced with young people.

The programme engaged 230 participants and was delivered across different mediums, including topical school debates; YouTube videos of facilitated discussion on areas of relationships, loneliness, finance, and body image. Further formal opportunities were created for secondary school pupils in giving consideration for careers in mental health e.g inception of a youth advisory group in TEC Cymru, establishing of a mental health research award for sixth form students and a summer school programme.

The debates were complimented through further creative opportunities. The National Children's Laureate undertook a series of creative workshops with Schools, capturing themes that were then animated and shared through social media campaigns.

The whole programme was delivered bilingually, in English and Welsh, and showcased at the URDD National Eisteddfod.

The programme captured a series of issues that are important to young people, whilst it has informed and influenced the development of the National educational curriculum in Wales, and gave opportunity to directly inform Senedd members.

The programme informed the creation of the Senedd Cross-Party Group on Climate, Nature & Wellbeing that is co-chaired by a Senedd member and the Youth Climate Ambassadors.

The young people who attended the Senedd Summer School have been successful in applications to their first-choice university studies, whilst the recipient of the research award is now attending medical school.

A co-produced programme of public education can be both enriching for young people and serves to inform key government policy. It is a great way of engaging young people and destigmatising mental illness and related myths.

One of the effective interventions in reducing stress and burnout and increasing the job satisfaction and relationship of doctors is participation in Balint groups. The purpose of this study is to design, implement and evaluate the use of Balint groups in improving doctor-patient relationships among first-year psychiatry residents at the University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran.

This study was a pretest-posttest study conducted in 2022. First-year psychiatry residents at USWR were invited to join a Balint group through the Department of Psychiatry, and then they were called to attend an interview. During the interview, the inclusion and exclusion criteria for the study were reviewed. The requirements for participating in an online Balint group, including having a strong internet connection and the ability to work and communicate properly with the group, as well as ethical considerations such as the ability to keep confidential information within the group were examined.

12 group meetings were held for 6 months. The group leader had previously led various Balint groups for medical staff. Due to the COVID-19 pandemic, the sessions were held online on Skype.

The participants completed the demographic information questionnaire, the Jefferson Scale of Physician Empathy, and the patient communication questionnaire before and after participating in the Balint group. Next, data analysis was done using SPSS software version 25.

The average (standard deviation) age of the participants in the study was 30.70 (±4.54) years. Ten Participants included both male and female first-year psychiatry residents, eight of which were females, and eight were married. They all worked at the university. 70% had a high interest and 30% had an average interest in their field. Intra-group comparisons using the paired t-test showed that the the participants’ scores in the following areas significantly increased after the intervention: verbal communication skills (t=−6.26, P < 0.001), non-verbal communication skills (t=−9.76, P < 0.001) and total communication skills (t = −5.72, P <0.001). Also the results showed a significant increase in the scores of the Jefferson Scale of Physician Empathy after the intervention (t =−10.67, P < 0.001).

The results of the present study showed that participating in Balint group work can have a significant effect on the communication skills and the level of empathy among psychiatry residents. The results of this study are in line with Parker and Leggett's study (2012) and confirm the effectiveness of the Balint group work . Also, the results of this study are consistent with the studies of Airagnes et al. (2014) and Gajree (2021) and show that adding the Balint group work to the Iranian psychiatry residency curriculum can be useful.

Balint group work, psychiatry residency, doctor-patient relationship, empathy.

Alcoholism within the British Sikh Punjabi (BSP) community is a severe issue caused by a complex array of psychosocial, political, and cultural factors. The current biomedical model taught at UK medical schools fails to address psychosocial aspects of disease, restricting the ability for doctors to treat patients holistically. As a result, doctors under-diagnose and under-treat patients with alcohol use disorders (AUD). There is a need to understand how medical education can address the needs of communities like the BSP to ensure better treatment and management in the future.

To explore the factors affecting alcohol consumption amongst the BSP community, as well as the barriers and facilitators they experience towards help-seeking. The results will help to make recommendations on how current alcohol-related teaching in medical school curriculums may be improved, and specifically, how to produce more culturally competent future doctors.

Two narrative literature reviews were conducted. 37 studies were included. The first search underwent thematic analysis with reference to a Public Health England framework, and the second underwent inductive thematic analysis. Key themes were discussed, analysed, and consequently the results from both literature searches were compared to produce appropriate recommendations.

The first review found that alcoholism is increasing in prevalence in the BSP population. The eleven themes identified corresponded to drivers, determinants, and consequences of consumption. A prominent theme identified included ‘economic and social structures influencing alcoholism within the BSP community’, which addressed the impact of gender roles, acculturation, and racial discrimination on alcohol consumption. The second review identified two themes and three subthemes. The ‘current level of alcohol-related teaching in the curriculum’ theme highlighted that approximately 14 hours is dedicated to this crucial topic. Overall, these findings indicated the need for multifaceted interventions to change the current provision of education.

Currently, the BSP population fail to access treatment services due to fear of shame and stigma. Thus, doctors must be empathetic and sensitive to this, and be aware of how to explore psychosocial aspects of patient's lives and how this influences their AUD. Providing culturally competent services will ensure that holistic interventions are implemented, leading to earlier detection, prevention, and management of alcohol-related harms. This will ensure that individuals from the BSP community feel comfortable in help-seeking. Recommendations were targeted at medical schools and their students, with a predominant focus on the provision of culturally competent services.

Access to a healthy environment offers broad health benefits and has been declared a human right (UNHCR, 2021). However, despite the release of position statements by royal colleges on the climate and ecological emergency, there appears to have been limited opportunities for dissemination and sharing of knowledge, understanding and opportunities for action for many doctors and medical students in the North of Scotland. Hence, this project was aimed to create awareness on the importance of nature connectedness and explore its association with good physical and mental health and well-being. It was also so the medical students can understand the relationship between nature connectedness and the experiences in nature through active observation and hands-on engagement activities alongside acknowledging already active allies providing practical environmental volunteering activities.

9 Medical students, 3 Core Psychiatry Trainees, 1 Psychologist and 1 Child and Adolescent Psychiatrist met at Trees for Life, Dundreggan. We were introduced to 2.5 hours of mindful grounding techniques, mindful eating, connecting with nature through art along with sensory exercises such as tree hugging and trust building activities by Nature for Health. We interacted in group work to design nature-based activities that can be used in clinical practice to improve mental well-being in people living with OCD, depression, ADHD, trauma and eco-anxiety.

Learning experience amidst nature was well received by participants who also gained positive effects on their own personal well-being. The project successfully brought the participants together to access, care for and enjoy green spaces whilst learning about allied programs available in the community. The participants also learnt how nature can aid mental health recovery and well-being, whilst giving people a chance to do their bit towards the fight against climate change.

We suggest to incorporate teachings on climate change in medical education with consideration on using green spaces as delivery sites to enhance nature connectedness (local green social prescribing opportunities such as Green Walking, Green Gym, conservation volunteering, city farms, forest schools by The Conservation Volunteers, The Wildlife Trusts and the ‘Rewild and Recover’ programme from Trees of Life). We also suggest to promote our future healthcare professionals to collaborate with other groups linking nature restoration to human health and well-being. Awareness on benefits of nature connectedness should become one of the most important aspects of medical education in this century to foster a generation of healthcare professionals with pro-nature attitudes and active engagements with the natural world.

It has long been recognised that psychiatry trainees face challenging and unique stressors within their working and training environment. Many of these stressors were exacerbated by changes to the working environment and training and education programmes during the COVID-19 pandemic. When elected to the role of Higher Trainee Representatives for the Faculty of Forensic Psychiatry one of our key aims was to create a national network of Higher Trainees in Forensic Psychiatry to improve trainee well-being, ensure national views are represented within the Faculty of Forensic Psychiatry and share educational and research opportunities.

1. 1. Creation of a National Forensic Trainee mailing list for the dissemination of networking, research and educational opportunities.

2. 2. Links to the mailing list sign-up form were disseminated through a variety of avenues including local trainee ‘WhatsApp’ groups, by contacting postgraduate administration teams within appropriate NHS Trusts and appropriate social media outlets.

3. 3. A National Forensic Trainee ‘WhatsApp’ group was established, combining several local groups. Members were encouraged to add their peers.

Prior to May 2022, the previous Higher Trainee Representatives for the Faculty of Forensic Psychiatry only had access to a mailing list of 19 local representatives. This did not cover all deaneries nationally, and several email addresses were inactive following trainee rotations.

Following our campaign, we have established a mailing list of 66 interested parties which includes: 51 Higher Trainees in Forensic Psychiatry, 12 Core Psychiatry Trainees, 1 SAS doctor and 2 medical students.

By establishing new routes of communication, we believe we have met our aim of creating a supportive national network of Forensic Psychiatry Trainees. The Higher Trainee Representatives of the Faculty of Forensic Psychiatry now have an up-to-date mailing list that can be inherited each year by their successors. Subscribers can unsubscribe if they wish and new members can be added via sign-up links, meaning the mailing list will be able to evolve as trainees complete their clinical training and new trainees commence their training in forensic psychiatry. The COVID-19 pandemic has presented a very challenging time to be a doctor in training and initially significantly limited face to face contact with peers. However, it has also opened new avenues, such as the increased familiarity with video conferencing, dismantling barriers that have previously impeded the sharing of opportunities that should be available to all trainees, wherever they are training.

Certificate of Eligibility for Specialist Registration (CESR) is an alternative pathway for doctors to join the General Medical Council (GMC) specialist register in the United Kingdom (UK). Despite significant official resources provided online by both the GMC and the Royal College of Psychiatrists (RCPsych), a lot of doctors working toward CESR in psychiatry specialties find the system complex and do not fully understand how to start, especially candidates from abroad. Therefore, a WhatsAppTM group has been set up to provide peer support to any doctors who want to achieve CESR in psychiatry specialties. This article is aimed to share the reflective experience of managing the WhatsAppTM peer support group.

The WhatsAppTM group entitled “CESR Aspirants” was created on 23 April 2020 by four UK speciality doctors. The number had grown to the size of 218 participants on 19 December 2022. Any doctors could join the group via the common link. All questions and inputs were welcomed as long as the professionalism and values of the group were respected. The discussion was analysed and grouped into different themes to understand the common questions.

The participants in the group come from 12 countries. The main themes of discussion include the following: clarification of the official guidelines, exploration of types of primary evidence for different domains, troubleshooting individual challenges, sharing of experience and resources, questions about resources available, recognition of CESR in the international arena, motivation to each other, and validation of others’ frustration. There is a significant heterogeneous level of support from local employers to CESR candidates, ranging from the absence of support due to prioritisation of service delivery to a structured CESR fellowship. Psychotherapy and electroconvulsive therapy emerged to be commonly discussed issues as not all candidates had access to those services in their practice. More questions were asked by doctors practising in the UK rather than candidates from abroad. There were three candidates who obtained their CESR in the group.

CESR requires significant effort from candidates. The repetitive theme in certain aspects of clinical domains reflects the common challenges faced by candidates as a result of limitations at the workplace. Therefore, support from the employer is essential for candidates to be successful in their CESR journey. Ultimately, a successful CESR candidate will mean extra consultant psychiatrist manpower to the employer. The creation of a local fellowship or mentorship programme will likely be helpful.

Core trainees in psychiatry (CT) must attain competencies in at least two psychotherapy modalities before they are allowed to sit for the final Royal College of Psychiatrists’ membership exam. The common training approaches in the United Kingdom include regional training workshops, weekly Balint groups, and access to individual supervision. Some CTs express their wish to have extra opportunities to practice psychotherapeutic skills and discuss cases in order to enrich their experience in learning psychotherapy. Therefore, the peer-led GC-PSP, i.e. Gogledd-Cymru (North Wales) Peer Supervision in Psychotherapy is conceptualised as a quality improvement project (QIP) for North Wales CTs. This article aims to illustrate the lessons learned after two years of GC-PSP.

A baseline survey was done to identify trainees’ ideas, concerns, and expectations in psychotherapy training and weekly one-hour supervision sessions were set up in May 2021. Sessions were facilitated by a speciality trainee (ST) in psychiatry with experience in psychotherapy. The agenda was determined on the day based on the specific issue or expectation brought up by trainees which could include: clarification of psychotherapeutic concepts and knowledge learned elsewhere, skill training through role-playing, case formulation of clinical encounters, discussions on suitable intervention, and any topics that were relevant to psychotherapy or combination. Subsequent written and verbal feedback was gathered.

A total of 48 sessions had been conducted in two years, with 37.5% covering knowledge teaching, 45.83% skills training, and 39.58% case-based discussions. The top five modalities requested by CTs included: cognitive behavioural therapy (32.35%), psychodynamic therapy (20.59%) acceptance and commitment therapy (17.65%), motivational interview (11.76%), and behavioural activation (8.82%). The overall attendance had been inconsistent, ranging from no attendees and the highest of eight attendees comprising medical students, foundation year trainees, core psychiatry trainees, general practitioner specialist trainees, and specialist registrars.

Although inconsistent attendance results in the repetition of discussions and topics, all trainees feel the extra sessions support their learning in psychotherapy in a safe space as they feel the small group discussion allows more active participation and they are able to learn from others on top of their individual supervision (positive Kirkpatrick level 1 reaction). All trainees wish to have this initiative continued and prefer a semi-structured rather than totally flexible agenda so that they can plan for their attendance, which can be a consideration for future implementation.