To describe the development of public education materials provided by the Royal College of Psychiatrists in the ‘Help is at Hand’ series of leaflets, and to assess the acceptability and usefulness of information about mental health on the College website by analysis of the online responses of those accessing this information.

More than 4000 responses to 14 of the ‘Help is at Hand’ leaflets were analysed. Ratings were generally high, with the exception of the statement ‘This leaflet talks down to me’. Free text responses were generally positive.

The College website is an accessible source of high-quality mental health information of the sort demanded by both service users and current health policy.

There is interest in how outcome measures routinely used in mental health settings compare with each other in assessing risk and emotional disturbance. The relation between the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE–OM), a client-completed measure, and the Health of the Nation Outcome Scale (HoNOS), a clinician-completed measure, was explored using data from 297 clients referred to secondary services by a primary care mental health liaison team.

The correlation between CORE–OM and HoNOS was 0.50, with cluster and factor analyses revealing overlap between the measures in assessing risk to self and others and general emotional issues.

Although the measures are typically used in different settings, the overlap suggests that both might be useful in any setting where assessment for mental health problems and risk is needed.

Our aim was to determine the role of evidence and other factors in specialist service development in liaison psychiatry. We held two focus groups with liaison psychiatry practitioners working in different services throughout Europe. A topic schedule focused the discussions, which were taped and transcribed. We used content analysis to identify the role of evidence and other factors that had hindered or facilitated service development.

Our content analysis revealed two factors relating to evidence and 25 other barriers and facilitators of service development, which we grouped into national factors and factors related to local services.

Evidence appears to have some impact on service development but many other factors are influential. Clinical service development cannot be understood simply as emerging in response to research evidence.

The aim of the study was to evaluate the effectiveness of the care programme approach (CPA) in adults with learning disabilities in a specialist treatment unit by auditing all in-patient records over a 6-month period. A multidisciplinary team set CPA standards. Staff on the unit completed questionnaires about patients, including CPA screening and risk assessment/management, and carers completed questionnaires about their perceptions of risk and information sharing.

Of the 15 patients whose records were reviewed, 13 had CPA screening on admission and 12 on discharge. Before discharge, 9 patients had a CPA planning meeting and only 4 patients had a demonstrable risk management plan. Carers of 9 patients perceived that information was shared.

Major deficiencies identified in risk assessment and management and in information sharing may potentially jeopardise successful treatment and after-care.

Patients who self-poison are at increased risk of future self-poisoning and early death. Admission patterns and effective treatment strategies are unclear although psychosocial assessment may reduce readmissions. This study aimed to determine admission patterns and the proportion of patients receiving a psychiatric assessment in 4220 consecutive admissions.

The average age was 34 years (s.d.=13, range 13–94); most were female (56 v. 44%, P<50.001). Twelve per cent of patients were aged 13–18 years, again the majority were female (70 v. 30%, P<50.001). Twenty per cent of patients had multiple admissions, accounting for 42% of the total admissions. There were slightly more admissions per day at the weekend (Friday, Saturday and Sunday; P<0.002). As many as 245 patients were either not referred or ‘self-discharged’ before they were assessed by the liaison psychiatry service.

These findings may help target medical resources, suggesting that consistent numbers of staff are required during all days of the week.

To review and clarify the large number of psychophenomenological terms used to describe thought disorder. The most recent editions of the major psychiatric textbooks and medical dictionaries in the library of a London teaching hospital were used to compile a list of such terms. The various, often conflicting definitions were compared.

There were 68 terms identified. There was significant redundancy in these terms (i.e. more terms than significantly different concepts described). Different sources gave different definitions for the same terms.

The understanding of many of the terms used to describe thought disorder is poor. This is confusing for clinicians, trainees and patients.

To describe the experiences of psychiatric senior house officers (SHOs) of being on call. A survey of SHOs on three on-call rotas across south Birmingham was conducted to investigate their opinions about on-call work and to consider how time on call is spent.

SHOs in psychiatry gain a broad range of experience out of hours on a traditional on-call rota. On-call periods were valued as a learning experience and 63% of SHOs were confident in their decision-making while on call. However, on-call work was often viewed as isolating, and not all SHOs felt that they were working as part of a team when on call.

As changes to working patterns are introduced, for example in order to implement the European Working Time Directive, care must be taken to retain the positive aspects of current on-call systems. Such changes should be seen as an opportunity to improve working lives so that SHOs feel less isolated when providing out-of-hours cover.

To explore the role of the consultant psychiatrist using an observational approach. Five consultant psychiatrists were shadowed by a trained observer. Observations were subjected to a qualitative analysis based on a grounded theory approach.

Six themes emerged as being significant; these were administration and secretarial support; training aspects of the role; clinical activity; the referral process; supervision, support and continuing professional development; and organisational systems.

The results indicated significant difficulties in the role of the consultant psychiatrist and the need for change. Any change in this role would have an effect on the roles of other professionals and on the whole system in which they work.

Associations have been reported between aggression and psychoactive substance use, and a link with violence has been demonstrated in community samples. This study aimed to assess the prevalence and nature of aggressive incidents and to examine the factors associated with violence in a specialist substance misuse treatment unit. Data were collected about assaults, aggressive patients and the object of their aggression during a 12-month period.

Eighteen of 165 patients admitted during this period were involved in aggressive incidents. Patients dependent on more than one substance were significantly more aggressive than other categories of drug users. Past history of assaultive behaviour, younger age group and shorter duration of use were also significantly associated with incidents of aggression. Socio-demographic variables such as gender, marital and employment status were poor predictors of aggression.

The incidence of serious violence in this substance misuse treatment unit was low when compared with other psychiatric units. The findings suggest that there are differences in levels of aggression among the various types of drug users. The study reinforces the need for an accurate drug history in order to improve the quality of risk assessment.

This study aimed to assess how referrers to specialist child and adolescent mental health services (CAMHS) wanted priorities to be determined. Postal questionnaires were sent to practitioners referring to the service in the Bridgend district.

Nearly three-quarters of the questionnaires were returned (n=184). There was wide variation between professional groups in the priority attributed to different presenting problems, their modification by ‘contextual factors' and acceptable waiting times for the service. Mental disorder, self-harm, child abuse and complex cases require greatest priority.

Needs of referrers must be considered when deciding priorities for specialist CAMHS, however diverse these appear. If youth mental health needs are to be addressed, better communication between services, and clearer definition of the role of specialist CAMHS is imperative.

A questionnaire was sent to 122 psychiatric trainees in the west of Scotland to clarify the extent to which trainees provide physical healthcare to their in-patients and to establish trainees' views on the need for further training.

Almost all of the 65 respondents were expected to provide emergency care, and a large majority dealt with physical health problems on a regular basis. Few respondents had received any formal training in physical health care problems since entering psychiatry.

The results of the questionnaire suggest that psychiatric trainees are currently providing a considerable amount of physical healthcare for psychiatric in-patients. Clarifying the medical experiences and training of psychiatric trainees may help to inform future debate as to the appropriate management of physical healthcare for psychiatric patients.

The aim of this literature analysis was to establish the range of doses of haloperidol decanoate effective in preventing relapse in schizophrenia. Studies reporting relapse rates in patients treated for longer than 6 months were included. Relapse rate was then plotted against dose or log dose to allow drawing of dose–response curves.

Fifteen publications reporting 13 individual studies were identified. of these, 6 studies met inclusion criteria and were analysed. Dose–response curves indicated limited effect at 25 mg/4 weeks but near maximal effect at doses of 50 mg/4 weeks. There was no clear evidence that increasing the dose above 100 mg/4 weeks provided additional benefit in preventing relapse.

The recommended dose range for haloperidol decanoate (50–300 mg/ 4 weeks) does not reflect the findings of this study. Optimally effective doses appear to be around 50–100 mg/4 weeks. The use of doses above 100 mg/4 weeks is difficult to support given data available.