Estimates of the impact of the London 2012 Olympic Games on general health service demand have been made. However, there are no formal estimates for mental health demand. Our aim was to conduct a review to identify data on mental health service demand during the previous ten Summer Olympics.

Eight relevant papers were identified. Little has been published on mental health demand; however, available data suggest demand will not substantially increase.

NHS London has no pan-London strategy for mental health services during the Olympics. This may not be unreasonable given the lack of evidence for increased demand during previous Olympics. However, high bed occupancy rates in mental health units in London and other strains on resources may amplify the impact of even small increases in demand on services.

To evaluate the quality of services offered by community drug and alcohol teams (CDATs) to pregnant women in substitution treatment. A full audit of the practice across all local CDATs against national standards was undertaken in 2008 and 2010.

Quality of services improved and met three standards in 100% and the fourth standard in 96% of cases. There was good implementation of the recommendations arising out of the action plan of the first cycle, which resulted in significant improvements in interagency liaison and risk-benefit analysis documentation within the CDATs.

Management of pregnant women in substitution treatment can be improved by adhering to a multipronged approach as identified by this audit.

We report an audit of the provision of psychiatric postgraduate education within the foundation programme and psychiatry specialty programmes in the UK. Our primary measure was the number of foundation posts in psychiatry. Our audit standard was that all foundation doctors should receive programmed training in psychiatry via a psychiatry foundation post.

We found a total of 413 foundation posts in psychiatry in 21 out of 22 foundation schools in England. This figure is only a fifth of that required to meet the audit standard. There is training capacity for 500 core trainees and 460 higher trainees in psychiatry per year. Currently, 13.6% of specialists other than general practitioners on the General Medical Council registers are psychiatrists.

The provision of programmed postgraduate training in psychiatry in UK foundation schools is inadequate. The training needs of all doctors, the mental healthcare needs of all patients, and recruitment to psychiatry are all likely to suffer as a consequence.

We investigated how decisions regarding disclosure of an offender's history to a third party without the offender's consent are made at Multi-Agency Public Protection (MAPP) meetings. Ten questionnaires were sent to a level 2 MAPP meeting in each of the 33 police and probation areas in London, with a request that the MAPP meeting administrator hand them out to up to 10 regular attendees.

Of 321 questionnaires handed out, 196 were returned, giving a response rate of 61.1%. Seventy-six participants (37%) had made a disclosure without a MAPP meeting discussion in the past 12 months. A total of 109 participants (55.9%) reported that in their experience it had always been possible to reach a consensus on disclosure at MAPP meetings, but participants' responses to five hypothetical scenarios indicated a wide spread of opinions about when a disclosure should be made. Significant proportions of participants endorsed statements suggesting that people have a right to know offenders' histories.

Training on the evidence base, law and guidance relevant to disclosure decisions is necessary, and a governance system to monitor and improve decision-making should be considered. Advocacy for offenders may also improve practice.

To investigate whether medical tribunal reports were meeting acceptable standards as set out in the practice direction issued by the Tribunal Service in 2010. We looked at 50 medical reports and compared the content of the reports with a 13-item checklist that was derived from the recommendations set out in the practice direction.

The results show a number of areas where the reports are not meeting acceptable standards. For 5 of 13 items in our checklist, less than 80% of reports evaluated included the required information.

The results have important clinical governance implications. As clinicians we need to improve our report writing, not least because it is our professional and statutory duty but also to avoid potential repercussions from the tribunal in terms of their legal power to order remedies, sanctions and costs. Improvements might be achieved through robust performance management of individual clinicians and consideration being given to including this in revalidation procedures.

To explore the patterns of alcohol consumption and its impact on clinical outcomes in schizophrenia in low- and middle-income countries. We performed a cross-sectional survey of 315 patients with schizophrenia and calculated the prevalence of alcohol consumption and alcohol use disorder. The patients' sociodemographic profiles and clinical outcomes, including Brief Psychiatric Rating Scale (BPRS) scores, were compared between abstainers and drinkers using the χ2- and t-tests.

The 1-year prevalence of drinking, hazardous drinking and alcohol dependence was 16.8% (95% CI 12.9–21.4), 5.7% (95% CI 3.4–8.9) and 2.5% (95% CI 1.1–4.9), respectively. Male gender, single or post-marital status, higher education and being economically active were significantly associated with alcohol consumption. Alcohol drinkers were significantly more likely to be on combination psychotropics compared with abstainers. The mean total BPRS score was significantly lower in alcohol drinkers compared with abstainers. Drinking alcohol was associated with fewer deficit symptoms.

Cultural settings have a significant impact on the prevalence of alcohol use disorder in schizophrenia.

We assess and compare: (a) the attitudes of final-year medical students in 2010 to their 1994 counterparts; (b) the attitudes of third-year medical students with those of their final-year colleagues; (c) the impact of two different teaching modules on students' attitudes. All students completing the year 3 psychiatry preclinical module and the final-year clinical clerkship were asked to anonymously complete three well-validated attitudinal questionnaires on the first and final day of their module in psychiatry.

These data indicate that Irish medical students have a positive attitude to psychiatry even prior to the start of their clinical training in psychiatry. This attitude is significantly more positive now than it was in 1994. A positive attitudinal change was brought about only by the final-year psychiatric clerkship. Students who have completed a degree prior to medicine are less likely to express an interest in a career in psychiatry.

If we are to address the recruitment difficulties in psychiatry we need to look at innovative and specific ways of translating these positive attitudes into careers in psychiatry.

High rates of metabolic syndrome exist among patients on clozapine. Monitoring its parameters facilitates interventions which may alleviate negative health consequences. We completed an audit of the monitoring of the parameters of metabolic syndrome in patients on clozapine. The results were compared with the Maudsley Guidelines for monitoring in patients on any antipsychotic medication.

Initial audit showed high overall rates of concordance with guidelines for the frequency of measurement of blood pressure (91.8%), but much lower rates for measuring fasting blood glucose (43.2%) and lipid profile (52.7%), and no record of analysis of waist circumference. This prompted development of a formal protocol for measuring parameters. Repeat audit after 1 year showed marked improvement in rates of measurement.

Implementation of relatively straightforward measures, such as the introduction of a one-page form on which to record parameters, can lead to a much improved rate of monitoring for metabolic syndrome. This should in turn prompt therapeutic interventions, which are discussed.

To describe an interim service set up to examine the breadth of UK ex-service personnel's concerns in relation to their mental health and military service and provide a record of the first 150 individuals assessed following conformation of military service and examination of all available military and civilian medical records.

The majority of attendees were White male ex-soldiers. Average age, service and time to assessment were 44.5, 15.8 and 11.7 years respectively. Two-thirds were receiving help from the National Health Service and ex-service nongovernmental organisations. Rates of post-traumatic stress disorder were similar to previous UK studies. Obsessional symptoms were of relevance to the clinical presentation in a third. Fabrication and/or exaggeration occurred in about 10%.

The spread of diagnoses and delay in help-seeking are similar to civilians. The link between mental disorders and military service is seldom straightforward and fabrication or exaggeration is difficult for civilians to recognise. Verification and contextualisation of service using contemporaneous service medical records is important given the possible occupational origin of mental health conditions.

To carry out a survey to ascertain the role of academic clinical fellowship posts within the integrated academic training programme for academic training in child and adolescent psychiatry. Questionnaires were sent to UK academic child psychiatric units.

A total of 18 units returned questionnaires; this identified eight university lecturers and two academic clinical fellows in post.

Integrated academic training pathways seem unlikely to contribute substantially to academic training and to maintaining the pool of academic clinicians in child and adolescent psychiatry. It may need reappraising with regard to psychiatric specialties.