To evaluate the effectiveness of two psychodynamic psychotherapy teaching methods, a student psychotherapy scheme (SPS) and participation in a Balint group, in teaching first-year clinical medical students about doctor–patient communication and the doctor–patient relationship. The 28 students, who were randomly allocated to three groups (SPS group, Balint group starting at baseline and Balint group starting at 3 months and acting as partial controls), were rated on a questionnaire testing their knowledge of emotional and psychodynamic aspects of the doctor–patient relationship administered at baseline, at 3 months and at 1 year.

At 3 months, students in the SPS and Balint groups scored higher than the partial control group, the difference approaching significance at the 5% level. At 1 year, participation in either teaching method led to significantly higher scores compared with baseline.

Psychodynamic psychotherapy teaching methods are effective in increasing students' knowledge of the doctor-patient relationship and potentially also improving their communication skills.

The use of the term ‘client’ has become increasingly popular among non-medical staff in psychiatric practice. We sought to describe the preferences and attitudes of people attending a psychiatric clinic to the terms patient and client. A questionnaire and case note review was employed.

147 people completed the questionnaire, of these 77% preferred the term patient. There was no subgroup that preferred the term client. Attitudes towards the two terms were significantly different, with a greater antipathy demonstrated towards the term client.

The majority of people attending a psychiatric clinic prefer the use of the term patient; the term client is disliked.

To study the effects of patient suicide on both personal and professional life of consultant psychiatrists in Ireland. A questionnaire was sent to all practising consultants.

Most respondents (80%) had experienced patient suicide in their careers; in up to 97% it had an impact on either their professional or personal life. The most common effects were preoccupation with the suicide and guilt. Unpredicted suicides and perceived effect on patients' families worsened the distress. Informal support was of most help, with a large proportion of study participants suggesting independent case review would be helpful.

Patient suicide is an almost universally distressing event for psychiatrists. Although consultants receive psychological support from family and friends, many would also welcome an objective professional review.

To describe the change in the number of referrals of prisoners and the delay in transfer to hospital under the Mental Health Act following a change in the prison health care provision. The transfer time (time from referral to transfer to psychiatric hospital) of prisoners has been audited previously over 1996 and 1997.

There has been an increase in the number of prisoners transferred. Both transfers under Section 48 of the Mental Health Act and the proportion of transfers to high security have increased. The average delay in transfer remains lengthy and there is a trend of increasing delay with increasing level of placement security.

Despite Government policies to facilitate the transfer of mentally disordered offenders, we found an increase in the delay to hospital compared with previous audits.

This survey was conducted to ascertain the use of psychotropic medication in the treatment of patients with a primary diagnosis of personality disorder within a community mental health team. A sample of 113 patients were identified, their notes were reviewed, and details of current medications and diagnoses recorded.

Four-fifths of patients were prescribed at least one psychotropic medication. The most commonly prescribed medication class was antidepressant, comprising almost half of prescriptions. The total annual cost across 107 patients was £37 000.

Medication is commonly prescribed to people with personality disorder but more needs to be known about why prescriptions are started and stopped, what the benefits are, and how these are judged by patients and care teams.

To compare how newspapers cover psychiatric and physical illness. We conducted a survey of relevant headlines in nine daily newspapers over a one-month period and judged whether the content was essentially positive, neutral or negative.

Over the one-month period, 213 article headlines about various aspects of medicine and 47 on psychiatry were identified. Ninety-nine (46%) of the former were critical intone as compared with 30 (64%) of the latter (odds ratio=4.42, 95% CI 1.64–11.94).We gained the impression that negative articles about physical medicine tended to criticise doctors whereas negative articles about psychiatry tended to criticise patients. Tabloid and broadsheet newspapers did not differ in their rates of negative coverage.

Psychiatry, psychiatrists and particularly psychiatric patients tend to be represented negatively in the newspapers. Psychiatrists should strive to influence the news agenda by proactively reporting positive messages, such as treatment advances.

Despite substantial evidence to show that unaccompanied refugee children suffer a high prevalence of mental illness, their access to services remains poor. One may hypothesise that this is associated with their negative perceptions of mental illness. However, there has been little research exploring this important subject. We aimed to explore unaccompanied refugee children's experiences, perceptions and beliefs of mental illness, focusing on stigma. Fifteen unaccompanied refugee children and 15 carers were interviewed by a semi-structured interview. Thematic analysis was used to analyse data.

Three main themes were identified, focusing mainly on issues of stigma related to mental health, mental illness and their treatment, and they were interpreted in detail.

Our findings will contribute to current understanding of stigma and discrimination, and their effect on service engagement, and will hopefully stimulate interest to further explore this area and develop potential solutions.

To assess how common the subjective experience of coercion is in psychiatric care and what affects its prevalence. A review of published data was undertaken to assess prevalence of coercion and potential confounding variables. The heterogeneity of results was studied using meta-regression to quantify the relative impact of four potential explanatory variables.

The raw prevalence of perceived coercion ranged from 16 to 90%. A quarter of legally detained patients did not feel coerced into psychiatric care, whereas a quarter of voluntary in-patients reported coercion in care. Coercion was more common in studies outside the USA, among patient populations subject to legal detention and populations studied using the MacArthur Perceived Coercion Scale as opposed to other measures. Timing of the interview was not associated with coercion.

Coercion in psychiatric care remains highly prevalent but varies widely by study. Consistency in measurement is necessary to allow better comparison between studies.

To explore service users' experiences of receiving a diagnosis of schizophrenia and the stigma associated with the diagnostic label. Seven participants were interviewed about their perceptions of these experiences. Interviews were analysed using interpretative phenomenological analysis.

Five superordinate themes resulted from the analysis: (1) avoidance of the diagnosis of schizophrenia; (2) stigma and diagnostic labels; (3) lack of understanding of schizophrenia; (4) managing stigma to maintain normality; (5) being ‘schizophrenic’. These, together with their subthemes, highlighted avoidance of the term schizophrenia by participants and use of alternative terms by professionals, which limited opportunities for understanding the label and challenging associated stigma. Participants strived to maintain normality despite potential stigma.

There is a need to address the process of giving a diagnosis as a phenomenon of consequence within its own terms. Implications relate to how professionals deliver and discuss the diagnosis of schizophrenia.

People with severe mental illness (SMI) die relatively young, with mortality rates four times higher than average, mainly from natural causes, including heart disease. We developed a computer-based physical health screening template for use with primary care information systems and evaluated its introduction across a whole city against standards recommended by the National Institute for Health and Care Excellence for physical health and cardiovascular risk screening.

A significant proportion of SMI patients were excluded from the SMI register and only a third of people on the register had an annual physical health check recorded. The screening template was taken up by 75% of GP practices and was associated with better quality screening than usual care, doubling the rate of cardiovascular risk recording and the early detection of high cardiovascular risk.

A computerised annual physical health screening template can be introduced to clinical information systems to improve quality of care.