To canvass the opinions of psychiatrists working in forensic settings on the recent proposals relating to dangerous people with severe personality disorder (DSPD). Psychiatrists from secure settings were invited to a series of meetings. A questionnaire was circulated and the discussions recorded.

Opinion remains divided over diagnosis, treatability and assessment of risk in personality disorders. The medicalisation of DSPD to allow indeterminate detention in unconvicted cases is unacceptable to the majority (75%). There is no consensus on the Government proposals relating to DSPD. Only a minority (20%) of psychiatrists would work in a new specialist service, which has significant implications for service development.

The involvement of psychiatrists in preventative detention solely for public protection requires greater discussion.

There have been no reports on psychiatric intensive care units (PICUs) in medium secure psychiatric facilities. Using case files, we retrospectively examined the characteristics and outcomes of 73 patients who were admitted to a PICU in a medium secure unit between 1 July 1994 and 30 April 1998.

The PICU population was predominantly male, suffering from illness and detained under Part III of the Mental Health Act, 1983. Although the mean length of stay was 75 days, the majority were ultimately transferred to less intensive nursing environments and only nine required transfer to maximum security. In 10% of cases PICU admission was owing to lack of appropriate facilities elsewhere.

Although the PICU was intended as a crisis facility for the management of challenging behaviours, its function was affected by the lack of clear admission and discharge criteria and appropriate facilities for patients with diverse mental, physical and security needs.

To survey forensic psychiatry teaching in UK medical schools. A questionnaire was sent to all 24 deans.

Twenty-one schools responded, 15 (71%) provided forensic psychiatry teaching. Thirteen organised one or more lectures and 13 organised visits to forensic psychiatric settings, predominantly high security hospitals, but these were usually only available to a proportion of the students in each year. Clinical placements, seminars or workshops and tutorials or supervisions were each arranged in about half of the schools. Only four schools offered special study modules (SSMs).

Forensic psychiatry teaching would benefit from further development, with additional use being made of medium secure hospital units and prisons for the purposes of clinical placements and visits. More SSMs should be organised.

General practitioners (GPs) were surveyed on their experience of and attitudes towards attention-deficit hyperactivity disorder (ADHD) treatment using methylphenidate, and asked about prescribing practice.

Most GPs have experience of children with ADHD and the use of methylphenidate. The majority felt that it was a drug that should be initiated by a specialist who should continue to provide clinical monitoring, but that primary care could provide ongoing prescribing and physical monitoring. There was a lack of training in this area, with most GPs requesting further training both on ADHD and its management.

ADHD is a topical issue both in the health service and with the public. This survey suggests that GPs may be willing to play a role in the management of ADHD once the child has seen a specialist, but that child and adolescent mental health services need to consider how training will be provided.

To identify psychiatrists' concerns relating to the use of legislation in children and young people with mental health problems. Four hundred and eighty members of the child and adolescent faculty of the Royal College of Psychiatrists were asked to list their main concerns.

Two hundred and fifty-eight members responded. The four most reported themes were: choosing between the Mental Health Act and the Children Act; general issues around consent to treatment; issues with social services departments; and the stigma associated with using the Mental Health Act.

The range of themes identified from this survey have served to focus the evaluation of the use of the Children Act and the Mental Health Act in Children and Adolescents in Psychiatric Settings (CAMHA-CAPS), and informed the design of subsequent data collection tools. The project report has now been submitted to the Department of Health for consideration.

To describe how the Learning Styles Inventory was used to assess the preferred learning styles of a group of senior and specialist registrars from different specialities attending a management course.

Of the 272 doctors studied, the learning styles of psychiatrists (n=42) emerged as significantly different to the group as a whole, favouring reflective observation and concrete experience rather than active experimentation or abstract conceptualisation.

Knowledge of learning styles can help improve interactions with other specialities that adopt different learning strategies, and assist with the individual psychiatrist's lifelong learning. To engage the interest of medical students, psychiatrists may need to consider different teaching approaches in line with the prevalent learning style.

Home treatment offers an alternative to in-patient care, but little has been written about the practicalities of running such a service. Using routine information sources, details of referral and outcome are presented for patients assessed by a home treatment service over 6 months.

Forty-eight per cent of referrals were not accepted, mainly because of lack of cooperation, risk to self or others or the illness not being acute enough. Referrals from junior doctors and accident & emergency were least likely to be accepted. Seventy-two per cent of patients accepted suffered from schizophrenia, bipolar affective disorder or depression with psychosis, similar to the diagnoses for in-patients. Twenty per cent of patients accepted had to be transferred to in-patient care later.

Staffing levels need to take account of time spent assessing patients. Junior doctors need training in how to use home treatment services appropriately and a wider range of options are needed to manage patients in crisis out of hours. It is possible to target patients with severe mental illness in a home treatment setting, but a significant number will need transfer to inpatient care.

There have been major changes in the duration and the requirements of higher specialist training in psychotherapy in the UK. A postal survey was sent to all higher specialist trainees in psychotherapy to study their attitudes to, and experience of, these changes.

Eighty-nine per cent of trainees responded. The majority of trainees expressed concern about the reduction in length of training. There were gaps in provision of some essential training modalities. A substantial group of trainees did not have protected research time.

Psychotherapy trainees believe the changes in training sacrifice depth for breadth. This highlights the ongoing debate about the future of psychotherapy within the NHS.