Bullying is a common problem. There has been much written on the subject, mainly relating to schools. In this study a questionnaire was sent to 66 child and adolescent psychiatric units in the UK, 50 (75%) were returned. The units were surveyed on frequency of bullying, whether an anti-bullying policy was in place and whether difficulties had been encountered setting up the policy. An anti-bullying policy was present in only 10% of units. Further research is needed on bullying and appropriate and effective methods of dealing with it on child and adolescent psychiatric units.

Mental health professionals are becoming increasingly involved with the criminal justice system through their work in psychiatric assessment and diversion schemes. Preparation of reports for the courts requires knowledge of the legal system. Those preparing such reports need specific training for this work.

This report describes one of the largest published surveys of users' views of services, with 287 users returning a 34-item questionnaire and 80 people interviewed about their views and satisfaction with services provided by two psychiatric day hospitals. The combination of questionnaire and interview methodologies provided data such as an overall satisfaction score (which was relatively high) and satisfaction scores with specific aspects of the service, as well as highlighting specific problems and providing recommendations on how to make improvements.

The diagnosis of vascular dementia may often be made on the basis of structural neuroimaging, this may not always be reliable. In view of this, a retrospective study of 30 case notes with diagnosis of vascular dementia was undertaken to examine the documentation of vascular risk factors and presence of cerebrovascular disease. Specific recommendations were then made for the future case note documentation. Nine months later, 10 case notes were examined to assess the impact of the recommendations. A noticeable improvement in the documentation of most risk factors was observed. The wider implications of these findings are discussed.

People with violent or dangerous behaviour represent a considerable health care burden. The health needs of this group have been considered a priority in recent years. Both health commissions and psychiatrists need to know the numbers of patients that they are responsible for and whether their needs are being met. The appropriateness of placement was used as the measure of need for this study.

In this study we explored the views of 245 opiate users attending a regional drug dependency unit about decriminalisation of drug use and their perception of the consequences of free availability on themselves and society. Contrary to expectation, opiate dependent individuals were not in support of decriminalisation but favoured controlled availability.

This paper describes the social and clinical characteristics of patients who attended a mental health promotion drop-in clinic that was set up in a primary care group practice. From consideration of the characteristics of the patients, the problems they presented with and the results of the consultations, we argue that there is a viable role for mental health promotion as a form of primary prevention of mental health problems, distinct from an extended treatment or therapeutic role. It is open to question whether the particular way we delivered the service is necessary to achieve such an objective and we draw attention to some of the constructive criticisms the primary health care team made at the final evaluation of the project.

This study, assessed 63 older, long-stay, learning disabled patients, the Health of the Nation Outcome Scales (HoNOS) highlighted the expected problems in areas of cognition, physical illnesses or disabilities, relationships and activities of daily living. No significant changes were observed in the problems assessed using the HoNOS over a six-month period in this group of patients with relatively stable health problems and needs. HoNOS proved to be useful in identifying some expected problems. However, further studies are needed to assess its sensitivity to changes secondary to improvement or worsening of problems along with wider use to see if its brevity allows it to give sufficient detail on the problems of persons with learning disabilities.

As staff on the acute psychiatric unit at St Ita's Hospital had recently become aware of an increasing number of referrals from Dublin airport, a retrospective analysis of case notes of such patients admitted from 1987 to 1994 was undertaken. Twenty-three patients were admitted over this period, the majority arriving from the UK. Mania was the admission diagnosis in 11 patients, schizophrenia in eight, unipolar depression in two, and schizoaffective and personality disorder in one case each. All but two had a past psychiatric history. Seventeen had Irish friends or relations; five of these acting upon ‘Ireland-related’ delusions. Ten patients required temporary certification. The mean duration of hospitalisation was 19 days and the total 433 days. All patients were repatriated, nine being transferred directly to psychiatric hospitals, with the relatives eventually bearing the cost of transport in all but one.

Ascribing human behaviour to the influence of genetic factors is a reductionist idea that inappropriately applies the explanations of physical science to the human social world. The result is that the designation of some behaviour as deviant is disguised as objective science. The high profile of genetic research means that we must be alert to the potential social consequences of this type of reasoning.

This is a retrospective study of 173 consecutive admissions to a general psychiatric hospital. The aim was to establish the frequency and adequacy with which alcohol and tobacco use were recorded. Regarding alcohol, in 41% of the notes there was no adequate quantitative history, in 29.5% there was a descriptive mention and in 29.5% no history was recorded. Female patients were less likely to have an alcohol history taken than male patients. With tobacco, in 64% of the notes there was an adequate quantitative history, in 6.4% there was a descriptive comment and in 28.9% no history was recorded. It is to be stressed to all doctors that an assessment of alcohol and tobacco use should be made for every patient, whatever their age, gender or ethnic origin.

Despite the widespread belief that the involvement of users and carers in the training of psychiatrists would provide a valuable addition to the training process, it is clear that many trainees do not receive this input as part of their current teaching. This article explores some of the questions and concerns that all those parties involved have raised and draws on the experience of users, carers and psychiatrists to address some of these issues and promote the further development of this practice.

Despite widespread acceptance that the sexual history is an important part of psychiatric assessment, concern continues to be raised that such questions are often neglected. It has been suggested that one reason for this is the belief of staff that patients do not want to discuss sexual matters. The response of 65 out-patients to a questionnaire concerning their attitudes and expectations to being asked questions about sex is reported. The majority of patients expected there to be some inquiry about sexual matters. While detailed enquiry was not anticipated, patients stated that most questions would not make them feel uncomfortable. This study does not support the view that patients are reluctant to give a sexual history.

It is a commonplace of clinical practice that those with obsessional disorder, or with obsessional features to a psychotic illness, often develop concerns about cleanliness and contamination, some with a focus on everyday bodily processes. In a search of the Patent Office for psychotic ideas (James & Gilluley, 1997), it became apparent that patents reflecting concern about bodily functions were strongly represented in the patent collection. These stood out from patents concerning innovation in conventional medicine or medical appliances, and some of them had the flavour of the more bizarre ideas on the subject put forward by patients in our psychiatric practice. It was decided to explore the collection of the Patent Office further, with a view to surveying the range of such patents and examining their relation to the times in which they originated. The procedure used was the same as in our previous article.

A study of 41 families who failed to attend their first appointment at a child psychiatric clinic is described. The study was prospective over a period of one year and the families were interviewed personally; 14.9% failed their first appointment. Improvement of the child's symptoms during the waiting period, anxiety about seeing a psychiatrist/social worker, financial difficulties and the invitation to the family to attend were common reasons given for non-attendance. Another important factor was that families were ill-prepared by the referrers.