The prevalence of delaying psychiatric care until the patient has received ‘medical clearance’, and the definitions and understanding of ‘medical clearance’ terminology by relevant clinicians, are largely unknown. In a service evaluation of adult liaison psychiatry services across England, we explore the prevalence, definitions and understanding of ‘medical clearance’ terminology in three parallel studies: (a) an analysis of trust policies, (b) a survey of liaison psychiatry services and (c) a survey of referring junior doctors. Content and thematic analyses were performed.

‘Medical clearance’ terminology was used in the majority of trust policies, reported as a referral criterion by many liaison psychiatry services and had been encountered by most referring doctors. ‘Medical clearance’ was identified as a common barrier to liaison psychiatry referral. Terms were inconsistently used and poorly defined.

Many liaison psychiatry services seem not to comply with guidance promoting parallel assessment. This may affect parity of physical and mental healthcare provision.

Smoking and vaping are prohibited on Ireland's Health Service Executive (HSE) campuses. The HSE states that there is no evidence to suggest vaping is less damaging than cigarettes. Recent meta-analyses have shown that e-cigarettes are in fact less dangerous and can help smokers quit. Our study analyses the current smoking policies in place in mental health ‘approved centres’ in Ireland, what is being done to help smokers quit while in-patients and the level of support among staff for the introduction of e-cigarettes as a harm reduction tool. Clinical nurse managers from each mental health approved centre were surveyed to assess adherence to smoking policies.

Only 5% of surveyed units enforce the HSE's Tobacco Free Campus Policy; 55% of units supported the idea of using e-cigarettes to help patients quit cigarettes.

Ireland's hospital campuses are not tobacco free. Changes need to be made to our smoking policies and their enforcement.

Nasogastric tube feeding under physical restraint is an intervention that clinicians working in specialist mental health in-patient units may need to implement.

To examine the impact of this intervention on people with lived experience, carers and staff.

People with lived experience and parents and/or carers were recruited via UK eating disorder charity Beat. Clinicians were recruited via the British Eating Disorders Society's research forum. Qualitative semi-structured interviews were conducted and transcribed, and the results were thematically analysed.

Thirty-six participants took part, and overlapping themes were identified. All participants spoke in relation to four themes: (a) the short-term impact on the patient; (b) the impact on those around the patient; (c) the long-term impact; and (d) the positive impact. Subthemes were identified and explored.

This lifesaving intervention can also negatively affect patients, parents and carers, peers and staff. Further research is needed to understand how interactions and environmental modifications can mitigate the negative impacts.

This study aimed to assess current levels of knowledge, opinions and attitudes regarding mental health among the local cohort of general practitioner trainees (n = 45) working in Malta. A questionnaire adapted from the Mental Health Literacy Scale was used. Data were analysed using one-way analysis of variance and Pearson correlation tests.

All participants had scores equal to or more than the mean score in their knowledge and confidence assessments; 51% of the participants achieved the maximum score for a very positive attitude towards mental health, with such scores found particularly among female trainees. Increased levels of knowledge are associated with a more positive attitude, which can in turn lead to greater acceptance and reduce stigma.

Knowledge is a powerful tool for reducing stigma and improving the doctor–patient relationship, indicating that regular training initiatives are necessary to equip budding general practitioner specialists with the necessary skills and confidence.

There are numerous challenges in the recruitment and retention of the medical workforce in psychiatry. This mixed-methods study examined the role of psychiatry clinical attachments for international medical graduates (IMGs) to enhance recruitment and retention. An online survey was launched to capture views and perceptions of IMGs about clinical attachments. The quantitative and qualitative responses were analysed to elicit findings.

In total, 92 responses were received, with respondents commonly from India, Pakistan and Egypt. Respondents were mostly aged 25–34, with ≥3 years of psychiatry experience. Over 80% expressed strong interest in completing a psychiatry clinical attachment and believed it would support career progression. Qualitative data indicated that IMGs hoped to gain clinical experience and understanding of the National Health Service (NHS). They wished for a clearer, simpler process for clinical attachments.

Clinical attachment can be mutually beneficial, providing IMGs with opportunity to confidently start their psychiatry career in the UK and enhance medical recruitment in mental health services across the NHS.