The aim of this study was to evaluate the predictive validity of the HCR–20 risk assessment instrument for the case-load of an inner-city community forensic team. File review and an interview with the keyworker for each patient were used to compile the information, and the author completed the HCR–20 for all patients. Cases were followed up for an average of 2.5 years to collect information on recidivism.

The risk profile for this sample was comparable to published North American studies. Patients who were subsequently charged with or convicted of violent offences all scored highly on the HCR–20.

The HCR–20 appears to be a useful instrument for stratifying risk within community forensic samples; this finding has implications for intensity of treatment and supervision. However, the data also suggest that services need to target criminogenic variables more effectively.

The aim of the study was to examine the association between the assessment of need by staff and by severely mentally ill patients using the Camberwell Assessment of Need in a semi-rural setting (Maidstone, n=50) and an inner-city area (Camberwell, n=127). Staff and patients were interviewed separately. We specifically examined differences in the total number of needs between Camberwell and Maidstone, differences in the number of unmet needs and differences in the level of agreement between staff and service users.

Patients in Maidstone had fewer needs than those in Camberwell according to both staff (4.9 v. 5.8) and patients (4.2 v. 6.3), fewer unmet needs rated (staff, 1.1 v. 1.5; patients, 1.0 v. 1.9) and a greater level of concordance between staff and patients.

The needs of severely mentally ill patients were greater in the inner-city area compared with the semi-rural one. The fact that agreement between staff and service users was less in the inner-city area also suggests that more stable staff–patient relationships existed in the rural area.

To evaluate the physical health and health risk factors in long-stay psychiatric patients in a high secure psychiatric hospital. A cross-sectional survey of consenting patients was undertaken using a semi-structured questionnaire, a brief physical examination and review of patient case notes. A comparison was made with data collected on admission and held on the Special Hospitals' Case Register.

Main findings were: a mean increase in weight since admission, in men of 10.62 kg and in women of 12.74 kg; high rates of smoking, obesity and large waist size; 54% of patients had one or more health problems.

The study's profile of the physical health of psychiatric in-patients indicates the need for health promotion initiatives in such hospitals and the need for primary care services.

To assess the value of computed tomography (CT) in patients presenting to an old age psychiatry service over a 2-year period, and to evaluate a set of clinical prediction rules and the recommendations of the Royal College of Psychiatrists on the selection of patients for scanning. A retrospective review of the reports of 178 consecutive scans and case note reviews was carried out.

Four scan reports (2.3%) suggested potentially reversible causes (PRCs) of dementia. of these, only two showed unequivocal organic brain lesions. Both of these patients were identified by each of the prediction rules tested. There was a high incidence of small vessel disease (32.8%) and infarcts (11.9%).

CT is a low-yield investigation in terms of identifying patients with PRCs of dementia. The tested clinical prediction rules appear sensitive in detection of PRCs. CT may demonstrate unsuspected cerebrovascular disease.

To describe the development of public education materials provided by the Royal College of Psychiatrists in the ‘Help is at Hand’ series of leaflets, and to assess the acceptability and usefulness of information about mental health on the College website by analysis of the online responses of those accessing this information.

More than 4000 responses to 14 of the ‘Help is at Hand’ leaflets were analysed. Ratings were generally high, with the exception of the statement ‘This leaflet talks down to me’. Free text responses were generally positive.

The College website is an accessible source of high-quality mental health information of the sort demanded by both service users and current health policy.

The aim of the study was to evaluate the effectiveness of the care programme approach (CPA) in adults with learning disabilities in a specialist treatment unit by auditing all in-patient records over a 6-month period. A multidisciplinary team set CPA standards. Staff on the unit completed questionnaires about patients, including CPA screening and risk assessment/management, and carers completed questionnaires about their perceptions of risk and information sharing.

Of the 15 patients whose records were reviewed, 13 had CPA screening on admission and 12 on discharge. Before discharge, 9 patients had a CPA planning meeting and only 4 patients had a demonstrable risk management plan. Carers of 9 patients perceived that information was shared.

Major deficiencies identified in risk assessment and management and in information sharing may potentially jeopardise successful treatment and after-care.