To assess the views of patients and mental health professionals on the practice of copying clinical letters to patients. Patients and professionals from local community mental health teams were asked to complete a questionnaire regarding their views.

The questionnaires were completed by 51 patients and 40 mental health professionals. Significantly more patients (83%) than staff (37%) thought that copying letters to patients was a good idea (OR=14.56, 95% CI 4.674 –45.158). Many staff appeared concerned that copying letters to patients could result in breakdown of the therapeutic relationship, causing distress and anxiety.

Considerable work is needed for clinicians to feel comfortable in copying letters to patients. The creation of working groups, including users, carers, managers and clinicians working in the field of mental health, would facilitate the development of guidelines for this practice.

In a cross-sectional survey, we assessed the attitudes of older patients and their carers towards receiving copies of letters about them and the effects upon outcomes of sharing letters. We also studied the opinions of consultants on letter-sharing.

Few old age psychiatrists shared letters with patients or carers, and many had concerns about this practice. In contrast, letters were considered ‘very welcome’ by 87% of patients and carers who received them, and 81% of those who did not would be ‘very pleased’ to receive them. Patients and carers who had received letters had significantly better knowledge of their care plan, whom to contact and ways of making contact with services.

Despite concerns expressed by psychiatrists, our findings support the sharing of letters with patients and carers of patients with dementia in old age psychiatry services.

To develop and evaluate a screening tool based on the observational skills of prison officers to identify adult male prisoners with severe mental illness. The tool was developed from open-ended interviews with officers and diagnostic interviews with prisoners. A case–comparison study was used to evaluate the tool. Fifty prisoners identified using the tool and 50 randomly selected prisoners underwent diagnostic interviews to determine the proportion in each group with severe mental illness.

Five behavioural indicators of severe mental illness were identified and incorporated into the tool. In the evaluation, 19 out of 50 (38%) of the cases identified were found to have severe mental illness compared with none in the comparison group.

The simple tool shows promise for the identification of prisoners with severe mental illness by prison officers. It does require further evaluation in other prison settings.

Despite the Royal College of Psychiatrists' recommendation that higher specialist trainees in general adult psychiatry should use logbooks to record their training-related activities, none is currently available. We developed a logbook and conducted a postal survey of specialist registrars in general adult psychiatry in the West Midlands and Merseyside Training Schemes to elicit their perceptions of its usefulness and feasibility.

All of the 35 specialist registrars who completed the questionnaire felt that there was scope for a logbook and that this format was easy to use. Three-quarters of the respondents suggested that their training curriculum should be incorporated into the logbook and 71% felt that the use of logbooks ought to be mandatory. Despite all acknowledging the need for a logbook, only 14% were currently using one.

Logbooks would greatly help higher specialist trainees to organise (identify, record and review learning objectives) the multifaceted aspects of their training. They would also help immensely in preparing for the Record of In-Training Assessment, appraisal and revalidation. There is clearly scope for a more ‘centrally’ produced (College) logbook for specialist registrars in general adult psychiatry, as indicated by the results of this survey. For logbooks to work in practice, they need to be simple and easy to use.

The aim of the study was to compare referrals to a liaison psychiatry service and a neighbouring community mental health team (CMHT). Demographic and clinical information were compared for 100 consecutive referrals to each service.

The liaison psychiatry service had a smaller ongoing case-load and a higher referral rate than the CMHT. Larger proportions of patients referred to liaison psychiatry had comorbid physical illness (49 v. 10%) or had harmed themselves (41 v. 10%). More patients referred to the CMHT had a primary diagnosis of a mood disorder (49 v. 28%), but fewer had organic disorders.

The differences in service delivery and clinical problems referred imply that different expertise is required by those working in each service. This supports the view that community and liaison psychiatry are separate specialties, with implications for higher specialist training.