Aims: ADHD is commonly comorbid with depression and this comorbidity is associated with increased symptom severity and worse outcomes than either condition alone. Depression is highly heterogeneous and may present differently in populations with ADHD. This study aimed to explore different symptom presentations of depression and associated clinical correlates in a clinical ADHD sample.

Methods: We analysed data from the Study of ADHD Genes and Environment (SAGE). Parents completed semi-structured questionnaires about their child’s psychopathology at baseline (mean age 10.9 years) and the Mood and Feelings Questionnaire to capture their child’s depression symptoms approximately 5 years later (mean age = 14.6 years, N=249). Depression symptom presentations were derived by latent profile analysis.

Results: Analyses found three presentations of depression symptoms: a ‘low symptoms’ (48.5% of the sample) class, a ‘high symptoms’ class (15.5%) with consistently high depression symptoms, particularly for suicidality and poor self-esteem items, and an ‘irritable/poor sleep’ class (36.1%) with intermediate levels of depression symptoms and high scores for irritability and poor sleep. All three classes had elevated irritability and symptoms that overlap with ADHD. Behavioural problems were associated with an increased likelihood of being in the high symptoms compared with low symptoms class, and higher autism symptoms were associated with being in the intermediate ‘irritable/poor sleep’ compared with low class.

Conclusion: Our findings suggest that while young people with ADHD often have elevated depression symptoms, there is notable heterogeneity. Young people with ADHD and behavioural disorders may be particularly at risk of more severe depression symptom presentations characterised by high suicidal cognitions, whilst those with ADHD and autistic traits may present with more irritability and poor sleep.

Aims: There was an exponential increase in the rates of deliberate self-harm (DSH) in Sri Lanka over the last two decades coinciding with the rise of social media. Werther effect is the phenomenon where sensationalised media reports on suicide/DSH leads to increased rates of DSH/suicide. Therefore, assessing the impact of social media on DSH and implementing media regulations are timely needs. The objectives of this study included assessing the extent of exposure and the severity of emotional disturbance incurred due to social media content depicting DSH/suicide and determining the association between exposure and emulating DSH behaviour they were exposed to.

Methods: This descriptive cross-sectional study conducted in 2022, consisted of a sample of 162 individuals presenting with DSH to NHSL. A semi-structured clinical interview was used to collect data. Relevant statistical tests were used to analyse data.

Results: The average duration this study population spent on social media (1–3 hours) surpassed previous records for Sri Lankans (34 minutes). Fifty per cent were aged 20–29 years and 59.8% were female; a notable over-representation of minority religious and ethnic groups compared with general population demographics in Sri Lanka was seen. Out of 162 participants, 148 (91%) acknowledged being exposed to social media content depicting self-harm at some point. Facebook and YouTube were the top two platforms through which individuals were exposed to DSH/suicide content and the commonest methods published were hanging and overdose.

Although there was no statistically significant association between age and sharing self-harm content on social media, an overwhelming majority (87%) were <30 years of age. Approximately 30% of the sample reported experiencing severe emotional disturbance following exposure to DSH/suicide content.

Individuals who intentionally searched social media for DSH/suicide content consisted 11% of the sample and they were more likely to emulate similar behaviour than those who did not actively search such content. Spending 5 hours or more in a day on social media significantly increased several risks including the likelihood of being exposed to content depicting DSH/suicide, experiencing emotional disturbance and emulating the self-harm behaviours they were exposed to.

Conclusion: The notable ethnic and religious disparity seen in this sample suggests the need to examine healthcare accessibility, socioeconomic disparities, and tailored mental health literacy programmes. Prolonged social media exposure, particularly over 5 hours increases the risks of exposure and emulation significantly, warranting implementation of policies to reduce harmful content on social media and targeted interventions to promote healthy social media use among vulnerable populations.

Aims: Clozapine is an atypical antipsychotic for treatment-resistant schizophrenia. Despite its efficacy, there are potential life-threatening side effects, including pericarditis, which has limited its usage. Clozapine-induced pericarditis may range from mild symptoms to life-threatening complications. Despite increasing case reports, a comprehensive synthesis is lacking, necessitating a systematic review.

Methods: A systematic review was conducted following PRISMA 2020 guidelines and registered in PROSPERO. Eight databases, including PubMed, Embase, and PsycINFO, were searched, identifying case reports published between 1980 and 2024. Inclusion criteria focused on English-language case reports diagnosing clozapine-induced pericarditis. Exclusion criteria included non-clozapine-induced pericarditis and mixed aetiologies without clozapine-specific data. Data extraction included demographics, clinical presentation, diagnostic findings, management, and outcomes.

Results: Of the 941 identified articles, 36 met the inclusion criteria. The mean age was 33.56 years (SD: 15.56), with males comprising 63.9%. Chest pain (63.8%), fever (52.8%), breathlessness (50%), and tachycardia (44.4%) were the most common symptoms. Diagnostic tests consistently indicated elevated inflammatory markers, including CRP (mean: 88.13 mg/dL) and ESR (mean: 72.72 mm/hr). Echocardiograms confirmed pericardial effusion in 88.9% of cases. Management strategies included colchicine (16.7%) and analgesics (19.4%), with cardiac recovery achieved in all but one case. Clozapine rechallenge was attempted in 16.7%, with successful outcomes in 83.3% of these cases. Time to recovery averaged 3.73 weeks (SD: 9.8). Psychiatric stability was maintained in most cases following substitution with alternative antipsychotics, primarily olanzapine and risperidone.

Conclusion: Clozapine-induced pericarditis is a rare but significant adverse event characterized by elevated inflammatory markers and diagnostic imaging abnormalities. Prompt recognition and tailored management, including anti-inflammatory treatment and careful rechallenge, can lead to favourable cardiac and psychiatric outcomes. This review underscores the need for heightened clinician awareness and standardized protocols to optimize care for patients requiring clozapine therapy.

Aims: Huntington’s disease (HD) is a progressive neurodegenerative disorder characterized by motor dysfunction, cognitive decline, and psychiatric symptoms. Among the psychiatric manifestations, psychotic symptoms such as delusions and hallucinations remain underreported and poorly understood. This systematic review aims to analyse the prevalence, clinical presentation, assessment tools, and treatment approaches for psychosis in HD patients.

Methods: A comprehensive literature search (PubMed, Embase, PsycINFO, and Google Scholar) was conducted using multiple electronic databases to identify studies reporting psychotic symptoms in HD patients. Inclusion criteria involved case reports that provided detailed psychiatric presentations, genetic findings, and treatment interventions. Data extracted included patient demographics, genetic CAG repeat counts, psychiatric symptoms, assessment tools, pharmacological and non-pharmacological interventions, side effects, and patient outcomes.

Results: A total of 53 case reports with 60 cases were included. The mean age of psychiatric symptom onset was 42.58 years, and the mean age at HD diagnosis was 38.09 years. The mean CAG repeat count was 44.71, and the mean age of onset of motor symptoms was 41.25 years. The review identified multiple cases of HD patients presenting with psychotic symptoms, including persecutory and grandiose delusions, auditory and visual hallucinations, and paranoia. Electroconvulsive therapy (ECT) was used in 20% of cases. The most frequently used antipsychotics were risperidone (26.7%), olanzapine (23.3%), clozapine (16.7%), aripiprazole (16.7%), and haloperidol (13.3%). A family history of HD was present in 73.3% of patients. In 36.6% of cases, side effects were reported, including extrapyramidal side effects, orthostatic hypotension, neutropenia, and increased sedation. In 93.3% of cases, symptomatic improvement was reported, though some patients exhibited persistent cognitive dysfunction and residual psychotic features.

Conclusion: Psychotic symptoms in HD are a significant but understudied phenomenon, frequently complicating disease management. The findings highlight the need for standardized assessment protocols and tailored treatment approaches to mitigate psychiatric distress while balancing cognitive and motor function preservation. Future research should focus on longitudinal studies to better understand the trajectory of psychosis in HD and optimize treatment strategies.

Aims: Psychiatric trainees are often the “first responders” to manage patients with personality disorders but receive little specific training in this. Transference Focused Psychotherapy (TFP) is a manualized evidence-based treatment for severe personality disorders based on a psychodynamic approach that focuses on object relations theory. There is an expanding experience in applying TFP in different psychiatric settings. While there is evidence of effective training of applied TFP in the UK, Europe, South Africa and India, TFP training in Malaysia is a relatively new concept.

The aim of the study was to evaluate the effectiveness of a series of teaching sessions on TFP as applied to patients with personality disorders, on improving the attitude and technical confidence of psychiatric trainees in one of the major universities in Malaysia (UiTM), in their clinical encounters with patients with personality disorders.

Methods: A cohort of psychiatric trainees at UiTM received four 2-hour teaching sessions on applied TFP over consecutive weeks via video teleconference. Nineteen trainees completed 2 questionnaires, pre and post four teaching sessions. The cohort included first-year trainees (n=7) and senior trainees (n=12, comprising second, third and final-year psychiatry trainees). The questionnaires used were the Attitude to Personality Disorder Questionnaire (APDQ) and the Clinical Confidence with Personality Disorder Questionnaire (CCPDQ), both are validated instruments with good psychometric properties.

Results: The mean age of participants was 33.18 years, with an average of 2–8 years of experience in psychiatry. Quantitative analyses revealed significant improvements in both attitudes and clinical confidence. For the Attitudes to Personality Disorder Questionnaire (APDQ), the mean pre-intervention score was 71.11±9.87, while the post-intervention mean score was 65.05±10.79, representing a statistically significant reduction (t(18) = 4.11, p=0.00065). This finding indicates improved attitudes toward patients with personality disorders. Similarly, the Clinical Confidence with Personality Disorder Questionnaire (CCPDQ) showed a significant increase in confidence levels. The mean pre-intervention score was 16.11±6.38, which rose to 22.58±7.76 post-intervention (t(18) = −3.58, p=0.0021).

Conclusion: Teaching sessions on applied TFP to personality disorders can significantly improve psychiatric trainees’ attitudes and technical confidence in clinical encounters with patients with personality disorders. Given the low resource requirements (8 hours of training, delivered remotely), and the growing international experience of effective teaching of applied TFP training, it may be considered not only in Malaysia but in a range of countries.

Aims: To outline the development and implementation of the West Midlands Psychiatry Leadership Programme, a pioneering initiative believed to be unique within UK psychiatry training, and to evaluate participant feedback on its impact and benefits.

Methods: The programme, led by honorary leadership tutors who are higher psychiatry trainees, combines three online training days and a face-to-face conference. Conducted across 2024, it allowed participants time to reflect between sessions. Open to all psychiatry higher trainees in the West Midlands Deanery, invitations were sent via email. Feedback, collected via Microsoft Forms, evaluated its impact in preparing trainees for consultant roles through theory, practical application, self-awareness, and team leadership.

Day 1: Focused on leadership roles within the NHS, exploring operational structures, financial frameworks, emotional intelligence, and personal leadership styles.

Day 2: Addressed “Preparing to be a Consultant” with presentations, scenario analysis, and panel discussions on transitioning to consultancy.

Day 3: Explored “Leading in Teams and Organisations” through organisational change frameworks, team-building exercises, and QI project workshops.

Conference: Provided a platform for trainees to showcase achievements, network, and gain insights from external speakers.

Results: Quantitative and qualitative feedback was collected.

Day 1: Overall satisfaction of the day averaged a score of 4.5/5. 48% of attendees rated the content as “very good” and 52% rated it as “good”. Participants praised the interactive breakout rooms and emotional intelligence sessions, with suggestions for enhanced face-to-face elements.

Day 2: Overall satisfaction of the day averaged 4.63/5. More specifically, 77% of attendees were “very satisfied” with the content. The practical consultant preparation talks and scenario-based discussions were highly valued. Feedback emphasised the value of real-world insights.

Day 3: Overall satisfaction of the day averaged 4.52/5. More specifically, 79% of attendees rated the content as “very satisfied”. The engaging role-playing activities and QI workshops were key highlights. Suggestions from feedback included more examples of successful QI projects.

Conference: Overall satisfaction averaged 4.53/5, with 80% reporting that they were “very satisfied” with speakers. 61% stated expectations were met, while 39% said expectations were exceeded. Networking opportunities and personal leadership insights were praised. Suggestions from feedback included a broader range of topics and more external speakers.

Conclusion: The programme addresses a critical gap in psychiatry leadership training by blending theory with practice and fostering collaboration. High satisfaction and positive feedback highlight its success. The conference enhances its impact by showcasing achievements and fostering networking. Future iterations will refine content, broaden participation, and assess long-term outcomes.

Aims: The psychiatry residency programme in Qatar recently faced challenges with didactic activities, prompting the formation of an educational committee composed of trainees and supervisors. Their mission was to revamp the curriculum to meet competency-based standards and address accreditation concerns. A pivotal change was designating one uninterrupted day per week for education. This structured day now starts with a redesigned morning report focused on real-time discussions of overnight emergency cases, integrating various disciplines to broaden clinical insight. Following this, residents engage in newly established, two-hour resident-led sessions covering DSM–5 diagnoses, multiple-choice question (MCQ) practice, simulated learning, and psychiatric disorder management. Afterward, junior residents join Balint groups for reflective practice, while senior residents participate in psychotherapy supervision. Additional activities include case conferences, journal clubs, and workshops, culminating in didactic lectures led by senior clinicians.

Methods: To evaluate the impact of this revamped schedule, the committee conducted a cross-sectional, anonymized survey among all psychiatry residents. The survey contained six core questions, each rated on a five-point Likert scale (1=strongly disagree to 5=strongly agree), supplemented by a free-text section to gather qualitative feedback. Of the 30 residents invited to participate, 22 (73%) completed the survey. Quantitative data were then analysed to assess perceived benefits, identify challenges, and guide further adjustments.

Results: Results indicated that first- and second-year residents reported substantial gains from both the structured teaching and the opportunity to collaborate closely with peers. In contrast, third- and fourth-year residents suggested splitting certain sessions by training level to better match their advanced needs. Another noted concern was the level of faculty engagement, with respondents requesting increased direct supervision, more robust involvement in lectures and case discussions, and pre-assigned case presentations. Residents also expressed a desire for more frequent mock interviews and for simulated sessions in additional languages, targeting the diverse patient population seen in Qatar. Dedicated sessions for MCQ practice were requested to enhance board exam preparation.

Conclusion: Overall, these curricular changes have produced a more interactive and clinically relevant educational experience. However, the survey highlighted clear areas for improvement, particularly with regard to tailoring sessions to various training levels and expanding faculty participation. Further refinements will rely on continuous resident feedback, systematic assessment of learning outcomes, and enhanced faculty development. By maintaining an adaptive and trainee-centred approach, the programme aims to strengthen psychiatric education and foster the clinical competencies necessary for high-quality patient care.

Aims: The aim of this project was to gain a better understanding of clinical and professional areas that international medical graduates find difficult and often these areas can be a barrier in further career progression. This project was undertaken as part of the Leadership and Management Fellow Scheme organised by the Royal College of Psychiatrists. The idea was to align the learnings to broader goals at organisational level.

Methods: A survey questionnaire was created to gather information about the areas that international medical graduates struggle with in their professional career. In response to this a 'Resource Hub’ was created to provide concise information on clinically relevant topics and this was made available for all participants to access. Feedback was obtained about the utility of those resources and this was used to further broaden the 'Resource Hub'.

Results: The areas where people struggled to gain competence ranged from membership exams (22%) to research and development (35%), mental health legislations, and trust protocols (50%).

Following this a list of topics were brainstormed and relevant resources were added on the Trust Home page.

Feedback result for the resources was collated in terms of content (84%), precision (90%), relevance (86%), and overall effectiveness (85%). Other suggestions were taken into consideration for additional resource linking to promote communication skills, tribunal reports, and preparation for appraisal.

Conclusion: It was a valuable project which has helped to shed light on how to facilitate provision of clinically relevant resources that would help international medical graduates in their progress and overall attainment of career goals. The recommendations have been shared across the Trust with quality improvement and medical workforce race equality standards team.

Aims: Transcultural psychiatry is a critical field that examines the influence of cultural factors on mental health, illness, and treatment across diverse societies. It acknowledges that psychiatric symptoms and disorders can manifest distinctly based on cultural contexts, beliefs, and practices.

The Transcultural Psychiatry Workshop was held face to face at the Sheffield Health and Social Care Trust Grand Round in September 2024. The aim was to aid in implementing comprehensive training programmes, leverage workforce diversity, encourage culturally sensitive interventions, share helpful learning, enhance community engagement.

Methods: The workshop was 120 minutes and was attended by 104 doctors. The workshop included a specialist panel of experts from experience, carers and professionals, presentation regarding data regarding healthcare experience of ethnic minority groups in the area and case-based learning opportunity. Pre- and post-workshop surveys were administered to assess the effectiveness of the workshop and to inform future planning and educational strategies. They used a 5 point Likert scale for most questions.

Results: There were 75 responses received for the pre-workshop questionnaire and 48 for the post-workshop questionnaire. For the question how likely are you to effectively and consistently intervene when you observe discriminatory behaviours in others, there was an increase from 29.33% to 39.58% to be very likely. Regarding awareness of local policy those answering yes went from 28.00% to 97.92%. Whereas 26.67% of respondents felt their knowledge of transcultural psychiatry was below average and 4.00% felt it was far below average, after the workshop 0.00% rated in these two categories. The understanding of potential barriers for people from ethnic backgrounds when accessing healthcare increased in the above average category from 29.33% before to 66.67% after.

Conclusion: The feedback received from participants was predominantly positive and encouraging, reflecting the workshop’s effectiveness in meeting objectives.

Participants expressed particular interest in the diverse panel, including a representative from a third-sector organization, an expert by experience, a carer, a psychiatrist and chaplaincy, thereby enriching the workshop’s relevance and depth. These findings indicate that the workshop effectively enhanced understanding of transcultural issues and resources, underscoring the significance of educational initiatives in fostering cultural competence within healthcare settings.

Organise further education opportunities. Include greater lived experience and scenario discussions in next workshops. Cover topics like old age psychiatry, cultural backgrounds, correct cultural terminologies and expression of mental distress. Disseminate data regionally and nationally to raise awareness.

Aims: The overall aim of this project was to encourage mental health patients to participate in the general election. To raise awareness among staff about patient voting rights so they are better equipped to encourage patients to participate.

Methods: We conducted face-to-face interviews with all patients throughout the voting process from June to July 2024 on one of the wards.

– Created a page on the trust intranet with information about voting for staff.

– Created a leaflet that was available on the intranet for staff to print out and display.

– Made an educational video on the trust YouTube account and embedded it on the trust intranet.

– Conducted a staff survey after the election to assess knowledge and attitudes about mental health patient voting rights and to evaluate the effectiveness of our interventions.

Results: A survey was conducted and was open for 1 month until 18 October 2024. This was circulated to all staff via email distribution lists. We had 18 completed surveys.

– 44% of respondents were vaguely aware or not aware at all of patient voting rights.

– 39% were not confident about which mental health patients could vote in the general election.

– 67% of respondents did not see any of the voting resources.

– 83% were not confident in supporting patients at the general election.

– 88% of staff agreed that the trust should support patients to vote.

– 93% of staff thought it was important for the trust to promote voting rights of patients; however, 5% thought it was not important at all.

– Of all the patients on the ward (N=19), 7 (36.8%) were not interested in voting, 1 was not eligible and 57.9% were already registered.

– Of those registered, 5 (45.5%) made their own arrangements to vote and 2 were supported by the ward to vote (in person and by post).

– 36.4% (4) of patients who had registered to vote and had expressed interest in voting were not able to vote.

Conclusion: There is a need to increase awareness of voting rights among both staff and patients. Survey uptake was low, but from the data collected, most staff did not see any of our resources and most are not having conversations with patients about voting rights and the support available to exercise these rights

Aims: In collaboration with Birmingham Medical School, Birmingham Solihull Mental Health Foundation Trust (BSMHFT) Clinical Teaching Academy piloted a novel Balint Group (BG) scheme for 4th-year medical students during their psychiatry placement. To the best of our knowledge, this is the first time BGs have been accessible to 460 students in one year, and to every student attending psychiatry placement. Research shows that empathy declines in medical students as they progress through their career. However, BGs are known to improve student empathy and support the development of a clinical identity, yet no research has assessed whether through the process of Balint, students successfully gain skills in transference, emotional and cognitive learning, and case mirroring in group dynamics.

Methods: All 4th-year students participated in weekly BG sessions during their placement. Upon completing the 4 sessions, students filled out the Balint Group Questionnaire, which assesses three main learning principles: Reflection of Transference Dynamics in the Doctor-Patient Relationship, Emotional and Cognitive Learning, and Case Mirroring in the Group Dynamic. The questionnaire consisted of 15 questions, with a total score of up to 75. The results were analysed using SPSS.

Results: 210 students completed the survey. The mean score was 47.1/75. Scores were highest for the Mirroring domain (M=3.42, SD=1.05), followed by Transference (M=3.27, SD=1.04), and Emotional and Cognitive Learning (M=2.94, SD=1.15). A repeated measures ANOVA showed statistically significant differences between the domains. Transference (M=3.27) was rated higher than Emotional and Cognitive Learning (M=2.94), with a mean difference of 0.326 (p<0.001). Similarly, Mirroring (M=3.42) was rated higher than Transference (mean difference –0.152, p=0.022), and Mirroring was also rated significantly higher than Emotional and Cognitive Learning (mean difference –0.479, p <0.001).

Conclusion: Higher engagement in Mirroring suggests that BGs help students develop self-awareness and empathy by reflecting on emotional responses to cases, potentially improving patient care and clinical insight. Two more cohorts of students will participate in the study, and we expect similar results with a larger sample size. These findings support the positive role of BGs in medical education.

Aims: The culture of psychiatry in the UK is deeply rooted in Western biomedical paradigms, raising questions around its ability to meet the needs of culturally diverse patients. Literature consistently demonstrates that individuals from diverse backgrounds experience disproportionately poorer mental health outcomes, highlighting the need for a more culturally responsive approach to care.

This research examines how the concept of 'cultural competence’ is understood by current trainee and consultant psychiatrists, through the retelling of their experiences of navigating culture in the clinic.

This research aimed to (1) explore perspectives of UK psychiatrists of navigating culture in the clinic, and to (2) evaluate the effectiveness of the current postgraduate psychiatric curriculum in fostering cultural competence.

Methods: Employing a narrative inquiry approach, the primary source of data was collected through open interviewing to promote the process of storytelling. Three clinicians of various clinical grades were recruited, and five narratives extracted for analysis. Data was analysed using Labov’s method of structural organisation.

Results: The findings demonstrate that clinicians consistently frame their encounters with cultural diversity as challenging, often conceptualising them as conflicts to be overcome. Three core competencies for effective cross-cultural practice emerged:

1. 1. Curiosity and openness.

2. 2. Polycultural practice.

3. 3. Critical evaluation of resources.

These competencies informed the development of a new proposed model of cultural competence designed to guide educators in fostering these qualities in psychiatric trainees.

Conclusion: The findings highlight a significant gap in the existing postgraduate psychiatric curriculum, suggesting that current medical education frameworks are insufficiently aligned with the demands of a multicultural society. The study advocates for comprehensive curricular reform that starts with a shift in the underlying conceptual frameworks of psychiatric education, encouraging practitioners to adopt a more holistic, culturally sensitive approach to mental health care. Only once this conceptual foundation is established can practical reforms effectively follow, ensuring that trainees develop not only technical competence but also the cultural insight necessary for inclusive, empathetic care.

Aims: An interprofessional educational intervention integrating case-based teaching was introduced to the multidisciplinary team (MDT) of two acute adult inpatient wards aiming to improve understanding, compassion and team dynamics through protected time for reflection, learning and social collaboration.

Methods: All MDT members were invited to a monthly 90-minute teaching session for a period of 7 months. Attendees could join in person or online. Sessions were primarily led by 2–3 MDT members from different professional backgrounds e.g. doctor, psychologist, and pharmacist. Two of the sessions included external presenters on specialist topics including eating disorders and substance misuse.

Sessions were split into: A Case Presentation on a current inpatient; A Topic Presentation on a subject linked to the case.

Feedback was collected anonymously on paper forms and emailed to online attendees following each session. Likert and free-text questions were used to gather feedback on teaching content, style, quality, relevance, and value. Following the final session, feedback was collected about the overall programme and presenters were asked to provide feedback on their experiences collaborating with colleagues. Likert items were analysed using Microsoft Excel and a basic thematic analysis was undertaken for free-text questions.

Results: On average, 13 professionals attended in-person and 3 online per session. Attendees included resident doctors, consultant psychiatrists, nursing staff, physical health nurse practitioners, psychologists, pharmacists, occupational therapists, support workers, activity coordinators and speech and language therapists. The average session ratings were 9.8/10 (1 – poor,10 –excellent) for usefulness and 9.75/10 for content, relevance, and teaching skill. Attendees who provided feedback on the overall programme (n=13) found it extremely valuable and wished for the sessions to continue. Five themes were identified: improved accessibility to teaching, shared perspectives, better understanding of professional roles, improved patient understanding via case-focussed teaching and reflection, and team building. Presenters (n=7) found the experience very or extremely valuable and they would recommend it to colleagues.

Conclusion: This interprofessional case-based teaching programme was successfully integrated within the acute inpatient setting. Effective interprofessional collaboration can be a key mechanism for improving service delivery, patient care and safety, and enhancing teams. Attendees found it beneficial discussing challenging/complex cases, improving their understanding of patients’ difficulties and colleagues’ roles. The sessions allowed attendees to reflect on cases with colleagues, sharing experiences and learning from one another positively impacting professional relationships. It would be useful for objective measures to be integrated within future research design to quantitatively measure changes in outcomes such as compassion, empathy, burn-out and teamwork.

Aims: International Medical Graduates (IMGs) make up more than half of new recruits in the NHS and recent data shows that there is an increased likelihood of IMGs being referred to the General Medical Council (GMC) for fitness to practice investigations. Analysis of these complaints highlighted communication skills as an area of concern. We wanted to support relatively new IMGs, who started practicing in the country within the last 2 years, by enhancing their communication skills.

Methods: To deliver this initiative, medical education department, trust IMG tutor and two higher trainees (with recent lived experience as an IMG in the NHS) partnered with Talking Allowed (communication skills training company for healthcare professionals). 12 IMGs registered and were offered 5 half day online and 1 day face to face training using a mixed model of activities related to all aspects of communication – verbal, non-verbal and written. We ran role plays on: ‘Managing an upset relative’, ‘Breaking Bad News’, ‘Misunderstandings and Colloquialism’, ‘Dealing with disagreement/ conflict within the team’ and ‘Challenges to professional boundaries’.

During role plays, prior to candidates’ attempt, a ‘how not to do it’ version was acted out by the higher trainees followed by the enrolled participants going next. Each role play was further followed by reflective feedback sessions facilitated by PM, LH & RB to identify and reflect on positive as well as areas for improvement. Through the course one session focused on written communication, with homework and best practice guidance provided prior to the session. At the last session, there was a didactic presentation and discussion on acculturation with opportunities to reflect. Feedback was gathered at every session from the attending IMGs. 7–8 trainees engaged through the process, 2 dropouts and 2 non-engagements.

Results: 97.1% (n=35) rated the sessions as ‘highly engaging’ (on a scale of 1 to 4), 100% rated the sessions as ‘highly relevant’ (n=36); 91.4% (n=35) rated the course as ‘highly useful’. Compared with at the start of the course, subjective confidence in communication of participants improved by 2 points in a scale of 0 to 10. Initial score 6.8 and final score 8.8 (signifying 20% increase).

Conclusion: Focused communication skills training involving a mixed method of role play using simulation principles, complemented by general reflective exercises on communication especially in a cultural and emotional context as well as some reflection on the personal experience and the known intelligence on immigration and acculturation can be an invaluable tool for IMGs.

Aims: Demand for child and adolescent mental health services (CAMHS) in Northern Ireland (NI) has steadily increased in recent years. Currently, over 50% of families are waiting beyond the recommended nine-week target for assessment. A regional 10-year workforce review outlined the need to expand the CAMHS workforce by 102%, with specific focus on succession planning for psychiatrists. This highlights the need to fill vacant Child and Adolescent Psychiatry (CAP) higher training posts.

By hosting a recruitment event, we aimed to provide information regarding the application process to higher training in CAP and increase exposure to the breadth of career opportunities available. Longer term aims are to sustain recruitment into higher specialty training and bolster the consultant workforce.

Methods: The event was delivered as a two hour in-person meeting. Demographic information and anonymous feedback were collected via Microsoft forms. The programme included presentations from current higher trainees, consultants and the Training Programme Director. Topics covered included the following:

Application and interview process.

Structure of training including on-call rota arrangements.

Day-to-day experience of a consultant covering a step three community CAMHS post.

Overview of specialist service provision in CAMHS including eating disorder, autism and CAMHS intellectual disability services.

The event also provided opportunity for networking and an open-ended question and answer session.

Results: The event was attended by six local core psychiatry trainees. Four attendees had previously worked in a CAP post, whereas two had no CAP experience or only out of hours exposure to the specialty. All attendees ‘strongly agreed’ that the event had increased their knowledge about the opportunities in CAP in NI. Five attendees ‘agreed’ that the event had strengthened their aspirations to train in CAP with one attendee responding ‘strongly agree’ to this statement.

Conclusion: This was the first CAP higher training recruitment event hosted in NI. Although the number of attendees was small, feedback was overwhelmingly positive. Following a year without any regional recruitment into CAP, there have been six applicants for one post advertised for August 2025. Whilst a direct causal relationship cannot be established, we hope that this event reinforced aspirations to pursue this career path. Given the current vacancies across the CAMHS workforce, there is an opportunity to expand this event to include other members of the multi-disciplinary team, to equip the future workforce for the rising demand in services.

Aims: Developing core psychotherapy knowledge and skills is considered a key part of the Royal College of Psychiatrists curriculum. This cross-sectional study aimed to evaluate the current provision of psychotherapy teaching and supervision for core trainees within South-West London and St George’s Trust, identifying key concerns and proposing improvements to enhance the training experience.

Methods: 27 trainees participated in a trust-wide questionnaire, achieving a 58% response rate amongst core trainees in years two and three. The questionnaire was conducted online using Microsoft Forms, with a link distributed via email, including multiple-choice and open-ended questions, and focusing on the feelings trainees have towards psychotherapy teaching as well as the benefits and challenges they have observed. Data were analysed using Microsoft Excel and a thematic approach.

Results: A general feeling of anxiety was described by many, with some trainees describing the current system as “frustrating and disheartening”. Other key themes were the perceived lack of preparedness before starting psychotherapy cases, variation in expectations of supervisors and case allocation delays. 87.5% of trainees felt they lacked sufficient knowledge in psychotherapy before starting short-cases, 72% for long-cases. 56% stated they were providing or planning to provide sessions out of their working hours. Reasons given included fears of upsetting the patient, not providing continuity of care during their annual leave or zero days and not being able to complete their case in time for training requirements. 11% were dissatisfied with their short-case experience, 50% with their long-case experience. 61% of participants felt they would benefit from private therapy themselves, to support them during the process.

Conclusion: Results highlight concerns that trainees can have in psychotherapy training, which are being addressed locally but can also have relevance for other training programmes and practices. The perceived lack of adequate teaching prior to starting cases is striking, and could pose potential risks to patient safety. The high numbers of trainees who report offering therapy outside working hours poses risks to trainee well-being, as well as insurance coverage and patient safety. This study also revealed how a large proportion of trainees believe they would benefit from being offered personal psychotherapy, something that is not routinely offered in training. Enhancing psychotherapy training with timely, comprehensive and structured support, whilst also considering trainee wellbeing, could lead to improved educational impact, benefiting both trainee professional development and ultimately patient care.

Aims: Following the recent passage of the Terminally Ill Adults (End of Life) Bill (2024) through UK Parliament, we set out to understand the views of psychiatrists towards assisted dying and the nature of their education in this area.

Methods: We selected 2 previous surveys. Using a pragmatic group, we developed a survey based on previously used questionnaires in this area. We gathered demographic data including religious affiliation, and country of primary medical qualification. We surveyed 44 psychiatrists in total.

Results: 27% had experience of undergraduate education on assisted dying euthanasia while 11% postgraduate education.

We adapted a survey form to measure attitudes towards euthanasia, giving a score out of 16. 31% scored 0 (with very positive attitudes to euthanasia), 11% scored 16 (very negative), and the median was 2. Participants with negative attitudes to euthanasia had a higher degree of religiosity, were more likely to train outside of the UK, but had similar age distribution to the general population.

The second part of the survey looked at euthanasia in psychiatric patients. Only 14% agreed that it should be allowed for psychiatric illnesses, with 27% unsure and 59% opposed.

The most acceptable statement (86% agreement) was that psychiatric patients can find themselves in a medically hopeless situation. 75% agreed that psychiatric patients could suffer unbearably. 70% agreed that psychiatric patients may run out of treatment options.

Participants opposed to euthanasia also opposed it in psychiatric patients. They were more likely to doubt the above statements, but only one participant disagreed with all statements. Most disagreed with the statement that “a death request can be well-regarded and considered not only as a symptom of illness” (66%).

Of participants in favour of euthanasia in general, 42% said they were unsure of legalising euthanasia for psychiatric patients, while 21% were opposed. This group was more uncertain of the statement that “euthanasia assessment can be compatible with psychotherapeutic relationship” (50% disagreed or unsure).

Most participants had little education in this area. International Medical Graduates and those self-described as religious were more likely to have negative perceptions of assisted dying in general. While there was agreement that suffering from mental illness could be unbearable, very few supported euthanasia for mental illness alone.

Conclusion: There is a notable lack of education on euthanasia at both undergraduate and postgraduate levels which is known to have a strong influence on attitudes to assisted dying. There are aspects in medical ethics and medical law which need to be incorporated into curricula for medical training.

Aims: To establish if there is data to support the clinical impression that people with ASD are more likely to experience perceptual disturbances (visual and auditory).

Methods: Literature search using Athens/Pub Med. Clinical observations had been that young people with ASD seemed to experience increased perceptual disturbances but that these did not respond to antipsychotics. Detailed history taking also suggested that, especially visual hallucinations, were often long-standing and had started in mid childhood (typically while at primary school). These tended not to cause distress initially but often increased during adolescence.

Results: There is little specific data on this subject: there are numerous studies and case reports considering the increased risk of psychosis and schizophrenia in people with ASD but not specifically on non-psychotic young people with ASD who have perceptual disturbances (in the absence of other symptoms suggesting psychosis). Limited data that was available noted that people with ASD were 3 times more likely to experience auditory and/or visual hallucinations than their counterparts. Suggested pathways for this included shared pathological pathways (between schizophrenia and ASD), overlapping DNA (not established), that ASD is a risk factor for later development of schizophrenia and living with ASD may incur increased social stressors (bullying, exclusion, marginalisation, isolation etc.).

Conclusion: Having ASD does appear to increase the likelihood of experiencing (psychotic and non-psychotic) perceptual disturbances. The reasons for this are largely inconclusive but may explain our clinical impression; that young people with ASD who are hearing voices or seeing things but who are not psychotic, do not appear to respond positively to antipsychotics. We would advise medications are used with caution in this (non-psychotic) patient group and that other avenues are considered for treatment, including self-help, psychoeducation and psychological support. We must be cautious about causing iatrogenic harm and over medicating. More research is needed in this field.

Aims: Following the approval of the Assessment Strategy Review (ASR) in February 2023, the Formative Assessment Working Group (FAWG) was created to discuss areas for consideration, in relation to formative assessment.

The aim was to consider the broad range of the College’s assessments, including written examinations, the Clinical Assessment of Skills and Competencies (CASC) and formative assessments undertaken throughout psychiatric training in the workplace. Whilst the ASR had a broad scope, one of the recommendations was to review formative assessment in detail, due to the varied nature of specialty and sub-specialty specific assessments and the differing experiences of resident doctors in the workplace.

Methods: The Formative Assessment Working Group (FAWG) met throughout 2023 and identified four specific areas for further consideration, development and implementation:

The introduction of enstrustability scales; a behaviourally anchored ordinal scale based on progression to competence, as part of workplace-based assessments (WPBAs).

Embedding formulation skills throughout training.

The introduction of feedback from patient and carers for resident doctors.

Consideration of guided supervision sessions relating to caseload-based discussion.

Results: Entrustability scales as part of WBPAs: An entrustability scale (ES) would not be suitable to all assessment types. Therefore, an adaptation of ES will be introduced to CS and ES reports. WPBA will see an improved version of the current Likert scale. Embedding formulation skills throughout training: Formulation training will be incorporated into case presentations. Resident doctors will be advised to undertake this yearly to demonstrate progression. For ST4+ trainees, one case-based discussion (CBD) will be replaced with a case presentation (CP), with the provision of presenting to MDTs. Introduce feedback from patients and carers for resident doctors: Resident doctors will be expected to collect one set of Multisource feedback (MSF) responses during core training and at least once per speciality training year. This will apply across all psychiatric specialties, including those who undertake dual training. The feedback should also form part of ARCP considerations. Introduce guided supervision session relating to caseload-based discussion: Direct Observation of Non-Clinical Skills (DONCS) will now feature HLOs 1–9 as part of the ‘skills observed’ part of the online portfolio. This will allow for resident doctors to capture skills and experience that aren’t covered elsewhere in their portfolios.

Conclusion: The changes should allow resident doctors to demonstrate the skills and knowledge acquired across their training. They will also be able to demonstrate a clear understanding of their progression and benefit from a variety of feedback opportunities.

Aims: Medical training, particularly in psychiatry, often confronts students with emotional challenges that extend beyond clinical skills. Recognizing that medicine is as much an art as it is a science, we invited fourth year medical students at the University of Birmingham to enter a creativity competition whilst on their psychiatry placements.

This project aimed to provide a reflective outlet for the students, encouraging them to explore and express their emotional responses to the realities of psychiatric practice. By drawing parallels between their own experiences and those of their patients, the students were able to utilise art as a source of personal insight on their clinical practice.

Methods: During their 5 week psychiatry rotation, students were invited to create and submit an artistic piece inspired by their clinical encounters. Creative submissions – ranging from poetry and paintings to drawings and even baking – were accompanied by a brief explanation of the inspiration behind the work. On the final day of placement, students had the opportunity to present or perform their piece in front of their peers, fostering an environment of shared reflection and support. One entry in each rotation would be selected as a prize winner, however the main focus of the project was to encourage students to utilise art as a medium of self-reflection and therefore understanding what impact the process had on them was key.

Results: 23 students participated in the initiative, producing a diverse collection of artworks that authentically portrayed their personal and professional experiences with mental health. Extracts from the explanations that accompanied the entries highlight that the students benefited from using art as a medium for processing and communicating complicated feelings about their psychiatric placement. The students reflected that art can be used as a therapeutic tool for both patients and clinicians. Many used their creative expression to consider the importance of seeing beyond the label of a diagnosis and to focus on the actual lived experience of the patient in front of us.

Conclusion: The creativity competition was met with enthusiasm, underscoring the value of artistic expression in medical education. Moreover, it suggested that integrating creative projects into clinical rotations can enrich students’ learning experiences and bolster empathy. It also encouraged students to continue to use creativity as an outlet to improve their own wellbeing in busy clinical periods. Future plans include publishing the entries in an anthology to share the moving artwork with a wider audience.