Our aim was to explore attitudes of in-patient mental health staff to smoking and the smoking ban. A questionnaire was distributed to staff (n=450) working at National Health Service psychiatric units in three different locations.

We obtained 308 responses, at a response rate of 68.4%. Staff were generally less permissive towards smoking in mental health units when compared with previous studies. However, most (78.9%) feared that service users' states would deteriorate if they were not allowed to smoke.

We found small but noticeable change in staff attitudes following initial reforms in smoking policy. However, there is a need for further significant change in staff attitudes to facilitate implementation of a total smoking ban from July 2008.

To assess the number of cocaine-dependent clients attending a typical addiction clinic, using urine drug testing for screening and a structured clinical interview for diagnostic assessment.

Of the 419 clients whose urine records were analysed, 38 were regular users of cocaine (9.1%), with at least half of their urine samples positive for cocaine in a 12-week period; 84.2% of these regular users of cocaine satisfied the criteria for cocaine dependence (7.7% of the total number of those attending the clinic).

Publicly funded addiction treatment centres in Ireland are mostly designed for the treatment of opiate addiction. There is, however, a significant problem of concomitant cocaine dependence in these centres. Increased availability of psychological/behavioural treatment programmes with proven efficacy in cocaine addiction may help improve overall treatment outcome.

There is a lack of tools to assess the needs of older people with enduring mental illness who have ‘graduated’ from adult mental health services and little is known about this population. the Elderly Psychiatric Needs Schedule (EPNS) was developed and applied to older people with enduring mental illness in contact with the old age and general adult components of an inner-city mental health service.

The EPNS proved reliable (mean agreement 96%, mean Kappa κ=0.90). the mean number of needs identified was 7.6, of which 4.3 were unmet and 3.3 were met.

The EPNS provided a reliable method of needs assessment in this population. the authors offer the EPNS as a tool to assess service needs of older adults with functional psychiatric disorders having ‘graduated’ from adult mental health services.

A postal questionnaire was sent to Scottish consultant psychiatrists asking about their attitudes towards unilateral and bilateral electroconvulsive therapy (ECT), and the difference in effectiveness between the two ECT types that they considered clinically significant.

The response rate was 61%. of those that responded, 62% were prescribers of ECT and most (79%) favoured bilateral ECT over unilateral ECT. the outcome that they were most concerned with was remission rate: 97% believe that an absolute difference of more than 5% in remission rate would make the difference in effectiveness between the two types of ECT clinically important.

Future investigators should focus on comparative remission rates of bilateral and unilateral ECT.

The assessment of the future dangerousness of firesetters is problematical but psychiatrists may be requested to perform assessment of arsonists for the courts. We surveyed the views of psychiatrists and others (n=54) on how 11 candidate historical variables might contribute to future dangerousness.

Hierarchical cluster analysis indicated that variables fell into three groups related to level of perceived dangerousness. Apparent intention to endanger life and setting fire to an occupied building were the items thought by psychiatrists to most indicate highest future dangerousness. Having previously set fires that caused extensive damage, failure to extinguish previous fires or alert the authorities were perceived as indicating moderate future dangerousness.

The study adds to what is known about how psychiatrists formulate assessments of future dangerousness.

The study aimed to assess the current provision of psychoeducation programmes for patients with mental illness in the UK. A postal questionnaire was sent randomly to 100 community mental health teams regarding the delivery and characteristics of psychoeducation programmes. Non-responders were contacted via telephone after 8 weeks.

The response rate was 87%. Eight services provided group psychoeducation, 40 provided individual psychoeducation within the care programme approach, and 39 did not provide any psychoeducation programme.

Patients with mental illnesses have limited access to psychoeducation in routine care. Group programmes should perhaps be more widely implemented as a relatively low-cost intervention.

Suicide in schizophrenia remains frequent. One of the best predictors of suicide, previous self-harm, is increasing in young people. the aim of this case-note review was to investigate the frequency of a history of self-harm for individuals presenting to psychiatric services with a first episode of psychosis in our local area and study their demographic characteristics.

A history of self-harm was found in 32% of the cohort. the predominant method of self-harm was self-laceration. In univariate analyses, age and gender were significant predictors of self-harming behaviour.

The rate of self-harm among those with first-episode psychosis is high. Efforts to reduce the rate of completed suicide in psychotic illness need to focus on this risk, which often predates contact with psychiatric services. This emphasises again the need for early detection and intervention in psychotic illness.