To improve the rate of documentation of risk in new referrals to a community mental health team. A retrospective audit of 46 case notes was followed by a training session on risk of violence. The following 50 case notes were studied for changes in risk assessment.

Prior to the study there were very low rates of documentation of risk of violence. Significant improvements were made in 45% of the items in the history and mental state although not in the formulation of a risk assessment statement.

It is possible to improve the risk of violence documentation with no extra time, resources or paperwork and with true multi-disciplinary involvement.

Users of a substance misuse service were asked to complete a questionnaire, detailing information about driving habits as well as attitudes about substance use and driving.

Of 120 subjects, 94 had ever driven, with only 36 currently driving. Fifty-six subjects had been charged with a driving offence but only 18 stated that they had been involved in an accident while intoxicated. The majority would not use drugs before driving and remain within a safe level of alcohol use. Most subjects stated that they were not informed of current legal issues concerning driving and substance use.

Users of a substance misuse service were reasonably responsible in their driving habits, however, it is still important for clinical staff working in such services to make their patients aware of the danger of driving under the influence of substances.

St John's wort is popularly taken as a herbal remedy, but it interacts with prescribed drugs. The aim of this survey was to estimate the prevalence of patients self-medicating with St John's wort. All new referrals to a community mental health team over 5 months were asked about any use of St John's wort.

Fifteen patients, of 101, had taken St John's wort at some time and of those seven were currently taking it. Patients who used St John's wort tended to be younger and female. Only nine of the 15 patients took it for depressive symptoms and none had received medical advice. One patient was taking an interacting medication.

A significant number of patients are taking St John's wort. In order to prevent drug interactions, doctors should ask all patients whether they use it, especially young women who may be on the contraceptive pill. Patients need better education about its risks and benefits and it should be taken with medical advice.

To describe eating disorder services in Scotland. Fifty-two services completed a postal questionnaire.

Six of the mainland health board areas, with a total population of 1.5 million, were not covered by any (self-defined) ‘specialist’ service. Although most services had access to in-patient facilities, we identified only one designated bed in Scotland for eating disorder patients, and this in a non-specialist service. In many other ways, services did not meet published recommendations for the provision of eating disorders services.

It is suggested that a national strategy should be formulated, and a model of service provision is proposed.

Mental illness may cause specific problems in the environment of an international airport. The aim of our study was to assess frequency, presentation and safety implications of mental disorders requiring formal admission at an international airport. We performed a retrospective study over 4 years including patients who were detained by the police and admitted.

The frequency of admissions was one per million passengers, the frequency of incidents raising safety concerns was four per 10 million passengers. An in-flight disturbance occurred in 1.4 per 10 million arriving passengers. Most common were schizophrenia or schizotypal disorder (46.8%) and mania (22.6%). Twenty per cent of patients presented with wandering.

Emergency admissions and incidents causing safety concerns were rare. Airport wandering was a frequent presenting sign that should be recognised.

We discuss the development of a service for children with learning disabilities within a child and adolescent mental health team using the Health Advisory Service Together We Stand tier system. The paper also includes an audit of the service 8 months after it was started.

We present a model of service that has proved successful to date. We give details from the audit of the service, its aims, funding, referral numbers, sources, types and criteria.

The audit suggests that the aims of the service are being achieved but given the fact that the numbers of new referrals significantly outweigh the discharge rate, it is concluded that a greater emphasis is placed on liaison, consultation and joint working with other agencies.