A survey was conducted to investigate physical assaults against mental health staff of a Nigerian psychiatric hospital in a 12-month period and also during their working career in the hospital retrospectively using a questionnaire method.

In total, 101 out of 120 questionnaires were completed (response rate 84.2%). Within the period of their employment in the hospital 49.5% of staff had been physically assaulted at least once, and over the previous 12 months 33.7% had been physically assaulted. Nursing staff (82.3%) were more frequently assaulted than doctors, most often during routine assessment of patients (44.3%). In total, 88% of staff sustained injuries requiring medical attention. Vulnerability to assaults was not associated with attending a course on prevention and management of psychiatric patient violence.

Assaults by patients against mental health staff, especially nurses, are quite widespread in Nigeria. There is a need to formulate policies on prevention and management of violence in people with mental disorders in Nigerian psychiatric hospitals.

To assess how well psychiatric teams follow up abnormal results from physical health monitoring of patients in a secondary care clozapine clinic compared with follow-up in a specialist secondary care physical health clinic, using an audit/re-audit method of comparison. Prevalence data for cardiovascular risk factors within the clinic population were also obtained.

Substantial and statistically significant (P < 0.01) improvements in follow-up of abnormal results were made following the introduction of a specialist clinic compared with treatment as usual. Prevalence of all cardiovascular risk factors among the patients on clozapine was very high compared with the general population.

Patients on clozapine have significant and multiple cardiovascular risk factors, which may be best managed within a specialist secondary care physical health clinic that can follow up abnormal results and coordinate care across primary and secondary care.

We looked at the contribution of psychiatric disorders to occupancy of National Health Service (NHS) beds in England in the past 11 years, using publicly available data on Hospital Episode Statistics from the financial years 1998–1999 to 2008–2009.

Patients with psychiatric disorders occupied between 14 and 16% of NHS beds in each year examined, and schizophrenia and mood disorders were among the top ten medical diagnoses of people occupying beds in every year. In terms of duration of admission, many individuals with psychiatric disorders, including schizophrenia and mood disorders, had a longer length of admission than those with other medical conditions. In 2008–2009 mean duration of admission for people with schizophrenia was 108 days and for people with mood disorders 42 days. In comparison, people with cerebrovascular disease stayed in hospital for 20 days on average.

Despite modern treatments, people with psychiatric disorders occupy a large proportion of NHS beds and stay in hospital for considerably longer than those with other medical conditions. Since the independent sector is providing increasing amounts of long-term in-patient care, these figures are likely to underestimate the total burden and costs of treating psychiatric disorders. Community services designed to reduce admissions have yet to have any substantial impact on bed use.

This study was conducted to ascertain the clinical characteristics of patients who repeatedly attend accident and emergency (A&E) department seeking psychiatric assessment and care. We identified 24 individuals who attended frequently and compared them with 72 matched single attenders using data abstracted by chart review.

Individuals who attended frequently made up 5.3% of all patients who attended the A&E department for psychiatric care but accounted for 19% of all such presentations. Compared with controls, they were younger at first psychiatric contact and had higher rates of schizophrenia and psychiatric admissions.

A small but distinctive group of patients repeatedly seek and obtain hospital-based psychiatric care. Early identification of these patients and targeting them with effective, community-oriented strategies, such as home treatment, could improve their quality of life and prognoses as well as reduce the cost of their care.

To assess the impact in the South London and Maudsley NHS Foundation Trust of a 20-month quality improvement programme on adherence with National Institute for Health and Clinical Excellence (NICE) recommendations for the use of valproate for bipolar illness in women of childbearing potential.

Significant improvement was noted between baseline and final audit in rates of information provision (10% v. 63%, P < 0.0001), contraceptive use (15% v. 38%, P = 0.0003) and folate prescription (3% v. 35%, P < 0.0001).

Adherence to guidance can be usefully improved by a sustained intervention programme.