To evaluate the effectiveness of treatment at the Traumatic Stress Service (TSS) by comparing pre- and post-treatment scores on patient self-report measures. Through a questionnaire survey, to explore therapists' views of problems presenting in addition to post-traumatic stress disorder (PTSD) and how, as a result, they adapted their approach to trauma work.

Therapists reported that their patients present with a range of complex problems, and self-report measures show that patients suffer particularly high levels of psychopathology. Therapists identified a number of adaptations to trauma-focused work to deal with these additional problems. Of the 112 patients who completed therapy, 43% filled in pre- and post-treatment questionnaire measures. Analysis showed clinically and statistically significant improvements in levels of PTSD, depression and social functioning.

The typical presentation of trauma survivors is often not ‘simple’ PTSD, but PTSD resulting from chronic and multiple traumas and complicated by additional psychological and social difficulties. Adaptations to trauma-focused work can successfully treat such ‘complex’ PTSD.

Two complete audit cycles were used to assess the completion of a bespoke risk assessment tool and whether an educational intervention, and subsequently the introduction of a standardised admission pack, led to improvements in completion rates.

The total rate of completion of forms improved from 60% to 81% following a brief educational intervention in the form of a lecture and email about the audit. The subsequent introduction of a standardised admission pack containing the tool maintained completion rates.

Audit coupled with a simple educational intervention can improve the completion of risk assessment forms by medical and nursing staff.

The aim of this study was to examine the subjective experience of the procedure for obtaining consent for electroconvulsive therapy (ECT) in an Irish setting. A total of 89 consecutively treated patients were sent a postal survey at an average of 17 weeks after ECT treatment.

This survey revealed low rates of perceived coercion in relation to consenting to ECT. Overall, there were high rates of satisfaction with the consenting procedure in terms of information and staff support.

In an accredited clinic, the consenting procedure can be conducted in an environment free of coercion, resulting in higher levels of patient satisfaction than previously reported.

To determine the point prevalence of mental incapacity and the ‘Bournewood gap’ in general adult and old age mental health in-patients. The correlation of mental capacity assessment between doctors and nurses was investigated. Data were gathered on one census day for all general adult and old age psychiatric in-patients at three hospital sites.

Half the sample lacked capacity and one third fell into the ‘Bournewood gap’. The capacity assessment by nurses and doctors correlated highly (κ=0.719, P=0.0001).

‘Bournewood gap’ patients should have their needs assessed in order to identify and protect their rights. Appropriately trained mental health nursing staff can undertake this assessment.

We sought to determine whether new procedures recommended by the UK Department of Health in partnership with the Home Office reduced delays in transferring mentally ill prisoners to hospital. Our main outcome measure was time taken from identification of a prisoner's need for transfer to actual transfer to hospital. Waiting times for transfers that took place during 6-month periods before and after introduction of the new procedures were assessed. We also assessed adherence to medication while awaiting transfer.

There was a reduction in mean waiting time from 77 days to 53 days (24 days; 95% CI –2 to 50). Approximately 50% of patients offered medication while awaiting transfer were non-adherent.

Despite the new procedures, many individuals with acute mental illness remain untreated in prison for several months while awaiting transfer to hospital. We recommend that time limits should be specified for hospital transfers from prison comparable to norms under civil sections.