This study considered patients admitted to hospital following deliberate self-poisoning. The characteristics of the patients and the outcomes of assessments by trainee psychiatrists and a mental health nurse were compared.

There were no significant differences in the outcome of 68 assessments performed by a trainee psychiatrist and 77 by a mental health nurse. The nurse assessment service was well-received by the poisons unit, a medical ward specialising in overdose treatment, and trainee psychiatrists.

Psychosocial assessments following self-poisoning can be provided by appropriately trained and supervised mental health nurses. The introduction of a nurse-led service should enhance relationships with the local poisons unit and reduce the workload of junior doctors without compromising their training needs.

To audit the missed-fit rate of a consultant-led electroconvulsive therapy (ECT) clinic adhering to a stimulus dosing policy. After an initial first audit a standard for the missed-fit rate was set at ≤ 5%. A second and third audit examined whether the standard was met and then maintained over time.

The audit standard of maintaining a missed-fit rate ≤;5% was achieved in the second audit and maintained in the third audit. The missed-fit rate dropped from 5% in the first audit, to 2% in the second audit and to 1.8% in the third audit.

A missed-fit rate of ≤ 5% was achieved and maintained over a 6-year period with rigorous adherence to a stimulus dosing policy in a consultant-led ECT clinic. This compares favourably with missed-fit rates of 25% found in national audits of ECT. A missed-fit rate of ≤ 5% might provide one possible standard for the efficiency of ECT clinics nationally.

The main aim of the study was to establish the proportion of hospital trusts in England and Wales in which training in the assessment of suicide risk and risk of harm to others is available to mental health professionals. A questionnaire was sent to clinical directors covering training on these subjects and in mental health legislation, details of training and the existence of risk-related policies.

Seventy-six per cent of trusts said they provided training in suicide risk assessment for junior psychiatrists; for hospital and community nurses, the figure was just over 50%. Between 50% and 60% of trusts said they provided training in the assessment of risk of harm to others. Provision of training in mental health legislation was said to occur in most trusts. In some key areas of risk management, hospital policies were uncommon.

Despite the current importance of risk assessment in mental health services, many hospital trusts do not provide their staff with relevant training.

To obtain a prioritised list of psychiatrists' concerns relating to in-patient child and adolescent mental health services. Four-hundred and fifty-four members of the child and adolescent faculty of the Royal College of Psychiatrists were asked to list their main concerns.

Two-hundred and seventy-four members responded. The most reported themes included lack of emergency beds; lack of services for severe or high-risk cases; lack of beds in general; poor liaison with patients' local services; lack of specialist services; and poor geographic distribution of services.

The range of themes identified from this survey have served to focus the National In-patient Child and Adolescent Psychiatry Study (NICAPS) and several design changes have been made to NICAPS as a result.

To describe the information and help available on the internet for people who self-harm. We searched the internet using a meta-search engine. We visited sites and followed up links with e-mails and letters. We also searched bibliographic databases, seeking published material about the internet and self-harm.

The support that we found largely took the form of information about suicide, self-injury and psychological issues. Less often, sites offered e-mail support and online discussions. We found little information about self-poisoning, and most about self-injury. There is little published research about self-harm and the internet.

The unregulated sites of the internet contain much material about self-injury. Although it is not possible at present to weigh up risks and benefits, many individuals and organisations plainly regard internet information about self-harm as a valuable service.

To report the management of three cases of clozapine-induced enuresis, by description of these cases and literature review.

Heavy sedation, generalised epilepsy and diabetes mellitus induced by clozapine are some of the mechanisms that underlie the emergence of this side-effect.

These cases illustrate several different pathophysiological mechanisms necessitating further diagnostic investigations before adequate treatment can be started. Clozapine-induced enuresis is probably under-reported owing to the embarrassing nature of this side-effect.

The use of the Royal College of Psychiatrists' trainee's log book was evaluated by a cross-sectional survey of psychiatric trainees and their consultant trainers.

One-quarter of trainees had not received a log book. There was a lack of mutual commitment to using the log book, with fewer than 45% of trainees believing their trainers were committed to its use. There had been little use of the log book beyond the setting of educational objectives. However, concern that trainees would be against using the log book for formative assessment was not observed.

More work needs to be done by the College to promote the use of the log book to both trainees and trainers.