Psychiatric on-calls are often regarded as the most challenging aspect of core psychiatric training. This audit aimed to gain trainee feedback about on-calls at one of London's busiest mental health units, whether they were receiving adequate supervision for emergency and out of hours work and to design an intervention to improve on-call supervision experience for core and higher trainees.

A qualitative survey to assess the out of hours clinical experiences of trainees was conducted. The survey explored the following domains: trainees’ confidence in dealing with emergencies out of hours, quality of supervision and individual learning opportunities.

Results indicated low to moderate confidence levels among trainees in performing out of hours’ clinical tasks. The majority were of the opinion that further supervision for on-calls would be beneficial. 59% of trainees stated they struggled to complete work place based assessments (WPBAs) on out of hours cases. In view of the findings, a quality improvement framework was used to introduce a supervision group that gave trainees the opportunity to learn from their out of hours complex cases with a Consultant Psychiatrist as a chair. Following the implementation of the group, a qualitative survey revealed improved confidence, morale and training satisfaction among trainees. The results of the survey and feedback from trainees will be shared in details in the poster. This group has been running successfully for the last one year.

The introduction of an out of hours supervision group in busy mental health units can lead to an improvement in confidence and enable professional and educational development for trainees, which will also help improve overall morale as evidenced by this audit. Additional supervision and developing confidence of junior doctors in dealing with out of hours’ complex cases has enabled trainees to feel more supported and has led to increased training satisfaction at St Charles Hospital, London.

To investigate factors associated with suicidal ideation (SI) around the time of dementia diagnosis. We hypothesised relatively preserved cognition, co-occurring physical and psychiatric disorders, functional impairments, and dementia diagnosis subtype would be associated with a higher risk of SI.

Cross-sectional study using routinely collected electronic mental healthcare records.

National Health Service secondary mental healthcare services in South London, UK, serving a population of over 1.36 million residents.

Patients who received a diagnosis of dementia (Alzheimer’s, vascular, mixed Alzheimer’s/vascular, or dementia with Lewy bodies) between 1 Nov 2007–31 Oct 2021: 18,252 people were identified during the observation period.

A natural language processing algorithm was used to identify recorded clinician recording of SI around the time of dementia diagnosis. Sociodemographic and clinical characteristics were also measured around the time of diagnosis. We compared people diagnosed with non-Alzheimer’s dementia to those with Alzheimer’s and used statistical models to adjust for putative confounders.

15.1% of patients had recorded SI, which was more common in dementia with Lewy bodies compared to other dementia diagnoses studied. After adjusting for sociodemographic and clinical factors, SI was more frequent in those with depression and dementia with Lewy bodies and less common in those with impaired activities of daily living and in vascular dementia. Agitated behavior and hallucinations were not associated with SI in the final model.

Our findings highlight the importance of identifying and treating depressive symptoms in people with dementia and the need for further research into under-researched dementia subtypes.

We aimed to reduce the number of patients absent without leave (AWOL) by carrying out an audit of processes around granting leave for those patients and the action taken when they absconded. We also wanted to determine factors which might be associated with patients absconding.

Nile ward is a 14-bedded male psychiatric intensive care unit (PICU). All patients admitted to the ward are under section 2 or 3 of the Mental Health Act. Patients who are AWOL may pose a risk of harm to themselves or others. The Royal College of Psychiatrists’ Quality Network for PICUs has developed applicable standards, which include criteria on developing a leave plan, actions to take when patients are AWOL and involvement of carers.

Patients who went AWOL during a six month period in 2019 from ward records. The electronic medical records for identified patients were reviewed to assess whether the following eight criteria were met: risk assessment documented; leave conditions specified; consultation with the multi-disciplinary team; crisis card provided to patients or families; risk management plan enacted when AWOL; relevant authorities informed; incident form completed; relatives/carers involved in patient's care if they consented. In reviewing the notes, factors that might have been associated with an increased risk of AWOL were also assessed in order to inform risk assessment.

Six patients were identified who went AWOL during the six month period in question. For six of the criteria, all of patients' cases met the audit standards. Five patients' did have involvement of relaties/carers if they consented, but in one case no details were available for making contact. All patients lacked documented details of crisis numbers being provided before they went on leave. Preliminary findings that might be associated with an increased risk of AWOL are differing views between the patient and the treating team on the care plan and concerns about mental state.

The audit showed many of the standards are met. However, a quality improvement intervention is planned to ensure all audit standards are met, in particular around providing a crisis card to patients and these findings will be presented on the poster, if accepted. Further research is needed into factors which might be associated with an increased risk of absconsion in PICU.