The clinical presentation of autism has been summarised in the 5th edition of the American Psychological Association’s Diagnostic and Statistical Manual for Mental Disorders (DSM–5). Assessment tools such as the Autism Diagnostic Observation Schedule have been developed to provide clinicians with the practical means to diagnose autism according to DSM–5. These medicalised assessments are deficit-based, focussing on what the autistic person cannot do compared to a non-autistic person. This juxtaposition can adversely affect the mental health of the autistic person and those who support them. The assessment can also place emotional burden upon the clinicians conducting them. The wider implication of the negative framing used in traditional tools is to perpetuate the stigma surrounding autism. Neurodiversity-affirmative identification is a new approach for clinicians. This methodology reframes the tragedy narrative of Autism to offer clinicians the means to work in collaboration with their clients to explore their autistic identity and not only identify their specific support needs but also their strengths. An understanding and acceptance of one’s sense of self world facilitates nurturing good mental health and improved life trajectories. This novel study examined the effect of the neurodiversity-affirmative way of working upon clinicians and how they make sense of the experience.

The experiential qualitative methodology of interpretative phenomenological approach was used. Phenomenology is relevant as it is the philosophical study of what it is like to be human in our lived experiences and what matters to the individual. Secondly, and more specifically, interpretative phenomenology is appropriate as it is more than merely gathering a description, but an analysis of the participants’ attempts to interpret their personal and subjective lived experiences. Semi-structured, qualitative interviews were conducted with clinicians who are practicing neurodiversity-affirmatively between September and October 2025. The sample size of five clinicians complied with the usual approach for such qualitative projects.

Five Group Experiential Themes were identified: pressure to accept traditional framing of Autism, haunted by the past, wrong assumptions, more than a job, it’s a vocation and validating Autistic experience.

The impact of conducting medical model assessments has been long-lasting and traumatic upon the clinicians. The results charted their intellectual transitioning from passive acceptance of the traditional assessment status quo to actively questioning it and finally being resolute that it needs to be revised and reframed and that the neurodiversity-affirmative approach needs to be widely adopted to better validate the autistic people they serve.

This study explores the historical roots of phobic disorders through an analysis of Abu Zayd al-Balkhi’s ninth-century written venture into mental health and wellbeing, “Sustenance of the Soul”. It compares al-Balkhi’s descriptions, differentiation, and management of phobia with the current ICD-11 framework. Previous comparative research has demonstrated consistencies in his writings when compared to contemporary framework. As such, we hypothesised that al-Balkhi’s account would show substantial conceptual overlap with modern nosology while offering a more integrated phenomenological perspective that remains relevant to current psychiatric practice.

A multi-stage content analysis was undertaken using the manifest analysis method. First, relevant thematic premises were identified through examination of al Bakhli’s text. Second, focussing on aetiology, symptomatology, and therapeutic approaches, psychological terminology and their implied meanings were extracted. Finally, these findings were compared directly with the ICD-11 phobia-related classification and associated diagnostic constructs. The analytical process and mappings were independently cross-checked by a secondary researcher.

Al-Balkhi described phobia as an excessive, maladaptive fear response–referred in his work as “terror”–that exceeds the individual’s control and impairs functioning. He distinguished normative fear states from the pathological using description of threat appraisal and temporal proximity, paralleling modern distinctions between general anxiety and phobia. He also described symptoms of physiological arousal and cognitive interferences during fear states, including restricted clarity of thought. Management strategies included education regarding feared stimuli and desensitisation-like techniques, anticipating the core principles of contemporary psychological treatments.

Al-Balkhi’s account of phobia correlates to a significant degree with ICD-11 categorisations of anxiety and phobic disorders. Although some of the ideology lacks modern political correctness which reflects its era, the underlying clinical observations are notably consistent with modern phenomenology and psychologically informed care. These findings support the value of historical psychiatric scholarship in refining contemporary understanding and suggests that pre-modern consolidative models may still enrich current diagnostic and therapeutic approaches.

Hypoxia-ischaemia (HI) is one of the leading causes of neurological injury and death among newborns. In developed countries, its incidence is estimated in approximately 1/1000 neonates, while globally it can represent up to 23% of children’s mortality rate. In those who survive, long-term neuropsychological impairments may emerge as a consequence of HI, causing a significant impact in quality of life.

Using a preclinical model of neonatal HI, the aim of this study was to investigate whether a progression in HI severity (from moderate to severe) may be associated with worsened functional and psycho-behavioural performance.

Seven-day-old (P7) Sprague Dawley neonatal rats were randomly assigned to: i) HI-moderate (left common carotid artery ligation + 120 min of 8%O2/92%N2 hypoxia; n=13); ii) HI-severe (same surgical procedure and 150min of hypoxia; n=18); Sham (without HI, n=36). At P42 (early young equivalent) and P90 (adult), animals underwent three behavioural tests: the novel object recognition (NOR) test to analyse cognitive deficits in recognition memory, the cylinder test to measure sensorimotor asymmetries and deficits, and the T-maze test to evaluate possible cognitive disabilities.

When evaluating cognitive deficits in recognition memory with NOR test, both moderate (p<0.01) and severe (p<0.05) injured animals showed worse performance than sham at P42. At P90, this was also observed in moderate-injured animals (p<0.001). In the cylinder test, HI-moderate (p<0.01) and HI-severe (p<0.001) groups showed significant sensorimotor asymmetries when compared to sham at P42 and P90, which were independent of HI severity. Similarly, all HI-animals revealed a reduction in alternation in the T-maze test, thus suggesting cognitive disabilities in both moderate (p<0.05) and severe (p<0.0001)models vs sham. Again, no differences were found when comparing severities.

Psycho-behavioural assessments showed the development of cognitive deficits and neuromotor impairments in the long term after neonatal HI. Further studies may confirm if the absence of differences between moderate and severe HI models may relate to a critical threshold reached in the former and/or to possible compensatory mechanisms in the latter.

Innovative teaching methods and gamification are increasingly sought in medical education to promote active learning and engagement amongst students. This interactive andnovel approach has gained popularity within medical education and allows students to consolidate their clinical knowledge and apply their skills to unfamiliar scenarios.Students are encouraged to think in a holistic manner, and this teaching intervention facilitates experiential learning.

The aim of this study was to design and deliver a psychiatry-themed escape room for Fourth year medical students at Bushey Fields Hospital. This is a novel approach to undergraduate psychiatric teaching, which focused on consolidating clinical knowledge regarding basic principles of psychiatry and encouraging collaborative problem-solving.

A 45–60minute escape room was developed, centred around a fictional patient who was admitted to hospital after experiencing psychosis. Students were given a backpack with a padlock that contained clues and five tasks to solve. Working in groups of 3–5, students solved tasks centred around history taking, mental state examinations, assessing risk, physical health monitoring and contemplating management approaches.

A mixed method approach was undertaken, and pre- and post-session questionnaires (Likert scaled) assessed student-rated confidence regarding management of psychiatric situations, assessing risk, formulating differentials and management plans were distributed. Further qualitative data was gathered from students regarding their learning and experiences regarding the psychiatry-themed escape room.

Eighteen students participated over four escape room sessions. Post-session confidence scores increased across all measured domains, especially when undertaking risk assessments and knowledge of the Mental Health Act.

Qualitative data was thematically analysed and students reported that this was a useful opportunity to apply their skills and knowledge, using a simulated case.

The results of this study suggest that this approach helped students to engage with psychiatric teaching in a novel and innovative manner. Students reported that they felt that consolidating their psychiatric knowledge using a simulated case was a safe environment to learn further.

Students reported a greater appreciation regarding the use of legal frameworks, history taking skills and undertaking mental state examinations. These are key considerations and skills used within psychiatry, which will lead to resident doctors being well equipped with key psychiatric principles, improvement in future practice and patient care.

This psychiatry-themed escape room will be offered at other sites within the Trust, and future work includes possible expansion to resident doctors early within their training based locally.

People with severe mental health problems are affected by disparities in physical health outcomes compared to the general population. The risk of physical deterioration increases as patients grow older and comorbidities accumulate. This risk is particularly relevant in the population affected by functional and cognitive psychiatric disorders, where patients’ ability to detect and report symptoms can be impaired. This places a key responsibility on staff in older adult mental health services, who are well positioned to identify deterioration through routine physical health monitoring. However, confidence gaps exist amongst multidisciplinary team members in the recognition and escalation of physical health deterioration. To address this, the physical health teaching programme was implemented.

Hypothesis: The teaching programme will result in an improvement in the perceived confidence of staff in identifying physical health deterioration and escalating concerns.

Weekly teaching sessions were conducted in an older adult mental health service over a period of three months. All members of the multidisciplinary team across both inpatient and community settings were invited to participate. Teaching was delivered using posters and interactive worksheets, covering topics such as vital signs, fluid intake, bowel output monitoring and delirium. Pre- and post-teaching questionnaires were designed to evaluate confidence levels using a Likert scale and knowledge was assessed via multiple-choice questions.

Results were analysed from 17 participants who completed both pre- and post-teaching questionnaires. The first two teaching sessions focused on vital signs and fluid intake. Preliminary findings demonstrated an overall improvement in staff confidence. However, pre-teaching knowledge scores were high for these topics and minimal improvement was seen on repeating the multiple-choice questions. These findings demonstrate the feasibility of a targeted physical health teaching programme.

A physical health teaching programme can improve staff confidence in identifying and escalating physical health deterioration in an older adult mental health service.

The Balint group was established in the 1950s as an avenue for doctors to bring forththeir experiences and feelings relating to patient interactions, in a humanistic rather than clinical way. Commonplace in Psychiatry, the use of Balint groups is spreading. Building on a previous pilot, we ran a Medical Student Balint Group weekly in a confidential, consistent space. We aimed to assess their knowledge of Balint, empathy, and communication skills and style, at the start and end of the group. This was alongside a tool for assessment of Burnout levels at the start and end of the group.

A weekly Balint group cohort of 10 third year medical students was facilitated by a Core Trainee and supervised by a Consultant Medical Psychotherapist. The students were given a set of questions about the psychological factors pertaining to doctor-patient interactions, including 2 questions about their prior knowledge of these groups, and the same questionnaire was given at the end, but with 2 open-ended questions about their reflections of the process. A validated burnout self-test was also given at the start and end.

Weekly attendance varied slightly. All participants returned both initial questionnaires, with 8 returning both ending questionnaires. Burnout scores showed significant reduction, and students generally showed eagerness to attend Balint groups in future. On starting, half the students felt that the application of a Balint group was ‘interesting’ but afterwards most felt an expanded perspective on the doctor–patient relationship and able relate to patients better. Self-awareness and confidence with communication also improved. Qualitative results supported above quantitative results.

Balint groups for medical students now have an increased evidence base as part of the undergraduate medical curriculum. They enhance their ability to see their patients’ perspectives, improving empathy, and markedly reducing burnout. They also enhance self-awareness and communication in medical students.

People with severe mental illness have a life expectancy that is 10 to 20 years shorter than the general population. Cardiovascular disease plays a major role in this gap. Additionally, forensic inpatient population often experiences prolonged admissions and has limited access to community physical health services. QRISK3 is a tool that estimates an individual's 10-year risk of having a heart attack or stroke. This project aimed to assessQRISK3 scores in forensic low and medium-secure male wards and offer atorvastatin for primary prevention when appropriate.

A snapshot review was conducted in November 2025 among 59 inpatients in Brockfield House low and medium secure male wards. 5 patients younger than 25 years old were excluded as QRISK tool is only valid for patients aged 25–84 years. QRISK3 scores were calculated for all eligible individuals using Mobius (an electronic record system) and patient interviews. Patients with a QRISK3 score of 10% or higher were informed of their increased cardiovascular risk and offered atorvastatin based on primary prevention guidelines (https://cks.nice.org.uk/topics/cvd-risk-assessment-management).The collected data was saved in a password-protected Excelspreadsheet.

A total of 54 patients were included in the analysis. The mean age was 41.98 years (range 25–69).14% of patients were current smokers (n=8), 50% were ex-smokers (n=27), 31% had diabetes mellitus (n=17), and 11% were prescribed antihypertensive medication (n=6). The mean BMI was 32.33 kg/m², 91% of patients had a BMI ≥25 kg/m² (n=49), indicating overweight or obesity. 16 patients had a QRISK3 score ≥10%. Of these, 11 patients were already prescribed a statin. The remaining 5 patients were offered atorvastatin for primary prevention; 4 agreed to commence treatment following consultation, while one declined. QRISK3 scores were documented in Care Programme Approach (CPA) reports for all patients in whom they were calculated. On average, it took 12 minutes and 36 seconds to gather information and calculate the QRISK3 score.

This QIP demonstrates that cardiovascular risk assessment using QRISK3 in forensic psychiatric inpatient settings is practical, time-efficient, and clinically valuable.Integrating QRISK3 scoring into routine CPA documentation may improve identification of patients at increased cardiovascular risk and increase appropriate statin prescribing for primary prevention in line with NICE guidelines.

Under the Mental Health Act (MHA) 1983, patients detained under Section 3 must have their capacity to consent to treatment assessed on admission and reassessed at the three-month point. Failure to complete these assessments risks breaching patient rights, including those protected under the Human Rights Act, and undermines lawful and person-centred clinical practice.

Aims were (1) To determine compliance with documentation of capacity assessment at admission and at the three-month point for Section 3 inpatients; (2) to identify practical improvements to enhance compliance.

A retrospective audit was conducted on 13 inpatients detained under Section 3 on Vales Ward, Discovery House (LPFT). Admission dates and capacity-assessment records were extracted from the RiO electronic patient record for the period December2019–November 2022. The primary outcomes were the presence or absence of documented capacity assessment at admission and at the three-month review.

Capacity assessment at admission was documented in 46.2%(6/13) and not documented in 53.8%(7/13).

Three-month reassessment was documented in 7.7%(1/13) and not documented in 92.3%(12/13).

Compliance with MHA Section 3 statutory requirements for capacity assessment was poor, particularly at the three-month review. We recommend: (1) implementing automated RiO reminders to clinical and MHA administration teams at −1 month, −1 week, and −1 day before the three-month point; (2) delivering targeted staff education on the legal and clinical significance of capacity reassessment; and (3) providing patient information leaflets regarding consent and MHA rights. A reauditis planned to evaluate the impact of these interventions.

Undergraduate psychiatry education is frequently limited by variable clinical exposure, ethical constraints in involving acutely unwell patients, and restricted opportunitiesfor students to practise high-stakes consultations. Generative artificial intelligence (AI) simulation platforms offer a potential solution by enabling students to rehearse clinical encounters in a structured and safe environment. This poster aims to present lessons learned from the implementation of generative AI-supported simulations for fourth-year medical students at Aston Medical School. Specifically, it explores how students and tutors experienced the integration of AI-facilitated consultations into the curriculum and identifies factors that influenced engagement, learning value, and trust in assessment.

A mixed-methods educational evaluation was conducted following the introduction of AI-based consultation simulations within the fourth-year psychiatry programme. Feedback was gathered through anonymised student questionnaires, facilitated debrief sessions after simulation use, and structured discussions with clinical tutors involved in teaching and assessment. Data focused on students’ perceived learning value, alignment with clinical placements, clarity of feedback and marking criteria, and overall usability of the platform. Tutor reflections on feasibility, integration with existing teaching, and impact on small-group learning were also collected. Qualitative themes were identified through thematic review of student and tutor comments.

Students generally recognised the potential value of generative AI simulation as a safe environment to practise structured consultations, particularly for OSCE preparation and rehearsal of high-risk scenarios such as suicide risk assessment and capacity evaluations. Many reported that the tool was most effective when used after formal teaching or placement exposure, supporting consolidation and revision. However, engagement was reduced when simulations were used as a first exposure to unfamiliar clinical material or were misaligned with placement timing. Some students expressed uncertainty about AI-generated markingcriteria and pass thresholds, noting that checklist-based feedback could sometimes feel disconnected from authentic clinical reasoning. Mandatory debrief sessions were valued when they facilitated reflection and discussion but were perceived as less helpful when they repeated automated feedback. Tutors highlighted the importance of clear learning objectives, integration with small-group teaching, and transparency around assessment processes.

Generative AI simulation can enhance undergraduate psychiatry education by providing scalable opportunities for structured practice and feedback. Its effectiveness depends on thoughtful curriculum integration, alignment with clinical teaching, and clarity around assessment and feedback. Student and tutor perspectives suggest that AI is most beneficial when used to augment, rather than replace, traditional teaching and reflective debriefing. These lessons offer practical insights for educators seeking to incorporate generative AI into medical education in a pedagogically meaningful and learner-centred way.

Women accessing perinatal mental health services face marked physical health inequalities, exacerbated by pregnancy-related risks and the metabolic burden of psychotropic medication. Despite national guidance, compliance with physical health monitoring is poor, lifestyle interventions are inconsistently delivered, and engagement with external services is limited. This quality improvement project (QIP) aimed to address these gaps by establishing a dedicated in-house perinatal physical health clinic within our perinatal mental health service.

To improve compliance with NICE recommended physical health monitoring for women prescribed antipsychotics; improve staff knowledge and confidence in physical health assessment and monitoring and increase access to holistic lifestyle and women’s health support.

A baseline audit evaluated compliance with antipsychotic physical health monitoring (weight, blood pressure, glucose/Hbs-362c-glycated haemoglobin, lipid profile,ECG-electrocardiography, and movement disorder assessment) and the provision of lifestyle and women’s health advice. Staff knowledge and confidence were assessed using a pre-intervention survey. A twice-weekly physical health clinic was introduced, offering comprehensive physical health checks, structured lifestyle questionnaires and advice (diet, exercise, smoking and alcohol), and women’s health education (contraception and screening). Targeted teaching sessions were delivered to staff, and a repeat audit and post-intervention staff survey were completed following a four-week pilot.

Post-intervention audit data demonstrated substantial improvements in all monitoring domains, with completion rates for baseline physical health measures increasing from 40–60% to 100%. Monitoring for movement disorders and metabolic risk factors also significantly improved, whilst completion of lifestyle questionnaires increased from 0% to 100%, and documentation of dietary, contraceptive, and breast and cervical screening advice became universal. Staff confidence markedly improved, with only 14% initially reporting very good understanding of antipsychotic monitoring, compared to 100% reporting good to excellent understanding following teaching. All respondents reported increased confidence and would recommend the programme.

Introducing a dedicated in-house perinatal physical health clinic resulted in significantly improved compliance with national guidance, enhanced staff confidence, and strengthened the provision of holistic care. This model demonstrates a sustainable, transferable and scalable approach to reducing physical health inequalities within perinatal mental health services.

Assertive Outreach Teams (AOT) provide enhanced community support for people with serious mental illness and complex needs, amongst whom there is a higher risk of comorbid alcohol use, for which engagement in structured interventions can be challenging. Mental health professionals can deliver ‘Bitesized’ interventions directly to patients, however this can represent a relatively infrequent window of opportunity. AOT patients often have regular contact with care and support staff who may not have clinical expertise. Empowering this wider support network to discuss alcohol use with patients could reduce alcohol-related harm.

A teaching session was delivered to non-clinical staff at a residential home which supports patients under the care of the AOT. The session covered background knowledgeregarding alcohol use and health, and how the staff could deliver informal ‘Bitesized’ interventions through their daily interactions with residents. Pre- and post-session feedback was obtained through questionnaires which utilised Likert scales to assess confidence in discussing key topics and the likelihood they would talk to patients about alcohol use. The questionnaire also assessed specific knowledge markers including safer alcohol limits and risk levels.

8 questionnaires were returned.

Post-session, 100% of respondents reported confidence in discussing alcohol use with residents, including a 33% increase in those feeling ‘very confident’. The same results were found when asked about discussing relevant physical health risks. In the pre-session questionnaire, high-risk drinking levels were correctly identified by 50% of respondents, increasing to 88% post-session.

When asked pre-session about confidence discussing mental health risks relating to alcohol use, 25% of respondents selected ‘very confident’ and 13% selected ‘not confident’. Post-session, 100% reported confidence, with 71% selecting ‘very confident’.

Following the session, 86% of respondents said they would talk to residents more frequently about alcohol use, with 100% of respondents reporting the session to be helpful.

Results suggest that brief teaching delivered to non-clinical staff can improve confidence in discussing alcohol use, and related risks, with mental health patients, and increase the likelihood they will have these discussions more frequently. This project offers only a small sample and does not provide information about whether the results will translate into meaningful change in patient outcomes. It offers a platform for ongoing rehabilitationwork and demonstrates the utility in multidisciplinary working in delivering holistic care for patients with complex mental health needs. Future directions may include trialling similar or substance-related interventions elsewhere and designing sessions for delivery directly to patients.

The psychiatry workforce faces persistent shortages driven by high attrition and poor retention across training and consultant grades. This scoping review aimed to map the existing evidence on psychiatry workforce retention and attrition, identify factors influencing decisions to stay or leave, and examine interventions, strategies, or policies designed to address workforce instability.

We conducted a scoping review following Arksey and O’Malley’s five-stage framework, reported in line with PRISMA-ScR guidance. MEDLINE, EMBASE, PsycINFO, Scopus, and Web of Science were searched alongside grey literature sources. Studies addressing retention, attrition, turnover, progression, or intention to stay or leave among psychiatrists or psychiatry trainees were included. Data were synthesised using descriptive mapping and inductive thematic analysis.

Screening identified 4110 articles. Of 193 articles selected for full-text review, 65 articles were included. Attrition was consistently associated with excessive workload,burnout, inadequate staffing, unsafe working environments, administrative burden, and poor supervision or training quality. Retention was linked to supportive supervision, meaningful clinical work, flexible job design, professional development, and a sense of belonging. Migration decisions were shaped by systemic push factors, including low pay and under-resourced services, and pull factors such as better working conditions, training quality, and social stability. Few proposed retention strategies had been formally evaluated.

The psychiatry workforce is characterised by substantial instability driven by multi-level factors spanning individual, organisational, and system domains. Although many retention strategies are proposed, robust evaluation is lacking. Addressing workforce sustainability will require system-level investment and evidence-based interventions targeting workload, training environments, supervision, and career flexibility.

To examine trends and identify potential contributing factors among young people who were supported by the Alliance Team prior to admission to a Tier 4 bed over a one-year period.

To examine the impact of Alliance Team involvement in implementing national guidance regarding avoiding unncessary admissions and improving the experience of those for whom admission was unavoidable.

A retrospective review of the Alliance Team caseload between April 2024 and April 2025 was undertaken. Electronic patient records were reviewed using the West London RiO system. Data collected included age, gender, referral reason, legal status at the time of admission, reason for admission, location and duration of admission, prior community team involvement, Alliance Team involvement in gatekeeping decisions, and recorded diagnoses of Attention Deficit Hyperactivity Disorder (ADHD) or Autism Spectrum Disorder (ASD). Data were collated and descriptively analysed using Microsoft Excel.

During the study period, the Alliance Team received 465 referrals, with 20 young people admitted to Tier 4 services (4.3%). Most admitted patients were female (70%) and aged 17 years (65%). The majority were admitted under the Mental Health Act, with only one informal admission. 65% were admitted to local beds. The most common reason for admission was risk to self that could not be managed in the community, followed by psychosis. Admission duration varied, with 35% staying less than 30 days, while 35% had admissions exceeding 100 days. Most patients (80%) were already known to community Child and Adolescent Mental Health Services (CAMHS), and the Alliance Team was involved in gatekeeping decisions in 70% of cases. 60% of the young people did not have a recorded diagnosis of ADHD or ASD at the time of admission.

The Alliance Team maintained a low Tier 4 admission rate (4.3%), with further improvement compared to previous years. Admissions were predominantly among older adolescents with high clinical complexity, which is reflected in an increased use of the Mental Health Act and prolonged inpatient stay. This shows the success of community-based crisis intervention in avoiding Tier 4 admissions, in all but the most severe of case. A substantial minority (35%) continued to be admitted out of area, likely due to ongoing system pressures. The high proportion of patients already known to CAMHS (80%) and involvement of the Alliance Team in gatekeeping decisions (70%) suggest opportunities for early collaborative intervention to reduce admissions. For future, Alliance Team should focus on improving support for 17-year-olds, improving clinician’s understanding of psychosis, and further evaluation of factors impacting length of stay and admission locality.

To assess adherence to recommended baseline physical, laboratory, and additional investigations within 24 hours of admission in psychiatric inpatients, identify gaps, implement targeted interventions, and evaluate improvement in compliance.

ET AL AUTHORS :

6. Dr. Muhammad Zubair - General Practitioner- muhammadzubair1103@gmail.com

A closed-loop quality improvement audit with a repeated cross-sectional design was conducted in the Psychiatry Department over 2 months. Fifty patients were included: 25 pre-intervention and 25 post-intervention phases. Pre-intervention data were collected retrospectively from patient records for physical examination (general + systemic), vital signs, BMI/weight, ECG, standard laboratory tests (CBC, LFTs, RFTs, serum electrolytes, fasting lipid profile, fasting glucose, viral markers), and special/indicated investigations (pregnancy test, urine drug screen, TFTs).

Documentation of findings in clinical notes was also assessed. Interventions included staff education sessions, standardized admission checklists, reminders during ward rounds, and coordination with laboratory and ECG services. Post-intervention data were collected prospectively using identical criteria to measure improvement.

Pre-intervention (n=25): Physical examination was documented in 72%, vital signs in 80%, ECG in 52%, and BMI/weight in 60%. Laboratory investigations showed completion rates of80% for CBC and LFTs/RFTs, 84% for serum electrolytes, 68% for fasting lipid profile and glucose, and 72% for viral markers. Pregnancy testing was completed in 7.7% of eligible females, urine drug screening in 0% of indicated cases, thyroid function tests in 20%, and documentation of findings in 56%.

Post-intervention (n=25): Physical examination improved to 92% (+20%), vital signs to 96% (+16%), ECG to 80% (+28%), and BMI/weight to 88% (+28%). Completion of CBC and LFTs/RFTs improved to 96% each (+16%), serum electrolytes to 92% (+8%), fasting lipid profile and glucose to 84% (+16%), and viral markers to 88% (+16%). Pregnancy testing in eligible females increased to 85% (+77.3%), urine drug screening to 75%, thyroid function testing to 80% (+60%), and documentation of findings to 92% (+36%).

Baseline compliance with physical health investigations within 24 hours of psychiatric admission was variable, with significant gaps in ECGs, metabolic screening, special investigations, and documentation. Following targeted interventions, substantial absolute improvements were observed across all domains, particularly in ECG performance, metabolic monitoring, pregnancy testing, thyroid function testing, and documentation quality. This audit demonstrates that structured educational and system-based interventions can significantly enhance physical healthcare delivery in psychiatric inpatient settings. Ongoing re-audit is recommended to sustain improvements and ensure patient safety.

The Advice and Guidance Service for Young Adult Mental Health Service (age 18–25) in Suffolk was established in October 2024 to support GPs with quick and effective treatment advice through a non-face to face platform in managing young adults with mental health difficulties.

No formal evaluation of the service had been conducted since the commencement of the service in October 2024.

The aim of this service evaluation project was to understand the use of the service; its effectiveness and any barriers associated with its use.

Data around the use of Advice and Guidance service by GP surgeries in both East and West Suffolk region was collected from the eReferral System (eRS) portal.

Specific Evaluation Questions were used to get feedback regarding the awareness and user experience of the A&G service for YAMHS in Suffolk from the GP trainees who work closely with GPs in various GP surgeries in Suffolk.

There were a total of 82 referrals to Suffolk YAMHS via the Advice and Guidance Service and the number of referrals was limited to less than 12 each month.

It was evident that the service was being used by various GP surgeries in both East and West Suffolk.

When looking at the outcomes for these referrals, it was evident that 61 out of total 81 A&G referrals were returned with advice. Among the remaining 20 A&G referrals, 18 were converted into a full referral to the YAMHS team and 2 were returned to the referring GP requesting further information regarding the cases for the team to be able to provide any advice or guidance.

When looking into the barriers for use, unawareness of the existence of the service was a major factor.

An information leaflet was created and sent out to all the GP surgeries in Suffolk via email. Copies of the information leaflet were handed out to the GP trainees attending the West Suffolk GP teaching programme to increase awareness and encouragement towards the service.

The A&G service for YAMHS holds the potential to be an extremely helpful service for the GPs and secondary mental health services in reducing the number of referrals and unnecessary waiting times for cases where quick and effective treatment advice can be appropriately provided through a non-face to face platform.

The barrier in using the Advice and Guidance service for YAMHS was unawareness of the availability of the service among the GPs and their trainees.

We believe that increasing awareness of the service in primary care would greatly increase the use of the service.

In 2021, in order to optimise the quality of informant questionnaires, the local memory service introduced the Brief Informant Questionnaire (BIQ), consisting of five short prompts that allow family members or carers to share their observations about memory changes, daily functioning, behaviour, and any potential risks such as safety concerns. As part of this, we asked the simple binary question “Do you think it is dementia”.

Aim:

• • To evaluate the accuracy of a single item on the BIQ by comparing the informant’s response with the clinical diagnosis following comprehensive assessment.

• • Data was collected from the 50 randomly selected patients who attended the local memory clinic from 2022 to 2024. 5 informants did not provide the response to the question “Do you think it is dementia?” and they were not included. As such, 45 cases were included in the final analysis.

• • In scenario 1, only definite “Yes” and “No” responses were used to evaluate the diagnostic performance.

• • In scenario 2, “Not sure” responses were combined with “Yes” responses.

Scenario 1:

Patient had dementia and informant agreed: 28/29 Sensitivity: 96.5%

Patient did not have dementia and informant agreed: 5/5 Specificity: 100%

Positive Predictive Value: 28/28=100%

Negative Predictive Value: 5/6=83.3%

Scenario 2:

Patient had dementia and informant agreed or was not sure: Sensitivity: 34/35=97.1%

Patient did not have dementia and informant agreed or was not sure: Specificity: 5/10=50%

Positive Predictive Value: 34/39=87.1%

Negative Predictive Value: 5/6=83.3%

The BIQ demonstrates very high sensitivity in both analysis scenarios (96.5% and 97.1%) and a strong positive predictive value (100% and 87.1%), indicating that an affirmative response was highly indicative of a true dementia diagnosis.

When “not sure” responses were grouped with “yes,” the specificity decreased, reflecting reduced ability to identify non-dementia cases.

Although the number of negative cases was small, the findings suggest that the BIQ performs reliably within the current assessment pathway and is clinically useful.

Completing this questionnaire prior to the initial assessment helps ensure that relevant information is available from the start, improves the quality and efficiency of the assessment process, and supports more person-centred assessments and care planning.

Overall, these findings provide evidence to support the use of this single item from the BIQ across wider memory services as an aid to identifying possible dementia.

Effective clinical handover is essential for patient safety within mental health inpatient hospitals. However, concerns were raised at medical resident–senior forums highlightinginconsistent handover quality between ward staff and on-call medical doctors. Although handover policies existed, they did not clearly address interdisciplinary communication or clinical escalation pathways. This prompted a quality improvement (QI) project aiming to improve structure, clarity and consistency in handover practice. The aim was to improve quality and consistency of clinical handovers between ward staff and on-call doctors, and to implement a clearer, standardised interdisciplinary handover process.

A mixed-methods baseline assessment was completed in 2024 involving questionnaires for nursing and medical teams, multidisciplinary process mapping, and root-cause analysis via fishbone methodology. Key issues identified included lack of structure and key information within handovers, unclear urgency or action required, and uncertainty around escalation routes if on-call phones are unanswered. Interventions selected through PICK chart analysis included: SBAR simulations delivered on pilot wards, SBAR prompt posters, embedding SBAR within junior doctor induction, developing a clinical escalation protocol with matrons, appointing locality SBAR champions (from multidisciplinary backgrounds) and trust-wide communication via screensavers and intranet SBAR resources. Questionnaire data was again collected in 2026.

Following implementation of the interventions, ward staff reported overall improvements in handover quality. Good–Excellent ratings for doctor-to-ward handovers increased from 53% to 75% and use of structured approaches by doctors increased from 44% to 50%. Staff understanding of patients following handover rose from 82% to 93%. Self-rated handover confidence (≥8/10) increased from 56% to 82%, with staff attributing this to training, experience and improved clarity of information. 93% of staff self-reported sometimes or always using handover structure. Ward managers on pilot simulation wardsreported improvements in regular SBAR use and staff confidence several months afterwards. Doctors reported fewer poor-quality handovers from wards, though improvements are still needed. The proportion reporting no structure to ward handovers reduced from 92% to 50% and 94% of doctors self-reported using a handover structure themselves. Further areas that still required improvement included variable on-call phone signal, and lack of clarity from some ward handovers.

Co-designed interventions like SBAR training, visual prompting, clear escalation pathways and locality champions improved confidence, structure and standardisation in interdisciplinary handovers. Sustaining these improvements will require continued reinforcement, wider simulation rollout and senior leadership support, reflecting the challenge of changing communication culture. Following these results, the inpatient handover policy has been updated and distributed trust-wide.

Stigma involves the devaluation of individuals based on personal attributes and can lead to discrimination, social exclusion, and poorer mental health outcomes, strongly shaped by cultural and social norms. The United Arab Emirates (UAE) provides a unique context to examine mental illness stigma, particularly among university students and healthcare-related groups, where stigma may hinder help-seeking and care delivery. This study aimed to quantify levels of mental illness-related stigma and examine socio-demographic and occupational correlates among university students, medical professionals and allied health workers in the UAE.

We conducted a cross-sectional, questionnaire-based study using the nine-item Stigma-9 Questionnaire (STIG-9) to assess perceived public stigma towards people with mental illness (total score 0–27; higher scores indicate greater stigma). Participants were recruited via non-probability sampling at a federal university and multiple tertiary hospitals in the UAE, using email invitations to participate in an anonymous online survey. Demographic variables included gender, age group, nationality, continent of origin, marital status, religion, family income, caregiver experience, occupation/status, type of activity and place of study/work. Descriptive statistics summarised sample characteristics and STIG-9 scores. Independent-samples t-tests and one-way ANOVA with Tukey post hoc tests compared mean stigma scores across groups; significance was set at p<0.05.

A total of 510 participants completed the questionnaire; 70.4% were female, and 48.0% were Emirati. Most were aged 16–25 (43.5%) or 31–40 (24.9%). 42.2% were healthcare providers or administrators, 40.0% were undergraduate students, and 17.8% were postgraduate students. The mean STIG-9 score was 17.5 (SD 5.64), indicating substantial perceived stigma in this educated cohort. Age was significantly related to stigma (F(4,505)=2.52, p=0.04): 16–25-year-olds reported higher stigma than 31–40-year-olds (mean difference 1.81, p=0.031). Emirati participants scored higher than non-Emiratis (t(508)=2.33, p=0.02, Cohen’s d=0.21). No significant differences in stigma were found based on gender, nationality, marital status, religion, income, caregiver experience, occupation, study/work location, or when comparing medical vs. non-medical students, undergraduate vs. postgraduate students, or healthcare groups.

Mental illness stigma is common among university students and healthcareprofessionals in the UAE, despite high education levels. Higher stigma among younger adults and Emirati nationals indicates cultural and generational influences. Culturally informed anti-stigma education in universities and healthcare training, especially for younger Emiratis, could reduce stigma, enhance help-seeking, and promote equitable mental healthcare.

No financial sponsorship has been received for this study.