To evaluate the implementation of autism and ADHD assessments within the Swansea Bay community perinatal team and mother and baby inpatient unit in South Wales, focusing on service outcomes and patient and staff experiences.

Perinatal inpatients and outpatients assessed for ADHD or autism from Feb 2024–Aug 2025 were identified. Assessment outcomes were captured, and all 22 patients were invited to provide feedback on experience and impact. MDT members from inpatient andcommunity perinatal services also provided perspectives. Thematic analysis was applied to all responses.

Quantitative: Of 867 screened perinatal cases, 22 underwent assessment (7 inpatients, 15 outpatients). Among inpatients, 6 met diagnostic thresholds (4 autism, 2 ADHD); all 15 outpatients met thresholds (13 autism, 2 ADHD).

Qualitative: Feedback from 12 staff members highlighted that diagnosis improved patient self-advocacy and family relationships but reported gaps in post-diagnostic support, leaving patients to interpret their diagnosis independently. Staff also noted the need to adapt practice and interventions for neurodivergent patients. Feedback also highlighted the need for internal gatekeeping to prevent oversaturation of the service and to avoid the service being used solely as an alternate pathway for quicker ADHD/autism diagnosis. Patient feedback (n=11) described benefits of validation, self-understanding, and stronger family relationships, praising the compassionate and personalised care received. Two patients highlighted the need for structured aftercare and follow-up.

Findings suggest a particular need for neurodivergence assessments during the perinatal period. Patient and staff feedback consistently reported improved self-understanding and family relationships but highlighted post-diagnostic gaps in support and aftercare, underlining areas for service improvement. This evaluation has highlighted the need for further development of the pathway for neurodivergence within the perinatal population ensuring the service provided is sustainable and adapted to meet patients’ needs.

Monitoring mental state and risk is central to psychiatric inpatient care. The narrative nature of the Mental State Examination (MSE), although essential for clinical decision-making, limits rapid detection of trends and communication of change across teams. Existingrating scales are often diagnosis-specific, time-consuming, or clinician-restricted, reducing feasibility for routine ward use.

MINDY is a brief, structured tool designed for repeated inpatient assessment to capture mental-state disturbance and risk in a reproducible format.

This study aimed to evaluate whether repeated MINDY assessments meaningfully reflect clinical change in mental state and risk during psychiatric admissions.

We hypothesised that MINDY scores and risk classifications would show clinically coherent variation over time and align with changes documented in nursing notes.

This ward-based service-evaluation and retrospective case-note review was conducted on an adult psychiatric inpatient ward. Three resident doctors completed daily MINDY assessments for inpatients under a single consultant team over a randomly selected two-week period.

MINDY outputs were compared with concurrent nursing documentation. Data were anonymised and handled in accordance with NHS information-governance and General Data Protection Regulation requirements. Analyses were undertaken by an independent medical student with no prior clinical involvement.

The case-record analysis focused on MINDY’s capacity to track clinical change over time. Documentation completeness, inter-rater reliability and predictive validity were not assessed.

On days with both MINDY and nursing documentation available, suicide or self-harm risk was recorded on six occasions, all classified by MINDY as Risk-Group C (100% sensitivity and negative predictive value). Specificity was 87.5%, with three Risk-Group C classifications on days without documented risk. Agreement between Risk-Group C and nursing-documented risk was substantial (κ=0.74). Documented risk was significantly more frequent on Risk-Group C days than others (66.7% vs 0%), with a large effect size (h=1.91; p=0.00014).

Graphical longitudinal plots showed clinically interpretable trajectories. Patients discharged during the intervention recorded sustained low risk and scores, concordant with nursing notes, while those remaining on the ward showed fluctuating scores and shifting risk zones reflecting variable clinical courses.

MINDY’s Risk-Group classification identified nursing-documented suicide and self-harm risk with perfect sensitivity and substantial agreement. Longitudinal visualisation demonstrated clinically meaningful trajectories associated with discharge and ongoing admission.

The findings support MINDY as a practical, structured tool for tracking inpatient change and guiding discharge decisions, though further refinement of risk stratification is needed.

Burnout among psychiatry inpatient staff is often attributed to challenging patient behaviour; however, organisational conditions may play an equally important role. Staffing adequacy and organisational responses following incidents represent potentially modifiable determinants of staff wellbeing. Therefore, we aim to examine associations between perceived staffing adequacy, post-incident support, and burnout among psychiatry inpatient staff.

A cross-sectional survey was completed by inpatient psychiatry staff (n=115). Burnout was assessed using a validated 7-item composite scale (α;=0.915). Organisational factors were measured using Likert-scale items assessing perceived adequacy of staffing levels to manage risk safely and perceived support from the organisation following incidents. Multivariable linear regression models were constructed adjusting for professional role group, years working in psychiatry, and work pattern. Effect modification by post-incident support was tested using interaction terms. All statistical analyses were performed using IBM SPSS Statistics.

Lower perceived staffing adequacy was strongly associated with higher burnout in univariable analysis (β=−0.41, p < 0.001), explaining 16.9% of variance in burnout scores. This association remained robust after adjustment for staff characteristics (adjusted B=−0.30, 95% CI −0.45 to −0.16; p < 0.001). Higher perceived post-incident support was independently associated with lower burnout (adjusted B=−0.35, 95% CI −0.49 to −0.20; p < 0.001). There was no evidence that post-incident support modified the association between workplace stressors and burnout (interaction p=0.23).

Perceived staffing inadequacy is a major organisational determinant of burnout among psychiatry inpatient staff. While post-incident support is associated with lower burnout overall, structural factors such as staffing levels appear to play a central role. Interventions aimed at improving staff wellbeing should prioritise workforce capacity alongside supportive organisational practices.

To assess medical students’ attitudes towards mental health and psychiatry across three domains:

Psychiatry as a medical specialty.

Mental health patients.

Stigma in mental health.

Medical students on placement in the Northern Trust and in the South-Eastern Trust (NI) were sent a survey to complete. The survey contained demographic data as well as 15 statements attached to a 5-point Likert scale, for students to select strongly agree, agree, neither agree nor disagree, disagree, or strongly disagree. Completed surveys were collected via a third party and forwarded to me for review, ensuring anonymity.

17 students completed the survey in full and their responses were analysed. Some statements had very consistent responses which produced a strong theme, as follows:

• 100% agree/strongly agree that ‘all medical students should complete a placement in psychiatry’.

• 100% disagree/strongly disagree that ‘psychiatrists are not real doctors’.

• 100% disagree/strongly disagree that ‘psychiatrists are less credible than doctors in other specialties’.

• 88% agree that ‘mental health conditions can be effectively treated’ – with 12% neither agreeing nor disagreeing. No students strongly agreed.

By contrast, a number of statements yielded a wide variety of responses with no clear theme, as follows:

• All five responses were selected (in various numbers) for the statement, ‘medical professionals treat patients with mental illness differently to those with physical illness’.

• All five responses were also selected for ‘patients with mental illness receive poorer care than those with physical illness’.

• All five responses were selected for “I worry that seeking help for my own mental health might negatively impact on my future career’.

• For the statement, ‘I would feel uncomfortable being alone with a patient who has a serious mental health issue’, 41% disagreed while 47% agreed/strongly agreed.

Some clear, consistent themes have emerged from the surveys. There is general respect for psychiatry as a specialty, with all students agreeing on psychiatry placements being necessary, and psychiatrists being credible, ‘real doctors’. This may stand against the stigma experienced by psychiatrists.

Almost all students agree mental health conditions are effectively treatable (88%) – however zero students strongly agreed.

Some issues remain divisive for students: how mental health patients are treated, how comfortable they would feel seeking help for mental illness, or being left alone with a mental health patient.

This study had a small sample size (n=17), and would benefit from both more responses, as well as focus groups to gather qualitative data.

Catatonia is a syndrome characterised by decreased, increased, or abnormal psychomotor activity and is seen in conditions such as schizophrenia, and depression. Global meta-analysis carried out in 2017 found mean catatonia prevalence to be 9.0%. This case involves an adolescent patient treated for catatonia.

A 15-year-old boy with a background of severe dyspraxia but otherwise normal development and no prior health problems was admitted to an adolescent mental health unit due to rapid cognitive, motor, functional, and psychological decline, suggestive of catatonia. A paediatric immunology work up found no organic or autoimmune cause. An MRI head was unremarkable. A lorazepam challenge produced transient improvement. Due to persistent severe catatonia with emerging psychotic symptoms, an eight-session course of ECT was initiated under an STDC, later converted to a hospital CTO. Gradual recovery was observed, with Bush–Francis Catatonia Rating Scale scores reducing from 16 to 0. The patient regained normal motor coordination and speech, with improved emotional regulation and social interaction. Residual psychotic symptoms were mild, with preserved insight. Discharge plans included medication review, movement from inpatient to community, phased return to school, and gradual home passes. The patient was discharged from inpatient care after a 2.5 month stay.

Adolescent catatonia is frequently under-recognised and misattributed to neurological or functional disorders, leading to delays in effective treatment. This case is notable due to the rapid progression and severity of symptoms, with prominent motor, cognitive, and autonomic features closely mimicking organic pathology. Although benzodiazepines are recommended as first-line treatment, response in paediatric populations is often incomplete. This patient demonstrated partial improvement which necessitated escalation, illustrating the importance of early consideration of ECT, which is supported by growing evidence as safe and highly effective intervention for severe, or treatment-resistant paediatric catatonia, with reported response rates exceeding 70%. Additionally, the case highlights the ethical and legal complexities of compulsory treatment in young people, demonstrating how proportionate use of legislation can facilitate recovery and restoration of autonomy.

Catatonia in adolescents is serious but highly treatable. Early recognition and escalation of treatment reduce morbidity and risk. Benzodiazepines are first-line, but clinicians should maintain a low threshold for ECT in cases of partial response or high clinical risk, given its safety and efficacy in young people. Treatment guided by clinical presentation can result in full functional recovery and improved outcomes.

Due to their higher acquisition costs, long-acting injectable (LAI) antipsychotics are often seen as more expensive substitutes for oral antipsychotics (OAs). However, Schizophrenia is a chronic and relapsing- remitting illness; non-compliance to oral therapy frequently results in hospitalisation and emergency care, which are significant contributors to overall healthcare expenses. Therefore, rather than concentrating solely on pharmacies, evaluating treatment value necessitates a total cost of care (TCOC) perspective.

Aims were to determine, using economic data, whether the higher costs of LAI antipsychotics result in an overall increased healthcare cost when compared to oral antipsychotics in adults with Schizophrenia.

Our data sources for the study included administrative claims databases (Medicaid and commercial), cost-effectiveness models, mirror-image (pre-post) studies, national health system cohorts, systematic reviews and meta-analyses. We conducted a structured narrative evidence synthesis from the above data.

We focused on real-world economic and pharmacoeconomic studies comparing LAI antipsychotics with OAs. The total healthcare costs and/or component costs (pharmacy, inpatient, emergency department, and outpatient) were reported in the studies. Results were analysed directionally rather than pooling them statistically, due to heterogeneity in settings,currencies, and time horizons.

It was noted that across US, European, and Asian studies, LAIs consistently demonstrated lower inpatient and emergency department costs but higher pharmacy costs in comparison to OA’s.

Several pre-post analyses revealed a reduction in hospitalisation costs after LAI initiation. However, few claims-based and meta-analytic studies reported no statistically significant difference in total healthcare costs between LAIs and oral therapy.

Cost-effectiveness models indicated that LAIs may be cost-effective over multi-year horizons, despite similar or slightly higher total costs, driven by improved compliance and reduced relapse rates.

The findings demonstrate a robust “cost-offset effect”, in which the higher upfront medication costs of LAIs are balanced by the downstream savings from avoided hospitalisations.

The generalisability of this pattern for stakeholders and policy/decision-makers was supported by the fact that it was consistent across healthcare systems, study designs, and LAI molecules.

LAI antipsychotics do not significantly raise overall healthcare costs and may be economically beneficial by lowering expensive relapse-related care, though they may appear to be raising pharmacy expenditures initially. Treatment evaluations for schizophrenia should focus on the overall cost of care rather than just the cost of the medication.

Assessing risk is a fundamental skill in psychiatry, particularly for Core Trainees who are developing their skills during Out-of-Hours (OOH) shifts. However, the time pressure in these shifts often leads doctors to quickly document their admission notes without much thought for risk management. Failing to record Mental Health Act (MHA) status, leave permissions, or observation levels may create significant safety gaps and falls short of the standards set by the Mental Health (Care and Treatment) (Scotland) Act 2003. We retrospectively collected data that supported this notion and posted simple, structured posters to guide trainees in robust risk documentation. The goal was to encourage active thought processing that aligns with local risk protocols, ensuring that documentation isn't just a box-ticking exercise but a helpful guide for nursing staff. This helps empowers nurses to use their discretion in line with the admitting doctors opinion and adjust care safely as a patient's risk fluctuates on the ward.

We conducted a retrospective audit (Cycle 1, n=52) of OOH admission notes which showed only 15.4% of notes documented observation levels and 13.5% failed to mention leave status entirely. In response, we placed posters in key resident doctor work areas to act as a visual “nudge,” explicitly prompting doctors to define legal status and safety monitoring plans. A re-audit (Cycle 2, n=29) was completed one month later to see if these visual cues changed behaviour.

The second cycle showed a distinct improvement in how risk was recorded. Documentation of observation levels rose from 15.4% to 55.2%. Documentation regarding leave status also improved significantly, reaching 65.5% vs 1.9%. MHA status documentation remained roughly consistent (82.7% vs 75.9%). The rise in documenting recommended observation and leave status suggests that trainees are no longer relying on implied safety levels and are instead engaging in active risk assessment when there is a clear reminder to prompt them.

The marked increase in recording observation and leave decisions suggests that visual prompts are an effective way to remind trainees to pause and reflect on their risk assessment and how this applies to the patient’s admission journey. The posters helped convert risk assessment from an administrative afterthought into a conscious and adaptable management strategy. This simple intervention not only improves compliance but fosters a culture where active risk management is embedded into the admission process, ultimately ensuring safer handovers and better support for the nursing team.

This study aimed to computationally investigate interactions between DAT and a range of ligands across different conformational states using molecular docking and structural modelling, with the goal of identifying residues associated with ligand binding and potential conformational specificity.

Recent Cryo EM structures of DAT representing inward-facing and outward-facing conformations were obtained from the Protein Data Bank and prepared using MODELLER.Eight compounds (Amphetamine, Buproprion, Methamphetamine, Modafinil, Methylphenidate, Mephedrone, Vanoxerine and Nortriptyline) were categorised based on binding preferences. Molecular docking was performed using Cresset Flare, generating ten poses per compound, which were ranked using Lead Finder scores. The lowest-energy protein-ligand interactions were visualised with VMD and further analysed using Schrodinger Maestro and Nanome VR.

In the inward-facing conformation, conserved interacting residues across compounds included Val328, Tyr156, Phe326, and Val152. In the outward-facing conformation, conserved residues included Tyr156, Val152, Ala423, Asp79, Phe320, Phe76, Phe326, Ser149, and Ser422. Asp79 and Val328 were observed to participate in interactions that differed between conformational states.

These results identify recurring residues involved in ligand interactions with DAT and suggest conformation-dependent interaction patterns that may be relevant to transporter modulation. Future work will build on these docked complexes using molecular dynamics simulations with AI-guided analysis of protein dynamics to support drug discovery efforts aimed at the development of novel treatments for stimulant use disorder.

Driving is a complex activity that may be significantly impaired by mental illness, acute psychiatric symptoms, cognitive impairment, and the side effects of psychotropic medication. In the UK, the Driver and Vehicle Licensing Agency (DVLA) provides clear guidance regarding fitness to drive for individuals with mental health conditions. Patients are legally responsible for informing the DVLA of any condition that may affect their ability to drive; however, clinicians have a professional duty to ensure that patients are appropriately advised, and that this advice is clearly documented.

Despite this, DVLA advice is often inconsistently delivered and poorly documented in discharge summaries. This creates risks including:

• Patients unknowingly driving when unfit to do so.

• Potential harm to patients and the public.

• Medico-legal risk to clinicians and the organisation.

• Poor continuity of care for GPs and community teams.

The primary aim of this Quality Improvement Project is:

To improve the delivery and documentation of DVLA driving advice for patients discharged from a mental health inpatient unit, thereby reducing medico-legal risk and improving patient safety.

This project followed the Plan–Do–Study–Act (PDSA) framework.

PDSA Cycle

• Plan: A baseline audit was conducted to retrospectively review discharge summaries for patient discharge on 1–31 August 2025 and showed no patients had DVLA advice given or documented in their discharge summaries.

• Do: A single, targeted intervention was implemented: An additional question was added to the discharge summary template prompting clinicians to consider and document DVLA driving advice. Effecting this change needed high level hospital management approval. The quality improvement idea was presented in different management meetings including Digital delivery group, corporate delivery group and clinical oversight delivery group before this change was approved and implemented.

• Study: Following implementation, a post-intervention survey was conducted to assess the delivery and documentation of DVLA advice. It showed that all the patient discharges in January 2026 so far have DVLA advice given and documented. This is a significant improvement from the pre-intervention survey.

Act: We confirm effectiveness and consider sustain ability and wider rollout by implement the change in other clinical areas of the hospital as appropriate.

Overall, the intervention was associated with improved compliance with DVLA guidance and safer discharge practice.

While this project has revolutionised how discharge summary is being written in the Trust by introducing a single and concise way of documenting DVLA advice, a more robust intervention could have been more appropriate, for example creating a different form specifically for DVLA advice on electronic medical records. But this would, however, need management financial approval and more paperwork for clinicians.

• • To ensure the Southwest Crisis Function Team (in HPFT) manages non-cognitive symptoms of dementia as per NICE guidelines, and provides appropriate non-pharmacological and pharmacological management options.

• • If not possible, identify reasons and challenges, and suggest methods for improvement, which could be implemented and re-audited.

1. All referrals received by CFT in a 12-month period were obtained through the SPIKE database.

2. 48-hour referrals and wrong referrals were excluded.

3. Only service users with a diagnosis of dementia AND were presenting with agitation, aggression, distress or psychosis were included. This information was obtained through PARIS.

4. Service users’ case notes were reviewed to ascertain whether they or their carers:

○ Had a structural assessment and had been offered psychosocial and environmental interventions as initial and ongoing management to reduce distress for service users.

• Had been offered antipsychotics and:

• If they were at the time at risk of harming themselves or others, or were experiencing agitation, hallucinations or delusions that are causing them severe distress.

• If they had discussions about risks and benefits of antipsychotics.

• Had been started on the lowest effective dose possible and were recommended to be reassessed by the prescriber.

1. In 2023, a total of 247 new Service Users (SU) were referred to CFT. After excluding 48-hour follow up referrals and inappropriate referrals, A total of 55 referrals were for SUs who were diagnosed with dementia and were presenting with agitation, aggression, distress, or psychosis. 12 out of the 55 referrals were for 6 SUs who were referred twice at different times during the year.

2. 100% (55/55) of the included referrals received a structural assessment to 1- explore possible reasons for their distress, and 2- check for and address clinical or environmental causes. 100% (55/55) were also offered psychosocial and environmental interventions as initial and ongoing management to reduce distress for SUs.

3. In 12/55 referrals, SUs were already on antipsychotics. In 7/55 referrals, SUs could not be managed without a new prescription of antipsychotics.

4. In these 7 referrals (12.7% of total eligible SUs), SUs received new prescriptions of antipsychotics as a pharmacological intervention and in all 7 referrals, the SUs were at risk of harming self or othersorwere experiencing agitation, hallucinations or delusions that are causing them severe distress.

5. 100% of the 7 referrals showed that SUs were started on the lowest effective dose of the prescribed antipsychotic.

6. However, out of the 7 referrals that received new prescriptions of antipsychotics, none of them (0%) had documentation on PARIS about discussions of risk and benefits of antipsychotics.

7. Finally, when looking at all the referrals where antipsychotics were used (19 referrals in total), there was clear documentation on PARIS about reassessment or a recommendation for reassessment of antipsychotic after 6 weeks in 4/19 referrals (21%).

• • 100% of referred SUs received a comprehensive, structural assessment.

• • The team offered psychosocial and environmental interventions to all SUs who were eligible.

• • The team offered antipsychotics only when necessary, in a small percentage of cases(12.7%), and followed NICE guidelines for initial doses and service user eligibility.

• • However, no documentation in any of the service user’s case notes mentioned discussions about risk and benefits of antipsychotics and only 21% had recommendations for reassessment of the antipsychotics within 6 weeks.

This quality improvement project sought to design and implement a new handover system for mental health hospitals in North Glasgow. The new system aimed to improve ease of access and editing, alongside reducing the frequency of missed tasks for resident doctors.

Resident doctors across Gartnavel Royal Hospital and Stobhill Hospital were surveyed (cycle 1) between 06/06/25 and 13/06/2025 regarding their opinions on their respective existing Microsoft Excel handover systems, as well as the frequency of missedtasks and their willingness to try a new system. A new system was designed for each hospital using the Planner task management software on Microsoft Teams, adapted from a similar successful pilot in South Glasgow. Training sessions were delivered over June and July 2025, and the new systems were implemented on 18/07/2025. Resident doctors were surveyed again (cycle 2) between 04/08/2025 and 12/08/2025 regarding their opinions on the new system, any missed tasks and whether they wished to keep the new system or revert to the previous one. Adjustments to systems were made as per respondents’ wishes. Guidance posters were displayed in each hospital between October 2025 and January 2026 to aid using the systems, and the doctors were surveyed once again (cycle 3) between 28/01/2026 and 04/02/2026 using the same questions.

Please note “easy” will be used where respondents rated the system easy or very easy. There were a total of 10 respondents in cycle 1: 70% found the now-previous system easy to access, only 50% found it easy to edit and 40% found they had missed tasks. Only 10% were opposed to trialling a new system. In cycle 2, there were a total of 22 respondents: 73% found the new system easy to access, 81% found it easy to edit and only 18% had missed tasks. 73% wished to keep the new system. In cycle 3, preliminary results show 10 respondents thus far: 100% found the new system easy to access and edit, only 10% had missed tasks and 100% wished to keep the new system. The system is now part of Standard Operating Procedure in North Glasgow.

A new digital handover system replaced previous systems for each North Glasgow mental health hospital. The new system improved ease of access and editing as well as reducing the frequency of missed tasks for resident doctors. Displaying guidance posters further improved each of these categories and all doctors wished to keep the new system.

This audit evaluates the prescribing and monitoring practices of sodium valproate, particularly in females of childbearing potential. Sodium valproate is a medicine that is commonly used in the treatment of bipolar disorder and epilepsy, and less commonly migraine prophylaxis. Valproate is an effective treatment for bipolar disorder, however there are significant risks that come with the use of valproate medication including the risk of teratogenic effects should pregnancy occur.

The audit aims to assess compliance with the Pregnancy Prevention Programme (PPP), share findings ahead of the June 2025 national audit, and highlight updated initiation steps post-April 2024.

The audit standards were derived from national guidelines including the Royal College of Psychiatrists CR210 and MHRA Prevent Programme. They are also a replica of the standards measured in the National POMH Valproate Audit. The purpose of auditing the standards is to review compliance prior to the next POMH Valproate audit which will take place in June 2025.

The audit reviewed documentation of prescribing rationale, annual reviews (therapeutic benefit, adverse effects, medication adherence), and PPP compliance including Annual Risk Acknowledgement Forms (ARAFs).

The sample included 22 female patients aged 12–55 currently prescribed valproate. These patients were identified by the Clinical Director of Pharmacy. Sample characteristics such as age and ethnicity were also explored.

• Rationale for prescribing was documented in 20 out of 22 cases (91%).

• Only 23% of patients had all elements of the annual review documented.

• ARAF compliance was poor:

- 9 non-compliant cases where pregnancy was possible.

- 10 non-compliant cases where pregnancy was not possible.

• Common issues included missing or incorrectly completed ARAFs and lack of documentation of Patient Guide distribution.

The audit revealed significant gaps in compliance with PPP requirements and documentation standards. There was confusion around when ARAFs are needed, especially for long-standing patients and those post-menopausal. Baseline checks prior to initiation (BMI, FBC, LFT) were not consistently documented. The findings suggest a need for improved education and communication among prescribers.

The audit highlights the need for better adherence to national guidelines in prescribing and monitoring valproate. Key areas for improvement include annual review documentation, proper completion of ARAFs, and baseline physical health checks. Recommendations include targeted education for consultants and improved documentation practices to ensure patient safety and regulatory compliance.

Eating disorders (ED) are associated with high morbidity, mortality, and relapse, yet access to evidence-based care remains limited. Digital interventions have improved scalability but often lack responsiveness to individual symptom profiles and changing clinical risk. Artificial intelligence (AI) has been proposed as a means of enabling personalised andadaptive interventions. However, the feasibility and safety of AI-enabled approaches in ED care remain unclear. This review evaluated the feasibility and safety of AI-enabled personalised interventions for anorexia nervosa, bulimia nervosa, and binge eating disorder, and explored potential clinical applications and evidence gaps.

A systematic review was conducted in accordance with PRISMA 2020 guidelines. MEDLINE, APA PsycInfo, and Global Health were searched alongside grey literature sources including ProQuest, OAIster, EthOS, and Overton for studies published between 2020 and 2025. Eligibility criteria were defined using the SPIDER framework to capture quantitative, qualitative, and mixed methods evidence. Included studies examined AI-based approaches such as machine learning, natural language processing, digital phenotyping, or conversational agents used to personalise ED interventions and report feasibility or safety outcomes. Methodological quality was assessed using the Mixed Methods Appraisal Tool, and findings were synthesised narratively.

Eight studies met inclusion criteria across four domains. The evidence suggests that AI-augmented approaches can feasibly support aspects of personalised ED care, although findings remain early and heterogeneous. Machine learning methods showed potential for individualised risk prediction, relapse monitoring, fidelity monitoring in digital therapies, and just-in-time adaptive interventions, with substantial variability in performance and limited generalisability. Sensor-based systems demonstrated promise for low burden, real-time behaviour detection, but were evaluated in very small samples. Conversational agents were generally acceptable and engaging, though safety and autonomy concerns were identified. Clinician and service user studies indicated cautious openness to AI use, alongside ongoing concerns regarding trust, transparency, empathy, and governance.

AI-enabled personalisation for ED is technically feasible and shows promise in enhancing risk monitoring, treatment augmentation, and continuity of care. However, clinical effectiveness and safety remain unestablished. Prospective trials, diverse samples, systematic monitoring of harms, and integration within ethically governed, AI-augmented, clinician-led models are required before routine clinical implementation.

Attitudes toward social engagement describe how individuals perceive, value, and participate in social interactions and communal activities. Currently upcoming trends such as Fear of missing out is governing social interactions but one may wonder are there accompanying trends such as Joy and Relief of missing out. Attitudes toward social engagement reflect how people navigate the tension between connection and independence and in this study, we aim to evaluate these attitudes based on Fear/Joy/Relief of missing out on social obligations. An exploration of balance between importance of internal values versus social acceptance is also explored.

A questionnaire on how social engagement is perceived by an individual was developed based on principles of anxiety feelings of being left out within social events compared to relief of missing social engagement and to satisfaction that comes from choosing not to participate in certain activities.

Alongside generic questions on autonomy as compared to social pressures were evaluated within survey.

There were 92 respondents on an online survey.

67% responders reported that they have moderate social interaction.

30% responders reported that they are affected by pressures of missing out.

Less than 20% responders reported comparison with others’ experiences.

15% reported distress on seeing others’ activities.

50–60% responders reported preference for solitude, time for oneself and own schedule.

45% responders reported satisfaction if they could decline obligations.

40% responders reported relief when they are excluded from social obligations.

45% responders reported relief if social plans fail.

There was evidence of empowerment when avoiding social media.

75% responders reported importance of internal values as opposed to social obligations.

Though 35% felt need to be a part of social group there was limited evidence on need for acceptance and even lesser on comparing with others.

Though Fear of missing out (FOMO) is an upcoming social trend within community interactions a generic survey indicated that a significant majority feel the need for importance of internal values, solitude and preference for time for individual activities as opposed to social obligations. Interestingly higher number of responders reported relief if excluded from social obligations and greater satisfaction if they could decline obligations. The survey also showed less importance for external validation from social circles with limited need for acceptance and even limited comparison with others’ activities. It may be interesting to note that a significant majority of responders felt a greater relief on missing outon social activities rather than the fear of missing out. One may wonder whether the Fear of missing out is overemphasized whilst in actuality there is relief or joy of being excluded.

Menopause is when a woman has not had a period for at least 1 year. The median age is 51.Perimenopause is a transitional period associated with fluctuating hormones and heightened vulnerability to mental health symptoms, including depression, anxiety, stress, and sleep disturbance. Fluctuating hormones are noted from the age of 35 years or so. Holistic, non-pharmacological interventions have emerged as potential strategies to address these symptoms, but evidence has not been systematically synthesised.

Aim and Objectives:

1. To review systematically and analyse the evidence on holistic interventions for the management of mental health difficulties in perimenopausal women.

2. To identify various holistic interventions, including psychological, lifestyle, mind-body connection and complementary therapies for perimenopausal mental health symptoms.

3. To evaluate the effectiveness of these interventions for common perimenopausal symptoms.

4. To assess the quality of evidence and to identify the gaps for future research and practice.

A systematic review of randomised controlled trials was conducted, focusing on holistic interventions for mental health symptoms in perimenopausal women. Databases were searched using MeSH and free-text terms related to perimenopause, mental health, and holistic or complementary therapies. Study quality was assessed using the Cochrane ROB 2 tool.

Twenty RCTs involving approximately 2,700 participants from the USA, Europe, and Asia were included. Interventions were categorised as psychological (CBT, MBCT, MBSR), physical activity-based (yoga,Pilates, tai chi,aerobic exercise), lifestyle modification, or complementary therapies (acupuncture,reiki, music therapy).

CBT-based interventions and mind–body practices consistently improved depression, anxiety, stress, sleep quality, and quality of life. Physical activity-based interventions demonstrated moderate benefits. Evidence for complementary therapies was limited and mixed. Most trials were at low or moderate risk of bias.

Holistic interventions are effective and person-centred approaches for managing mental health symptoms during perimenopause. Psychological and mind-body interventions yielded the most robust benefits. Limitations included heterogeneity of interventions, reliance on self-reported outcomes, and short-term follow-up.

Holistic interventions, particularly CBT, mindfulness, and structured physical activity, improve mental health in perimenopausal women. Future research should focus on larger, culturally diverse trials with standardised outcome measures and longer follow-up to strengthen evidence for clinical guidelines.

The growing number of elderly individuals living alone presents a major social issue, encompassing loneliness, isolation, economic and health challenges, and increased risk ofsuicide. This study aimed to identify factors associated with suicide risk among elderly individuals living alone in Jeju.

A total of 4,742 participants completed questionnaires to assess their sociodemographic characteristics. Depressive symptoms were evaluated using the Short Form Geriatric Depression Scale-Korean version (sGDS-K), with a cutoff score of eight indicating the presence of depressive symptoms. Suicide risk was assessed using the Mini-International Neuropsychiatric Interview-Plus. Multivariate logistic regression analysis was performed to identify significant correlates of suicide risk.

Multivariate logistic regression analysis identified the following factors as significantly associated with suicide risk: poor subjective health status (odds ratio [OR]=1.590, 95% confidence interval [CI]: 1.137–2.224), current drinking (OR=1.511, 95% CI: 1.119–2.042), hypertension (OR=1.419, 95% CI: 1.133–1.778), and sGDS scores ≥8 (OR=4.318, 95% CI: 3.408–5.469).

This study highlights the importance of intensive mental health services and socioeconomic support in preventing suicide among elderly individuals living alone. Targeted interventions should focus on those who have poor subjective health status, are current drinkers, have hypertension, or exhibit depressive symptoms.

To evaluate the impact of sleep interventions on sleep quality, duration, and efficiency in adults with psychotic disorders, and to assess secondary effects on psychotic symptoms, daytime functioning, and mental health stability.

A systematic review of studies published in the past 10 years was conducted, including meta-analysis, randomized and non-randomized trials, and observational studies. Eligible studies involved adults (≥18 years) with psychotic disorders and documented sleep disturbances. Interventions included pharmacological agents (melatonin, Z-drugs, antipsychotics), psychological therapies (CBT-I), and other complementary therapies (light, relaxation).

Twenty-three studies met inclusion criteria. Cognitive Behavioural Therapy for Insomnia (CBT-I), was the most frequently studied and consistently effective intervention across delivery formats. Pharmacological agents offered variable short-term benefits but raised concerns about side-effects, tolerance, and dependency. Adjunctive therapies such as music therapy, relaxation and exercise, light-dark rhythm modulation etc. demonstrated promise in specific subpopulations. Common limitations included methodological heterogeneity, small samples, and limited long-term follow-up.

CBT-I, adapted for psychotic disorders, appears the most robustly supported intervention. Integrated approaches combining psychological, pharmacological, and adjunct therapies may optimise outcomes. Large-scale, long-term studies and pathways for routine care integration are warranted, with inclusion in national guidelines.

Guided by the Model for Improvement, this project aims to increase the completion of core assessments and capacity-to-consent documentation in MHA referrals made by the MHLT to at least95% within six months. The ultimate objective is to enhance resource efficiency, ensure compliance with the MHA Code of Practice, and guarantee that formal detention is initiated only when legally and clinically justified.

A baseline diagnostic analysis of referrals from the Mental Health Liaison Team (MHLT) at Chesterfield Royal Hospital revealed that 33% (10/30) of MHA referrals did not result in detention. Critically, 90% of patients without a recorded core assessment and 70% without documented capacity were ultimately admitted informally or discharged. This diagnostic phase indicated a direct correlation between missing documentation and a lack of clinical necessity for formal detention, suggesting that a lack of structured assessment acted as a barrier to identifying less restrictive alternatives.

The project involved mapping the current MHLT referral process, identifying a lack of a structured, mandatory protocol as a key driver for poor-quality referrals. A driver diagram was developed to focus on staff competency and referral mechanics. Two PDSA cycles are currently being implemented:

• • System Mechanics: Introduction of mandatory digital fields in the referral pathway requiring confirmation of a core assessment, capacity assessment, and documented consideration of informal admission.

• • Staff Competency: Delivery of structured teaching sessions to MHLT staff regarding MHA principles and the introduction of visual aids prompting documentation prior to referral submission.

Based on the diagnostic phase, which showed that formal assessment was more frequently omitted in referrals that ultimately did not require detention, we expect a substantial improvement in referral quality by ensuring these steps are taken pre-referral. We are currently implementing these changes and monitoring process measures. A follow-up audit will be conducted to formally measure the increase in documentation compliance and the subsequent reduction in referrals not resulting in detention, aiming to demonstrate improved resource efficiency and adherence to the MHA Code of Practice.

This ongoing QI initiative indicates that structural changes to referral mechanisms, paired with targeted staff education, can be effective in improving documentation fidelity. By enhancing the decision filter for referrers, this project aims to ensure that MHA assessments are initiated only when legally and clinically justified

This project examines how mental health professionals perceive and engage with digital phone applications (apps) in clinical practice. ‘MindMeds’, a patient-developed mental health app at Southwest London and St George’s Mental Health (SWLSTG) Trust, was used as a case example. Findings will inform strategies to improve adoption of the MindMeds app, as well as embedding digital tools into clinical practice, workflow embedding and aligning with Trust digital health priorities.

A qualitative staff survey was distributed via Microsoft Office Forms to all SWLSTG Trust staff. Recruitment was conducted through mass email and Trust communications. The survey collected key demographic information and included Likert-scale items assessing digital confidence and familiarity with mental health apps. Semi-structured free-text questions explored staff awareness, attitudes towards digital apps, key enablers and barriers, clinical considerations of how apps fit into workflows, as well as wider systemic factors such as the Trust’s position on digital innovation.

Qualitative data were analysed using reflexive thematic analysis following Braun and Clarke’s six-step framework, with quantitative findings used to contextualise findings and gauge the prevalence of emerging themes.

31 responses were received and thematic saturation was achieved. Although reported digital confidence was high (median 8/10), awareness and regular use of digital apps (particularly MindMeds) was low. 45% of respondents had never heard of the app despite multiple publicity efforts.

Five key themes emerged: 1) Time and workload pressures; 2) Concerns regarding safe integration with electronic patient records; 3) Uncertainty regarding evidence base and regulation; 4) Limited awareness and visibility of Trust-endorsed apps; 5) Variable patient digital literacy and access.

Challenges were particularly pronounced in inpatient, crisis, and CAMHS settings. Clinicians consistently reflected that apps were more likely to be adopted when aligned with existingworkflows, had a clear clinical purpose, and allowed patient-generated data to be accessed within the electronic patient record.

Digital mental health apps remain poorly embedded in routine practice in SWLSTG Trust, with MindMeds gaining little traction despite extensive development. Uptake appears to be limited less by staff attitudes, and more by structural, governance, and workflow barriers. Improving adoption may require simplification of digital tools, integration with core clinical systems, and clear Trust-level governance, training, and operational support. Focusing on high-value use cases alongside co-design and targeted awareness efforts may enable more effective and equitable integration of digital apps into mental health care.

Multidisciplinary care is essential for safe and effective inpatient psychiatric treatment. Involvement of social work and psychology services supports psychosocial assessment, risk management, discharge planning, and continuity of care. This audit assessed compliance with local guidelines for multidisciplinary inpatient care, informed by the Royal College of Psychiatrists’ Core Standards for Inpatient Mental Health Services (Centre for Quality Improvement), which emphasise timely multidisciplinary involvement, including psychology and social work input, and clear documentation in multidisciplinary team reviews. We aimed to identify good practices and any gaps in early referral and documentation.

A retrospective audit at the Behavioural Sciences Institute (BSI), Al Ain Hospital, United Arab Emirates, reviewed electronic records of 193 psychiatric admissions. Four standards from the Royal College of Psychiatrists’ Core Standards were assessed: (1) social work referral within a week; (2) psychology referral within a week of admission; (3)documentation of social work input in multidisciplinary team (MDT notes; and (4) psychology input documented in MDT notes. Compliance was measured by percentage, stratified by unit type (male, female, forensic) to explore practice variation. Descriptive data analysis was used.

Social work referrals within one week were completed in 29.0% of admissions, and psychology referrals in 32.6%. Documentation rates were higher but still suboptimal: social work input was recorded in 38.3% of cases, and psychology in 44.0%. There was variation between units. The male unit had the lowest early referral compliance, with social work and psychology orders in 16.0% and 22.0% of cases, respectively. MDT documentation was higher but incomplete. The female unit performed better, with social work orders in 47.5% and psychology orders in 50.8%, though psychology documentation was low at 32.8%. In the forensic unit, early referrals were moderate for social work (34.4%) and low for psychology (25.0%), but MDT documentation was the highest, with social work noted in 75.0% and psychology in 56.3%. Overall, MDT documentation rates exceeded early referral rates, indicating delayed multidisciplinary involvement.

This audit found gaps in referral practices for social work and psychology in psychiatric inpatient care, especially early referral within a week of admission. Documentation in MDT notes was more frequent but still below standards, indicating delayed engagement. To improve care, structured admission pathways, automated referrals, standardised documentation, and staff education are needed.

No financial sponsorship was received for this project.