There is a consensus that mental health in-patient services need improvement, and one potential approach is the development of residential alternatives in the community. We review published accounts of such alternatives and outline a new study that will describe and evaluate currently available services of this type.

Clinical attachments are an essential step in the process by which international medical graduates (IMGs) secure training posts in the UK. Although the British Medical Association (BMA) provides general guidelines for clinical attachments, the current system lacks a structured process regarding selection, defined length of posts, predetermined contents of training and detailed guidance for consultants supervising clinical attachments in psychiatry. This article outlines the experience in Nottingham of developing a formalised clinical attachment scheme and includes the lessons learnt and difficulties faced during the process. Also presented are the results of feedback surveys from consultants and IMGs who have partaken in the new formalised scheme.

The European Union now includes 27 member states. The Council of Europe stretches even further with 45 member states. A comprehensive definition of Europe geographically embraces all of Eastern Europe, including the western part of Russia and the western part of Turkey. Increasing mobility and national cooperation within Europe requires enhancing mutual knowledge and understanding of the context of evaluation and treatment of mentally disordered offenders and similar individuals who manifest antisocial behaviour and violence. A recent study confined to the previous 15 member states of the European Union provides a useful baseline for subsequent European comparisons (Salize & Dressing, 2005).

‘Soap opera’ is a popular television genre that ‘invites the audience to … identify with characters' (Livingstone, 1990). Storylines tend to be shaped by national and local culture, although they may feature a disproportionate number of unstable relationships and tragedies (Liebes & Livingstone, 1998). Narratives evolve continually, allowing scriptwriters to incite viewer debate on myriad topical social issues, including mental illness (Reveley, 1997).

Inappropriate use of statistics can seriously undermine the validity of published medical research. This paper aims to make recommendations to authors on the use and presentation of statistics in submissions to the Psychiatric Bulletin. We derive our recommendations from a review of the quality of statistical reporting in 50 consecutive ‘original’ papers published in the Psychiatric Bulletin. However simple the methodology of a study, adequate emphasis needs to be given to the correct and appropriate use and presentation of statistics in scientific papers.

Service models differ for the provision of mental healthcare for elderly medical in-patients. Input by the general adult liaison psychiatry service with no age cutoff (Lipowski, 1983) and sector-based old age community mental health teams (CMHTs) (Scott et al, 1988; De Leo et al, 1989) have been described, as well as a consultation–liaison model. Holmes et al (2003) showed that old age psychiatrists favoured a liaison rather than a consultation model.

Attention-deficit hyperactivity disorder (ADHD) affects 3–7% of school-age children (Goldman et al, 1998) and causes symptoms of inattention, hyperactivity and impulsivity (DSM–IV; American Psychiatric Association, 1994). In the UK, many adolescents are currently being treated for ADHD; the prevalence of treated ADHD among boys aged 5–14 years was estimated at 5.3 per 1000 in 1999 (Jick et al, 2004). This means that over 40 000 boys aged 5–14 years are currently treated in the UK (2001 Census; http://www.Statistics.gov.uk/census2001/census2001.asp).

The Mental Health Act 2001 was formally enacted by the Irish Houses of Oireachtas (parliament) on 8 July 2001 and implemented in full on 1 November 2006. The Mental Health Act 2001 replaces and updates a number of older pieces of legislation, including the Mental Treatment Act 1945. The purpose of this paper is to outline the central provisions of the Mental Health Act 2001 as they relate to psychiatric practice in Ireland. This paper does not aim to examine the issues surrounding delays in the implementation of the Act; these issues are well explored elsewhere (Daly, 2005; Ganter, 2005; Lawlor, 2005; Owens, 2005).

Nepal has a short and slowly developing history of psychiatry. Recent political turmoil has crippled Nepalese healthcare in rural areas. Although the final quarter of the 20th century saw some development of psychiatric services in Nepal, the majority of Nepalese people remain deprived of such services even today. There is no national health programme or Mental Health Act. Psychiatric services are hospital based and most are centralised in the capital. Nepalese psychiatrists need urgent help, but they have been unable to form a strong professional body. This report presents the historical background, current state of affairs and suggestions for modernising mental health services in Nepal.

This paper describes the use of simulated patients in medical education and how actors have been deployed with medical students in Aberdeen. The advantages and disadvantages of using actors for student education are summarised and we conclude with some possible future developments. At the outset, it may be helpful to outline some definitions, as in the review by Barrows (1993). A ‘standardised patient’ is an umbrella term for both an actual patient who is trained to present his or her own illness in a standardised way and also for a simulated patient who is a well person trained to portray an illness in a standardised way. This paper will use these terms but will relate mainly to the use of professional actors (not volunteers from the general public, who are often deployed by medical teachers) as simulated psychiatric patients.

Paice & Ginsburg (2003) surveyed postgraduate medical trainees in London and found that most considered their training as satisfactory and the proportion that evaluated their training as poor had fallen compared with a previous survey. They also reported, however, that the training experience for some trainees remains unsatisfactory and that the single most important factor in determining trainee satisfaction is the quality of supervision provided by the consultant trainer. In the light of this it is alarming that in a recent survey of psychiatric trainees in the West Midlands, 47% had experienced bullying and in 27% of cases of alleged bullying the perpetrators were senior medical staff (Hoosen & Callaghan, 2004). Paice et al (2004) reported consultants as the source of bullying in 27% of cases in a survey of bullying among doctors in training in north London.

Despite efforts to integrate and harmonise legislation across the member states of the European Union (EU), mental health legislation, including legislation for the detention and treatment of offenders with mental disorders, differs widely across Europe. With changes to the Mental Health Act 1983 in the UK currently underway, investigating the different approaches to compulsory psychiatric care in other countries can be a stimulating and worthwhile exercise. We explored the Finnish mental health law with regard to compulsory admission and treatment and forensic care. Relevant differences between the Finnish approach and legislation in other European countries will be discussed.