A cross-sectional study to ascertain levels of personal and perceived public mental illness stigma in a university student population and the association between the respective levels of stigma and help-seeking intention. An adaptation of the Discrimination-Devaluation scale was used.

A total of 735 students participated in the study (response rate 77%). There were higher mean perceived public stigma levels than personal stigma levels. Perceived public stigma was not significantly associated with future non-help-seeking intention (odds ratio (OR) = 0.871, P = 0.428). Personal stigma was significantly associated with a decreased likelihood of future help-seeking intention (OR = 1.44, P = 0.043). Being younger than 25, having no history of or treatment for mental illness and having no personal contact with someone with a history of mental illness were all associated with higher personal stigma levels.

This study indicates that personal stigma as distinct from perceived public stigma is a significant barrier to mental health utilisation for a student population and future stigma reduction campaigns could strategically focus on this.

Electroconvulsive therapy (ECT) prescription rates in Scotland are decreasing. This study aims to look for possible causes, in particular psychiatrists' attitudes. Ninety-one Scottish psychiatrists completed a survey in 2009 relating to demographics, training, current practice, National Institute for Health and Care Excellence (NICE) guidelines and attitudes.

The mean number of times the psychiatrists had prescribed ECT in the past 2 years was twice. About 43% felt that their prescribing rates had decreased. Reasons for this included more effective medication, public and patient perception, and NICE guidelines. There was a significant correlation between doctors' gender and estimated prescription rates (P = 0.004), however, not with other prescription data. Almost all surveyed psychiatrists (97%) agreed that ECT has a place in current psychiatric practice.

Despite generally positive attitudes to ECT shown by psychiatrists in this study, prescription rates were low and decreasing. With more effective medication the role of ECT in therapy appears to be changing.

Dialectical behaviour therapy (DBT) is associated with particularly high drop-out rates in the National Health Service (NHS). This paper seeks to investigate the characteristics of patients with borderline personality disorder dropping out from DBT and the role of care coordination in this phenomenon. Data for the 102 patients receiving DBT in east London, 58% of whom had dropped out of treatment prematurely, were analysed.

In a multivariable analysis, a history of care coordination was the only variable significantly correlated with drop out: 88% of patients with a history of care coordination dropped out prematurely compared with 52% of patients without such history.

The experience of comprehensive care within the care programme approach, particularly care coordination at the start of DBT, affects the retention of patients in DBT. Further qualitative research is required to understand how care coordination and DBT drop out are related, which could lead to changes in how the therapy is delivered in the UK and influence decisions regarding the use of care coordination with patients with borderline personality disorder.

We examined the impact of implementing a new Acute Mental Health Emergency Assessment Protocol (AMHEAP) on joint psychiatric assessments out of hours within Forth Valley, Scotland, over the course of 4 calendar months. The protocol states that assessments should be carried out by a junior doctor and a registered, qualified mental health nurse. The impact measures were taken as admission rates and experience of the doctor in training.

In the 4 months that were examined (1 June–30 September 2011), 79.5% of out-of-hours emergency assessments were performed jointly. Admission rates were significantly decreased (P<0.001) compared with a similar period in 2008, before the AMHEAP protocol was developed. Most junior doctors valued the experience of joint assessment.

Joint assessment can enhance patient experience, reduce hospital admission, and provide a learning opportunity for junior doctors in emergency psychiatric assessments. However, it represents a move away from the doctor as sole decision maker.