To explore what young people who self-harm think about online self-harm discussion forums. SharpTalk was set up to facilitate shared learning between health professionals and young people who self-harm. We extracted themes and illustrative statements from the online discussion and asked participants to rate statements.

Of 77 young people who participated in the forum, 47 completed the questionnaire. They said they learned more about mental health issues from online discussion forums than from information sites, found it easier to talk about self-harm to strangers than to family or friends, and preferred to talk online than face-to-face or on the telephone. They valued the anonymity the forums provided and reported feeling more able to disclose and less likely to be judged online than in ‘real life’.

Mental health professionals should be aware of the value of anonymous online discussion forums for some young people who self-harm, so that they can talk about them and assess their use with their patients.

Tackling discrimination, stigma and inequalities in mental health is a major objective of the UK government. The project aimed to determine the effect of presenting a person with a mental illness as having either a biological illness or a disorder that arose from psychosocial stress to a randomised representative panel of members of the general public. The 20-point Attitude to Mental Illness Questionnaire (AMIQ) was used to assess stigmatised attitudes.

Overall, 187 individuals returned their questionnaires (74% response rate). The mean AMIQ stigma score for the ‘ill’ group was 1.4 (s.e. = 0.3; n = 94). The mean AMIQ score for the ‘stress’ group was 0.5 (s.e. = 0.3; median n = 106; P = 0.0837, median difference = 1; power (for 5% significance) 81%).

There was no difference in the stigmatised attitudes towards a person with mental illness regardless of whether they were presented as biologically ill or as having an illness that was a response to psychosocial stress.

The provision of 24-hour specialist child and adolescent mental health services (CAMHS) is a key target for service commissioners. However, a lack of data exist on models of service delivery or levels of need for out-of-hours specialist CAMHS to guide service development. We aim to describe a model of 24-hour service provision and provide information on the demand for and outcome of assessments of a service in Dublin, Ireland, using a 6-year retrospective case study design.

A total of 468 emergency presentations occurred during the study period; 80% presented with self-harm or suicidal ideation. Two-thirds presented outside of working hours. All presentations received a specialist CAMHS consultation. Over 50% required admission to a paediatric ward and 80% required onward referral to specialist CAMHS.

There is a need for a 24-hour specialist CAMHS and this allows increased rates of specialist assessment and onward referral for a high-risk group.

To appraise the value of additional information from objective measurements (QbTest system) in the clinical assessment of children and adolescents with attention-deficit hyperactivity disorder (ADHD). Two groups of ADHD assessments were compared. In the first group, assessments were undertaken without objective measures, whereas in the second group objective measures were added to the assessment. Practice outcomes were followed up over 1 year.

Objective measures improve differentiating between ADHD and other conditions whose symptoms are known to overlap with ADHD. Objective measurements reduce the risk of unidentified ADHD (P < 0.0035) as measured by subsequent rates of revised diagnosis over a 12-month period.

Introducing objective measurements into the clinical assessment of ADHD provides an increased robustness of the clinical diagnosis strengthening clinical decisions for treatment interventions.

To examine the association between the use of cholinesterase inhibitors (ChEIs) and time to care home placement. We compared patients who were prescribed ChEIs in 2006 with those who were not with respect to their placement in care homes over a 4-year period, using survival analysis.

During the first 30 months of follow-up there was a delay in care home placement by a median of 12 months in those who took ChEIs compared with those who did not. However, at the end of the follow-up there was no significant reduction in the probability of being in a care home setting between those who had taken ChEIs compared with those who had not (hazard ratio 0.75, 95% CI 0.25–6, P = 0.1).

The study provides some evidence to suggest that prescribing ChEIs may be associated with a delay in the timing of care home placement as observed in the first 2.5 years of treatment. However, based on purely observational data, no conclusion can be made as to whether such association is causal.

We explored the views of foundation doctors on psychiatry placements to inform further post development. Following criticism of some South Thames Foundation School (STFS) psychiatry placements, STFS staff reviewed existing information on post quality and 21 foundation doctors in psychiatry posts took part in three focus groups.

Trainees are concerned about the general quality of posts (including supervision and induction); isolation of mental health trusts from ‘acute’ trusts; the professional position of junior psychiatrists; and responsibilities related to the Mental Health Act and risk assessment. Requirements for posts to address these issues have been developed and are now being implemented locally.

The conclusions are relevant to the quality management of foundation posts in mental health trusts, responses to the Collins Report (2010) and future recruitment into psychiatry.