Tackling discrimination, stigma and inequalities in mental health is a major UK government objective yet people with intellectual disabilities continue to suffer serious stigma and discrimination. The project aimed to determine the effect of viewing a picture of a person with intellectual disability on stigmatised attitudes. The 20-point Attitude to Mental Illness Questionnaire (AMIQ) was used and a representative panel of members of the general public were randomised to complete the questionnaire either with (experimental) or without (control) looking at a picture of a man with Down syndrome. Six months later the same experiment was performed with the groups crossed over.

Results were received for 360 participants (response rate 87–93%). The sequence (control or experimental) had no significant effect on the outcome. The mean AMIQ score in the control groups was 1.56 (s.d. = 2.85, s.e. = 0.21, n =186) and in the experiment group (after looking at the pictures) was 2.43 (s.d. = 2.59, s.e. = 0.12, n = 174; median difference 1, P = 0.0016 Mann-Whitney U-test; effect size 0.23).

Looking at a picture of a man with Down syndrome significantly reduces reported stigmatised attitudes.

To analyse clinical outcome indicator data from the Health of the Nation Outcome Scales for People with Learning Disabilities (HoNOS-LD) in adults with intellectual disability admitted to mental health wards during a 19-month period; and to identify clinically relevant domains of change associated with in-patient admission.

Significant improvements were found in mental state, behaviour and social functioning. Improvements were also found in cognition and activities of daily living.

The HoNOS-LD is a useful tool for measuring clinical outcomes in several relevant domains and guiding in-patient treatment in learning disability psychiatry. It may also provide a currency for payment-by-results and influence the commissioning of learning disability services.

To investigate the attitude of staff towards the recovery approach in forensic mental health services and the impact of training on staff knowledge and attitudes. A specially constructed 50-item recovery approach staff questionnaire, which focused on the core components of the recovery approach, was completed by 137 members of staff in in-patient forensic services in Lambeth, south London.

Staff were generally very positive about the implementation of the recovery approach in forensic services and those who had received training scored significantly higher on the questionnaire than non-trained staff.

The great majority of staff agree that the recovery approach to care does have a place in forensic services. This is important and needs to be built into the implementation of this approach in forensic services.

To describe the first 6 months of the newly introduced community treatment orders (CTOs) in Birmingham and Solihull mental health services; to establish a clearer picture of patterns of use and some early outcomes. Computerised note systems were used to collect a range of sociodemographic and clinical data using a specially designed data collection tool.

We observed higher than expected numbers of CTOs compared with previous use of Section 25 supervised discharge. Our results were consistent with international studies in showing that CTOs are typically used in males aged around 40 with a primary diagnosis of psychotic illness. Compared with the census population, Black and minority ethnic groups were overrepresented in our sample. There were high recorded rates of comorbid alcohol or substance misuse and violence. The majority of patients on CTOs were being followed up by community mental health teams or assertive outreach teams.

It is difficult to draw firm conclusions at this early stage of implementation. However, there are likely to be resource implications in view of the high numbers of CTOs applied compared with Section 25 discharge. Service providers, clinicians and commissioners need to ensure CTOs are backed up by high-quality care. Further research is required into the impact of CTOs on a range of outcomes and to understand differential rates of CTO across different ethnic groups.

To assess the individual needs for psychiatric services of a representative sample of homeless men living in hostels. A standardised procedure was used to assess the needs of 101 randomly selected homeless men.

The main mental health needs of the study sample were for psychiatric and social assessments and for alcohol and drug services. Men with psychotic problems had a high level of needs for psychiatric services and a higher proportion of unmet needs.

Our findings support the need for community-based multidisciplinary services that work specifically with homeless people to meet their needs. These services should incorporate psychiatric, social and substance misuse services.

The collection of results of a specific outcome measure, the Health of the Nation Outcome Scales (HoNOS), is mandatory for mental healthcare providers in the National Health Service in England. Not all providers collect HoNOS data and coverage varies widely. This paper explores, by means of interviews with clinicians and policy makers and econometric analysis of HoNOS data, the barriers and incentives to the uptake of HoNOS and outcomes more generally, and the key characteristics associated with providers who do undertake HoNOS.

The main barriers to the collection of outcomes involve a lack of adequate feedback mechanisms, a lack of perceived clinical relevance and poor information technology infrastructure. Econometric results show HoNOS collection is associated with providers who produce high-quality data.

Initiatives should focus on putting systems in place to encourage feedback mechanisms for clinicians.

The audit aimed to assess current senior registrar posts in child and adolescent psychiatry in Ireland in terms of working environment, conditions and training issues. The posts were compared with standards set down by the Child and Adolescent Psychiatry Specialist Advisory Committee of the Royal College of Psychiatrists and the National Higher Training Subcommittee of the Irish Psychiatric Training Committee.

The audit cycle was completed twice and a 100% response rate was achieved on both occasions.

Higher training posts in child and adolescent psychiatry in Ireland compare favourably to standards for training and education, but poorly for working environment, case-load and educational supervision.