To follow up homeless people with psychoses treated by a dedicated team; changes in accommodation, risk behaviour, mental state and psychiatric care were examined.

Service uptake improved as did symptomatology and residential stability. However, substance use and criminality continued to be prevalent and a minority remained homeless.

Specialist psychiatric teams are a valuable adjunct to mainstream services in areas with high levels of homelessness.

The aim was to provide effective time-limited management of acute episodes of mental illness in the community, thus reducing dependency on the psychiatric services. A multi-disciplinary team supplied intensive psychological and pharmacological interventions.

Fifty-nine per cent were discharged within 12 weeks to the care of their general practitioner. Twelve per cent were admitted to in-patient care.

A time limited multi-disciplinary approach will have benefits to patients and the service.

Demographic and medical characteristics of waiting list patients for National Health Service (NHS) psychotherapy, non-NHS psychotherapy or NHS general adult psychiatry were compared by postal questionnaires.

One hundred and eighty-three subjects replied. High rates of psychiatric morbidity were reported in both psychotherapy populations but general psychiatric referrals were more disturbed, taking more psychotropic medication than non-NHS psychotherapy but not NHS psychotherapy subjects. The biggest referral source to non-NHS psychotherapy was general practitioners.

Non-NHS psychotherapists should be able to recognise severe mental illness and have a basic understanding of psychotropic medication and psychiatric services.

This report was prepared as the basis for wider consultation within the Old Age Faculty and the College. Some literature and practice is reviewed and practical suggestions made for the future in this area.

Although older patients are less likely to be refused for psychological intervention attitudes are slowly changing.

The clinical implications of this development include a greater consideration of the unique emotional life of each of our patients and an improved understanding of our reluctance to engage in psychotherapeutic work with older people.

The aim of the study was to investigate changes in child care arrangements after admission of mothers to acute psychiatric wards. Data were collected by interview where possible and from case notes.

Twelve out of 63 children of mothers interviewed had to move house. Chronicity of psychiatric disorder was evident in half the mothers.

Children's lives are affected by maternal psychiatric admission with the likelihood of repeated disruption where psychiatric disorder is chronic.

In an attempt to reduce patient non-attendance at first appointments, consultant referrals were handled differentially over three years. From referral letters some patients were referred elsewhere, some sent appointments and some invited to make appointments.

There was a reduction in patients who did not attend an appointment and an increase in the proportion of patients, not referred elsewhere who were seen.

This system reduces consultant waiting time in clinics and the interval before a patient is seen.

To determine the attitudes of psychiatrists towards the practice of evidence-based medicine by use of a postal questionnaire. A survey was sent to Consultant Psychiatrists and to Higher Trainees in Psychiatry in the West of Scotland Region.

While older influences on decision-making such as tradition and deference still play a part, almost all respondents consider the adoption of more effective care based on best available external evidence desirable; most think it attainable. The technology is generally available, but further training is desired to access the information and its critical analysis.

Educational activities should increasingly focus on skills for data search and critical analysis.

Audio-recordings were made over a period of six months of liaison–consultation meetings between general practitioners and a community mental health team in the Scottish Borders to show general trends in length of discussion and information exchange.

Meetings were predominantly supportive, with high levels of shared information, but little educational content. Some trends in discussion time are shown.

Audio-recording could form the basis for reviewing the function of liaison-consultation meetings.

To describe the outcome of rough sleepers admitted to an acute psychiatric ward; the professional most involved with the person was interviewed.

Eleven out of 12 people admitted with a psychosis were accommodated and in touch with mental health services at follow-up (median of 21 months) compared with two out of 10 people, admitted without a psychosis, accommodated and four out of 10 people in touch with mental health services.

Psychiatric admission with good aftercare is worthwhile for rough sleepers with a psychosis, even if it requires involuntary admission.

The study aimed at developing a brief cognitive intervention suitable for everyday management of psychotic patients. A brief cognitive therapy package was developed and tested on different patients with psychosis.

In conjunction with medication, a brief cognitive intervention helped some patients with psychosis at different stages of the illness.

This encouraging report justifies more detailed studies.

In order to identify the role and responsibility of the speciality tutor, the tutors' post in old age psychiatry was compared across two regions.

The role was narrow; but different in the two regions depending on training programmes.

Tutors in all faculties should have an expanded and standardised job description, separate from the role of the regional representative, in order to strengthen the input of the specialisms to training at all levels.

The study aimed to evaluate the effectiveness of the naturalistic use of olanzapine. Prescribers of olanzapine were asked to provide baseline and six-week Brief Psychiatric Rating Scale scores for 56 in-patients. Withdrawals from treatment were also noted.

Olanzapine was not effective in any of the 12 patients with refractory schizophrenia and four patients worsened. In 36 patients with non-refractory schizophrenia, 16 (44%) improved and 10 (28%) were categorised as treatment failures. of eight patients with non-schizophrenic psychosis, only one improved and two were treatment failures.

Olanzapine is effective in treating non-refractory schizophrenia, but appears to have no beneficial effect in refractory schizophrenia.