Background: There is no published research on attitudes of psychiatrists towards children visiting parents who are acutely-unwell and inpatients in psychiatric hospitals. Nor is there information on facilities available for such visits.

Objectives: (I) To assess the attitudes of Irish psychiatrists towards children visiting. (II) To determine the availability of child-friendly facilities within admission units.

Method: A questionnaire was posted to every consultant psychiatrist accepting acute adult admissions in the Republic of Ireland and Northern Ireland.

Results: The response rate was 69%. Ninty-seven per cent were in favour of children visiting. Almost half felt that decisions on visits should depend on the particular situation, considering the child, parent, ward, etc. However, only 11% of units had a room/area designated for children visiting. 90% had no facilities they considered child-friendly on their unit. A majority felt that arrangements for children visiting were inadequate.

Conclusions: This topic is of interest to psychiatrists, and can be contentious, particularly when considering supervision of, and legal responsibility for, children visiting. Guidance on these issues would aid psychiatrists and hospital management. Poor facilities and infrequent visits may be a factor in the early development of stigma towards mental illness. Further research, improvements in facilities and staff training in liaison with children are needed.

Objectives: This study was designed to test a proposed relationship between the total impact score (devised by the authors) and the quantum of damages in compensation received by victims of criminal and political violence. In so doing, the authors sought to develop a mathematical formula which could be used to quantify damages in a simple and expeditious manner.

Method: Data on 2,191 victims of violence was collated forming three databases of information, on the incident, on the victim and on the outcomes. A tool of measurement of the psychosocial impact of the traumatic event was designed (the Total Impact Score). Information on a subsample of the 208 survivors of attempted assassination was then selected and the TIS for each individual was calculated and examined for correlations with other variables including the quantum damages awarded.

Results: The TIS was shown to have validity as a measure of the psychosocial impact of a traumatic event upon an individual. The analysis showed a significant relationship between the TIS and quantum awarded. This relationship was used to generate a mathematical formula which could be used to calculate quantum damages in any case. Compensation = £500 × (10(0037t+0.059y) -1), where t is the TIS and y is the number of years after 1985.

Conclusions: The TIS can be taken as a valid tool for quantifying the psychosocial impact of a traumatic event or violent act. The tool consists of a checklist of readily ascertainable outcome variables each of which can be scored and a TIS calculated. From this score the amount of damages can be ascertained. The authors believe that this measurement tool represents a fair and equitable method of calculating a case's worth.

Objectives: This paper aimed to examine the outcome of hostel treatment including the effect on hospitalisation rates.

Methods: The work of the four medium/long term Gloucester hostels developed between 1983 and 1993, to provide 24-hour nursed care to ‘new long stay’ patients in Gloucester is described.

Results: Fifty-eight patients with predominately severe mental illness were admitted to the hostels up to 1999, and demographic/illness data is presented. Mean duration of hostel stay was 4.8 years, and one third of patients were readmitted to hospital (most briefly) during their hostel admission, one patient 11 times. Thirty-four patients were discharged from hostels, 29 to less dependent settings, but four referred to hospital care. There was a significant reduction in the number of admissions and duration of hospitalisation in the time between discharge from the hostel to the present or death, as compared with the same time frame for each individual prior to entering the hostel system.

Conclusions: The data adds further support to the potential value of 24 hour nursed care for patients with severe mental illness.

Recent years have seen renewed emphasis on the importance of mental health policy as a key component of health and social policy at both national and international levels. In 2001 the European Commission produced a public health framework for mental health in the EU. In the same year, the World Health Organisation devoted its annual health report to mental health and called on countries to formulate, update and implement mental health policies. The EU and WHO initiatives both recognised that the challenges facing mental health policy makers are increasingly transnational in scope, related to issues such as rapid demographic change, increased transnational migration, the protection of human rights and the implementation of a growing number of international laws, directives and protocols in relation to mental health care.

Significant progress has been made in the development of Irish mental health services over the past 40 years. Nevertheless, many challenges remain. The aims of this paper are to outline:

• Prevailing theoretical perspectives on mental health policy

• Mental health policy in Ireland since the last major policy revision in 1984

• Relevant economic and demographic changes in Ireland since 1984

• Relevant clinical, legislative and policy developments in relation to mental health

• Future directions for mental health policy.

Electronic literature searches were performed using Psyclit (American Psychological Association, 1887–2003), Medline (United States National Library of Medicine, 1985 – 2003), with broad search terms related to mental health policy. Additional books and papers were identified by tracking back through references and consulting with colleagues. Policy documents and selected literature on Irish psychiatric services were reviewed and related to recent literature on mental health policy.

Within psychiatric practice, psychotherapy occupies a unique role. Not only is it a mode of treatment for some patients, it is also an explanatory model; not only is the psychotherapist called upon to fulfil numerous overt functions within the institution, there are also all sorts of other functions which a psychotherapist may be called upon or expected to fulfil, some more welcome and appropriate than others.

Within medicine the choice of becoming a psychiatrist is often seen as feminine, unscientific, perhaps unsafe and slightly illicit. The same applies within psychiatry, to the choice of psychotherapy, and the decision to leave behind dopamine and clozapine for immeasurable, bizarre, unconscious objects. This paper will describe some of the overt and covert roles in the life of a consultant psychotherapist within the National Health Service (NHS) and then in more detail elucidate these roles with two examples from clinical practice.

We wish to describe a case of gamma hydroxyl butyrate (GHB) withdrawal, including seizure activity in a 34 year old male, who had been taking the substance over a two year period. The syndrome has many aspects in common with alcohol withdrawal (delirium tremens) and benzodiazepine withdrawal (long duration of symptoms), however detoxification presents many challenges for clinicians.