To test the National Institute for Clinical Excellence (NICE) assertion that characteristics of participants in the majority of clinical drug trials in schizophrenia do not reflect clinical practice. In particular they were concerned about the relative exclusion of women, older adults and patients with comorbidity. The baseline characteristics of a sample of 600 patients with schizophrenia recruited to be as representative as possible of UK community practice were compared with those from one of the largest international drug trials of an atypical antipsychotic.

Although comparisons could only be made on a limited range of characteristics the two samples were broadly comparable.

Current drug trials from pharmaceutical companies may have more relevance to clinical practice than their stated exclusion criteria may indicate.

A before-and-after design was used to evaluate whether the routine implementation of functionalised community mental health teams (CMHTs) would reduce demand for in-patient care. Residents of west Birmingham, aged 16–64 years, who were in hospital between 23 March 1992 and 22 September 1992 were identified. The same period was studied in 2003 by which time the newly introduced teams were well established.

The number of people in hospital fell by one-third between 1992 and 2003. There was no change in the number of admissions by each patient or the length of stay. The percentage identified as Black, single, living with other adults, resident in hostels and unemployed increased, as did the proportion with schizophrenia or manic depression and those detained compulsorily.

Functionalised CMHTs can decrease the use of in-patient care in inner-city areas. They may also attenuate, but by no means halt, the rise in compulsory admissions seen across the UK in the past decade.

The Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) were developed as a routine measure of outcomes in child and adolescent psychiatry. In a preliminary study we administered sub-scale 12 of HoNOSCA (Family Life and Relationships) to 20 families and compared the results with two well-established measures of family functioning and a measure of abnormal psychosocial situations associated with psychopathology.

Strong correlations were found between HoNOSCA sub-scale 12 and both self-assessed and clinician-assessed measures of family functioning. However, there was little relationship between HoNOSCA (12) and a measure of abnormal psychosocial situations.

HoNOSCA (12) appears to provide a quick and valid assessment of overall family dysfunction and can be used in a time-efficient manner as a means to assess where further more comprehensive family assessment or family therapy may be required.

In order to examine the opportunities for senior house officers (SHOs) to undertake emergency psychiatric assessments we conducted a retrospective cohort study of such assessments in a district general hospital.

Senior house officers conducted few assessments for self-harm compared with psychiatric liaison nurses (P < 0.001), and were involved in only 40% of emergency referrals where psychiatric opinion was requested. Senior house officers continue to undertake more assessments out of hours than any other group (P < 0.01).

Although the introduction of psychiatric liaison nurses has improved capacity and reduced waiting times for emergency assessment, the opportunity for SHOs to undertake emergency assessments has been reduced, particularly with regard to assessment of suicidal risk following self-harm. These results suggest the need for better monitoring of SHO experience, particularly in the light of service developments that have an impact on psychiatric training.

A postal survey was conducted to determine what proportion of psychiatric specialist registrars working in Scotland (n=119, excluding those specialising in psychotherapy) met the requirements for experience in psychotherapy. Since 2004, this has been a compulsory part of eligibility criteria for the MRCPsych part II examination.

Two-thirds of those surveyed responded. One-third of respondents met the Royal College of Psychiatrists' requirements for psychotherapy experience. Half the respondents reported competence in at least one modality of psychotherapy. Four-fifths of respondents were interested in gaining further experience and training, two-thirds in developing a special interest and one-quarter in dual training, in at least one modality of College psychotherapy. There was no significant association between adherence to the requirements and self-perceived competence, qualification or the wish to gain further training and experience in psychotherapy.

The majority of trainees, even those interested in psychotherapy, still fail to meet College requirements. Many trainees would appreciate an opportunity to gain greater depth of psychotherapy experience, in addition to gaining broad experience of various aspects of psychotherapy as required by the College.