The Lifemusic project ran from 2008–2011 as part of a UK government funded programme demonstrating the potential benefits to community well-being from knowledge exchange between universities and their local communities. The Lifemusic method, which grew out of 20 years of development and community practice, uses music improvisation as a primary resource for group health and well-being. It presented a training programme and over 400 workshops with a variety of client groups including mental health. This paper introduces and outlines the Lifemusic method, placing it within a tradition of humanistic approaches to community health and goes on to describe its impact in a mental health facility where the approach was introduced and sustained. It looks at the practical aspects of setting up the programme, the challenges of client participation and sustainability and outlines the positive outcomes and benefits to patients and the methodology used in measuring well-being.

Background: Previous studies about the effectiveness of Dialectical Behaviour Therapy for the treatment of Borderline Personality Disorder have had promising results. However, no previous studies have examined its effectiveness when delivered in low secure inpatient services for women. Aims: To evaluate clinical outcomes during and after a 1-year period of admission within a low secure unit for women offering a Dialectical Behaviour Therapy programme. Method: A naturalistic, within subjects study of clinical data collected as part of routine practice was conducted. Participants were18 consecutively admitted women who met the diagnostic criteria for Borderline Personality Disorder and had completed at least 1 year of treatment. Measures covered: risk behaviours; self-reported symptoms of Borderline Personality Disorder, and current mood and symptom experience; staff reports of clinical problems, needs and social functioning. Scores were compared between admission and at 6 months and 1 year. Results: There was a statistically significant improvement on all 13 measures over the year's treatment. Most improvement was demonstrated between admission and 6 months. Conclusions: Engagement in1-year's treatment was associated with significant reduction in risk behaviours and both staff-rated and self-rated outcome measures. Some significant questions remain about which elements of the programme are most effective but the results are encouraging.

Aims: To describe the methods of self harm incidents in a low secure unit population and to identify and compare the clinical characteristics of patients displaying inpatient self harming behaviours with those who do not display such behaviours.

Method: A retrospective case control study was conducted. Details about the inpatient self harming incidents were collected from an incident database. Clinical characteristics of those who displayed inpatient self harming incidents (cases) and those who did not display such behaviours (controls) were compared. Analysis was performed to establish statistical significance on the observed differences.

Results: 80 admissions resulted from 78 patients during a 6½ year period. 21% of patients presented with inpatient self harming behaviours. 57% of the incidents were caused by 13% of patients. Clinical characteristics such as white ethnic background, histories of self harm, physical or sexual abuse, childhood conduct problems and lack of educational qualifications and having a diagnosis of schizoaffective disorder were more likely to be associated with inpatients self harming in low secure settings. Sexually inappropriate behaviours and a diagnosis of schizophrenia were less likely to be associated with this group.

Conclusion: The majority of self harm incidents are caused by a minority of patients. Most of the clinical characteristics associated with the low secure inpatient self harming patients are similar to those observed in other psychiatric inpatient settings.

This article describes in detail the service delivered by the Multidisciplinary Team at the Montpellier Low Secure Unit in Gloucester. The development of the service, the physical environment and the admission criteria are described. The article focuses on the stages of treatment experienced by the patient namely: assessment, ongoing care and treatment and pre discharge planning.