Psych Talk was developed by the British Indian Psychiatric Association (BIPA), a UK-based charitable organisation, to support doctors from diverse training backgrounds in developing effective psychiatric communication skills. The programme aimed to improve confidence in OSCE-style assessments and routine clinical encounters through structured exposure to realistic psychiatry case scenarios. Objectives included providing practical, exam-focused guidance relevant to MRCPsych examinations, strengthening rapport-building and therapeutic alliance skills, supporting the management of difficult conversations, and use of non-verbal communication.

Psych Talk comprised 13 online teaching sessions delivered between June and December 2025. Sessions were held on weekends, lasted 1.5 hours each, and were chaired by UK resident doctors with support from consultant psychiatrists. Each session focused on two to three OSCE-style scenarios across psychiatric subspecialties, explored through role play, group discussion, and structured feedback. Pre-session and post-session surveys collected demographic information, career stage, confidence levels, learning sources, and qualitative feedback, with all responses analysed anonymously. Descriptive analysis evaluated changes in confidence.

A total of 189 participants completed the pre-session survey and 403 completed post-session feedback, with more responses obtained post-session possibly as participants completed these to receive CPD certificates. Participants represented a diverse cohort, predominantly from the UK (n=74), India (n=39), and Pakistan (n=8), with additional representation from Ireland, Egypt, the UAE, Myanmar, Malaysia, and a mixed or unspecified group (n=58). Participants who did not disclose their career stage formed the largest group (49.7%), followed by core resident doctors (35.4%). Doctors in non-training UK posts accounted for 7.4%, and IMGs outside the UK for 6.3%. Before attending Psych Talk, only around one in five participants reported feeling confident or very confident; most described themselves as somewhat confident, and 13.8% reported no confidence. After completing the sessions, nearly two-thirds reported high confidence, and those reporting no confidence fell to 1.0%. Participants valued the practical, exam-focused approach, realistic OSCE scenarios, interactive format, and clarity of guidance. Chairing by resident and consultant psychiatrists was rated excellent by nearly 75% and good by a further 20%. Mostparticipants learned about the programme through social media (37%) or colleagues (29.3%), and nearly all expressed interest in future sessions.

Psych Talk was associated with a meaningful improvement in self-reported confidence in psychiatric communication among a globally diverse cohort. As a free and accessible charitable initiative, it highlights how shared learning environments can bridge gaps between UK and international training systems and support MRCPsych-related skill development.

Feedback was collected from Core Trainees (CTs) working at Black Country Healthcare Foundation Trust to survey their satisfaction with the way that ECT was being delivered at the time. Primary aim was to assess/rectify CT issues that were causing difficulties in achieving their ECT competencies with secondary aims to improve delivery of ECT from a patient/trust perspective as well.

Initially a prequestionnaire was delivered to determine the extent of the need and whether CTs would be positive towards a separate rota.

Afterwards we implemented a new specific rota for ECT clinic, over a trial period of 3 months, where a dedicated CT would cover the entire ECT list rather than the rostered on-site on-call doctor (if that doctor was agreeable to this). This was tracked via a live Excel document that was regularly updated to show the ECT clinics that were and weren’t available and CTs were able to put themselves down for available clinics.

We then performed a post-trial survey with comparable questions to assess for benefit of the rota and then asked the cohort for their views on the ECT rota itself and whether it should be reimplemented (as well as advice on improving that process if it were to restart).

Pre-trial responses showed that 65% and 71% of CTs had not received ECT induction or had competencies signed off, respectively. Over half had difficulties achieving competencies and 94% thought a more structured programme would help with achieving these.

Post-trial feedback was overwhelmingly positive with significant improvements in all measured parameters. Particular highlights being how 100% of CTs surveyed had now performed ECT vs 65% previously; and 94% favoured re-introducing the ECT rota. The percentage of CTs that had their ECT competencies signed off more than doubled (from 36% to 67%) and the vast majority felt the ECT rota made things better and less stressful whilst it was running.

Our conclusion was that a separate ECT rota was required going forward, particularly considering the Royal College's current ECT training requirements for CTs. Itwas recommended – and agreed to – that a centralised rota managed through the postgraduate medical rota coordinators would be beneficial. These findings were discussed and presented at the Tutors and Trainees meeting, attended by College Tutors and the Head of School.

Trainees’ wellbeing is constantly becoming an area of increased interest in the recent years. The impact of the pandemic, increased workload while balancing exams, training requirements, and family and caring responsibilities can pose significant demands on trainees. Psychiatry trainees are not immune to those challenges, but furthermore, they are susceptible to challenges unique to psychiatry – such as patient suicide, working in a field that still suffers from stigma from both patients and healthcare professionals. Despite the presence of resources, wellbeing remains an area for improvement.

In our study, we sought to explore areas that impact the wellbeing of psychiatry trainees in the northwest of England; the challenges encountered and the factors that contributed both negatively and positively to health and wellbeing.

We conducted online focus groups with psychiatry trainees in different stages in their training (CT1-ST8), to explore factors affecting health and wellbeing. Each session was co-facilitated by the research team, and structured into three sections: challenges faced, unhelpful experiences, and helpful experiences. Sessions were transcribed via Microsoft Teams, with participants informed of confidentiality and anonymity, and demographic data collected via an anonymous online questionnaire. Transcripts were thematically analysed by the research team to identify key themes.

Trainees reported multiple factors negatively affecting their wellbeing, including the rotational nature of the job, significant workload, lack of rest facilities, lack of appropriate supervision, and lack of individualised support for trainees with personal vulnerabilities. Challenges were compounded by difficulties navigating administrative systems and accessing occupational health or professional support. Helpful factors included supportive and flexible supervisors, strong team relationships, good workplace integration, as well as respecting and nurturing trainees’ autonomy and sharing constructive feedback.

The quality of the trainee–supervisor relationship emerged as the most important factor influencing wellbeing, with emotionally intelligent supervisors who notice struggles and encourage reflective practice being particularly beneficial. While multiple support resources exist, they are often not tailored to individual needs or widely known; targeted training for supervisors, including guidance on supporting neurodiverse trainees, may improve accessibility and effectiveness of wellbeing support.

The Collaborative Learning and Improvement Programme (CLIP) is a hospital-wide educational initiative on medication safety, co-visioned and co-produced by interdisciplinary members of the Changi General Hospital (CGH) Medication Safety Committee (MSC). CGH is a public hospital in Singapore, where CLIP has been operational since October 2023 and various educational materials have been implemented into hospital-wide junior, senior doctor and interprofessional education and training. In September 2024, inspired by a departmental case conference which triggered discussions on Neuroleptic Malignant Syndrome (NMS), the MSC Chairperson from the department of Psychological Medicine worked with departmental trainees on developing CLIP educational material on NMS. We aimed to design a CLIP educational infographic on NMS and implement this in hospital-wide mental health training.

Digital technology-enhanced learning using the infographic, with microlearning as the pedagogy, formed the framework to design the CLIP interprofessional educational infographic.

The design phase involved engaging stakeholders and end-users from the department, including Psychiatry trainees, from September–October 2025. Pharmacist, nursing and medical members of the MSC were engaged at the committee meeting in November 2025 to ensure interdisciplinary stakeholder contribution to designing the infographic. The final version of the infographic was implemented and shared in a mental health training session for the hospital’s Internal Medicine department conducted by a Psychiatry consultant in December 2025.

Qualitative feedback was captured at the planning, design and iteration phases.Qualitative and quantitative methodology was employed to capture end-user feedback from medical doctors in the implementation phase.

Qualitative feedback in the design phase led to various iterations of the infographic content, design and aesthetics, with the finalised infographic incorporating the themes captured from this feedback.In the implementation phase, quantitative feedback captured from end-users showed improvements in self-rated awareness of risk factors (69.6% to 100%) and signs and symptoms (60.9% to 100%) of NMS, and confidence in recognizing and managing NMS (4.3% to 70.6%). All participants rated the infographic as useful in aiding recognition and management of NMS. Qualitative feedback centred on the usefulness of the infographic’s design, organization and informativeness.

We designed a trainee-led infographic on NMS underpinned by interdisciplinary feedback, the implementation of which in the mental health training of general medical doctors has shown promising results, reinforcing the value of the CLIP. The CLIP NMS infographic will be made accessible to all hospital staff via the hospital intranet as a systems intervention and will be incorporated into interdisciplinary CLIP educational programmes.

To evaluate the impact of AI use on psychotherapy training for “core trainee” psychiatry residents as understood by the psychotherapy tutors. The psychotherapy training for residents includes theory-based teaching, courses, Balint groups, and completion of two psychotherapy cases across different modalities, all supervised by experienced psychotherapists. This includes an anonymised case summary with a formulation.

A questionnaire was sent to the psychotherapy tutors via a national (England) email list enquiring about their use of AI in psychotherapy training. The data is both quantitative and qualitative, summarising emerging themes. A similar survey was done for core trainees and is reported in a separate poster.

16 tutors completed the questionnaire (sent to 48 tutors).

75% of tutors stated that they don’t use AI for psychotherapy training or teaching. Of the 4 tutors who use AI, their responses include using it to: brainstorm, create images, find references, summarise different models, or serve as a “thinking partner”.

Most tutors (56.3%) were unsure whether residents used AI; 18.8% said residents used it, and 25% reported they didn’t. 7 tutors commented on the residents’ use of AI, with 4 expressing concerns about its use for formulations or summary letters. Other examples of AI use included teaching planning and creating captions for recorded sessions.

When combining the “yes” and “maybe” responses, support for potential AI use was greater for teaching psychotherapy concepts than for assisting with scribing or aiding formulations (75%, 43.8%, and 43.8%, respectively).

56.3% of tutors expressed concerns about the impact on relevant learning and critical thinking, especially the reflective and emotional aspects of the psychotherapeutic work. Further concerns regarding confidentiality and misrepresentation of the cases were raised if AI was used to record or summarise information. Two tutors also expressed concerns about how patients may be using AI.

When asked how best to use AI, the most common response (37.5%) was to use it to summarise concepts or theory.

The results demonstrated concerns regarding the impact on psychotherapy training (acquiring reflective capacity skills, emotional learning, critical thinking skills) and confidentiality, however there was support for utilising AI especially for learning or summarising psychotherapy concepts. Some concerns may be more easily addressed through governance policies (e.g. data protection), but the potential impact on experiential learning requires further discussion and guidance.

In 2023, 75% of resident psychiatry doctors (n=210) in Southeast England had experienced verbal abuse, 50% physically threatened, and only 33% felt confident in workplace security measures. A similar survey was carried out within South London and Maudsley NHS Foundation Trust (SLAM) in 2023, which found 70% of Foundation Doctors had experienced verbal or physical abuse from patients. Measures were put in place to improve safety, however were not clearly defined, and a review of their effectiveness has not yet occurred. This research aimed to bridge this gap by understanding the safety measures currently in place, and to determine whether doctors feel safe within their psychiatry placements.

We conducted a cross-sectional survey of SLAM Foundation Doctors on psychiatry placements between August 2025 to February 2026, to explore perceptions of safety during their training. The survey was distributed electronically and comprised of both quantitative and qualitative items, including closed-ended and free-text questions. Using this data, we identified areas that need improvement, and now aim to implement strategies to aid in improving foundation doctor experiences.

A total of 8 doctors responded to the survey. 62.5% of doctors feel unsafe or somewhat safe in their psychiatry placement. 87.5% did not receive any personal safety or breakaway training on starting their job. Only 25% of doctors received a safety induction for their ward or hospital, including how to locate emergency buzzers and staff alarms. 62.5% of doctors have been verbally assaulted, and report experiencing something they found traumatic during the rotation.

Qualitative data highlighted fears surrounding being left alone with acutely unwell patients due to a lack of safety induction and information on personal safety alarms.

Our research highlights that a high proportion of foundation doctors report feeling unsafe during their psychiatry placements. Most respondents did not receive personal safety or breakaway training, and only a minority received a local safety induction. Qualitative findings reinforced these findings, highlighting concerns around being left alone with acutely unwell patients, alongside a lack of safety and de-escalation training. Experiencing violence or aggression alongside a lack of safety training may adversely affect doctors’ experiences, engagement with learning opportunities, and ability to deliver a high standard of care. Identifying gaps in safety provision is therefore essential to inform targeted quality improvement initiatives and enhance both doctor training experiences and patient outcomes.

To explore the main barriers facing Palestinian mental health professionals conducting inpatient psychiatry research in Palestine.

A qualitative approach, through unstructured interviews with medical professionals who worked on academic papers at Bethlehem Psychiatric Hospital (BPH).

Four themes of challenges to inpatient psychiatric research in Palestine were identified:

Theme 1: Ethical Dilemmas: Inpatient psychiatry comes with complicated ethical issues, including involuntary treatment, safeguarding and capacity assessments. This makes studying hospitalized patients, often in relapse, prospectively or during admission difficult, and often impossible. Participants interviewed reported that obtaining consent is difficult as it connects to patients’ capacity details, which requires access to medical records.

Theme 2: Systematic Healthcare and Documentation Issues: Mental health services and protocols at BPH have been constantly changing, adapting to resources and demand. This is reflected in documentation; admissions had different forms and therefore, information is not homogeneous throughout the years. Further complicating the already tedious manual data collection from the paper-based system. Despite the growth and interest in Palestinian psychiatry academia, it still lacks awareness, education, institutional support, and funding.

Theme 3: Clinical Setting: Being the only standing inpatient psychiatric facility in Palestine, the hospital’s wards are frequently crowded, under-resourced, and understaffed. Participants reported that many medical and psychological investigations and interventions are not available, and data collection needs to go through delicate paths to not “stand in the way” of patient care. BPH is a stand-alone psychiatric facility. Meaning there is no integrated system that connects it to other medical wards or outpatient clinics. This limits studying cases or phenomena that overlap with other specialties, and restricts outcome assessment and continuity of care.

Theme 4: Sociopolitical issues: The volatility of politics in Palestine renders all aspects of life unpredictable: from roadblocks to safety concerns, and patients’ mistrust in existing institutions. Writing about Palestinian mental health demands navigating medical “neutrality” without compromising critical social determinants of health. Finally, social challenges, including stigma, socioeconomic disparities, accessibility issues and cultural beliefs and misconceptions, hold patients and families back from sharing their information with investigators.

Several hurdles prevent the publication of inpatient psychiatric research in Palestine. Researchers must be culturally sensitive and prioritize patient care and safety in vulnerable populations. The role of systematic change remains pivotal.

Alcohol withdrawal can potentially result in a life-threatening condition. This requires early recognition, prompt assessment and treatment. The National and Humber Trust guidelines emphasise use of validated tools such as Severity of Alcohol Dependence Questionnaire (SADQ) and Clinical Institute Withdrawal Assessment for Alcohol–Revised (CIWA–Ar) to guide treatment decisions.

An incident of alcohol withdrawal in the 136 suites, in which the patient’s symptoms were not recognised early and treatment was inadequate, alongside the presence of new staff within the team and informal discussions with staff, highlighted variability in staff knowledge regarding assessment tools and the treatment pathway.

The aim of the project was to improve staff confidence and knowledge in assessing and managing alcohol withdrawal in line with Trust Guidelines as measured by the pre-and post-intervention questionnaire.

The project followed the PDSA cycle of Quality Improvement:

Plan: Improve staff knowledge and confidence in managing alcohol withdrawal.

Do: We conducted a teaching session with staff on alcohol withdrawal symptoms, assessment tools and how they are used and required treatment.

We also created a flowchart to summarise the diagnosis and treatment of alcohol withdrawal. These flowcharts were pasted in suite 136 for staff to use as quick reference.

Study: Post-intervention results showed improved staff knowledge and confidence. Flowcharts were frequently used as quick reference points, and lectures enhanced understanding of assessment and management.

Act: Continue teaching and display of flowcharts. Future cycles may focus on evaluating clinical outcomes of alcohol withdrawal management.

The results showed that the intervention carried out led to significant improvement in staff knowledge of alcohol withdrawal assessment tools, treatment pathways, and guideline access.

The project showed that combining lectures and visible flowcharts effectively improved staff knowledge and confidence in managing alcohol withdrawal. Ongoing reinforcement and feedback are essential to ensure that improved knowledge translates to consistent practice.

This project helps staff to manage alcohol withdrawal more efficiently thereby saving time. It also helps to optimise use of resources. Early recognition and treatment initiation helps to prevent complication thereby cost saving.

Driving is a complex activity that may be significantly impaired by mental illness, acute psychiatric symptoms, cognitive impairment, and the side effects of psychotropic medication. In the UK, the Driver and Vehicle Licensing Agency (DVLA) provides clear guidance regarding fitness to drive for individuals with mental health conditions. Patients are legally responsible for informing the DVLA of any condition that may affect their ability to drive; however, clinicians have a professional duty to ensure that patients are appropriately advised, and that this advice is clearly documented.

Despite this, DVLA advice is often inconsistently delivered and poorly documented in discharge summaries. This creates risks including:

• Patients unknowingly driving when unfit to do so.

• Potential harm to patients and the public.

• Medico-legal risk to clinicians and the organisation.

• Poor continuity of care for GPs and community teams.

The primary aim of this Quality Improvement Project is:

To improve the delivery and documentation of DVLA driving advice for patients discharged from a mental health inpatient unit, thereby reducing medico-legal risk and improving patient safety.

This project followed the Plan–Do–Study–Act (PDSA) framework.

PDSA Cycle

• Plan: A baseline audit was conducted to retrospectively review discharge summaries for patient discharge on 1–31 August 2025 and showed no patients had DVLA advice given or documented in their discharge summaries.

• Do: A single, targeted intervention was implemented: An additional question was added to the discharge summary template prompting clinicians to consider and document DVLA driving advice. Effecting this change needed high level hospital management approval. The quality improvement idea was presented in different management meetings including Digital delivery group, corporate delivery group and clinical oversight delivery group before this change was approved and implemented.

• Study: Following implementation, a post-intervention survey was conducted to assess the delivery and documentation of DVLA advice. It showed that all the patient discharges in January 2026 so far have DVLA advice given and documented. This is a significant improvement from the pre-intervention survey.

Act: We confirm effectiveness and consider sustain ability and wider rollout by implement the change in other clinical areas of the hospital as appropriate.

Overall, the intervention was associated with improved compliance with DVLA guidance and safer discharge practice.

While this project has revolutionised how discharge summary is being written in the Trust by introducing a single and concise way of documenting DVLA advice, a more robust intervention could have been more appropriate, for example creating a different form specifically for DVLA advice on electronic medical records. But this would, however, need management financial approval and more paperwork for clinicians.

To improve compliance with Trust and NICE guidance requiring completion of venous thromboembolism (VTE) risk assessments within 24 hours of admission for adult psychiatric inpatients.

Baseline data were collected in May, 2025 from 20 inpatients to assess timeliness and documentation of VTE risk assessments following admission. Electronic records (RiO and NerveCentre) were reviewed to determine whether assessments were completed within 24 hours and whether reasons for delay were documented.

Following baseline measurement, a series of targeted quality improvement interventions were introduced. These included ward poster reminders, education during handovers and MDT meetings, VTE training incorporated into resident doctor inductions, routine MDT review of VTE status, addition of a VTE column to doctors’ handover sheets, ward-specific completion protocols, and reinforcement of documentation standards.

Post-intervention data were then collected retrospectively in November 2025 for 13 inpatients admitted after implementation of these measures. The same outcome measures were analysed to assess improvement.

Overall VTE assessment completion was 100% at both baseline and post-intervention. Timely completion within 24 hours improved from 50% (10/20) at baseline to 84.6% (11/13) post-intervention. Delayed assessments decreased from 50% to 15.4%. Documentation of reasons for delay improved from 20% to 100%. Mean time to assessment reduced substantially from 36 hours to 11.6 hours. Documented reasons for delay included patient refusal and the patient being asleep at the time of assessment.

Targeted, low-cost quality improvement interventions led to marked improvement in the timeliness and documentation of VTE risk assessments in an adult psychiatric inpatient ward. Although the NICE target of >95% completion within 24 hours has not yet been achieved, substantial progress was demonstrated. Sustained education, system prompts, and MDT oversight are expected to support further improvement and enhance patient safety.

Child and Adolescent Mental Health Services (CAMHS) are navigating a landscape of significant growth in service demand and increasing clinical complexity. To ensure long-term workforce sustainability and maintain the highest standards of patient care, it is essential to understand the various factors influencing staff well-being. This project, undertaken as part of the Royal College of Psychiatrists Leadership Fellowship, sought to evaluate the current well-being landscape across a multi-disciplinary CAMHS workforce. The goal was to identify existing protective factors and pinpoint areas where additional systemic support could be optimised to foster a resilient and stable work environment.

A baseline assessment was conducted involving 65 multi-disciplinary staff members, including practitioners, psychologists, psychiatrists, and administrators. Using the Copenhagen Burnout Inventory, the project measured three domains: Personal, Work-related, and Client-related well-being. Qualitative feedback was also gathered, identifying primary stressors and the visibility and perception of existing organisational support, providing a data-driven foundation for future Plan–Do–Study–Actcycles, ensuring that subsequent interventions are tailored to the service's needs.

Preliminary findings as of February 2026 indicate a large variation in response rates across teams. While staff remain committed to their roles, notable pressures exist regarding personal (Mean=65.4) and work-related (Mean=55.0) well-being. Significantly, client-related burnout was lower (Mean=40.8), suggesting that direct clinical work remains relatively rewarding. Data identified workload, case complexity, and administrative processes as primary areas for attention.

Qualitative themes highlighted interpersonal support as a significant strength; peer and line-manager relationships were the highest-rated positive influences on resilience. The assessment identified an opportunity to improve visibility of Trust-wide initiatives, as nearly half of respondents were either unaware of available offerings or felt they lacked CAMHS-specific tailoring. This has led to a proposal for creative arts therapies as a tailored resource; these interventions have shown promise in other settings. Feasibility, training, and impact assessment for these are currently under discussion.

CAMHS staff demonstrate high dedication despite systemic pressures. While the strong culture of peer support provides a vital foundation, workforce stability requires both increased resource accessibility and the development of newer, tailored support models. These findings will be shared with the Children and Young People’s Mental Health Board for collaborative action planning. Further breakdown of responses that are team and role-specific will help address locational and job-specific burdens, fostering closer engagement between the Trust and staff to mitigate attrition and ensure a sustainable model of care for the future.

People with severe mental illness (SMI) experience disproportionate cardiometabolicmorbidity and mortality. Antipsychotic medication contributes to metabolic risk, necessitating systematic monitoring and early intervention.

Aim: was to evaluate compliance with national metabolic monitoring standards and the local WISE framework for patients prescribed antipsychotics within an inpatient rehabilitation service.

A retrospective audit was conducted on 30 inpatients admitted between 16 May 2024 and 5 August 2025. Data were extracted from electronic records, laboratory systems, and a structured audit dataset. Outcomes included weight change, completion of metabolic monitoring, and documentation of interventions.

At admission, 76.7% were overweight/obese. Clinically significant weight gain (≥5%) occurred in 36.7% of patients. MUST screening occurred in 76.7% of cases, but only 16.7% had care plans referencing weight, and 3.3% had discharge summaries documenting weight-related plans. Metformin use was documented in 26.7% of cases with complete data.

Weight gain during admission was common, and documentation of interventions was limited. Strengthened monitoring templates, structured care plans, and clearer escalation pathways may improve adherence to national standards and continuity of care. MUST ≠ weight-gain surveillance: it scores BMI, unintentional weight LOSS and acute disease. For antipsychotic WEIGHT GAIN, use WISE + SMI checks (baseline, weeks 4/8/12, then quarterly; annual labs) with early intervention.

Attention Deficit Hyperactivity Disorder (ADHD) commonly co-occurs with psychotic disorders. First-line treatment for ADHD involves stimulant medications, which increase dopaminergic transmission and may exacerbate psychotic symptoms in vulnerable individuals. Patients within Early Intervention in Psychosis (EIP) services who are prescribed stimulant medication therefore represent a potential prescribing safety risk, particularly when antipsychotics are co-prescribed.

Aims were to assess documentation of stimulant-associated psychosis risk and monitoring practices in patients with comorbid ADHD and psychosis within an EIP service, and to identify areas for quality improvement.

A retrospective cross-sectional review of electronic patient records was conducted for all patients under the North Kent EIP service. Patients with at least one episode of psychosis and a formal diagnosis of ADHD were identified. Data collected included ADHD and psychosis diagnoses, prescribed stimulant and antipsychotic medications, documentation of stimulant-related psychosis risk within risk assessments, evidence of monitoring plans, and records of stimulant discontinuation or medication review due to psychotic symptoms.

Of 152 patients under the EIP caseload, 16 (10.5%) had a confirmed diagnosis of ADHD. Four patients were prescribed stimulant medication, two of whom were concurrently prescribed antipsychotic medication. No risk assessments documented the potential for stimulant-associated psychosis exacerbation, and none included a specific monitoring plan addressing this risk. ADHD was referenced as a comorbidity in 75% of risk assessments. No cases of documented stimulant discontinuation due to psychosis were identified.

Although ADHD was frequently recognised as a relevant comorbidity, risk assessments did not address the potential for stimulant-associated psychosis exacerbation or include monitoring plans. This represents a gap in prescribing safety within EIP services. A targeted educational intervention has been developed to improve staff awareness and documentation so that improvements can be made in the safety of prescribing amongst this underrepresented group.

Psycho education is a vital component of holistic and effective care within Child and Adolescent Mental Health Services (CAMHS). High-quality, accessible information enables young people and their families to better understand their mental health conditions and recommended treatments. This helps engagement, informed decision-making, improve clinical outcomes and patient safety. However, services face challenges in delivering consistent psychoeducation due to variability in available resources and clinician awareness. This Quality Improvement Project aimed to assess clinicians’ awareness, confidence, and use of psychoeducation resources within CAMHS in BCHFT and to develop a centralised system to support high-quality psychoeducation across the Trust.

This project was developed using the PDSA quality-improvement framework. An anonymous self-report survey was distributed to clinicians across the four boroughs, consisting of 14 items: 11 Likert-scale questions and 3 open-ended prompts. The survey examined clinicians’ awareness of psychoeducation resources, confidence in delivering psychoeducation, frequency of use, and familiarity with local materials such as websites, books, apps, leaflets, workshops, and skills groups. Clinicians were also invited to propose ways to improve psychoeducation provision to guide us in the development of a centralised resource for each borough.

A total of 32 clinician responses were analysed. Most respondents (96%) recognisedthe importance of psychoeducation for recovery and relapse prevention, and 90.5% reported routinely offering it in consultations. However, notable knowledge gaps emerged: 37% were unaware or strongly unaware of the Trust’s Service Directory, and 25.5% were neutral or unaware of existing CAMHS psychoeducation workshops. Although 85% felt confident delivering psychoeducation, only 62% were satisfied with current provision. Verbal explanation and website signposting were used most frequently, followed by leaflets. Clinicians recommended improving access to resources through printed materials, shared drives, and Microsoft SharePoint, as well as increasing availability in waiting areas. Additional suggestions included materials on parental mental health, coping strategies, condition summaries, staff training, and a parent portal.

The survey highlighted a wide range of psychoeducation resources used across CAMHS but revealed inconsistent awareness, with more experienced clinicians accessing a broader selection. These findings highlighted the need for a centralised approach to share resources. In response, a resource booklet has been developed for each locality and will be circulated to all clinicians, with plans for regular review. This project aims to strengthen clinician confidence, improve service quality, and enhance the wellbeing and safety of children and families accessing CAMHS.

Patients assessed by liaison psychiatry frequently have mental health conditions or are prescribed medications that may impair fitness to drive. General Medical Council (GMC) and Driver and Vehicle Licensing Agency (DVLA) guidance require clinicians to assess driving status, provide appropriate advice, and document this clearly. Local observations suggested that this aspect of assessment was frequently omitted, posing patient safety and medico-legal risks.

Aims were to improve the identification, documentation, and communication of driving status and DVLA advice in liaison psychiatry assessments within an acute hospital setting.

A baseline audit of 20 consecutive liaison psychiatry assessments was conducted to assess documentation of driving status and DVLA advice when indicated. A series of Plan–Do–Study–Act (PDSA) cycles were implemented. Interventions included the addition of a “Driving Status and DVLA Advice” prompt to the assessment template, regular verbal and email reminders to the multidisciplinary team, sharing real-case learning points, and displaying visual prompts within the team office. Weekly re-audits were undertaken to assess change over time.

At baseline, driving status was documented in 5% of assessments, and no patients received documented DVLA advice when indicated. Following sequential PDSA cycles, documentation of driving status improved progressively to 50% by week three. Provision of DVLA advice also increased, reaching 13.6% of assessments by week three. Improvements were most marked following repeated reinforcement strategies alongside system-level prompts. Persistent gaps were identified in consistently providing DVLA advice once drivingstatus was confirmed.

Simple, low-cost system and behavioural interventions led to meaningful improvements in documenting driving status and DVLA advice in liaison psychiatry assessments. Sustained improvement required repeated reinforcement and team engagement. Embedding prompts into assessment templates and incorporating DVLA guidance into staff induction are key to long-term sustainability.

An Emergency Detention Certificate (EDC) can be issued by any registered medical practitioner in Scotland. An EDC authorises detention of a person with a likely mental disorder in hospital for up to 72 hours. The granting of an EDC poses significant restrictions on a patient’s liberty and rights. It is therefore crucial that the completion of EDCs meet both sufficient clinical and legal requirements.

The aim of this quality improvement project is to systematically evaluate EDCs issued across 2 sites in NHS Lanarkshire over a defined time period to identify any areas for improvement. Ultimately, we aim to improve compliance with completion of EDCs in line with the principles of the Mental Health Act.

EDCs across NHS Lanarkshire in a 6-month period were obtained. A standardised scoring system was devised to evaluate each EDC against a minimum criteria. The standardised scoring system utilised by the three reviewers generated a total score of 28, with a higher score reflecting a higher quality of EDC completion.

Data regarding the practitioner who completed the EDC and if Mental Health Officer consent was sought was also obtained.

A total of 125 EDCs were identified. 8 EDCs utilised the incorrect form and so were excluded. 117 EDCs were reviewed. We found a range of scores from 16 to 28. The average score was 23.

EDCs were completed by doctors from a range of settings. 51.3% of EDCs were completed by psychiatry resident doctors or psychiatry consultants, 11.1% by GPs and 37.6% by resident doctors in medical wards. The average score for EDCs completed by doctors working in psychiatry was higher at 24.2. EDCs completed by doctors working in medical wards and by GPs scored 22.1 and 20.2 respectively. 35% of EDCs completed had MHO consent. Of the EDCs that had MHO consent, 53.6% EDCs were placed by doctors working in psychiatry.

Completion of EDCs remains suboptimal and there is still work to be done in improving the quality of EDC completion. EDCs are generally completed to a higher standard by doctors working in psychiatry which may be due to a range of factors includingteaching on EDC completion and regular informal feedback. MHO consenting to the granting of an EDC continues to remain low at 35%.

This quality improvement project highlights the need for teaching and education tools as anintervention to improve the standard of completion of EDCs.

1. To synthesize fragmented evidence: The study seeks to bring together diverse research from community, hospital, and caregiver-focused studies to create a unified understanding of schizophrenia in Africa.

2. To guide clinical practice and service delivery: The study aims to provide evidence-based insights that help develop culturally appropriate healthcare and support services.

3. To evaluate research methodology and design: The review aims to examine how studies are conducted, focusing on study designs, diagnostic criteria (such as ICD–10 or DSM), and analytical approaches used across the continent.

4. To identify gaps in current literature: The study aims to highlight areas where evidence is lacking–specifically regarding interventional studies, caregiver burden, and long-term psychosocial outcomes.

5. To inform international policy and practice: The study aims to draw lessons for global mental health strategies, including care for African diaspora communities in high-income settings such as the UK.

We conducted a systematic review of observational and interventional studies on schizophrenia in Africa. Searches covered PubMed, Embase, PsycINFO, African Journals Online, and Web of Science (terms: “schizophrenia” AND “Africa” with no language restrictions). All studies provided were included, and overlapping cohorts were explicitly flagged but retained. Data were extracted using standardized tables aligned with PRISMA and MMAT-compatible reporting. Extracted variables included study design, setting, population characteristics, diagnostic criteria, data collection, and analytical approach.

A total of 24 studies (1987–2025) from East, West, Southern, and North Africa were included. Study designs comprised longitudinal cohorts (n=5), cross-sectional surveys (n=14), mixed-methods studies (n=1), and randomized or dyadic trials (n=4). Diagnosticapproaches varied, most commonly CIDI/SCAN, ICD–10, or DSM criteria. Community-based cohorts were concentrated in Ethiopia, while hospital-based studies dominated West and Southern Africa. Evidence on caregiver burden and psychosocial interventions is emerging but remains limited in scale and duration. Interventional studies are few, with small sample sizes and heterogeneity in outcome measures.

The African schizophrenia literature demonstrates robust observational foundations but limited interventional and caregiver-inclusive evidence. Heterogeneity in diagnostic and outcome measures constrains comparability. To improve clinical care, research should prioritize standardized assessments, scalable psychosocial interventions, and caregiver-inclusive approaches embedded in routine services. Future efforts should collaborate with African-led initiatives and integrate findings into WHO guidelines to enhance equitable schizophrenia care worldwide.

Improve identification of patients with restricted eating, standardise the assessment and weight monitoring of patients with restricted eating and improve monitoring for at-risk young people.

This project followed a Plan–Do–Study–Act cycle. The Reading West CAMHScommunity patient list was analysed to gain a baseline measurement of:

• The consistency in identification of patients with restricted eating.

• The effectiveness of weight monitoring being undertaken for the patients on the team caseload.

An anonymous survey was sent to the multidisciplinary team to analyse perceived barriers to identifying patients with restricted eating and gather perspectives.

A focus group was organised involving clinical psychology, psychotherapy and medical teams to examine these barriers and to generate potential interventions.

Based on these findings, changes were implemented in the team, with the intention to expand to other localities if shown to be effective.

Interventions:

• Development of a standardised protocol for documenting weight.

• Addition of screening questions for restricted eating to the proforma for initial assessments of young people.

• Education for the MDT on the risks associated with restricted eating and the importance of early identification and consistent monitoring.

These interventions were disseminated across the team using established channels.

Of the 49 patients on the treatment list, 19 (39%) had documented evidence of restricted eating. Of these, 7 (37%) had adequate weight monitoring and documentation.

Reviews of the notes of these patients found that weight was not always documented, and if it was it was not in a standardised format.

Survey responses highlighted recurring themes including a lack of training and confidence in identifying restricted eating, concerns about the impact of monitoring on therapeutic relationships and the absence of a local protocol. Additional concerns were raised regarding escalation pathways and clinical responsibility.

The preliminary findings indicate that patients with restricted eating make a significant proportion of the caseload, however monitoring of these patients and documentation is not standardised. This indicates missed opportunities to identify and monitor these at-risk patients.

Several barriers to the identification and efficient weight monitoring of at-risk patients were found. These included staff training and confidence and poor standardisation of practice.

We anticipate improved consistency in weight monitoring and identification of high-risk patients with the implemented changes. Repeat analysis will be needed to confirm the post-intervention effect.

Further work will include the development of robust monitoring protocols, establishment of clear escalation pathways and implementation of defined clinical responses for young people identified as high risk.

A clear and well-timed induction is important in helping resident doctors work safely and confidently in mental health services. Psychiatry presents specific challenges, including the use of legal frameworks, managing risk, and working within multidisciplinary teams. Feedback from doctors starting in the Trust suggested that the induction programme was variable and that some felt unprepared when beginning clinical work.

This Quality Improvement project aimed to review the current induction programme, identify gaps that affect clinical readiness and patient safety, and support improvements in how the induction is structured and delivered.

A mixed-methods survey was sent to resident doctors who had completed the Trust induction programme within the previous 12 months. The survey included rating-scale questions on coverage, usefulness, and preparedness, alongside open-ended questions about individual experiences. Quantitative responses were summarised using simple descriptive measures, and free-text responses were reviewed to identify common themes. The project followed a Plan–Do–Study–Act approach. As this work was carried out as a Quality Improvement project, formal ethical approval was not required.

Eight out of ten resident doctors across different training grades responded. Mostfelt that the induction helped them understand their role within psychiatry, but fewer felt prepared for on-call duties and seclusion reviews. Practical sessions, such as IT access, prescribing systems training, Mental Health Act teaching, and breakaway training, were viewed positively, especially when delivered early and in person. Several key areas, including discharge summaries, ward rounds, and educational meetings, were reported as not covered for some doctors. Common concerns included induction sessions being spread over several weeks, limited protected time, and starting clinical duties before completing essential systems training. These factors reduced attendance and confidence. Most respondents felt that online or recorded learning materials would support learning alongside face-to-face teaching.

The induction programme contains important psychiatry-specific content but is less effective due to delays, poor sequencing, and lack of protected time. A shorter, more focused induction period, completion of essential training before clinical duties begin, and a blended approach to teaching may improve preparedness and support safer patient care. These findings will inform a revised induction programme and a further PDSA cycle.

Carers are important stakeholders in the recovery journey of patients admitted to inpatient psychiatry units. Often carers report not being involved in the admission journey and recovery process of those they care for. This sometimes leads to bad outcomes for patients and complaints from carers. On Keats ward, Meadowbrook Unit – an adult female inpatient acute psychiatric unit, we had multiple incidents of career dissatisfaction and complaints which birthed the idea of this quality improvement project. A baseline audit in October 2024 showed a general poor performance at key stages of carers’ engagement during the admission process. The aim of this project was to develop, test and implement a uniform tool to facilitate, capture and document carers engagement during different stages of the patient’s journey.

Prior to onset of the project, the project team met repeatedly to identify thematic areas where career engagement could be improved. Ten key areas were initially identified.These ten key areas were presented to patient groups and carer representatives in focused group discussions. From these discussions, the thematic areas were reduced to five key areas from which we formed our audit tool. The project team working with senior leadership and ward staff, developed and implemented a standardised Carer Contact Form as a tool to collect, document and facilitate carer engagement during a patient’s admission. Implementation took place over several PDSA cycles between November 2024 and July 2025, supported by regular re-audits, staff training and competency assessments for nursing assistants.

Re-audit results after the first nine months of implementation showed marked improvements in all domains including: carer notified of admission (30% to 87%), adocumented carer care plan (50% to 60%), obtaining collateral information from carer (30% to 87%), and notifying carers of patient discharge (40% to 80%). Nursing assistant staff were trained to use the carer contact form and staff reported greater confidence in engaging with carers and there were fewer complaints from families.

We found that the carer’s contact form was a simple and effective tool in improving carer’s engagement during the admission process on the ward. Carers’ engagement improved massively across all the indicators. Ward staff reported generally that it supported them greatly and improved their confidence in engaging with carers. A downside we worried about was creating more paperwork for staff; however, staff generally found it more helpful than problematic. We have received fewer complaints from carers and relatives about not being involved in admissions and discharges, and other wards within the unit have adopted and implemented this tool.