A review of studies on violence by psychiatric in-patients is presented. Violence in various settings has been studied and a few general conclusions emerge. The assailant is commonly a young schizophrenic. Only few patients are repeatedly violent. Persistently violent schizophrenics have been shown to have neurological impairments. Violence usually occurs in crowded, unstructured settings. There is no agreed definition of assaults and how they should be graded. Although violence is common it rarely leads to serious physical consequences. Victims are most often nursing staff. Some staff and patients are assaulted more often than others. Violence is difficult to predict. Ways of preventing assaultive behaviour are discussed. After considering some problems with existing studies, areas for further study are suggested.
Assessing new outpatient referrals to old age psychiatry services at home reduces non-attendance. This improves efficient use of medical time in a small geographical catchment area but may not apply to rural or larger areas.
Postgraduate psychiatric training is usually assessed by regular College visits. A number of training schemes, including the Liverpool training scheme, also scrutinise their training independently of the College. As far as we know, trainees as the ‘consumers’ of training have never assessed its quality themselves. The following account deals with two such audits in the Mersey region organised under the mantle of the Association of Liverpool Psychiatrists in Training (ALPIT).
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