The paper presents evidence of: the validity of a new leadership instrument; the differential relationship between leadership quality and staff attitudes to work and their sense of wellbeing at work; and a predictive relationship between leadership quality and organizational performance.

Aims and method We aimed to evaluate the availability and nature of services for people affected by personality disorder in England by conducting a survey of English National Health Service (NHS) mental health trusts and independent organisations.Results In England, 84% of organisations reported having at least one dedicated personality disorder service. This represents a fivefold increase compared with a 2002 survey. However, only 55% of organisations reported that patients had equal access across localities to these dedicated services. Dedicated services commonly had good levels of service use and carer involvement, and engagement in education, research and training. However, a wider multidisciplinary team and a greater number of biopsychosocial interventions were available through generic services.Clinical implications There has been a substantial increase in service provision for people affected by personality disorder, but continued variability in the availability of services is apparent and it remains unclear whether quality of care has improved.

Some risk factors for physical health problems are present at the onset of psychosis, but these may be explained by unemployment.

The outcome of psychosis is complex but differs between UK African-Caribbeans and British Whites. This may reflect risk factors that increase the rate of psychosis in UK African-Caribbeans. Treatment differences require further investigation.