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Patient risk factors for suicide are well known to psychiatrists, yet the availability of clinically useful, routine and systematic methods for risk recognition are limited. This article outlines the structured professional judgement approach to suicide risk assessment and management. This method combines psychiatric assessment and formulation with the evidence base for suicide risk factors. Structured professional judgement is contrasted with actuarial and clinical judgement approaches. A categorisation of risk factors is presented, with four groups described – static, stable, dynamic and future. Case histories illustrate long-term high risk contrasted with sudden and unpredictable onset of suicidality.

Aims and methodThis study examined the attitudes and knowledge of patients regarding their depot neuroleptic medication. All patients were attending a community mental health centre in Clydebank, Scotland.ResultsMany patients had limited knowledge of their medication, its benefits and side-effects as well as the rationale for its use. The biggest gaps were found in patients' knowledge of the long-term side-effects of their medication.Clinical implicationsOur findings raise doubts as to the capacity of some patients to give informed consent to their treatment. A number of steps are outlined in order to raise patients' standard of knowledge.

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The physical health of patients with severe mental illness is often neglected or managed poorly, and regular review of physical health is now being strongly advised. The study described here explored the feasibility of such reviews in a community mental health care setting. A small group of patients was invited to attend for blood tests and a brief physical examination. The findings from the study suggest that the monitoring of patients with severe enduring mental illness is an important but difficult task. It will require careful planning and the engagement of patients, general practitioners and community mental health teams.

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