Data are lacking about the prevalence of psychiatric disorders and suicidal behaviour in incarcerated adolescents in Asia. This cross-sectional study evaluated the prevalence of psychiatric disorders and the prediction of suicidal attempts in 100 incarcerated males aged 12-19 years in Shiraz. Data were collected in face-to-face interview using the Kiddie Schedule for Affective Disorders and Schizophrenia (Farsi version). The mean age was 16.8 (SD 1.3) years and mean age at first imprisonment was 16.0 (SD 1.5) years. Nearly 70% of the adolescents had at least one current psychiatric disorder, the commonest being: conduct disorder (55%), oppositional defiant disorder (48%) and attention deficit hyperactivity disorder (33%); 11% had major depressive disorder and 2% schizophrenia. In all, 20% had self-harmed without intent to kill themselves and 12% had attempted suicide, 50% of whom had tried more than once. In logistic regression analysis only self-harming behaviour and major depressive disorder were significant predictors of attempted suicide.

IntroductionA history of drug and alcohol use influences various aspects of inpatient care. It is important to ascertain the history of drug and alcohol use in new admissions. This knowledge ensures the appropriate detoxification of patients. It also allows the management of various risks such as the risk of violence, of escape, of drugs being brought onto the ward and of drug use amongst other patients. It can explain the lack of therapeutic progress in patients.ObjectivesTo ascertain whether new patients admitted to an acute ward on a medium secure unit in London are being asked about their drug and alcohol usage history.AimsTo establish what proportion of 18 male inpatients on a medium secure unit have their drug and alcohol history documented in their admission notes.MethodsThe notes of all 18 patients on an acute ward in a medium secure unit were scrutinised. An audit tool was used to record whether the admission notes contained an entry about the history of drug and alcohol use.ResultsThere were 18 male patients. Four were under a section 3, four under a section 47, four under a section 48, one under a section 38, five under a section 37 of the Mental Health Act 1983. Only 5 of 18 patients had been asked about their history of drug and alcohol use on admission.ConclusionAn important part of the history is being missed in a large proportion of new male admissions to a medium secure unit.

Introduction:Child protection guidelines within a London mental health trust state that all mental health professionals should identify patients who have dependents, if so it should be established that these dependents are safe, and any concerns should be taken forward to relevant agencies.Objectives:Establish if child protection guidelines are being followed in emergency psychiatric assessments.Aims:Establish whether patients are being asked whether they have dependents, if the dependents are safe, and whether concerns are being discussed with child protection services.Methods:An audit was carried out in which documentation from 3 days of emergency assessments where examined to see whether the above questions were being asked.Results:In cycle 1, 11 out of 18 patients asked about dependents, 7 had dependents, 4 were documented as being safe, 3 raised child protection concerns, 0 taken forward.In cycle 2, 7 out of 17 patients asked about dependent, 6 had dependents, 3 documented as being safe, 0 child protection concerns were raised.

IntroductionThe forensic history is a vital part of the assessment in patients referred to forensic services. It influences decisions made about risk and the link between illness and offending behaviour. Doctors should view the police national computer, (PNC) record in all assessments of referrals.ObjectivesTo establish whether PNC records are available to doctors conducting forensic psychiatric assessments of new referrals at a medium secure unit (MSU).AimsEstablish what proportion of patients referred to a MSU in London had a PNC record present at the time the assessment report was presented to the admissions panel.MethodsThe admissions panel of a MSU in London has kept data on all assessments carried out since 2011. All of this data was reviewed to see what proportion of patients had a PNC record present at the time the assessment report was presented to the admissions panel.ResultsIn total there were 186 patients. 21 of these were women. 165 of these were men. 59% of the assessments had a PNC record present. In 19% of assessments a PNC was not requested. In 18% it was requested but not available. In 4% it was deemed not necessary.ConclusionsA PNC record was not available in 41% of forensic assessments carried out by a large forensic service in London. In 19% of these cases a PNC had not been requested. Suggested recommendations are that the PNC is requested at the time that the referral is received by the trust.