Online health information is increasingly popular and may bring both benefits and potential harm to users with mental health problems. The encouragement of harmful behaviour among this population is a particular concern. The website healthtalk.org provides the benefits of shared experience by publishing excerpts from rigorous research interviews with patients, contextualised with medical information. This article sets out evidence for the positive and negative effects of online mental health information and describes the methodology behind healthtalk.org, with an overview of the mental health information it provides and how it can benefit patients and health professionals.
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Aims and method Dialectical behaviour therapy (DBT) is associated with particularly high drop-out rates in the National Health Service (NHS). This paper seeks to investigate the characteristics of patients with borderline personality disorder dropping out from DBT and the role of care coordination in this phenomenon. Data for the 102 patients receiving DBT in east London, 58% of whom had dropped out of treatment prematurely, were analysed.Results In a multivariable analysis, a history of care coordination was the only variable significantly correlated with drop out: 88% of patients with a history of care coordination dropped out prematurely compared with 52% of patients without such history.Clinical implications The experience of comprehensive care within the care programme approach, particularly care coordination at the start of DBT, affects the retention of patients in DBT. Further qualitative research is required to understand how care coordination and DBT drop out are related, which could lead to changes in how the therapy is delivered in the UK and influence decisions regarding the use of care coordination with patients with borderline personality disorder.
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Where There is No Child Psychiatrist: A Mental Healthcare Manual. By Valsamma Eapen, Philip Graham & Shoba Srinath, RCPsych Publications, 2012, £10.00, pb, 208 pp. ISBN: 9781908020482 - Volume 37 Issue 11
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SummaryRecent concerns about the future of psychiatry have led to various calls for action. We argue that an overhaul of postgraduate training in psychiatry is the necessary first step to ensuring a strong future for the profession. Central to these improvements are reaffirming the ideals of psychiatric training, ensuring appropriate prominence of crucial knowledge and skills in the curriculum and providing tailored training placements with an emphasis on excellence. It is imperative that short-term service-provision need does not adversely have an impact on the training that is needed to ensure excellent patient care for the future. We urge the College to continue to work closely with psychiatric trainees to secure their future.
Tom Trauer, who has died aged 68, was a leading researcher in psychiatric outcome measurement and advocate for mental health service development.His 2010 book, Outcome Measurement in Mental Health: Theory and Practice, and his many peer-reviewed articles on this subject advanced the field significantly, while his work with colleagues in Australia and across the world led to numerous collaborations to improve mental health service delivery across the Asia Pacific region.As well as his major research interests in mental health outcomes and service delivery, Tom collaborated on research into the mental health of people with physical illness, transplant recipients, caregivers and patients with cancer.He was generous with his time and frequently supported junior researchers, providing patient advice and assistance with statistical analysis.His passion for education led to university lecturing, research supervision, clinical teaching and coordination of the statistics component of Melbourne University's Master of Psychological Medicine degree.His considerable output included two books and around 200 peerreviewed publications, of which he was the primary author for nearly half.After fleeing Eastern Europe to England during the Second World War, Tom's family moved to Adelaide in 1949, when Tom (born 10 November 1944 in Manchester) was 5 years old.His father repeated his medical degree to practise in Australia.Eventually settling in Melbourne, Tom attended Brighton
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Aims and method To assess the competence of psychiatry trainees in identifying major abnormalities in a 12-lead electrocardiogram (ECG). This was a three-stage prospective study. In stage 1, selected ECG traces were presented to the trainees. They were then asked to comment on any abnormalities of note on the ECG traces. In stage 2, an ECG e-book was made available to the trainees and the survey repeated. In stage 3, ECG workshop sessions were introduced in the mandatory teaching programme and the survey was repeated.Results The number of correct responses after the introduction of the workshops were significantly more when compared with correct responses in stage 2 (P = 0.0002), and stage 1 (P = 0.0091). When compared with stage 1, the correct responses in stage 2 actually showed deterioration (P = 0.0284).Clinical implications Our study not only shows that providing access to an e-book is not enough to improve these skills, it also shows that ECG refresher sessions improved the diagnostic accuracy markedly.
