In the liminal spaces of mental health law - what to do when section 136 expires?

The pressure on mental health services has not gone unremarked and is of widespread concern in England and Wales. This can have implications when a bed is being sought for a patient who has undergone a Mental Health Act assessment and is deemed to meet the criteria for being formally admitted to hospital. Once the 24 h period for assessment under section 136 of the Act has lapsed, the ongoing detention of the patient can lead to a legal grey area.

Affect recognition and the quality of mother-infant interaction: understanding parenting difficulties in mothers with schizophrenia.

This study investigated the quality of mother-infant interaction and maternal ability to recognise adult affect in three study groups consisting of mothers with a diagnosis of schizophrenia, mothers with depression and healthy controls. Sixty-four mothers were recruited from a Mother and Baby Unit and local children's centres. A 5-min mother-infant interaction was coded on a number of caregiving variables.

A trial of low doses of risperidone in the treatment of patients with first-episode schizophrenia, schizophreniform disorder, or schizoaffective disorder.

This UK multicenter, noncomparative, open-trial study assessed risperidone in 74 first-psychotic-episode patients (DSM-IV schizophrenia) treated with flexible doses. Treatment commenced at 1 mg/day, increasing to 2 mg after 3 days; then adjusted to 8 mg/day maximum. Treatment duration was 12 weeks (Phase 1) with follow-up of 62 patients to 1 year on risperidone or another antipsychotic (Phase 2).

Heavy users of acute psychiatric beds: randomized controlled trial of enhanced community management in an outer London borough.

Background: Heavy users of psychiatric services, often defined as the population that uses the most beds, consume a large part of the resources used by the whole service, despite being relatively small in number. Any intervention that reduces heavy use is therefore likely to lead to significant savings, and enhancement of standard care using a form of intensive case management akin to assertive community treatment was thought to be a pragmatic strategy for testing in this group.

Methods: The effectiveness of enhanced community management (ECM) was compared with standard care alone in heavy users, who represented the 10% of patients with the highest number of hospital admissions and occupied bed days over the previous 6.

'Do not resuscitate': How? why? and when?

Objective: The main objective was to discover who had 'Do Not Resuscitate' (DNR) status, why, how, when and by whom these decisions were made.

Design, Setting And Patients: The medical and nursing notes of all inpatients (139) (age range 16-100 years) in an inner city district general hospital on a single day were examined to determine the resuscitation status, age, sex, and diagnosis of each patient.

Result: A decision not to resuscitate had been taken in 28 (20%) of the cases.