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A nationwide mapping of services for high users of emergency departments in England: observational study. 英国急诊部门高用户服务的全国地图：观察性研究。
IF 2
BJPsych Bulletin Pub Date : 2026-06-16 DOI: 10.1192/bjb.2026.10251
Sonia Saraiva, William Lee, Kate Welsh, Christina M van der Feltz-Cornelis, Gerlinde Pilkington, Steven Ariss, Stephanie de-la-Haye, Chris Burton, Suzanne Mason, Else Guthrie
{"title":"A nationwide mapping of services for high users of emergency departments in England: observational study.","authors":"Sonia Saraiva, William Lee, Kate Welsh, Christina M van der Feltz-Cornelis, Gerlinde Pilkington, Steven Ariss, Stephanie de-la-Haye, Chris Burton, Suzanne Mason, Else Guthrie","doi":"10.1192/bjb.2026.10251","DOIUrl":"https://doi.org/10.1192/bjb.2026.10251","url":null,"abstract":"<p><strong>Aims and method: </strong>Services for people who are high users of emergency departments (EDs) have developed in a piecemeal fashion, including those embedded within liaison mental health services, over the past decade. We conducted a national survey of all 171 National Health Service hospitals in England with an ED to identify high user services, alongside 20 interviews from exemplar services to characterise the interventions offered.</p><p><strong>Results: </strong>We had a 100% response rate. Of the 171 hospitals, 76 (44%) had a high user service in the ED without designated staff and 71 (42%) offered services with some designated staff time; 10 (6%) had community services, either separate or with hospital outreach; and 14 (8%) had no service. Interviews revealed great variability among services on most parameters, including staffing levels, entry criteria, case-load and types of intervention.</p><p><strong>Clinical implications: </strong>There is a need for clarity on entry criteria, case-load and types of intervention, to improve consistency and effectiveness of these services to guide decision-making.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-7"},"PeriodicalIF":2.0,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Electroconvulsive treatment for schizophrenia: decade of national Scottish data. 精神分裂症的电休克治疗：苏格兰国家十年数据。
IF 2
BJPsych Bulletin Pub Date : 2026-06-11 DOI: 10.1192/bjb.2026.10256
David M Semple, Szabolcs Suveges, J Douglas Steele
{"title":"Electroconvulsive treatment for schizophrenia: decade of national Scottish data.","authors":"David M Semple, Szabolcs Suveges, J Douglas Steele","doi":"10.1192/bjb.2026.10256","DOIUrl":"https://doi.org/10.1192/bjb.2026.10256","url":null,"abstract":"<p><strong>Aims and method: </strong>To evaluate the real-world effectiveness of electroconvulsive therapy (ECT) in schizophrenia and schizoaffective disorder, and to identify clinical predictors of response. We conducted a naturalistic study using routinely collected data from the Scottish ECT Accreditation Network between 2009 and 2018. Individuals with schizophrenia or schizoaffective disorder who had complete pre- and post-treatment Clinical Global Impression ratings were included. Clinical improvement and associations with demographic and clinical variables were examined.</p><p><strong>Results: </strong>A total of 153 patients were included (94 with schizophrenia, 59 with schizoaffective disorder). Overall, 86% showed clinical improvement following ECT. Marked improvement ('much' or 'very much improved') was observed in 65% of patients with schizophrenia and in 78% with schizoaffective disorder. In schizophrenia, younger age, greater baseline depressive symptoms and receipt of emergency treatment were associated with higher likelihood of improvement.</p><p><strong>Clinical implications: </strong>These findings indicate robust effectiveness of ECT for schizophrenia and schizoaffective disorder in routine National Health Service practice and highlight clinically relevant predictors of response, suggesting that current guideline positions may warrant re-evaluation.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-9"},"PeriodicalIF":2.0,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Towards a feminist psychiatry. 走向女性主义精神病学。
IF 2
BJPsych Bulletin Pub Date : 2026-06-11 DOI: 10.1192/bjb.2026.10259
Linda Gask
{"title":"Towards a feminist psychiatry.","authors":"Linda Gask","doi":"10.1192/bjb.2026.10259","DOIUrl":"https://doi.org/10.1192/bjb.2026.10259","url":null,"abstract":"<p><p>What can we learn from the principles of feminism that might improve care for our patients - of any gender? How can psychiatry address its historically difficult relationship with women, and what can we, as mental health professionals, consider doing differently in our everyday work? We discuss what psychiatrists might learn from the work of feminist theorists, and what we can do as a profession to create a feminist psychiatry. This includes acknowledging and owning our troubled history, pressing for gender-sensitive mental healthcare, promoting trauma-informed care that is focused on the importance of developing collaborative therapeutic relationships and improving our ability to listen.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-4"},"PeriodicalIF":2.0,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Critical psychiatry in the UK: potentially useful but in need of regeneration. 英国的批判精神病学：可能有用，但需要再生。
IF 2
BJPsych Bulletin Pub Date : 2026-06-11 DOI: 10.1192/bjb.2026.10260
Ahmed Samei Huda
{"title":"Critical psychiatry in the UK: potentially useful but in need of regeneration.","authors":"Ahmed Samei Huda","doi":"10.1192/bjb.2026.10260","DOIUrl":"https://doi.org/10.1192/bjb.2026.10260","url":null,"abstract":"<p><p>Medical decision-making involves choosing from diverse - even oppositional - viewpoints to guide patient care. Critical psychiatry aims to improve psychiatric practice by providing alternative viewpoints on several topics: interrogating psychiatric concepts (for example, 'mental disorder'); flattening power differentials between professionals and patients; highlighting misuse of psychiatric authority; increased focus on social factors; scepticism about biological emphasis in psychiatry; using natural science methodologies and the 'medical model' in mental health; and critiquing the psychiatric evidence base, such as the effectiveness of medication and concern over pharmaceutical company influence. Critical psychiatry has helped identify and raise awareness about treatment-related adverse effects. Among concerns regarding current critical psychiatry are a reluctance to reconsider its positions when many of them are contradicted by the evidence, and promotion of views that can be used to justify reductions in services and welfare benefits for patients. Changes in leadership within critical psychiatry may help address these issues.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-5"},"PeriodicalIF":2.0,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
People experiencing homelessness referred to general adult psychiatry teams in Dublin, Ireland. 无家可归的人被转到爱尔兰都柏林的普通成人精神病学小组。
IF 2
BJPsych Bulletin Pub Date : 2026-06-05 DOI: 10.1192/bjb.2026.10238
Margaret Gallagher, Jo-Hanna Ivers
{"title":"People experiencing homelessness referred to general adult psychiatry teams in Dublin, Ireland.","authors":"Margaret Gallagher, Jo-Hanna Ivers","doi":"10.1192/bjb.2026.10238","DOIUrl":"https://doi.org/10.1192/bjb.2026.10238","url":null,"abstract":"<p><strong>Aims and method: </strong>This study aimed to explore the demand for mental health services among people experiencing homelessness in multiple settings. Participants included all persons referred to nine community mental health teams (CMHTs), three in-patient psychiatric units and one emergency department in Dublin, Ireland, over 1 year (1 July 2022 to 30 June 2023). Key aspects of service provision were examined, including population characteristics, relevant history, referral outcomes and alternative care pathways.</p><p><strong>Results: </strong>There were 401 referrals to all services in the study period, the majority males. Half of those admitted acutely and one-quarter of out-patient referrals had a diagnosis of a psychotic illness. There were high rates of comorbid substance and alcohol use in presentations across all settings.</p><p><strong>Clinical implications: </strong>High rates of mental illness and comorbid vulnerabilities were found. Appropriately addressing the needs of this population will require increased resourcing of CMHTs, as well as the provision of assertive outreach.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-7"},"PeriodicalIF":2.0,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148161551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
When alarms are ignored: clinical reflections on ignorance culture in eating disorder care. 当警报被忽视：对饮食失调护理中无知文化的临床反思。
IF 2
BJPsych Bulletin Pub Date : 2026-06-01 DOI: 10.1192/bjb.2026.10257
Anita Federici
{"title":"When alarms are ignored: clinical reflections on ignorance culture in eating disorder care.","authors":"Anita Federici","doi":"10.1192/bjb.2026.10257","DOIUrl":"https://doi.org/10.1192/bjb.2026.10257","url":null,"abstract":"<p><p>In his analysis of 'ignorance culture' in eating disorder services, Downs describes how repeated alarms raised by patients, carers and clinicians are routinely ignored, deflected or reframed as individual pathology. In this Opinion piece, I reflect on the clinical implications of that analysis, arguing that ignorance culture is enacted through everyday treatment structures that misread multi-layered presentations, invalidate advocacy and displace responsibility. Drawing on dialectical theory and biosocial frameworks, and using multidiagnostic eating disorder-dialectical behaviour therapy as an illustrative example, I suggest that addressing ignorance culture requires treatment models that operationalise responsibility rather than merely espouse it.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-3"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
John Bowlby - author of Maternal Care and Mental Health (1951) but probably not the author of Child Care and the Growth of Love (1953). 约翰·鲍尔比——《产妇护理和心理健康》（1951年）的作者，但可能不是《儿童护理和爱的成长》（1953年）的作者。
IF 2
BJPsych Bulletin Pub Date : 2026-05-22 DOI: 10.1192/bjb.2026.10253
Julia Mannes, Robbie Duschinsky
{"title":"John Bowlby - author of <i>Maternal Care and Mental Health</i> (1951) but probably not the author of <i>Child Care and the Growth of Love</i> (1953).","authors":"Julia Mannes, Robbie Duschinsky","doi":"10.1192/bjb.2026.10253","DOIUrl":"https://doi.org/10.1192/bjb.2026.10253","url":null,"abstract":"<p><p>Bowlby's <i>Maternal Care and Mental Health</i> and its abridgement <i>Child Care and the Growth of Love</i> present two claims. The first (MCMH1) holds that children develop better mental health when they experience care from at least one familiar caregiver. The second (MCMH2) states that a child's development and well-being depend on their mother's constant presence and attention. Archival material suggests that the popular abridgement was written by Margery Fry rather than Bowlby, based on an interpretation of <i>Maternal Care and Mental Health</i> supporting MCMH2 and incorporating extracts supporting this conclusion. This may have contributed to enduring misconceptions about Bowlby's theoretical position.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-3"},"PeriodicalIF":2.0,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147986462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The real face of kindness in mental health: what it is and what it isn't. 心理健康中善良的真实面目：它是什么，它不是什么。
IF 2
BJPsych Bulletin Pub Date : 2026-05-11 DOI: 10.1192/bjb.2026.10244
David Francis Hunt
{"title":"The real face of kindness in mental health: what it is and what it isn't.","authors":"David Francis Hunt","doi":"10.1192/bjb.2026.10244","DOIUrl":"https://doi.org/10.1192/bjb.2026.10244","url":null,"abstract":"<p><p>Kindness is often championed in mental healthcare but is too easily reduced to niceness or rhetoric. Drawing on my experience of research working alongside mental healthcare teams, I argue for intelligent kindness grounded in relational, courageous, boundaried and systemic practice that seeks what is ultimately good for patients and protects staff, even if it is not immediately apparent. Misapplied kindness risks burnout, moral injury and stalled recovery, whereas intelligent kindness protects staff integrity and patient dignity. Importantly, it must be structurally enabled across clinical, organisational and policy levels. Intelligent kindness is a fundamental requirement for humane mental healthcare.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-3"},"PeriodicalIF":2.0,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147866542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cognitive analytic therapy in child and adolescent mental health services: systematic scoping review of evidence. 儿童和青少年心理健康服务中的认知分析疗法：证据的系统范围评价。
IF 2
BJPsych Bulletin Pub Date : 2026-05-05 DOI: 10.1192/bjb.2026.10218
Emma Salter, Matthew Carr, Frank Reakes, Scott Ankrett
{"title":"Cognitive analytic therapy in child and adolescent mental health services: systematic scoping review of evidence.","authors":"Emma Salter, Matthew Carr, Frank Reakes, Scott Ankrett","doi":"10.1192/bjb.2026.10218","DOIUrl":"https://doi.org/10.1192/bjb.2026.10218","url":null,"abstract":"<p><strong>Aims and method: </strong>Cognitive analytic therapy (CAT) is a relational, time-limited psychotherapy primarily evidenced to support adults with emotional and relational difficulties. The extent of evidence for CAT in younger populations is not known. This paper aimed to collate all published articles describing CAT with under-18-year-olds and establish feasibility and effectiveness of CAT in this population. An initial systematic search was conducted in MEDLINE, PsycINFO and CINAHL databases, with a second search using key terms and author names in the Association for Cognitive Analytic Therapy website bibliography.</p><p><strong>Results: </strong>Thirty-seven articles were found to meet the inclusion criteria, 11 of which contained quantitative studies. Articles described CAT as individual therapy for young people or their parents, group therapy and consultation frameworks for staff and parents.</p><p><strong>Clinical implications: </strong>The limited evidence published on CAT in under-18-year-olds suggests that it is feasible and accessible. Further randomised controlled studies and publication of practice-based outcomes are required.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-17"},"PeriodicalIF":2.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Restrictive intake self-harm in NHS settings: understanding relational dynamics and iatrogenic risk. 在NHS设置限制性摄入自我伤害：了解关系动力学和医源性风险。
IF 2
BJPsych Bulletin Pub Date : 2026-05-05 DOI: 10.1192/bjb.2026.10242
Susan G Simpson, Kirsty Gillings
{"title":"Restrictive intake self-harm in NHS settings: understanding relational dynamics and iatrogenic risk.","authors":"Susan G Simpson, Kirsty Gillings","doi":"10.1192/bjb.2026.10242","DOIUrl":"https://doi.org/10.1192/bjb.2026.10242","url":null,"abstract":"<p><p>Restrictive intake self-harm (RISH) describes a pattern of severe food and fluid restriction whose functions emerge primarily for reasons other than weight or shape psychopathology. RISH exhibits a distinct phenomenology from anorexia nervosa, rooted in conditional caregiving, attachment disruption and maladaptive internal working models that inhibit direct help-seeking. This paper draws on attachment theory and evidence on the functions of eating-disordered behaviour to argue that three relational configurations (boundary confusion, subjugation of needs and escalating distress signalling) create vulnerability to RISH and shape how individuals use restriction within relational contexts. It further proposes that risk-driven thresholds, hospital admissions and crisis-responsive models that characterise NHS care delivery may inadvertently reinforce these dynamics by validating the belief that suffering is required to access care. Highly restrictive and directive treatment plans for those with RISH can result in the escalation of dietary restriction, trauma and clinical deterioration. Medicalisation of care can also inadvertently reinforce care-seeking behaviour through restriction. A relational framework is therefore essential for understanding RISH, providing interventions that minimise iatrogenic harm and offering relational experiences in which needs can be expressed and met without bodily deterioration.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-4"},"PeriodicalIF":2.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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