Woody Caan

Using readmission rates as indicators of outcome in comparing psychiatric services

Patients with more than one ICD-9 diagnosis may require more admissions than do inpatients with single disorders. Rates of readmission were judged by either the number of admissions in the year following any dual diagnosis or by the interval to the next readmission (if any). Such rates were significantly higher for patients with second diagnoses of alcohol or drug dependence, compared to other dual diagnosis patients matched for a common mental health disorder or compared to patients with single diagnoses. Patients with schizophrenia were especially prone to readmission, if secondary alcohol or drug dependence was ever recorded.

Start as you mean to go on: Project management for beginners

Too many mental health projects, whether for scientific research or for service development, have delivered less than they promised because a structure to manage all the components necessary for success was not incorporated into their planning. Three contrasting models of project management are described. The PRINCE method in particular is suitable for most projects because of its adaptability and its contribution to clarifying the roles and responsibilities among collaborators throughout the lifetime of a project.

Coming together on alcohol and drugs: A capital idea

It may surprise readers outside the UK to learn that the metropolis of Greater London only gained an elected Mayor and a modest degree of local self-government during 2000. For this public health specialist working in the eastern outskirts of London, it was a most pleasant surprise to learn that one of the very first areas of London life to be addressed by the new Greater London Authority (GLA) would be the impact of alcohol and drugs on the wellbeing of its whole population. A fresh co-operation had already arisen between the new Mayor (Ken Livingstone) and the health service’s established Regional Director of Public Health (Sue Atkinson), with an innovative strategy for Health Impact Assessment. It was someone in a newly created inter-agency post (Hilary SamsonBarry) who took the initiative getting to grips with drugs, alcohol and an army of vested interests. In the Cool Britannia image of London’s tourism and leisure industries (imagining a city ‘open’ 24 hours a day, 7 days a week with a powerful emphasis on youthful hedonism) the commercial interests linked to substance use went far beyond just brewers, distillers and dealers. For local government, the key voice calling for an inter-agency approach to substance use came from the police, whose manpower was severely stretched by increased public disorder offences fuelled by alcohol and by burglary associated with heroin and cocaine habits.

The most undeserving poor

The Secretary of State for Work and Pensions, James Purnell, proposes removing payment of benefits from unemployed persons with addiction to crack cocaine and heroin.[1][1],[2][2] The proposed Green Paper[3][3] sets a remarkable precedent in terms of official, inter-agency response to that common

Pioneering, but open to prejudice

Moran et al deserve praise for their large-scale study of school-children that combines parental assessments of psychopathology with teacher assessments of emotional traits.[1][1] Opportunities for (unspecified) early intervention to prevent antisocial behaviour seem a worthy focus for community

The changing nature of happiness: an in-depth study of a town in North-West England 1938–2016

The year 2014 was a remarkable point in human history to study the Nature of Happiness. All around our World, a song called ‘Happy’ by Pharrell Williams (2014) connected with people of different cu...

Preventive psychiatry within public health

Thank you, BJPsych , for your timely editorial on population mental health.[1][1] It is a pity that the authors did not mention the strategy for England entitled No Health without Mental Health, launched in February (before their final submission) as this strategy did involve precisely the teamwork

Breaking up Blues: A Guide to Survival and Growth

[⇓][1] ![Figure][2] Scanning Amazon using ‘divorce’ yields dozens of titles – the market is well stocked. However, the author of Breaking up Blues is a British psychoanalyst whose monograph claims to be a ‘practical self-help book’. Divorce, especially splintering of families,