Purpose – The purpose of this paper is to establish gaps in training, involve staff in the implementation process by incorporating their views on what is helpful and what can be improved, as well as provide information that might be helpful to other sites who are considering implementing the START:AV. Design/methodology/approach – The current study is the first to examine a START:AV implementation and survey a multi-disciplinary team on their views about implementation in a medium secure service for adolescents in the UK. The survey was adapted from the one used by Collins et al. (2008). Once surveys were received the qualitative information was collated to explore themes, and frequency analysis was undertaken on the quantitative information. Findings – The staff survey on the implementation of the START:AV highlighted a number of strengths and challenges. There was significant support for the START:AV in relation to it being a dynamic assessment to measure change, that focuses equally on strengths and vulnerabilities, making the process individualised. Users of the START:AV reported that the process of rating the START:AV as a team improved communication, teamwork, generated discussion and improved the detailed understanding of the patient being rated. Staff felt it was generally straightforward to use in terms of strengths and vulnerability ratings, but some difficulties emerged regarding making finer distinctions in ratings as well as completing risk formulations, highlighting further training needs. There was also some confusion about differentiating between certain strengths and vulnerabilities, leading to “double ratings”. Other difficulties highlighted centred on time and increasing workload. Research limitations/implications – The main limitation of the study relates to the low response rate to the survey (31 per cent). Practical implications – Recommendations for implementation and evaluation of new risk assessment procedures are made. Originality/value – The current study is the first to examine a START:AV implementation and survey a multi-disciplinary team on their views about implementation in a medium secure service for adolescents in the UK.

Purpose The purpose of this paper is to explore the validity and reliability of the Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV) to determine if it has predictive accuracy in relation to physical aggression, severe verbal aggression, property damage and self-harm, in a medium secure setting. In addition, the authors hoped to provide some of the first descriptive data available for the START:AV among a UK adolescent population in a medium secure adolescent unit. Design/methodology/approach The sample consisted of 90 female and male adolescents, with and without developmental disabilities. It was important to explore the measure’s predictive accuracy across specific population groups, such as between males and females, as well as those with developmental disabilities, and those without. Findings Some significant relationships were found between the START:AV and adverse outcomes. For instance, total strength and vulnerability scores were predictive for verbal and physical aggression. Differences in predictive validity were evident when comparisons were made between males and females, with relationships being evident amongst the male population only. When splitting the male sample into developmental disability and non-developmental disability groups, significant relationships were found between strength and vulnerability scores and verbal and physical aggression. Practical implications A number of practical implications are considered, such as the START:AV is relevant for use with adolescents in hospital settings and the significant inverse relationship between strength scores and negative outcomes supports the importance of considering protective/strength factors when working with at risk youths. Originality/value There is currently limited validation data for the START:AV in the UK or elsewhere.

Aims and methodThe level of reading ability required to understand written information about key mental health issues designed for service users is examined. Information was taken from four reputable internet sources and analysed for readability. The relevant literature in relation to psychiatric patients and literacy is reviewed and potential solutions are proposed.ResultsA considerable proportion of the available information has a reading age at or above 14 years. Some organisations appear better than others in providing information at a more appropriate level of reading ability.Clinical implicationsWritten information aimed at users of psychiatric services may not take into account that they are more likely to have impaired reading ability, even though they might not have an identified intellectual disability. Professionals who develop written materials can use tools in word processing software to assist with the appropriate development of these materials. Information technology could in the future provide information directed at users of psychiatric services that does not rely so heavily on written material.

Ward climate is a key element within psychiatric settings, associated with positive clinical outcomes. The Essen Climate Evaluation Schema (EssenCES) is a ward climate measure, which is validated for use within UK forensic settings. It has been studied within neurodevelopmental psychiatric inpatient settings with mixed findings on its appropriateness, and there is a dearth of EssenCES research which has been conducted within an adolescent psychiatric inpatient setting. The present study piloted the EssenCES within an inpatient psychiatric neurodevelopmental setting for adolescents in the East of England, in order to explore its usefulness within this setting and to provide preliminary normative data for a child and adolescent mental health services inpatient learning disability population. Staff and service users from a locked ward ( N = 28) and low secure ward ( N = 31) participated in the pilot. Results are discussed in relation to the body of the literature on ward climate, including consideration of discrepancies in the results between wards and discrepancies between staff and service.