An exploration of the experience of mental health service users when they decide they would like to change or withdraw from prescribed medications.

This paper reports on a collaborative research project initiated by service user representatives and led by clinicians from the mental health service in Derbyshire. The study explored the experiences of mental health service users when they either changed or terminated their use of mental health-related medications. Three focus groups were conducted with mental health service users from across the county. An inductive thematic analysis identified six key themes, three of which are reported here: the 'two faces' of service provision, describing the positive and negative experiences of services; the general practice/mental health divide, relating to the lack of continuity between the two services; and becoming an informed service user, where participants discussed the importance of seeking information. It is important that mental health professionals always consider presenting their 'best face' to service users, and facilitate the prescribing process with general practitioners. The findings also highlight the potential for supporting service users in using different sources of information to become more informed about medication.

Management of burned long bones.

The management of severely burned and exposed supportive osseous tissues is not fully standardized. We present two patients in whom extensive debridement and decortication of the involved bone may have contributed to subsequent stress fractures. We propose an alternative therapeutic approach for this problem, including: minimal debridement of the bone, early coverage of the exposed bone with vascularized muscle, and adequate prophylactic protection.