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Purpose The purpose of this paper is to provide a commentary on the preceding article describing changing patterns in the provision and take-up of accommodation services for adults with learning disabilities in Ireland, in the context of the types of reductions in funding that have been apparent internationally for some time.Design/methodology/approach The commentary examines some of the implications and discusses some of the underlying quality of life issues implicit in the data presented. It also explores the tensions between owning one’s home and receiving specialist support and examines what supported living might enable services to achieve.Findings The paper concludes that the nature of economic policy and professional practice, alike, have implications for the quality of home life enjoyed by adults with learning disabilities; and that the interplay between them is more complex than is often allowed.Originality/value These issues are not new, but frustratingly enduring. Their fresh consideration might assist the urgent need to achieve a more coherent narrative capable of consistent application for present and future generations. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to outline the historical background and policy context of mental health services for people with intellectual disability (ID) in Ireland. It then considers recent implementation and lessons from the Irish experience.Design/methodology/approach The policy background and research literature relevant to the development of mental health services for people with ID in Ireland was reviewed and discussed.Findings Mental health services in Ireland remain in a state of change, moving towards the implementation of specialist multi-disciplinary teams in the community, alongside previous models of care and service.Research limitations/implications This paper summarises recent advances and research regarding mental health services for people with ID in Ireland.Practical implications The paper illustrates the process of delivering changes to mental health services with practical implications for mental health services internationally.Originality/value This is the first paper in many years to summarise the development of mental health services for people with ID in Ireland. There has been considerable recent change and it is therefore important to provide a useful reference for the current status of services. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to describe a small scale pilot study undertaken in Northern Ireland to gather service user feedback from individuals who have been subject to adult safeguarding procedures.Design/methodology/approach The aims, methods and findings of the “Adult Safeguarding: 10,000 Voices” pilot project are presented.Findings The pilot project highlighted how an initiative which captures the experiences of patients, service users, carers and staff in the health and social care sector (10,000 Voices) could be successfully adapted for use in adult safeguarding, facilitating the collation of complex experiences and enabling insights to be gleaned and shared.Research limitations/implications The pilot study is limited by the small number of participants. The findings are preliminary.Practical implications For the first time in Northern Ireland the 10,000 Voices model was utilised in the context of a non-health related service, namely, adult safeguarding.Social implications This outline of the model and methodology for obtaining service user feedback can inform user involvement in other contexts.Originality/value This paper provides an accessible overview of an innovative approach to engaging service users in adult safeguarding, such approaches, to date have been limited. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to evaluate the effectiveness of a stepped-care primary care psychology service through triangulating clinical outcome data, service user satisfaction ratings and feedback from referrers. Design/methodology/approach: A mixed method approach including a repeated measures design (pre- and post-clinical data on standardised psychometrics) for clinical outcomes and an online and postal survey with quantitative and qualitative elements offered to all service users and referrers to the service. Findings: In total, 125 service users completed a full intervention with the service with 56% treatment completers demonstrating a reliable reduction in the symptoms of low mood and 49.6% in anxiety. Of those within the clinical range for depression at assessment, 66.67% achieved clinical recovery following an intervention. Of those within the clinical range for an anxiety disorder at assessment, 62.03% achieved clinical recovery following an intervention. Service users reported high levels of satisfaction with the service specifying particular interpersonal qualities of the therapists and the individualisation of service provision as crucial positive factors. Referrers similarly reported high levels of overall satisfaction with the service, specifying that the speed of response to referral and length of intervention was of greatest importance to them. Practical implications: Stepped-care psychological interventions reduce psychological distress in treatment completers with mild to moderate symptoms of anxiety and low mood. The overall interpersonal experience may be of greater importance to service users in their evaluation of a service than clinical outcomes. In their relationship to a Psychology service, referrers value speed of response and ongoing feedback. Building a robust, highly valued service may require the triangulation of evidence from all key stakeholders. Originality/value: This paper provides a pragmatic template of how a rigorous evaluation of a primary care psychology service requires evidence from multiple stakeholders. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore keyworkers’ experience and perceptions working with people experiencing homelessness and the use of psychologically informed approaches in an Irish context.Design/methodology/approach In this paper a qualitative descriptive methodology was employed and face-to-face in-depth semi-structured interviews were conducted. Data collected were analysed using a thematic framework and transcribed by the researcher.Findings It was the view of the keyworkers psychological approaches allowed them greater understanding of psychological trauma and its effects promotes safe physical and emotional environments builds rapport between staff and clients and enables keyworkers to work more effectively with people with complex needs. There was also convincing evidence staff are quite receptive to training.Originality/value Given there is no research exploring the use of psychologically informed approaches in homelessness service settings, this study researched an area that has not yet been explored in Ireland. This qualitative descriptive research provides a platform from which further research can be conducted. It is hoped that highlighting the psychological issues of homeless people, the data obtained will help improve Irish homeless services, and the findings extracted beneficial in terms of future service developments, professional training and education. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to examine the barriers preventing women in prostitution from accessing co-ordinated health services in the Republic of Ireland. By examining the experiences of migrant women engaged in prostitution, the research contributes to knowledge pertaining to the psychosocial experiences of female sex workers’ access to healthcare.Design/methodology/approach The study interviewed migrant women across Ireland, using a biographical narrative approach and an adapted voice-centred relational model of analysis to determine the necessity for a health promotion strategy for this demographic.Findings The findings indicate migrant women work primarily indoors, hold precarious legal status and are in Ireland due to processes of globalisation, migration and economic necessity. The women discussed their entry into prostitution and their experiences within prostitution in the context of their psychosocial experiences.Research limitations/implications While the findings are from a small qualitative sample confined to the Republic of Ireland, it is the first study to prioritise migrant sex workers’ psychosocial experiences in Ireland.Practical implications The research concludes education and service development that respects the various social determinants impacting women in prostitution is missing but remains necessary in Ireland. It finds a gendered reform of policies using an ecological framework for health that can address issues of poverty, migration and the global trends of the sex industry.Social implications This means a national review of current services in health, social work and community development fields is timely.Originality/value This paper gives insight into the lives of migrant women involved in the sex industry and can make an important contribution to future research directions and practice in Irish and European prostitution contexts. [ABSTRACT FROM AUTHOR]

Purpose – Child participation is increasingly a global phenomenon as stated by Article 12 of the United Nations Convention on Children's Rights. This supports the first principle, Democracy, of the Health Promoting School movement. The purpose of this paper is to facilitate a three-phase participatory research process (PRP) to document the views of children about participation in school. Design/methodology/approach – A total of 248 primary school pupils aged nine to 13 years participated: the first group of pupils answered two questions on individual coloured paper; the second group categorised these data separately, by question, assigning labels for each of the categories; and the third group used the categories to develop schema. The analysis was inductive. Findings – The most common categories for what made pupils feel a part of their school were school uniforms, sports, friends, teachers and their school/classroom environment. Increase in the number of school activities, encouraging friendship and equal participation were key indicators of how pupils would ensure that everybody felt a part of the school. The findings indicate that interpersonal relationships and belonging are in the opinion of children important for taking part in school life. Originality/value – The paper illustrates children's understanding of what taking part in school means to them. The PRP encouraged pupils to have control of the three-phase research process, and demonstrated the ability of children to work together in groups while having fun at the same time. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore student experiences of learning from mental health service users and carers.Design/methodology/approach In total, 30 clinical psychology trainees and ex-trainees took part in an online survey (n=21) or focus group (n=9). Responses were analysed using interpretative thematic analysis.Findings A number of themes were identified. There were two pre-conditions of learning: valuing the teaching and emotional arousal. Participants' learning experiences were characterised by cognitive and meta-cognitive processes: active learning, reflection, increased attention and vivid memories. Furthermore, participants might have a meta-cognitive experience of having learned something, but being unsure what that something was. Participants reported learning about the lives of service users, about themselves and about the wider societal context for people with mental health difficulties.Practical implications In order to facilitate learning students should value the input of service users. This allows them to contain and use the emotional arousal the teaching produces. Furthermore, leaving students with a feeling that something has been learned but not being exactly sure what that has been may facilitate students seeking out further opportunities for service user involvement.Originality/value Few studies have explored the process of learning from mental health service users and carers. In the current study, the emotion aroused in participants was primary. Furthermore, a new meta-cognitive experience, namely, the experience of having learned something, but not being sure what has been learned, has been identified. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to examine the support experiences of older people who have been abused in Ireland. Design/methodology/approach – Recruited through dedicated elder abuse services, nine older people who had experienced elder abuse participated in in-depth, semi-structured interviews. The data were analysed using thematic content analysis. Findings – The study highlighted the help-seeking pathways of abused older people and revealed that few older people sought help for themselves and most were unaware of the services available to support and protect older people. Data analysis identified the range and type of help received from family, friends, voluntary and statutory services, as well as the perceived barriers to accessing help and support. Research limitations/implications – The research did not include abused older people who lacked mental capacity or who had experienced self-neglect, criminal victimisation by strangers or who had not received statutory support services. This field may benefit from future research that seeks to examine the support experiences of these groups. Practical implications – Family, staff and professionals who care for older people need to be cognisant of the signs of elder abuse, and bring them to the attention of older people should they have concerns, as older people may not always recognise that they are being abused. Originality/value – The paper contributes to our understanding of the support needs of older people in Ireland and the perceived barriers to accessing help and support. [ABSTRACT FROM AUTHOR]

Purpose There has been an increase in the use of registers and record linkages to study migrant mental health. However, the accuracy of these registers and the degree to which they are representative of the migrant population in Northern Ireland (NI) are unclear. The purpose of this paper is to explore: the coverage of the NI migrant population in general practitioner (GP) data and Census records; the issues faced by migrants in terms of registering and accessing the local health system; and the reporting of racial hate crimes against migrants to police.Design/methodology/approach Two focus groups of professionals (n=17) who worked with migrants were conducted. Group discussions were guided by a research-informed topic guide, and the data were analysed using thematic analysis.Findings Three main themes emerged: issues with the use of GP registration, Census and hate crime data for researching migrant mental health; barriers to health service use (e.g. low cultural awareness among health staff and access to interpreters); and risk factor exposure and mental health status in migrant communities (e.g. poverty, isolation and poor working conditions).Originality/value Record linkage and registry studies of migrant health and well-being using Census and health service sources need to be mindful of the likelihood that some migrants may be missed. The possible underrepresentation of migrants in health registers may be explained by reduced use of such services which may be caused my encountering staff with limited cultural competency and the inability to access an interpreter promptly. [ABSTRACT FROM AUTHOR]

Purpose – Mental health difficulties are often stigmatised because of situated ways of talking that become taken-for-granted “truths”. Against this backdrop, identities of those affected are constructed. The purpose of this paper is to explore identities of former inpatients at an Irish Child and Adolescent Mental Health Service. Design/methodology/approach – Ten young people (aged 18-22) participated in discussions and their discourse was analysed using a critical discursive perspective. Findings – Three key identities emerged: a hidden identity, a misunderstood identity and the struggle for a re-claimed identity. Research limitations/implications – Findings indicate the power of discourse in creating stigma and the need for mental health professionals to draw on empowering discourses to help service-users construct positive identities. The importance of involving service-users in research is also implicated. Originality/value – This research involves service-users who are increasingly, although not traditionally, involved in research. Use of qualitative methodology allows their voices to be heard and gives meaning to their experiences. [ABSTRACT FROM AUTHOR]