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Despite the increasing recognition of the importance of mental health promotion, its implementation in practice remains underdeveloped in most countries. Having a standalone strategy ensures commitment to delivering on mental health promotion within the political and policy system. This paper outlines the process of developing the first Mental Health Promotion Plan for the health service in Ireland. The process of developing the Plan, together with key reflections and learnings from the experience are outlined. The framework for the development of the Mental Health Promotion Plan, and the processes involved are outlined. The development process constituted three distinct phases over a two and a half year period: (i) planning; (ii) identifying core actions; (iii) stakeholder engagement. The steps involved in each of these phases are described. The Mental Health Promotion Plan takes a lifecourse and settings-based approach, including 27 actions for enhancing protective factors for mental health and minimising risk factors. A wide range of stakeholders from across sectors contributed to the development process. The development of this Plan marks a watershed in placing mental health promotion on the policy agenda at a national level, building on the existing health promotion policy and practice infrastructure in Ireland. [ABSTRACT FROM AUTHOR]

The societal role which sports clubs can play in promoting health has been underexploited, and sports clubs have called for support from policymakers. Based on the Health Promoting Sports Clubs National Audit Tool, the present study has as objective to investigate how national public policies support health promotion in sports clubs, by questioning indicators of quality (references to other document, policy framing and evaluation), the content (target groups, health topics, type of policy instruments) and the mechanisms used by Irish decision-makers for coordination, evaluation, dissemination and implementation of these policies. The tool was completed in two steps comprising a systematic search of policy plans, programmes or regulations and 12 interviews with key informants. A content analysis of 17 policy documents, identified 49 policy actions targeting HP in sport clubs, coming from different sectors, but only policies from the health sector considered a settings-based approach, supporting a unique sports federation programme. Policies focus on a single health behaviour, where the most targeted were physical activity participation, gender inequity and the disability gap in access to sport clubs. The policy structure lacks coordination, monitoring, media campaigns and events, and therefore not adopting the HPSC concept, but only a health education approach. Future studies should support the acknowledgement of HP as an umbrella concept, in order to support the understanding and development of organisation and system change since policies are drivers for sport federations, local sport actors and sports clubs. [ABSTRACT FROM AUTHOR]

This paper describes a research study carried out in Ireland looking at transport provision in rural areas in Ireland. The objective of the study was to look at experiences of older people in rural Ireland and to assess how well current levels of transport provision were meeting their transport needs. A series of focus groups with older people living in rural areas was conducted in different parts of rural Ireland, both in the Republic of Ireland and in Northern Ireland. A number of interesting findings were revealed. This paper focuses on the findings relating to health trips and accessibility of health services. It was apparent that trips to health facilities (such as doctors, clinics, and hospitals) were the most important trips for older people and were also the most difficult trips to make in rural areas. It was clear that this was due to a lack of synergy between transport operators and health service providers and also a lack of synergy and coordination between government bodies devising and implementing health policy and government bodies implementing transport policy. It was also discovered that driving cessation is a major issue for older people in rural Ireland, who are often forced to give up their car at some point due to ill health or visual impairment and that this leads to significant decreases in relative mobility. [ABSTRACT FROM AUTHOR]

Background: The Irish Government has adopted 'Gender Mainstreaming' as a strategy to promote equal opportunities between women and men in its National Development Plan. While current mental health policy addresses the principle of partnership and social inclusiveness as a way forward for mental health service provision, it still does not explicitly deal with the notion of gender and gender sensitivity. Indeed, Irish mental health policy and service provision is criticised for being gender-neutral. Aim: This paper explores the relationship between gender, mental health policy and service provision. Method: The literature on theoretical perspectives on mental health policy, gender and mental health in relation to Irish mental health policy is reviewed. Results: The importance of gender for policy development and service provision is recognised, and the need to reformulate debate within a gendered context is discussed. Some key theoretical perspectives and their significance for mental health policy are considered with possible explanations for the absence of a gender perspective for Irish mental health policy presented. Conclusion: Arguably, a move towards developing gender-sensitive mental health policy and service provision requires a stronger awareness of and connections between the macro, meso and micro levels for policy development and analysis. [ABSTRACT FROM AUTHOR]

Contemporary health policy increasingly positions responsibility for the management of health with the individual which reflects newer neo-liberal discourses of health. Such an approach can be seen as problematic in the context of men's health, with men tending to be seen as largely 'irresponsible' towards their own health. This paper addresses this question by drawing on qualitative data on how men conceptualise responsibility for health. Whilst the desire to be responsible for health was borne by most of the men in the study, this was not always reflected in practice. There was also evidence of strategies that men adopted for either divesting themselves of responsibility for health or for legitimising lack of responsibility. In some instances, acting 'irresponsibly' was what defined participants as 'real men'. The implications of these findings for men's health policy are discussed with specific reference to the recent publication of Ireland's National Men's Health Policy. [ABSTRACT FROM AUTHOR]

A high prevalence of smoking has been reported among people receiving care within inpatient and forensic mental health services. An Irish inpatient mental health service introduced a "smoke free campus" policy in 2018. Six semi-structured interviews were completed with patients within this setting in 2019. Using thematic analysis, five themes were identified: Experience of stakeholder support, routine, experience of being an inpatient, the meaning of smoking, and the experience and perception of the smoking policy and governing bodies. The findings have implications for staff who work in mental health inpatient settings or who develop policies regarding smoking on hospital sites. [ABSTRACT FROM AUTHOR]

Ireland passed the world's first blanket ban on new psychoactive substance in 2010. This article traces the historical processes culminating in the Criminal Justice (Psychoactive Substances) Act (2010) through a systematic review of Irish media articles published between 2000 and 2010 (N = 338). The review found that head shops were largely tolerated when they sold cannabis paraphernalia (2000–2008), possibly indicating the normalisation of cannabis in Ireland. Some mild condemnatory language emerges between 2008 and 2009 when head shops began selling some new psychoactive substances. The review suggests that the 2010 Act was partly a product of a moral panic, driven and managed by a range of moral entrepreneurs and, involving both peaceful and violent protests. Unlike some traditional moral panics, young people were not identified as folk devils but rather as under threat from a new drug distribution model (head shops) and new drugs (NPS). [ABSTRACT FROM AUTHOR]

Issues arising from the death of Savita Halappanavar in Ireland in October 2012 include the question of whether it is unethical to refuse to terminate a non-viable pregnancy when the woman's life may be at risk. In Catholic maternity services, this decision intersects with health professionals' interpretation of Catholic health policy on treatment of miscarriage as well as the law on abortion. This paper explores how these issues came together around Savita's death and the consequences for pregnant women and maternity services worldwide. It discusses cases not only in Ireland but also the Americas. Many of the events presented are recent, and most of the sources are media and individual reports. However, there is a very worrying common thread across countries and continents. If further research unearths more cases like Savita's, any Catholic health professionals and/or hospitals refusing to terminate a pregnancy as emergency obstetric care should be stripped of their right to provide maternity services. In some countries these are the main or only existing maternity services. Even so, governments should refuse to fund these services, and either replace them with non-religious services or require that non-religious staff are available at all times specifically to take charge of such cases to prevent unnecessary deaths. At issue is whether a woman's life comes first or not at all. Parmi les enjeux soulevés par la mort de Savita Halappanavar en Irlande en octobre 2012 figure la question de savoir s'il est contraire à l'éthique de refuser d'interrompre une grossesse non viable quand la vie de la femme est menacée. Dans les maternités catholiques, cette décision est liée à l'interprétation que font les professionnels de la santé de la politique de santé catholique sur le traitement des fausses couches ainsi que la loi sur l'avortement. L'article étudie comment ces questions sont apparues autour du décès de Savita et les conséquences pour les femmes enceintes et les services de maternité dans le monde. Il examine des cas en Irlande, mais aussi aux Amériques. Beaucoup d'événements présentés sont récents et la plupart des sources sont des reportages ou des récits individuels. Néanmoins, il existe un dénominateur commun très inquiétant entre pays et continents. Si de nouvelles recherches mettent à jour d'autres cas comme celui de Savita, les professionnels de la santé et/ou hôpitaux catholiques refusant d'interrompre une grossesse comme soin obstétrical d'urgence devrait être privés de leur droit d'offrir des services de maternité. Dans certains pays, ils représentent les principaux ou les seuls services de maternité. Malgré cela, les autorités devraient refuser de financer ces services et les remplacer par des services non religieux ou exiger que du personne non religieux soit disponible à tout moment, spécifiquement pour prendre en charge ces cas et prévenir tout décès prématuré. La question est ici de savoir si la vie d'une femme passe ou non avant tout. Entre los temas examinados tras la muerte de Savita Halappanavar en Irlanda, en octubre de 2012, figura la interrogante si es poco ético negarse a interrumpir un embarazo no viable cuando la vida de la mujer podría correr peligro. En servicios de maternidad católicos, esta decisión cruza la interpretación de profesionales de la salud de la política católica en cuanto al tratamiento del aborto espontáneo, así como la ley referente al aborto. En este artículo se explora la interrelación de estos asuntos a raíz de la muerte de Savita y las consecuencias para las mujeres embarazadas y los servicios de maternidad mundialmente. Se analizan casos no solo en Irlanda sino también en las Américas. Muchos de los sucesos expuestos son recientes y la mayoría de las fuentes son medios de comunicación e informes individuales. Sin embargo, hay un hilo común muy preocupante entre países y continentes. Si en futuras investigaciones se descubren más casos como el de Savita, a todo profesional de la salud y/u hospital católico que rehuse interrumpir un embarazo como cuidados obstétricos de emergencia se le debe despojar de su derecho a ofrecer servicios de maternidad. En algunos países estos son los principales o únicos servicios de maternidad. Aun así, los gobiernos deberían rehusar financiar estos servicios y sustituirlos con servicios no religiosos o exigir que haya personal no religioso disponible en todo momento específicamente para encargarse de tales casos para evitar muertes innecesarias. La interrogante es si la vida de la mujer es o no lo primordial. [ABSTRACT FROM AUTHOR]

Background. Dealing with work related stress is a declared priority of European Union mental health policy. A particularly under-researched sector in this regard is the community vocational support sector for people with mental health and intellectual disability problems. Aims. To report on the organisational profile of the vocational support and rehabilitation sector forpeople with mental health and intellectual disabilities as this relates to occupational stress, in five European countries (Austria, Ireland, Italy, Romania and UK). Methods. A sector profile questionnaire was distributed to representative organisations in five countries and a short face-to-face survey was conducted with 25 local managers (five from each country) to draw up a profile and facilitate a comparative description and analysis. Results. It was found that there is no national and European data collected at any level in this sector upon which to base effective policy interventions to combat occupational stress specific to professionals working in this sector. Results indicate that the sector in a number of the countries sampled does not have effective mechanisms in place to deal with occupational stress. Conclusion. Developing effective transnational occupational stress management policy that supports staff working in this sector and measuring its success is greatly impaired by a failure to effectively define the purpose of the sector and collect and collate national data to support it. [ABSTRACT FROM AUTHOR]

World health reports highlight the increasing prevalence of mental health problems and the need to recognize that mental well-being is a fundamental aspect of any health policy. The scale and cost of mental health problems mean that appropriate policies and strategies must be developed and implemented. In Ireland this is a period of substantial review and reflection on mental health policy and practice, but to date little consideration has been given to the development of a cross-border strategy. Cooperation and collaboration has been largely dependent on the leadership of a number of individuals supported by short-term European Union funding. This paper is informed by a study which was concerned with examining the issues associated with promoting mental health across the Irish border. Insights were provided by 38 individuals who were involved in the delivery of cross-border mental health services in the North West region. The article argues that there is substantial support for working across borders and developing sustainable cross-border health strategies. In the absence of a statutory all-Ireland coordinated policy overseeing the development of mental health promotion, the sustainability of projects emerged as a key issue. The results suggest that whilst much innovative and creative work has been undertaken by committed individuals, what is now required is a strategic response from both the British and Irish governments which will ensure the needs of service users in these deprived border regions can be effectively addressed. Also, at a policy level this strategic development would be seen as a reflection of the value placed on promoting mental health and well-being. [ABSTRACT FROM AUTHOR]

There is a need to ensure public health policies are robustly evaluated to establish their benefits and harms on the population and subgroups. We aimed to assess the comparability of Northern Ireland (NI) and Republic of Ireland (RoI) alcohol-related data to determine their suitability for evaluating the effectiveness of alcohol policies on alcohol consumption, sales, and related outcomes. A comparability analysis of NI and RoI alcohol-related hospital admissions, deaths, consumption, sales, and crime administrative and survey data was undertaken. Data sources were compared, where applicable, in terms of coding systems, population coverage, definitions, quality, response/completion rates, and question similarity. The NI and RoI consumption and sales data were found not to be comparable enough for use in a natural experiment study; comparability for hospital admission data was acceptable. Key barriers to comparability included variations in population coverage and lack of overlap in questionnaire topics. Data access issues made it difficult to fully determine data comparability for alcohol-related crime and deaths. By contrast, NI alcohol-related data were more comparable with other UK countries, making comparisons for the purpose of policy evaluation possible. RoI would benefit from identifying another economically and culturally similar country with comparable alcohol-related data. [ABSTRACT FROM AUTHOR]

The objective of this study was to measure consensus among expert stakeholders on a set of positive aging outcome indicators in Ireland. Stakeholders from academic, public, and voluntary sectors and older people participated in a 3-round, online Delphi study to evaluate indicators for participation, security, healthy aging, attitudes to aging, and information access. Evaluation criteria included: acceptability, utility, accessibility, ranking, and balance and coherence. Consensus was achieved on 56 key indicators that are aligned with action areas in the National Positive Ageing Strategy. These indicators will be reported on a biannual basis to monitor progress in positive aging in Ireland. [ABSTRACT FROM AUTHOR]

In response to the unhealthy, threatening living arrangements separated children seeking asylum were provided with in Ireland in the early 2000s, the Social Work Team for Separated Children committed itself to replacing the inadequate care with care that truly meets the needs of children. However, the transition to the level of service provided today has only been achieved after years of criticism and a slow, steady commitment to transparency. Increased levels of discretion afforded to the social workers has led to an evolving definition of the best interest of the child and given rise to a child-protection service that provides safe environments for children to thrive and grow. This report serves to briefly sketch the history of the service, outline several distinctive features of the service, and place the service in a broader European context. [ABSTRACT FROM AUTHOR]

This article presents the findings of a qualitative study of parents' perceptions of a video-modelling assisted group-based parent training programme, the Parents Plus Children's Programme (PPCP). PPCP was developed in Ireland and is culturally sensitive to the Irish context. PPCP aims to reduce emotional and behavioural difficulties in children aged 6'11 years. Twenty-one caregivers of children attending a child and adolescent mental health service in Dublin with significant behavioural problems were interviewed five months following completion of PPCP. Thematic analysis was used to explore caregivers' perceptions of changes in their children, benefits of participation and effective programme strategies, with a view to identifying cognitive factors mediating outcome. Improvements observed included children being calmer, being better able to communicate feelings and needs, and having better emotional regulation. 'Tuning in' to children, engaging in play, explaining rules, communicating calmly and planned sanctions were identified as effective programme strategies. Group support emerged as the main benefit of participation. Perceived parental control, ability to reframe children's misbehaviour, consistency with discipline and hopefulness differentiated participants who observed improvements and those who did not. The findings were interpreted within a social-cognitive theoretical framework with reference to self-efficacy beliefs. Implications for clinical practice are also discussed. [ABSTRACT FROM AUTHOR]

The author of this conceptual article was awarded a Churchill Fellowship to travel to the United States, Ireland, and United Kingdom to meet with researchers, practitioners, and community agencies and review how support for people with intellectual disability is provided. A specific focus was upon provision of care for individuals who were either ageing or requiring palliative care. The project took place from June to August 2013 and involved face-to-face interviews and site visits with key academics, government representatives, and community providers in Los Angeles, Chicago, New York, New Jersey, Dublin, Edinburgh, London, Oxford, Cambridge, Bath, Bristol, Birmingham, and Stoke-on-Trent. A priority was placed upon examining how the key features of leading practice models could be implemented within the Australian environment featuring a National Disability Insurance Scheme (NDIS). On the basis of the observations of practice, key points are discussed regarding the potential for improvements to the support of people with intellectual disability within the Australian context of the NDIS. [ABSTRACT FROM AUTHOR]

In this article, the authors argue that the association between socioeconomic status and motivation for a health-literate health care system has implications for health policymakers. As Ireland now undergoes health care reform, the authors pose the question, “Should policymakers invest in health literacy as predominately a health inequalities or a public health issue?” Data from 2 cohorts of the Survey of Lifestyle, Attitudes and Nutrition (1998 and 2002) were used to construct a motivation for a health-literate health care system variable. Multivariate logistic regressions and concentration curves were used in the analyses of this variable. Of the 12,513 pooled respondents, 46% sought at least 1 attribute on a health-literate health care system. No discernible trend emerged from the main independent variables—social class grouping, medical card eligibility, level of education, and employment—in the regression analyses. The concentration curve, for 2002 data, graphically showed that the motivation for a health-literate health care system is spread equally across the income distribution. This analysis and more recent data suggest that health literacy in Ireland should be viewed predominately as a public health issue with a policy focus at a system level. [ABSTRACT FROM PUBLISHER]

Background Statistics are critical in holding governments accountable for the well-being of citizens with disability. International initiatives are underway to improve the quality of disability statistics, but meaningful ID data is exceptionally rare. Method The status of ID data was evaluated in a review of 12 national statistical systems. Recurring data collection by national ministries was identified and the availability of measures of poverty, exclusion, and disadvantage was assessed. Results A total of 131 recurring systems coordinated by 50 different ministries were identified. The majority included general disability but less than 25% of the systems screened ID. Of these, few provided policy-relevant data. Conclusions The scope of ID data was dismal at best, though a significant statistical infrastructure exists for the integration of ID data. Advocacy will be necessary. There is no optimal form of data monitoring, and decisions regarding priorities in purpose, targeted audiences, and the goals for surveillance must be resolved. [ABSTRACT FROM AUTHOR]