Search

Mental health services in prisons in the United Kingdom and Ireland have long received criticism for falling behind that of services available in the community. In recent years, the mental health of people in prison has received increasing attention and developments have been seen in commissioning, provision and quality. This paper summarises the key findings from the first three annual reports of a quality improvement initiative, the Quality Network for Prison Mental Health Services (QNPMHS), organised by the Royal College of Psychiatrists' Centre for Quality Improvement. Between 2015 and 2018, participating services were subject to review against a set of evidence-based specialist standards via an annual process of self and peer-review. The paper explores whether any changes have been observed in the average compliance of the quality standards during this period. Slight improvements were observed in five of the nine standard domains; however, a longer period of review is required to fully assess the impact of such programmes within prison mental health services. [ABSTRACT FROM AUTHOR]

As a social work lecturer I have, over the years, developed strong links with service-user/survivor groups in an effort to contribute to a more context-focused and democratic approach to mental health education and practice. User narratives of psychiatric survival have been central in organizing resistance toward dominant constructions of 'mental illness'. Within education, user narratives have created spaces for co-production with a transformative potential, as traditionally silenced voices can be heard and affirmed. However, recent debates suggest that such narratives are often used by mental health and educational systems to promote their own agendas. In this context, user narratives are no longer considered a transformative act of co-production or resistance. They are a commodity servicing primarily the interests of these systems. This paper adds to these debates through a self-reflexive discussion on my experience of including user/survivor narratives in Irish social work education, as user narratives remain insufficiently critiqued in this context. I consider the significance of power operations in the contexts where narratives are shared and heard and argue for the need to honor what has been achieved while problematizing what may be lost through the inclusion of service-user narratives in social work education. [ABSTRACT FROM AUTHOR]

The aim of this study was to provide evidence of the acceptability of the primary care psychology services that have been enhanced by the employment of assistant psychologists in Ireland to the parents of children with psychological difficulties. Data were collected from a sample of 74 parents who responded to quantitative and qualitative questions on the experience of service questionnaire. Reflexive thematic analysis was used to analyse the questionnaire responses. On average 88% of participants selected 'certainly true' in response to the statements in the experience of service questionnaire statement they were 'Totally satisfied'. Three major themes were developed; 'communication is more than talking', 'structure can facilitate or impede', and 'emotional reactions'. 'Communication is more than talking' is organised around communication The 'structure can facilitate or impede' acknowledges that systems influence psychological supports. 'Emotional reactions' captured parents' experiences, such as joy, frustration, and solidarity. The results demonstrate that the newly enhanced mental health service is acceptable to parents. Their voices provide ideas about what helps and hinders their experience of care. [ABSTRACT FROM AUTHOR]

Introduction: Internationally mental distress is more prominent in the LGBTI community than the general population. The LGBTIreland study was set up to take stock of this in the Republic of Ireland. This paper reports on the analysis of the transgender group with reference to minority stress theory and cognitive dissonance theory. Method: An online survey was conducted addressing several aspects of mental health and distress that received responses from all groupings (n = 2,264) among which 12.3% (n = 279) identified as transgender. The survey consisted of several validated tools to measure depression, anxiety, stress (DASS-21), coping (CSES), self-esteem (RSES), alcohol and drugs misuse (AUDIT) and a variety of questions addressing demographics, experiential aspects, coping and self-related factors. Data analysis focused on predicting mental distress using DASS-general (composite of depression, anxiety and stress). Results: Transgender participants reported higher levels of mental distress, self-harm, suicidal ideation and attempts, and lower levels of self-esteem in comparison with the LGB groups, as well as the general population. Hierarchical multiple regression showed that 53% of variance in mental distress could be predicted from reduced self-esteem, the experience of harassment and not belonging in school. Furthermore, mental distress was highest among younger participants, those who were 'not out', those who had self-harmed and used avoidant coping. There was no significant difference in distress levels among those who had sought mental health support and those who had not. Conclusions: To understand mental distress in transgender people, the minority stress model is useful when taking into account both adverse external (environmental) and internal (cognitive/emotional) factors. The cognitive dissonance mechanism is essential in outlining the mechanism whereby gender incongruence is associated with psychological discomfort, low self-esteem and high mental distress. [ABSTRACT FROM AUTHOR]

Based on the rich extant research in the field of mental health in acculturation, it is calling to identify religion as one of the meditative variables of the relationship between acculturation and mental health. In addition, little knowledge exists about the detailed religious experience of Chinese migrants in Ireland. This research adopted classic grounded theory to guide data collection and analysis. The findings show that Christian faith plays a significant role as a mediator in the cross-cultural adaptation of the participants with two aspects of the mental impacts: helping to cope with mental stress and providing spiritual satisfaction. The results in this paper are part of the findings from an investigation of the religious experience of the participants during their cross-cultural adaptation in Ireland. [ABSTRACT FROM AUTHOR]

The application of Pluralism in Qualitative Research (PQR) allows for a multi-perspective approach to understanding the nuanced social and psychological phenomenon. The complexity of what it means to qualitatively analyse and respond to sensitive data from the reflexive position of the analyst, is the focus of this paper. We introduce previous work in pluralism, and data from ReachOut.com, an online resource for young people in need of mental health advice in Ireland. We present our analysis of the posts from ReachOut.com which conveys the varied understandings of depression, from a medically understood illness, to a socially constructed lived experience. Analysis of the reflexive positioning of our group of experienced qualitative researchers highlights the need for support for those who engage with such data. Our findings reflect the outcomes and experience of using pluralism to examine mental health concerns which require further social, cultural and technological responses. [ABSTRACT FROM AUTHOR]

This paper considers the educational implications of the recent emphasis on the mental health and well-being of lesbian, gay, bisexual, transgender, questioning/queer (LGBTQ) people in Ireland. Operating from the perspective that discourses constitute rather than merely reflect material reality, thereby shaping or ‘structuring’ how we think about, and act, in relation to queer experience, the paper critically engages with discourses which position LGBTQ youth as universally at risk of mental health difficulties, including self-harm and suicidality. It also challenges the corresponding preoccupation with homophobic bullying as the primary lens through which queer experience is understood and addressed in schools, arguing that more space needs to be devoted to other, less harrowing narratives of LGBTQ experience and identity. It highlights some of the more problematic effects of LGBTQ mental health research which frame LGBTQ experience primarily in terms of vulnerability and victimhood and makes the case for a more expansive engagement with LGBTQ identities. The article illuminates the potential that after-queer scholarship holds for a re-imagining of queer youth, sexuality and gender within educational and social research, curriculum materials and educational institutions more generally and concludes with a consideration of specific knowledge and skills that educators should be equipped with in order to disrupt normative understandings of gender and sexuality. [ABSTRACT FROM PUBLISHER]

More attention has recently been paid to the unique experiences and health needs of LGBTQ + people. To date, there has been a limited focus on the distinct psychosocial needs of bisexuals. A larger mixed-methods study explored the wider needs of a LGBTQ + cohort. The aim of this paper is to report the specific experiences of bisexuals and highlight their distinct psychosocial issues and concerns. The online survey instrument contained Likert-scale and qualitative questions and was completed by a total sample of LGBT people (n = 125), of which 19 participants self-identified as bisexual. The qualitative responses of the bisexuals were extracted and analyzed separately to identify emergent themes that were: accessing responsive services, culturally competent services, supports and interventions, and knowledge, skills and confidence. The study findings inform and enhance the understanding of the issues that impact upon the health and well-being of bisexuals, thereby contributing to promoting the wider social inclusion and human rights agenda by guiding mental health service developments, policy initiatives, education provision and future research. [ABSTRACT FROM AUTHOR]

Social work practitioners face significant challenges in their professional lives when advocating for marginalised and disadvantaged people who face deep structural inequalities, lack of resources and inaccessibility to social and health care services. Many service users are long-suffering, dispirited, and demoralised without hope for a better future. This is particularly the case in community based mental health services where social workers provide frontline counselling and advocacy to individuals with serious and persistent mental illness. Prolonged adversity takes a toll on the resilience of the service user while social work practice, aimed at counteracting such structural adversity, takes a toll on the resilience of the practitioner. Too often, community mental health agencies fail to recognise this toll and do little to support the resilience of social work practitioners. This study looks at practitioner perspectives on resilience and explores the idea of relational resilience as a buffer against burnout and compassion fatigue. The paper identifies themes from qualitative interviews with social workers on community mental health teams (CMH) in Ireland and assertive community treatment teams (ACT) in Canada who are involved in front line mental health services. The words 'service user' and 'client' are used interchangeably to reflect common usage in the two locations. [ABSTRACT FROM AUTHOR]

This paper explores factors which contribute to happiness among lesbian, gay, bisexual, transgender and intersex (LGBTI) individuals as part of the largest study to date of mental health in the LGBTI community in the Republic of Ireland (LGBTIreland study). This mixed methods study informed by minority stress theory, contained an online survey (n = 2,264) which explored various aspects of mental health and distress, but also the extent and experience of happiness and concomitant factors. The survey included ratings of happiness and life-satisfaction and an open-ended question on LGBTI related happiness. Quantitative findings showed a mean happiness rating of 6.58 out of 10 (11-point scale), which is lower than the general population in Ireland. Those identifying as gay men or lesbian women rated their happiness significantly higher than bisexual, transgender, or intersex participants. There was also an effect for age: teenage LGBTI participants had significantly lower ratings than other age groups. Happiness ratings very highly correlated with life-satisfaction (.88). A multiple linear regression showed happiness was predicted most significantly by self-esteem and being in a relationship. Qualitative findings emphasized the importance of self-acceptance and peer support for happiness. Findings are discussed using the minority stress perspective and cognitive dissonance theory. [ABSTRACT FROM AUTHOR]

LGBTI clients present specific challenges for the mental health profession with key issues for transgender people identified as including isolation, fear, stigma, and family rejection, all of which contribute to the transgender community's high levels of depression, anxiety, substance misuse, self-harm, and suicide. This qualitative research paper explores the experiences of Irish psychotherapists working with transgender clients to explore specifically the nature of the therapeutic relationship. Using an interpretive phenomenological approach, it examines the subjective experience of three participant psychotherapists and endeavours to make sense of the phenomenology that emerged from semi-structured interviews. The phenomenological analysis of the data collected resulted in three salient themes emerging: (i) Therapeutic identification, (ii) Maternal countertransference, and (iii) Confusion. It is hoped that these findings which relate to the therapeutic relationship will be of utmost importance to others working within the mental health profession where recovery is dependent on the strength of this relationship. [ABSTRACT FROM AUTHOR]

Objectives: This paper reports the findings of two studies that examined factors predicting infertility distress in male partners within couples with an infertility diagnosis and where the couple was receiving fertility treatment. Design: A cross-sectional design was implemented using a questionnaire battery (The questionnaire battery comprised an inventory of four different standardised questionnaires compiled together into one booklet) compiled from earlier theory-building qualitative research conducted by the authors. Methods: Infertility related distress was examined in relation to a number of psychosocial variables including relationship dynamics, self-esteem, current mental health and attitudes towards idealised masculinity. The questionnaire battery was completed by 167 men undergoing or consulting for fertility treatment. Participants were recruited through Irish fertility clinics (Study 1, n = 111) and through an online survey (Study 2, n = 55). Results: Regression analyses identified four variables that predicted variance in infertility distress in both studies: 'Attitude towards idealised masculinity', 'Mental health', 'Relationship satisfaction' and 'Self-esteem'. This finding was found to be robust having controlled for age, time since diagnosis, number of attempts at treatment and diagnostic category (male factor, female factor or mixed factor infertility). Conclusion: Recommendations for fertility clinics and mental health professionals should be made in relation to managing infertility distress and supporting couples during fertility treatment. [ABSTRACT FROM AUTHOR]

The provision of high-quality education and training that is responsive, relevant, accessible and evidence based is critical if the vision for quality mental health services presented in recent policy initiatives in Ireland is to be fulfilled. This paper reports the findings related to pedagogical approaches and quality assurance mechanisms utilized within mental health education. The study involved canvassing all Higher Education Institutions in Ireland. A total of 227 courses in 31 educational institutes were identified and 149 questionnaires were returned from 129 Course Coordinators. Various quality processes were identified in existing programs; however, formal feedback from service providers, service users and carers was seldom reported. Ongoing evaluation and quality assurance strategies are a key element of governance and there is a need to develop strategies that explore the impact of education programs on mental health education and health outcomes. Recommendations are made in terms of future interprofessional mental health education and practice. [ABSTRACT FROM AUTHOR]

Within categories of special educational needs, emotional and behavioural difficulties have received much attention in recent years, particularly in relation to their definition and identification by parents and teachers. This paper stems from previous research which highlights how children from disadvantaged backgrounds and those attending schools designated as socio-economically disadvantaged are significantly more likely than their peers to be identified as having a special educational need of a non-normative type such as emotional behavioural difficulty (EBD). Using data from the Growing Up in Ireland study, it examines whether the EBD identified by teachers or within certain schools is matched by the child’s own performance on an internationally validated emotional and mental health measure – the Piers–Harris. Findings show that overall self-reported social emotional well-being bears a strong relationship to the probability of being identified with an EBD. However, boys, children from economically inactive and one-parent households and children attending the most disadvantaged school contexts are more likely to be identified with having an EBD, even after taking into account their social background characteristics and their scoring on the Piers–Harris measure. These findings suggest that the subjective nature of EBD identification is resulting in a disproportionate number of these children being identified with EBD. The implications of this study are explored for existing disability/SEN classification systems, school-wide intervention models and the impact on individual students labelled as EBD. Overall, the findings pose searching questions about the validity of employing SEN classification systems in deciding eligibility and types of appropriate provision. [ABSTRACT FROM AUTHOR]

Many studies have measured the prevalence of mental health issues amongst the student population. Of note in the literature is the absence of help-seeking amongst most sufferers. Several barriers to help-seeking have been identified in the literature. While in many cases treatment facilities are available, the literature is strangely quiet on attempts to overcome these barriers. In this paper we detail a series of studies and experiments designed to overcome such barriers. These involve the most common, and indeed, preferred method of communication amongst students, namely texting. Texts were sent on a fortnightly basis to students at an Irish third level institution. Intermittently, texts exhorting help-seeking were broadcast to all students, and the responses of students measured. Attitudes to receiving texts from the college were also evaluated. Our conclusions suggest that students do not object to receiving texts on a regular basis from the college, provided they are about college matters, and that such texting has a role to play in encouraging reluctant and needy students to avail of college counseling services. As we are seeking to persuade through technology, the application of captology (computers as persuasive technology) to help-seeking by text is also discussed. [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]

The aim of this study is to determine the moderating effect of perceived social support on the relationships between ACEs and depression/anxiety, and CPTSD symptoms in older adults in Ireland. Moderated regression analysis was used to evaluate these relationships in a sample of 535 residents of Ireland, aged 50 or above. The results show statistically significant predictive relationships between ACEs and mental health outcomes as well as a significant moderating effect of perceived social support. These findings suggest that ACEs in Ireland should be considered and measures to increase perceived social support should be implemented. [ABSTRACT FROM AUTHOR]

Disclosure of childhood sexual abuse is a process that is often laden with boundary testing, decision-making and, at times, risk. Disclosures tend to be delayed, often into adulthood and later life, with disclosures to authorities remaining relatively low. In the Republic of Ireland adults who disclose experiences of childhood sexual abuse are directed towards child protection services due to an interplay between jurisprudence, child protection policy design, and mandatory reporting obligations, requiring social work practitioners to balance the social and the legal. This article compares Foucault's concept of the confessional to current social work practices of engaging with adult victims and survivors of abuse. It is argued that thinking about these interactions as a confessional-like system highlights a process of knowledge creation that is taking place when a personal narrative of abuse is shared, willingly or via mandated reporting, with a child protection agency under the auspices of a modern state. This 'confessional-lens' helps us identify a tipping of the balance in this area of social work practice, away from provision of care and person-centredness, across a boundary, to legalistic practice. Narratives of childhood abuse are transformed into knowledge deemed necessary to assess current risk to children. A process that places the adult on the periphery, leading to a potential for harm and re-traumatisation. [ABSTRACT FROM AUTHOR]

Medical students have reported high prevalence of mental health difficulties and burnout. However, there are limited investigations examining the association between resilience and these difficulties. We investigated: (1) depression, anxiety, personal and professional burnout, and comorbidity; (2) demographic and education characteristics associated with these outcomes; (3) the association between resilience and these outcomes; and (4) whether these results were attributable to sampling bias. Participants were n = 521 medical students from RCSI University of Medicine and Health Sciences. Outcomes were measured using validated scales. We report descriptive statistics, and risk factors for the difficulties were investigated using generalized linear modelling. One-in-three students reported incidence of depression or anxiety (24.5% co-morbidity). 8.9% of students reported all four difficulties. Difficulties were more common in female students and those in middle years of the programme. Resilience was negatively correlated with all outcomes and stable across demographic and educational variables. Weighting the data for sampling bias did not affect these results. Our results emphasise the high incidence of depression, anxiety, burnout, and comorbidity in students. We advocate for further investigation into the role of resilience as a modifiable factor that may ameliorate the incidence of depression, anxiety, and burnout in medical students. [ABSTRACT FROM AUTHOR]

Background: Gay, bisexual and other men who have sex with men (GBMSM) are at far greater risk of experiencing poor mental health (MH) than wider society. This disparity was exacerbated by additional 'unique to sexual minority status' COVID-19 stressors. Objective: This sequential, mixed-methods study examined remote MH help-seeking among GBMSM in the U.K. and Ireland during the first COVID-19 lockdown. Methods and Results: Quantitative survey data (n = 1368), analysed with logistic regression, suggested GBMSM experiencing moderate-to-severe anxiety and those with a past MH diagnosis were most likely to seek MH support. Thematic analysis of qualitative interview (n = 18) data identified multiple barriers and enablers to GBMSM seeking remote MH help, with the help primarily sought from GBMSM-facing organisations and generic online resources. Finally, the behaviour change wheel was used to generate theoretically informed recommendations to promote MH help-seeking among GBMSM in Scotland. Implications: We discuss how applying these recommendations in the short, medium and long term will begin to address GBMSM's MH needs, post COVID-19. [ABSTRACT FROM AUTHOR]

Increasing rates of mental ill-health among students in higher education has led to rising demand for campus counselling services and longer waiting times, while considerable unmet need also exists. To design more effective services, it is important to understand what aspects of service provision are most valued by students. We present results from a choice experiment using a survey of over 5,000 students in Ireland. Waiting time is the most important attribute for students, which has implications for the funding of services and we discuss ways in which this could be addressed. We also find considerable preference heterogeneity for attributes across students and we consider how this can be incorporated in the design of effective services. Finally, we address the issue of how any changes in the provision of campus counselling services might be financed, which is a particularly important issue within resource-constrained education sectors. [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]

Open Dialogue (OD) is a needs-based, service-user initiated approach to mental health service delivery that emphasises dialogue, and shared understanding between service users, and their support network. The aim of this study was to explore the lived experience of being part of an OD-informed mental health service in Ireland. Data were collected through semi-structured group interviews and analysed using thematic analysis. Three primary themes were identified across the data set namely: diversity across practice; unpacking the taken-for-granted and mental health as shared experiences. Participants experienced enhanced communication, improved relationships with mental health staff and developed shared understandings of mental health. This small-scale implementation demonstrates the received value for service users and their networks of an OD-informed approach within a traditional care pathway. As a relational and collaborative way of working, it requires a shift in clinical practice for mental health staff and service users that is experienced as a welcome change from treatment-as-usual (TAU). [ABSTRACT FROM AUTHOR]

Objective: To evaluate the relationship between loneliness and cognitive functioning, and whether depressive and anxiety symptoms have intermediate roles therein. Methods: Information about 7,433 participants of the Irish Longitudinal Study on Ageing (a prospective, representative cohort study), aged over 50, was collected at three time-points two years apart, and analysed using Structural Equation Modelling to assess whether depressive and anxiety symptoms mediate the relationship between loneliness and cognitive functioning. Cognitive functioning was measured as a latent factor, with four indicators: measures of immediate and delayed word recall, verbal fluency, and a global measure (the MMSE). Loneliness was measured using the UCLA Loneliness scale, depressive symptoms using the CES-D-ML scale, and anxiety symptoms using the HADS-A scale. Results: Loneliness at time-point 1 predicted cognitive functioning at time-point 3, β = −0.103, p < 0.001, and depressive (β = 0.426, p < 0.001) and anxiety (β = 0.410, p < 0.001) symptoms at time-point 2. Depressive (β = −0.020, p = 0.001) but not anxiety (β = −0.000, p = 0.658) symptoms mediated the relationship between loneliness and cognitive functioning, total effect: β = −0.123, p < 0.001. Conclusion: The relationship between loneliness and cognitive functioning is in part explained by its relationship with depressive symptoms. Statistically, the mediation model helps us understand possible mechanisms through which loneliness impacts cognitive functioning. Results have implications for cognitive functioning interventions for older adults, and imply that loneliness is also a worthwhile target for intervention. [ABSTRACT FROM AUTHOR]

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study examined the prevalence of depressive symptoms and suicidal ideation among 220 first year undergraduate university students in Ireland. Data were collected using the Centre for Epidemiological Studies Depression Scale and the Suicidal Behaviours Questionnaire. Findings indicated that 59% of participants experienced depressive symptoms and 28.5% had suicidal ideation. Financial stress and poor relationships with both parents, increased the odds of experiencing depressive symptoms. Sexual orientation, financial stress, and poor relationships with fathers, increased the odds of experiencing suicidal ideation. Suicidal ideation was also higher in those who had sought help in the past from mental health professionals. Nurses need to be aware of the factors associated with mental ill-health in this population. [ABSTRACT FROM AUTHOR]

Many statutory mental health services worldwide have adopted a recovery-oriented rhetoric. These acknowledge that those who use mental health services have acquired valuable expertise through their contact with services and that such expertise should be used to inform health provision. The focus of this study was to tune into the perspectives of adult service users who have attended music therapy in statutory mental health services in Ireland. This aimed to furnish holistic descriptions of practice so as to augment existing understanding of what may be afforded to those who attend music therapy sessions. Six service users participated in semi-structured interviews in which they described their lived experience of attending music therapy sessions. Interview transcripts were analysed using interpretative phenomenological analysis. Six common themes were found across each of the six participant cases. These included “Music therapy offers an opportunity to be meaningfully occupied”, “Involvement in music therapy can pose challenges”, “Music therapy offers an agreeable process”, “Group music therapy fosters reciprocity”, “Music therapy is flexible and adaptable” and “Lack of musical instruction can cause frustration”. Findings relating to meaningful occupation, challenge, reciprocity and frustration broaden understanding of what music therapy can offer to service users in mental health provision. [ABSTRACT FROM PUBLISHER]

Background: Current mental health policy emphasises the importance of service user involvement in the delivery of care. Information Technology can have an effect on quality and efficiency of care. Aims: The aim of this study is to gain the viewpoint of service users from a local mental health service in developing a mental health app. Method: A qualitative descriptive approach was used. Eight volunteers aged 18–49 years were interviewed with the aid of a semi-structured questionnaire. Results: Interviewees defined a good app by its ease of use. Common themes included availability of contact information, identifying triggers, the ability to rate mood/anxiety levels on a scale, guided relaxation techniques, and the option to personalise the app. The researchers will aim to produce an app that is easily accessible, highly personalisable and will include functions highlighted as important (i.e. contact information, etc.). Conclusions: This research will assist in the development of an easy-to-use app that could increase access to services, and allow service users to take an active role in their care. In previous studies, apps were developed without the involvement of service users. This study recognises the important role of service users in this area. [ABSTRACT FROM AUTHOR]

Background: There is an unclear relationship between mental health literacy (MHL) and psychiatric stigma. MHL is associated with both positive and negative attitudes to mental illness. To our knowledge, no published peer reviewed study has examined this relationship in the Republic of Ireland. Aims: This study was conducted to assess MHL regarding schizophrenia and the degree of psychiatric stigma displayed by the general public in the Republic of Ireland. Method: A face-to-face in-home omnibus survey was conducted with a representative sample of residents of the Republic of Ireland. Participants (N = 1001) were presented with a vignette depicting schizophrenia and were asked questions to determine their ability to recognise the condition and to ascertain their attitudes towards schizophrenia and mental illness. Results: Among the participants, 34.1% correctly identified schizophrenia. Higher age, higher socioeconomic status, and an urban geographic location predicted identification. Those who did not correctly identify schizophrenia were significantly more optimistic about recovery and perceived people with schizophrenia as less dangerous. However, only the relationship with perceived dangerousness was considered robust. Conclusions: Participants with higher MHL displayed more negative attitudes to mental illness. Findings have implications internationally for MHL and anti-stigma campaigns. [ABSTRACT FROM AUTHOR]

Objectives:This study was undertaken to ascertain whether or not the body mass index (BMI) of urban disadvantaged children indirectly affects their health-related quality of life (HRQoL) through weight change desires and depressive symptoms and whether such mediation is conditional upon age and gender. Design:A total of 255 children aged 7–12 years (50% male) were recruited from 7 schools in urban disadvantaged districts in Ireland using consecutive sampling. A prospective longitudinal design was employed whereby children completed, at two time points, the Kidscreen-27, the Children’s Depression Inventory,  and the Health Related Behaviour Questionnaire, and had their BMI measured. The analyses involved multiple-, half-longitudinal- and moderated-mediation. Results:Results showed that the depressive symptoms of children wanting to change their weight may have lead, in large part, to poorer HRQoL (specifically psychological well-being when considering longitudinal data) rather than weight statusper se.The mediation effect of weight change desires occurred regardless of age or gender. Conclusions:Childhood obesity programmes that traditionally focus on the negatives of obesity and the need to control weight may need to take a more positive approach to health and well-being by, for example promoting intuitive eating, an active lifestyle, body acceptance and good mental health. [ABSTRACT FROM PUBLISHER]

Background: This article is based on the Arts+Minds research project which investigated the experience of arts participation for mental health service users in Cork, Ireland, and the potential of integrating the arts into mental health care. Methods: Based on the principle of user-controlled definitions of recovery, the voice of service users was central in this research. The authors used participatory observation methods and conducted qualitative interviews with project participants (service users, artists and mental health staff) to explore the impact of arts participation on service users and service structure and culture. Results: The research demonstrated the transformative potential of the arts to create environments conducive to recovery through empowerment, connection-making, confidence-building, hope, story-telling and story-making. Conclusions: Moving beyond the general agreement on the positive contribution of the arts in mental health care, this article highlights some of the challenges of introducing creative forms of engagement and expression in traditional biomedical settings. It is argued that a meaningful partnership between the arts sector and mental health services is not just a technical measure but requires a radical shift in the way we understand, respond to and engage with human distress. [ABSTRACT FROM AUTHOR]

The social work profession in the United Kingdom is criticized for its reluctance to engage with spirituality. Its absence in Northern Ireland is particularly significant given the role of religion in its political conflict. Drawing upon qualitative research with mental health service users and social workers about religion, spirituality, and mental distress, this article explores the ambivalence that exists around this subject in mental health social work practice. It appears that the political conflict continues to impact social work provision. Support is needed for practitioners and service users to give voice to this aspect of mental well-being. This study comprised one-to-one interviews with 12 mental health social workers and 12 mental health service users. Half of the participants from each group were invited to take part in a telephone interview. All of the participants were invited to bring an object which signified what religion and/or spirituality meant to them, to the interview. [ABSTRACT FROM PUBLISHER]

This article examines the impact on parents in an Irish context whose children have experienced sexual abuse and aims to explore the pathways to distress. This is in order to understand what factors facilitate or hinder parents from supporting their child to the best of their ability, given that parental support is a crucial moderating factor in children’s recoveries. Semistructured interviews were carried out with 13 parents in this context and analyzed using a grounded theory methodology. The overall concept that emerged was termed “systemic trauma” and was composed of eight categories that help to explain the pathways of impact for parents. This model can help clinicians understand and respond to the needs of parents in the aftermath of CSA. [ABSTRACT FROM AUTHOR]

This article presents the lived experience perspective of adult mental health (MH) service users of Irish origin receiving treatment from culturally diverse MH professionals. The current study applied Grounded Theory principles to explore the service users' experiences of MH service and being treated by ethnically diverse professionals within it. The aim of the research was to focus on the quality of the therapeutic process. The project is based on nine comprehensive interviews exploring the service users' experiences of their journey to recovery. Four core themes emerged: (1) treatment and recovery, (2) positive service attributes, (3) negative service attributes along with appreciation and (4) acceptance of cultural diversity. The subthemes of: positive, empowering therapeutic relationship with the service provider and trust in the expertise of the professional, regardless of the service provider's nationality, pervaded through other issues. Initial apprehension of cultural difference in relation to e.g. language was among the findings encountered. This and other results in relation to the service users' experience of cultural diversity among clinicians are discussed and suggestions for further research offered. [ABSTRACT FROM PUBLISHER]

International policy initiatives have highlighted the need to include older lesbian, gay, bisexual and transgender (LGBT) issues in the provision of appropriate health and social care. However, empirical studies in the area remain sparse. The aim of this study was to investigate the experiences and needs of LGBT people over the age of 55 years living in Ireland and this article reports on specific mental health issues. Mixed methods were used involving 144 surveys and 36 semi-structured in-depth interviews. The findings revealed that a significant number of the survey respondents had experienced a mental health problem at some point in their lives with interview participants providing further details of their concerns. It is recommended that policy makers address the mental health needs of older LGBT people in future strategic directives and develop standards of care that support the principles of equality, inclusion and respect for diversity. [ABSTRACT FROM AUTHOR]

Objectives. This study assessed the impact of the introduction of a Home-Based Treatment (HBT) Service on hospital admission rates from two adjacent sectors within a mental health service. Methods. This study used a naturalistic design to compare admissions into the acute inpatient psychiatric unit of Cavan General Hospital from two differently configured sectors - East and West Cavan Psychiatric sectors (East was a community-based and oriented service while the West was a more hospital-based service) prior to and following the introduction of a shared home-based treatment team. Data including demographics, date of admission, diagnosis at admission and sector of admission were retrospectively collected from a mental health register of hospital admissions between 1995 and 2002. Data was analysed using SPSS version 13 for windows. Results. There was a 50% reduction in admission to the inpatient unit in the first two years of the introduction of HBT. This drop was more marked in the West sector compared to the East. Conclusions. The introduction of HBT resulted in a marked reduction in overall hospital admission rates and this reduction was also evident in the sector where other elements of a modern community mental health service already existed. [ABSTRACT FROM AUTHOR]

The provision of online counselling and emotional support is a subject of intense debate among service providers. The subject is explored here by triangulating data from a statistical analysis of data from a children's helpline, interviews with practitioners and a focus group. Despite practitioners' concerns relating to misinterpretation, misrepresentation and the lack of non-verbal cues, online conversations are shown to span a greater variety of topics and focus on more sensitive issues than verbal sessions. Online services have potential for reaching clients in accessible and meaningful ways. However, practitioners need to consider online-specific issues, undertake specialised training and become comfortable with these new communication formats. [ABSTRACT FROM PUBLISHER]

The concept of recovery has become central to international mental health policy and service planning. At present there, however, is no unified theory of mental health recovery available to guide clinical practice. The aim of this study was to develop a coherent theory of recovering from mental health problems from the point of view of those recovering in Ireland. The study was guided by classic grounded theory and based on individual interviews with 32 volunteers who had experienced mental health problems. The participants' main concern was identified as striving to reconnect with life. The core category of reconnecting with life had three interactive subcategories: (1) reconnecting with self through accepting oneself as a worthy human being capable of positive change; (2) reconnecting with others through accepting and validating interaction; (3) reconnecting with time, through getting a glimpse of positive future, coming to terms with the past, and actively shaping and executing one's present and future. The study shows that accepting, validating and the hope-instilling interaction can facilitate the process of reconnecting with life and is, therefore, crucial for recovery-oriented care. [ABSTRACT FROM AUTHOR]

Facing infertility and undergoing fertility treatment can create emotional turmoil in couples' lives. It is essential for fertility therapy providers to assess the coping and communication strategies of couples before treatment in order to provide appropriate support. We performed a two time point (year 2003 & year 2009) cross-sectional study of patients attending our services to undergo in vitro fertilisation. All couples attending the Human Assisted Reproduction Ireland Unit, a tertiary referral academic centre at the Rotunda Hospital, were requested to complete a psychosocial questionnaire before commencing the treatment. The questions assessed couples' understanding of their own infertility, family background and support, relationship traits and stress levels prior to commencing fertility treatment. A total of 180 patients participated in the study. Our findings showed that within a 6-year time span, couples' attitudes have changed significantly. Compared to 6 years ago, couples now have a better understanding of infertility and are seeking treatment quicker. Interestingly, we showed higher stress levels nowadays with fewer couples following routine stress management. We also identified specific gender differences in that women have a more open attitude in discussing infertility and seeking more support from friends and family compared to men. [ABSTRACT FROM AUTHOR]

Ethnically, Ireland has diversified greatly over the past few years. According to the 2006 census, 419733 foreign nationals live in Ireland. Immigration is one of the one of the most stressful events a child can undergo; it involves profound changes, including a disruption of well-established relationships and acculturation. Since the long-established and dominant pattern for years had been emigration, Ireland is poorly equipped to meet mental health needs of immigrant children. [ABSTRACT FROM AUTHOR]

The Model of Human Occupation (MOHO) is frequently used to guide mental health psychosocial programs. However, the benefits of these programs are not fully understood. This study explores the impact of a program that addresses the volition, habituation, and skill challenges reported by those with mental health problems. Follow-up data were collected 32 weeks and I year after initial assessment. Based on follow-up data for 28 participants, improvements in the areas targeted by the intervention were found at both time periods. [ABSTRACT FROM AUTHOR]

This article reports on the relationship between same-sex attraction, experience of bullying in school and mental health measured using the 12-item version of the General Health Questionnaire (GHQ12). A random sample of 16 year olds, drawn from the Child Benefit Register, was invited to take part in the 2005 Young Life and Times survey, which is a postal survey carried out in Northern Ireland every year. Eight hundred and nineteen 16 year olds responded, which represented a return rate of 40%. The results of the survey showed that respondents who said they had been attracted to a person of the same sex at least once were significantly more likely to report experiences of school bullying. Same-sex-attracted 16 year olds were significantly less likely than those attracted to persons of the opposite sex only to say that their school provided real help to those who are being bullied. The 2005 Young Life and Times data also indicated that same-sex-attracted respondents were more than twice as likely as respondents who were only attracted to people of the opposite sex to have higher levels of psychiatric disorder. [ABSTRACT FROM AUTHOR]

This study investigated the involvement in bullying, the psychological distress, and the coping strategies of 99 males in an English young offenders institution. The Direct and Indirect Prisoner Behaviour Checklist (DIPC; Ireland, 1998), the 21-item Depression Anxiety Stress Scales (DASS; Lovibond & Lovibond, 1995) and the 48-item Coping Styles Questionnaire (CSQ; Roger et al., 1993) were administered. Over 60% of prisoners were involved in bullying (as a victim or bully), as indicated by responses on the DIPC. Emotional and avoidance coping were significantly related to psychological distress. Bully/victims were significantly more depressed than prisoners not involved in bullying, and being a bully/victim was a significant predictor of higher stress scores. Significant correlations were observed between all psychological distress measures and the number of bullying behaviours experienced by prisoners. These findings are discussed in relation to their implications for prisoner care and avenues for future research are proposed. [ABSTRACT FROM AUTHOR]

The concept of dangerousness is currently used to justify an increasing proportion of involuntary admissions to psychiatric beds in many modern societies, including the UK. However, this is not a new phenomenon. There was a similar increase in use of 'dangerousness' as a criterion for admission to Irish public asylums in the second half of the nineteenth century. The Irish experience is explored, using the annual reports of the Lunacy Inspectorate for Ireland and case records of the District Asylums at Belfast (opened 1825) and Omagh (opened 1853). The excessive use of 'dangerous lunacy' legal procedures in asylum admissions is discussed in the context of the uneasy political climate in Ireland at the time, the acceptance by the public of an obviously flawed law, and the gendered impact it had on the asylum population. Many of the issues raised are relevant to current mental health policy debates. [ABSTRACT FROM AUTHOR]