A national survey of offending behaviour amongst intellectually disabled users of mental health services in Ireland

2015 ◽  
Vol 33 (4) ◽  
pp. 207-215 ◽  
Author(s):  
P. Leonard ◽  
A. Morrison ◽  
M. Delany-Warner ◽  
G. J Calvert
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Mental Health Services ◽  
Health Services ◽  
Service Providers ◽  
Service Users ◽  
Republic Of Ireland ◽  
Disability Service ◽  
The Republic ◽  
Offending Behaviour

BackgroundOffenders with an intellectual disability pose a major challenge to Intellectual Disability Service providers in the Republic of Ireland. This is especially so as no national Forensic Intellectual Disability Service currently exists.The Forensic Intellectual Disability Working Group of the Irish College of Psychiatrists was established in order to take steps to address this issue by establishing the level of need for a Forensic Intellectual Disability Service in Ireland and developing a college position paper.No previous study has been carried out to measure offending behaviour amongst persons with an intellectual disability attending mental health services in Ireland.MethodsA postal survey was undertaken targeting the lead clinicians of all Intellectual Disability Psychiatry, General Adult Psychiatry and Forensic Psychiatry Services in the Republic of Ireland. This survey requested anonymous data regarding service users with an intellectual disability and offending behaviour in this population.ResultsData relating to 431 service users was returned. Those reported to engage in offending behaviour were predominantly young males. Assault was the most common offence type. A significant number of serious offences such as unlawful killing, sexual assault and arson were reported.ConclusionsThere is an urgent need for the development of a Forensic Intellectual Disability Service in the Republic of Ireland. The current efforts of the National Forensic Mental Health Service to establish such a service by the creation of a post of Consultant Forensic Psychiatrist (special interest in intellectual disability) are to be welcomed.

Barriers and Supports Experienced by Pacific Peoples in Aotearoa New Zealand’s Mental Health Services

2021 ◽  
pp. 002202212110398
Author(s):  
Christina Fa’alogo-Lilo ◽  
Claire Cartwright
Keyword(s):  
Mental Health ◽  
New Zealand ◽  
Mental Health Services ◽  
Health Services ◽  
Cultural Values ◽  
Mental Health Problems ◽  
Service Providers ◽  
Health Problems ◽  
Service Users ◽  
The Family

As with minority groups internationally, Pacific peoples in New Zealand (Pasifika) experience higher rates of mental health problems than the general population, and are less likely to access mental health services. This study investigated the barriers and supports for Pasifika accessing and using mental health services with participation of 25 Pasifika (10 service-providers, 11 ex-service-users, and 4 ex-service-users/providers) in order to gain their key informant perspectives. A Pasifika-appropriate Talanoa approach was used to guide the data-collection process and the qualitative data were analyzed using thematic analysis. Barriers included stigma among Pasifika regarding mental health problems, commitment to finding solutions within the family, and both mistrust and lack of knowledge of services. Within the services, non-Pasifika providers often lacked understanding of the collectivist cultural values and practices of Pasifika, including spiritual beliefs. They were more likely to use services if the providers were respectful of Pasifika practices and paid attention to developing relationships in a culturally appropriate way. This included involvement of the Pasifika family, when possible. Service-users often benefited from contact with Pasifika providers within mainstream services. These results support previous cross-cultural research that indicates the importance of offering evaluation and intervention services grounded in an understanding and respect for the cultural significance and meaning of mental health problems for the person, the family, and their community. While efforts are made to address these issues in New Zealand, change is slow and ongoing cultural training for service-providers along with psychoeducation for Pasifika about mental health services is strongly desirable.

scholarly journals Who is in the transition gap? Transition from CAMHS to AMHS in the Republic of Ireland

2015 ◽  
Vol 32 (1) ◽  
pp. 61-69 ◽  
Author(s):  
F. McNicholas ◽  
M. Adamson ◽  
N. McNamara ◽  
B. Gavin ◽  
M. Paul ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Service ◽  
Health Services ◽  
Young Person ◽  
Republic Of Ireland ◽  
Transition Boundary ◽  
The Republic ◽  
Service Need

ObjectiveThe ITRACK study explored the process and predictors of transition between Child and Adolescent Mental Health Services (CAMHS) and Adult Mental Health Services (AMHS) in the Republic of Ireland.MethodFollowing ethical approval, clinicians in each of Ireland’s four Health Service Executive (HSE) areas were contacted, informed about the study and were invited to participate. Clinicians identified all cases who had reached the transition boundary (i.e. upper age limit for that CAMHS team) between January and December 2010. Data were collected on clinical and socio-demographic details and factors that informed the decision to refer or not refer to the AMHS, and case notes were scrutinised to ascertain the extent of information exchanged between services during transition.ResultsA total of 62 service users were identified as having crossed the transition boundary from nine CAMHS [HSE Dublin Mid-Leinster (n=40, 66%), HSE South (n=18, 30%), HSE West (n=2, 3%), HSE Dublin North (n=1, 2%)]. The most common diagnoses were attention deficit hyperactivity disorder (ADHD; n=19, 32%), mood disorders (n=16, 27%), psychosis (n=6, 10%) and eating disorders (n=5, 8%). Forty-seven (76%) of those identified were perceived by the CAMHS clinician to have an ‘on-going mental health service need’, and of these 15 (32%) were referred, 11 (23%) young people refused and 21 (45%) were not referred, with the majority (12, 57%) continuing with the CAMHS for more than a year beyond the transition boundary. Young people with psychosis were more likely to be referred [χ2 (2, 46)=8.96, p=0.02], and those with ADHD were less likely to be referred [χ2 (2, 45)=8.89, p=0.01]. Being prescribed medication was not associated with referral [χ2 (2, 45)=4.515, p=0.11]. In referred cases (n=15), there was documented evidence of consent in two cases (13.3%), inferred in another four (26.7%) and documented preparation for transition in eight (53.3%). Excellent written communication (100%) was not supported by face-to-face planning meetings (n=2, 13.3%), joint appointments (n=1, 6.7%) or telephone conversations (n=1, 6.7%) between corresponding clinicians.ConclusionsDespite perceived on-going mental health (MH) service need, many young people are not being referred or are refusing referral to the AMHS, with those with ADHD being the most affected. CAMHS continue to offer on-going care past the transition boundary, which has resource implications. Further qualitative research is warranted to understand, in spite of perceived MH service need, the reason for non-referral by the CAMHS clinicians and refusal by the young person.

Jigsaw: Engaging communities in the development and implementation of youth mental health services and supports in the Republic of Ireland

2010 ◽  
Vol 19 (5) ◽  
pp. 422-435 ◽  
Author(s):  
Robert J. Illback ◽  
Tony Bates ◽  
Craig Hodges ◽  
Karen Galligan ◽  
Patrick Smith ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Youth Mental Health ◽  
Republic Of Ireland ◽  
The Republic ◽  
Services And Supports

scholarly journals Supporting mental health service users to stop smoking: findings from a process evaluation of the implementation of smokefree policies into two mental health trusts

2020 ◽  
Author(s):  
Susan E Jones ◽  
S. Mulrine ◽  
H. Clements ◽  
S. Hamilton
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Collective Action ◽  
Process Evaluation ◽  
Service Providers ◽  
Service Users ◽  
Process Data

Abstract Background: Life expectancy is 10-20 years lower among people with a severe mental health disorder. Most of these early deaths are due to chronic conditions, including cardiovascular and respiratory diseases. Smoking is a major risk factor for these conditions and introducing smokefree policies has been recommended to mental health service providers in England by the National Institute for Health and Care Excellence (NICE), in their Public Health Guideline 48: Smoking: acute, maternity and mental health services. This paper reports a process evaluation of introducing these policy recommendations, which were updated in 2013. Aim: To reflect on the process outcomes when introducing smokefree policies in National Health Service (NHS) Trusts providing mental health services in an English region. Method: Process data were collected through semi-structured interviews with staff (n=51), members of partnering organisations (n=5), service users (n=7) and carers (n=2) between November 2016 – April 2017. Normalization Process Theory (NPT) was used to design the data collection tools and analyse the data. A framework approach was taken with the analysis, using the four concepts of NPT: coherence, cognitive participation, collective action and reflexive monitoring. Results: The policy made sense to some staff, patients and carers (coherence) who ‘bought-into’ the idea (cognitive participation) but other participants disagreed. Although smokefree policies were operationalised (collective action), sometimes they were opposed. Progress was made, especially in some units, but continued to be resisted in others. Informal appraisal of progress (reflexive monitoring) presented a varied picture. Conclusion Some progress has been made in terms of changing an entrenched, smoking culture into one that is smokefree on Trust sites across the region. Perseverance and resourcing over the long-term is required to establish a non-smoking culture in on-site provision of mental health services.

scholarly journals Speaking Truth to Power: Mental Health Service Users’ Experiences of Participation in their Diagnosis and Treatment

2020 ◽  
Vol 22 (1) ◽  
pp. 137-156
Author(s):  
Gloria Kirwan
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service User ◽  
Help Seeking ◽  
Service Providers ◽  
Diagnosis And Treatment ◽  
Service Users

In a qualitative study, long-term mental health service users shared their views on the concept of ‘participation’ as shaped by their personal histories of contact with mental health services in Ireland. Adopting a narrative methodology, the study participants were asked to draw on their experiences with mental health services to illustrate their general views on participation by service users in mental health care contexts.In this study, the research participants recounted positive experiences of participation in which their expressed views regarding their symptoms and treatment needs were incorporated into the service responses they received. The data revealed that service users perceived open and inclusive communication by service providers as an important factor in optimising their ability to participate in help-seeking, diagnosis and treatment plans. However, the study also illuminated the chilling effect on participation when service users’ views were not heeded or acknowledged by service providers. The findings highlight how the failure to include service users’ insights can negatively encroach on service user participation. The service user narratives collected in this study exposed the often uneasy juxtaposition of the service user’s personally held ‘truth’ regarding their lived experience of mental distress versus the powerful system of expert diagnosis and treatment. This article focuses on reporting selective findings from the study regarding participation in the contexts of help-seeking, diagnosis and treatment decisions.

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