The Mental Health Act 2001 was implemented in 2006 to bring Ireland into line with international practice and United Nations Conventions on Human Rights. Previous studies have reported some practical difficulties for the professionals involved. We wished to examine the experiences of nursing staff and the impact of the Act on clinical nursing practice since its implementation.

This cross-sectional survey was conducted by questionnaire. It contained questions examining training in and attitudes to the Act, and any resultant changes in nursing practise.

A total of 317 questionnaires were returned. Of the nurses, 92% reported having received training in the Act, and 56% of nursing staff believed that their workload had increased as a result of the change in legislation. Of those who made a comment, 76.5% were negative, with increased paper work, lack of clarity and an excessive focus on legalities being the most common difficulties reported.

Nursing staff have shown mixed attitudes to the Mental Health Act 2001, but many of the difficulties encountered are similar to those experienced by other professionals.

The main objectives were to assess medical students’ opinions about e-learning in psychiatry undergraduate medical education, and to investigate a possible relationship between learning styles and preferences for learning modalities.

During the academic year 2009/2010, all 231 senior Royal College of Surgeons in Ireland (RCSI) medical students in their penultimate year of study were invited to answer a questionnaire that was posted online on Moodle, the RCSI virtual learning environment.

In all, 186 students responded to the questionnaire, a response rate of 80%. Significantly more students stated a preference for live psychiatry tutorials over e-learning lectures. Students considered flexible learning, having the option of viewing material again and the ability to learn at one’s own pace with e-learning lectures, to be more valuable than having faster and easier information retrieval.

Students prefer traditional in-class studying, even when they are offered a rich e-learning environment. Understanding students’ learning styles has been identified as an important element for e-learning development, delivery and instruction, which can lead to improved student performance.

The emergence of mental health services for older people is a relatively recent development in Ireland. Therefore, it is important to determine strengths and limitations of this modern-day care service. A starting point is to enquire from those who have been in receipt of their service and/or their respective carers.

This study aims to identify and describe the perceptions and experiences of past service users (SUs) and their carers, while in receipt of services from an acute mental health day hospital for Psychiatry of Later Life and to explore their needs/supports.

A qualitative, exploratory, descriptive design was employed. Purposive sampling achieved a sample of 13 SUs and six carers. Inclusion criteria set were that the SU had a diagnosis of a psychiatric disorder; had the capacity to make an informed consent and communicate verbally and the SU was discharged from the service between January and July 2011. Finally, carers of SUs in receipt of the service during this time were also included. Data were subjected to thematic, field analysis.

‘Person centredness’ emerged as an overarching theme. Six inter-related subthemes revealing how SUs and carers viewed their care emerged from the interviews: ‘therapeutic engagement’; ‘preservation of self-integrity’; ‘collaborative care’; ‘integrated care’; ‘social gains’; and ‘the relationship between the expectation, subsequent engagement and the perceived outcome of care’.

Findings concluded that high levels of care exist within this service. Strengths lie in the development of a therapeutic relationship, preservation of self-integrity, social gains and robust elements of person-centred holistic, integrated and collaborative care

Recommendations support the enhancement of a cohesive planned approach to admission, discharge/transition (integrated pathway).

This study was to assess the attitudes and practice of, senior psychiatric trainees with regard to bibliotherapy.

A brief online survey was used to assess the attitudes to and practice of bibliotherapy among senior psychiatric trainees in Ireland. There were 34 responses out of 82 (response rate 41.5%). Respondents were asked to indicate their agreement with three statements.

The majority 27 (79.4%) strongly agreed or agreed that they were comfortable recommending books, with none strongly disagreeing and 4 (11.8%) disagreeing. Over half 20 (58.8%) of respondents strongly disagreed or disagreed that self help books could only be a poor substitute for psychotherapy or counselling, with none strongly agreeing and 2 (5.9%) agreeing. Many 19 (55.9%) disagreed or strongly disagreed that self help books could do more harm than good, with 8 (23.5%) agreeing or strongly agreeing. Finally respondents were asked to state their awareness of prescribe-a-book schemes. 4 (11.8%) respondents reported awareness, with 30 (88.2%) unaware of any such schemes.

Although majority of senior psychiatric trainees were comfortable recommending self help books and did not consider them harmful, most were unaware of such schemes in Ireland.

This study sought to ascertain the prevalence rates and risk factors for a range of mental health difficulties, including suicidal ideation/self-harm among 16 and 17-year-old rural Irish adolescents, a vulnerable group in transition from childhood to adulthood.

Adolescents (n=237) took part in this cross-sectional study. Participants completed a questionnaire compendium consisting of generic questions on demographic information, use of mental health services and four normed questionnaires: The Youth Self-Report, the Children’s Depression Inventory, the Coping Inventory for Stressful Situations-Adolescent and The Family Assessment Device.

We found that 16.9% of adolescents reported clinically significant mental health difficulties. Significant gender differences were found on internalising and externalising difficulties. There were no gender differences in suicidal ideation or self-harm. Only 3.4% of adolescents were receiving professional help for mental health difficulties. Multiple regression analyses revealed that family dysfunction, emotion-focussed coping and poor academic competence were significant predictors of poorer mental health difficulties in both genders. Family dysfunction was the strongest predictor of mental health difficulties in males. Among females, emotion-focussed coping was the strongest predictor of internalising difficulties and depression. Social diversion (social support) was predictive of less internalising difficulties and depression for females.

The study shows that a significant number of Irish 16 and 17 year olds have mental health difficulties, yet very few are receiving treatment. Emotion-focussed coping, family dysfunction, poor academic competence and less social support were important predictors of mental health difficulties. A new finding is the stronger association that family dysfunction has with poorer mental health in males than females, when controlling for academic competence and coping skills. The findings may have implications for psychological interventions.

1) to assess compliance with the Data Protection Acts (DPA) by a Department of Psychiatry in a general hospital, 2) to implement measures that are likely to maximize compliance with the hospital data protection policy, 3) to close the audit cycle by assessing the impact of such measures on departmental compliance with the DPA over five months period.

An individual, anonymised staff questionnaire on data collection practices, procedure of disclosure of data to third parties and previous training on DPA was used to collect information from the department staff. The premises were inspected at different times over a week period using structured checklist. Default points were recorded during each inspection. Post-audit interventions included a mixture of educational interventions and practical solutions. A re-audited took place five months later using the same method.

The baseline audit demonstrated significant lack of compliance with the DPA among staff members and lack of staff training on the DPA. Following the interventions, staff awareness of the requirements of the act rose which in turn lead to better adherence to recommend practices in data handling and to mean default points dropped significantly. Management of manual files appears to constitute the biggest problem in this audit. Daytime breaks were found to pose higher risk to stored data compared with before and after working hours.

A combination of educational and practical interventions including training of staff on the DPA results in overall improvement in compliance and reduction in default points. However, management of manual (physical) data proves to be more difficult and hence will need more input.

Suicide is a major public health problem, with mental disorders being one of its major risk factors. The high incidence of suicide on the Isle of Wight has motivated this study, the first of its kind on suicide in this small geographic area.

The aim of the study was to identify socio-demographic and clinical risk factors for suicide in the population of service users and non-service users, and gender-related characteristics of suicidal behaviour in a limited geographic region.

Data were collected on 68 cases of suicide (ICD-10×60-X84) from residents of the Isle of Wight District between January 2006 and December 2009. All data were statistically analysed using Pearson’s χ2 test and Yates’ correction for continuity.

The mean annual suicide rates over the period were 5.65 per 100 000 for women and 19.28 for men. Significantly (p=0.0006), more men than women (male/female ratio 3:1) died as a result of suicide. Relatively (p=0.07) more women (56.2%) than men (32.7%), and significantly more (p=0.05) service users (45.3%) than non-service users (13.3%) were unemployed. Significantly, more (p=0.0006) service users (64%) than non-service users (20%) had a history of suicide attempts and relatively (p=0.06) more (50.9%) service users than non-service users (20%) had attended the accident and emergency department before their death; 69% had an adverse life event within a year before their suicide. Depression as the most common Axis-I illness was diagnosed in 36% of all; but significantly (p=0.008) more in women (66.6%) than men (17.3%). Relatively (p=0.07) more women (56.2%) than men (32.7%) have contacted services before their death. Suicide by hanging was the most common cause, accounting for the death of 71% of men and 50% of women.

The study found that 80% of all suicides occurred in people suffering from mental disorder. Men are at a significant risk of suicide. Depressive disorders in women and stress-related disorders in men were the most common mental disorders. Treating mental disorders and co-morbid conditions seems to be one of the key elements in suicide prevention strategies.

We present the case of a 27-year-old man with a background diagnosis of treatment resistant schizophrenia and absent insight who for the last 3 years has been residing in a high support residential setting on approved leave under the Mental Health Act (MHA) 2001. The case demonstrates how this man achieved clinical stability in the community with the assistance of long-term involuntary admission under the MHA 2001, in contrast to the previous years of his illness in which he had suffered multiple relapses of his psychotic illness with ssociated distress, poor self-care and repeated in-patient re-admissions. We discuss the equivalent use of community treatment orders in other jurisdictions and how the judicious use of approved leave under the MHA 2001 may be used as an alternative in Ireland where community treatment orders are not currently available.

Case Report.

The case report highlights how the use of long-term approved leave under the MHA2001 may be used as alternative in Ireland to mimic CTOs for certain difficult to treat patients with psychotic illness who would benefit from ongoing treatment, but lack capacity to engage in such treatment due to persistent symptoms and lack of insight.