Issue 6, November 2011
Minister of State for Mental Health opens at St Conal’s has closed, community services have These developments are a tribute to the HSE Staff in
been developed and the new acute admissions unit is the mental health services and their drive to
new Department of Psychiatry Admissions being opened. Yes, I am very happy to report that ‘A modernise and de-stigmatise mental health services.
Unit: A Vision for Change Chapter 17 Vision for Change’ is alive and progressing well in The common goal is simply to provide the best service
Donegal." The Department of Psychiatry Admissions in an environment which promotes recovery and well
Ms. Kathleen Lynch, T.D., the Minister of State for Unit consists of a single storey building with a total being for patients who use the service”.
Disability, Equality, Mental Health and Older People, floor area of approximately 1,790m2. Construction
has officially opened the new Department of started in March 2010 and the project cost €5.95m in Effective from Monday, 19th September, the
Psychiatry Admissions Unit on the grounds of total. The new unit will support a comprehensive telephone numbers for the new Department of
Letterkenny General Hospital. integrated mental health service for a defined Psychiatry Admissions Unit are:
catchment area of approximately 145,000 in 074 91 04700/ 07491 04704 / 087 6182621
The Department of Psychiatry Admissions Unit, population. It will provide a wide range of
which is part of Donegal Mental Health Services, has treatments, multidisciplinary interventions,
34 beds offering inpatient care to service users over counselling and support geared towards meeting
18 years of age, along with mother and baby individual needs.
accommodation and facilities which are specifically
designed to accommodate people over 65 with Speaking at the official opening on Monday, John
particular mental health needs. In addition, the Hayes, HSE Area Manager for Donegal, said; “The
local Mental Health service focus on rehabilitation
and recovery will be enhanced by the fully equipped
recreational and occupational therapy departments
at the new unit, along with administration,
treatment, teaching and tribunal facilities.
Service users celebrate success of
completing new self harm reduction
programme: A Vision for Change Chapter
15
opening of the new unit is a great step forward in the 12 service users from the HSE South’s North Lee adult
delivery of mental health services in Donegal. In mental health services in Cork graduated on
addition to the new unit we have a community September 14th 2011 having successfully completed a
Congratulating the Donegal Mental Health Services mental health team located in the primary care new self-harm reduction programme, called the
on progress made in the implementation of ‘A Vision centre in Letterkenny; a new base was established in “Endeavour Programme”. The graduates received
for Change’, Minister Lynch remarked that "the Donegal Town for Child and Adolescent Services in their certificates from Cork’s Lord Mayor, Cllr. Terry
Donegal Mental Health Service has reached a the past eighteen months; and rehabilitation services Shannon at Cork City Hall.
significant milestone here today; the old institution were established.
Issue 6, November 2011
The graduates have been diagnosed with borderline members and others who are concerned for a person
personality disorder, which is recognised by its key Mr. Flynn and two colleagues Dr. Mary Kells, Clinical
features of difficulties in managing emotions, Psychologist and Ms. Sarah Herley, Assistant
continual self-harm and repeated suicidal behaviour. Psychologist are also trained to deliver a 12 week
They have been learning how to cope with these family treatment programme to accompany the
difficulties through intensive individual therapy and Endeavour programme. The Family Connections
by learning alternative healthy coping skills and Programme developed by Dr. Alan Fruzetti and Dr.
behaviour. Perry Hoffman in the United States educates families
about borderline personality disorder and helps them
The Endeavour programme is an evidence based to cope more effectively with the challenges posed by
treatment using dialectical behaviour therapy (DBT), their loved ones' emotional and behavioural problems.
a treatment developed by Dr. Marsha Linehan, a US According to Mr. Flynn, “This has been invaluable to
based clinical psychologist. The treatment is families who have in many cases struggled for years in
comprised of group skills training, individual therapy not understanding their loved ones' difficulties and
and phone coaching (9am to 9pm Monday to Friday feeling isolated and marginalised. The Endeavour
and 2 to 6 pm on Saturday and Sunday) to help with BPD commonly report feeling overwhelmed and Family Connections Programme has allowed families
clients let go of self-destructive behaviour and traumatised by the behaviours that frequently to meet, gain understanding, learn coping skills and
improve their quality of life. The programme began accompany borderline personality disorder (suicide gain support from the service and each other. This
in early September 2010 and ran for a period of 12 attempts, intense anger and self-harm). This results has helped reduce both levels of family stress and
months. in highly stressful and chaotic situations for the anxiety in coping with the behaviours associated with
person and their families. their loved ones' condition.”
Self-harm and repeated suicidal behaviour is a
growing problem in Cork and indeed nationally in According to Daniel Flynn, Senior Clinical Psychologist Mr. Flynn acknowledged “the hard work and
recent years. To tackle this, six HSE South staff with and leader of the Endeavour Programme, “This is a dedication of both staff and programme participants
backgrounds in psychology, psychiatry, nursing and comprehensive treatment programme for patients in making the inaugural year of the Endeavour
art therapy based at the HSE South’s North Lee with severe self-harm. It represents how existing programme such a success” and announced that he
Adult Mental Health Services developed and co- mental health staff can work in a co-ordinated was “delighted that funding has been secured from
ordinated the Endeavour Programme for people fashion to deliver highly effective evidence-based the HSEs National Office for Suicide Prevention
diagnosed with borderline personality disorder. treatments to chronically self-harming and suicidal (NOSP), to expand the programme beyond North Lee
clients with minimal additional costs to the HSE. to all of Cork county in early 2012. This should enable
A Vision for Change (2006), the national mental These clients normally have frequent contact with us to offer the Endeavour programme to an additional
health policy document highlights that given the GPs, emergency departments and multiple hospital 36 service users and their families, with the potential
complexity of their presentations, individuals with admissions in the context of emotional distress and to expand this further in time.”
borderline personality disorder present a significant self-damaging behaviour. Today 12 programme
challenge for mental health services. Due to their graduates and their families should see a marked Maura (not her real name), one of Endeavour’s
severe self-damaging behaviours, these individuals decrease in this behaviour, which will improve their graduates said, “After 25 years of chronic low self-
can find it difficult to engage in standard care and lives and that of their families and should also reduce esteem, a combined total of 12 year’s hospitalisation
don’t respond well to typical treatments. Family their crisis attendances at our heath facilities.” on foot of repeated self-harming behaviours and
Issue 6, November 2011
multiple suicide attempts, my life is now For more information please contact North Lee
transformed. I am now working and studying part- Adult Mental Health Services 021-4921632
time, I am using the skills from the programme and
at last I am living life. I am so grateful for DBT and
to the Endeavour team. Without them I would not
be here today. I could not have lived another year WORLD MENTAL HEALTH WEEK EVENT:
as I was.” A Vision for Change Chapter 5
Families also appear to have benefited greatly from The North Strand Community Mental Health Team,
their improved understanding of their loved one's organised a multi-agency open day event to mark
difficulties and have begun to make changes too. World Mental Health Week. The theme of the day
One of the graduates’ family members was able to was ‘Resilience’. Over 25 local and national groups
go on holidays this summer for the first time in participated and the event was supported by Eileen
years. Dunne. The event reflected the team’s philosophy
that positive mental health is supported and For more information please contact: North Strand
Gretta Crowley, Operations Manager with the HSE promoted by many local and non-statutory agencies
South said “The staff involved in Endeavour has Community Mental Health Team members
within the community, in addition to HSE services. Antoinette Hughes, Michael McCormick or Laura
worked very hard to develop a programme that is in-
King on 01-8554590
line with best international practice, and now 12 The participants included local counselling services
months on we have seen the positive changes that for young people and adults, training/education
such work can bring for these individuals and their centres, family support services, suicide prevention
families. The Endeavour programme represents the and public advice services. The North Strand Addressing Mental Health needs in the
first comprehensive DBT programme in Ireland Community Mental Health Team had presentations on
outside of Dublin.
context of Primary Care: A Vision for
recovery process, mood and food, health body-health
Change Chapter 7
mind (exercise) and on how a multidisciplinary team
This graduation ceremony marks the end of a year of approach works well in mental health.
intensive intervention for the programme In 2010 primary care teams were first offered the
participants and celebrates the ongoing commitment Feedback from the event was very positive from both opportunity to participate in the “Mental Health in
of the HSE South in providing effective treatment participants and public – Primary Care” module in DCU. This course raised our
for those impacted by self-harm and chronic suicidal awareness of the mental health needs of the general
thoughts. New funding from NOSP is providing for population and the potential role of primary health
‘good to learn there is help out there for people my care professionals in addressing these needs.
the programme’s expansion throughout Cork county
age’
along with research projects, which will further our
‘great health promotion’
knowledge and understanding of the challenges Through our own practice and discussions with other
‘great to see services from different aspects of
faced by this client group and their families.” primary care team members and community workers
mental health’
it was apparent that stress and anxiety were affecting
people significantly in the community. In response to
-North Strand Community Mental Health Team. this we ran a 6-week “stress and well-being”
Issue 6, November 2011
programme earlier this year in a local community
centre. On Average, 13 people attended the group. I went along to my first Recovery group meeting in
This resulted in positive outcomes based on the Clontarf. I was so taken in by the support and
pre- and post-assessments used. Given the success understanding of what Recovery is about. Meetings
of this programme and level of demand we are are a place where peace and calm are fostered.
currently running a second programme with 18 Reading the work of Abraham Low’s book ‘Mental
people enrolled. health through will training’ is the fundamental
source of Recovery International. Gradually, my fears
changed from hopeless to hopeful.
It is hoped that this type of programme will promote
the mental health of participants and equip them in
Today, I have completed a third level degree and
dealing with stress and anxiety. postgraduate course and I am the assistant leader for
the Clontarf Recovery Group. I am more confident
For more information contact: and less fearful than previously in terms of raising my
Marie Kinsella (Social Worker: Dublin South emotional self-esteem. Most importantly, my
Central) and & Jennifer Clarke (Occupational daughters are my life greatest achievements.
Therapist: Dublin South Central) on 01-4150131. I first had depression about three years after the
breakdown of my marriage. During my working days
Recovery & Mental Health personal story and looking after my daughters, I had days of staying It takes time to learn the method, but Recovery
at home and thinking inner dark thoughts. At work I International has thought me to break everyday life
on overcoming depression with Recovery
was bullied and really felt put down and suffered into situations in part acts. I am incredibly grateful to
International: A Vision for Change from low self-worth and self-esteem. be part of Recovery International. It has helped me to
Chapter 12 speak about mental health problems. Depression took
For years I was filled with fear and feelings of over a big part of my life, but thank goodness, so
Wednesday evenings are Recovery nights. It has inadequacy. I was overcome with fatigue, does Recovery International. It is hard work but the
been 6 years since I started attending Recovery depression, anxiety, no spontaneity, fear of being in quality of life is improving day by day!
International. I now value my mental health. I have crowds and fear of isolation. I just didn’t want to
it because I practiced Dr. Abraham Lows’ method to exist. I stayed in bed, moving only when I absolutely For further information on Recovery International
get it. This includes both self-spotting and peer had to. Some days the effort of trying to decide what and a Group near you, contact:
comments on others’ examples. My life has changed to eat, make school lunches and getting up was so www.recovery-inc-ireland.ie Tel: 01-6260775
because Recovery International has given me more overwhelming.
hope and motivation than I could ever imagine.
After a few years with a variety of different support
groups and anti-depressants, I felt I was living in a
fog. I remember telling my counsellor, I was having a
breakdown. This understandable person, told me
about a self-help organization called Recovery
International in my local area.
Issue 6, November 2011
HSE National Office for Suicide Prevention For more information please contact National
Catherine Brogan, Acting Director, National Office for Office for Suicide Prevention on 01-635 2179
Look after your Mental Health on World Suicide Prevention said “The key message of the
Mental Health Day ‘Your Mental Health’ campaign is that sharing a
Help those around you and seek support problem with someone you trust will have a positive
when you need it: A Vision for Change effect on how you are feeling. We need to encourage Crumlin & District Mental Health
Chapter 15.7 people to seek information, support each other and Association Cairde Le Chèile Social Club
Trip to France:
A Vision for Change Chapter 12.
know that when things are tough
they can turn to someone they trust. This is so
important for us all given the current economic
downturn, and the impact it is having on people’s
stress levels and well being.” Our group gathered at Armagh Road on Monday 20th
June to go on our holidays to France. We set off
The HSE encourages people to seek out support by towards Rosslare Harbour and boarded the Oscar
visiting www.yourmentalhealth.ie. The site is part of Wilde Car Ferry on time. We had our evening meal
According to the World Health Organization, up to the HSEs National Office for Suicide Prevention’s
one in four people will experience a mental health and watched the entertainment, afterwards we
ongoing public education campaign, and helps visitors headed to our personal cabins to sleep through the
problem at some point in their lives. to learn about their own mental health and how to
With that in mind, the HSE today (Monday 10th overnight trip to Cherbourg.
look after it. It also provides a wide range of
October, 2011) on World Mental Health Day, is information on mental health topics, and shows how
advising of the importance of seeking help when We arrived in France on Tuesday and drove straight to
and when to access help and support services. our first destination the IBIS Hotel in Caen. On
times are tough, and listening to people around us
who need support through its mental health public Wednesday we started with a thoroughly ‘al la
awareness campaign. François’ breakfast. We had good fun following the
Issue 6, November 2011
strict instructions and Brendan did a sterling job shopping at the fabulous French markets. After
following the sometimes confusing guiding voice Sunday mass we had lunch and headed off in the Five “Dragons”, representing various mental health
issuing from the satnav along the French roads and afternoon to Cabourg. This is a beautiful seaside organizations, were asked to describe their ideal
motorways. We journeyed to Omaha Beach – the site resort not unlike the famous French Riviera. The vision of how mental health should be treated and
of the Normandy Landing in 1944, during World War weather was so good that day and the golden beach then asked what they think is truly realistic, given
II. was heavenly that Mary described it as not unlike logistical constraints. Audience members were free to
paradise. ask questions throughout, leading to a stimulating and
On Thursday we went to Lyon Sur Mer, another site engaging discussion.
of the Normandy Landing during the Second World On Monday we stopped at Port En Basin and went to a
War 1940 - 1945. Stephen, Peter, Mary and Brendan war museum of tanks, guns and old boats that were The panel consisted of:
had a swim in the Atlantic Sea. The other members abandoned at Dunkirk. We headed for the ferry
of the group had tea on the terrace overlooking the home. The entire trip was a great success and an Brian Howard - CEO, Mental Health Ireland. John
beach. The scenery and weather were beautiful. adventure enjoyed by all. A notable landmark in Saunders - Director, See Change and Shine, Cindy
Cairde Le Chèile activities. O'Connor - Clinical Director and CEO, Pieta House,
Tim Smyth - Headstrong Youth Ambassador, Nigel
O'Callaghan - ReachOut Ambassador.
For more information please contact Crumlin
Mental Health Association, St Columbas, After an hour or so, a competition was run.
Armagh Road, Crumlin, Dublin 12 Headstrong provided a fund of up to €2000 for any
086-287 3526 student to run a project within the college
community in order to improve mental health
Crumlin & District awareness or promote positive mental health. The
panel listened to 5 shortlisted finalists propose their
Mental Health Association ideas before deciding Róisín Garvey, a final year Law
student, was the deserved winner.
Róisín's project, entitled "Caoga", the Irish for fifty,
involves the dispersion of information cards across
Mental Health Awareness at Trinity College Trinity campus. There will be 50 different types of
A Vision for Change Chapter 5 cards; each will fall under one of three
Friday brought us to Lisieux, the home of Saint headings: 1.Tips on improving your mental health e.g.
Thérèse of Lisieux and on to Bayeux, where there is Trinity College played host to a panel of Dragons on take part in physical exercise 2. Information on the
the wonderful Bayeux Cathedral. Stephen went to Tuesday 25th October as part of The Dragon’s Den of services available in and out of college e.g.
see the beautiful Bayeux tapestry which is a Mental Health. This event was organized by DCU counselling service details, Samaritans, DubDoc
thousand years old. The tapestry is woven in fabric Psychological Society, in conjunction with the 2 3.Statistics and details on different psychological
that epics the Conquest of England by William the Student Peer Support Services and TCD Students’ disorders e.g. symptoms of bipolar disorder. Róisín
Conqueror in the battle of Hastings in 1066. It was Union, for TCD Mental Health Awareness Week. plans to have these cards distributed around college -
all most interesting. On Saturday we were free for
Issue 6, November 2011
on every lecture seat, bathroom, table and notice West Cork Mental Health Services received this categories. It is really important to us as it is a
board and given out by lecturers to first year commendation for their project entitled ‘Making the reflection of the commitment our staff and the local
students. The first student to collect all 50 cards “Vision” a Reality’. Changing the underlying culture partner agencies have undertaken to provide and
will win a prize for their class. is always the most difficult task for any organisation. sustain a high-quality mental health services for the
Yet in the field of mental health, this is exactly what people of West Cork. Involving service users in service
is demanded by our national policy on mental health, design and delivery in a meaningful way is a key
‘A Vision for Change’. In West Cork they have sought element of our transformation programme and I am
to make this a reality by: very proud of the achievements of everyone involved.
We came together with other organisations to create
HSE West Cork Mental Health Services • Service user and carer involvement at every the West Cork Mental Health Forum, in which
level individuals and organisations work together to combat
receives a commendation in 10th Annual • Strong community involvement stigma and to create supports for service users and
Irish Healthcare Awards: A Vision for • Working in partnership with the wider their families”
Change Chapter 9 community and voluntary agencies
• A genuine multidisciplinary commitment to Mr. Michael Bambrick, Director of Nursing for West
West Cork Mental Health Services (WCMHS) received care and assessment Cork Mental Health Service said “To receive this
a commendation under the category ‘Best Public • The centrality of ‘Recovery’ philosophy commendation is a great honour for all staff in the
Health Initiative’ at the 10th Annual Irish Healthcare service. Collaborate working with positive attitude
Awards ceremony which took place in Dublin Dr Pat Bracken, Clinical Director of the West Cork and values are key components in the provision of
recently. Mental Health Service said: ‘We are very honoured to good mental health care. This commendation affirms
be recipients of this commendation from the Irish this direction of care and I am very proud of our
Medical Times. Everyone knows that it is hard to get staff’s achievement. We appointed a team
everything right in the field of mental health. We coordinator who receives all referrals and liaises
have genuinely tried to make the vision of Vision for actively with GPs and other services.
Change’ a reality in West Cork. We have worked to
provide a service in which the values of respect and We developed an active counselling and
dignity are the bedrock underpinning all other psychotherapy programme, which is strongly
interventions. This has resulted in a very positive integrated with the multidisciplinary team and we
atmosphere in both our inpatient and outpatient developed a range of therapeutic groups (creative
facilities. We initiated a ‘residential review’ of our writing, art, music, and gardening) in our resource
service users in residential facilities, which resulted centre.
in a number of them moving to more independent
living conditions in the community” For more information contact Michael Bambrick,
Director of Nursing, West Cork
Ms. Gretta Crowley, Operations Manager for the
Mental Health Services in Cork said “This is a
fantastic achievement in one of the toughest
Issue 6, November 2011
WHO Award for High Support Unit in Historically, in the Irish Prison Service, at-risk Speaking about the success of HSU, Dr Damian Mohan
prisoners were accommodated in Special Observation the unit’s consultant forensic psychiatrist and said,
Mountjoy Prison: A Vision for Change Cells (SOCs) for considerable periods of time. The “The High Support Unit signifies a change in custom
Chapter 15.1 use of SOCs has been criticised by the Council of and practice in how individuals who are mentally ill
Europe Committee for the Prevention of Torture. are dealt with in the prison population. The advent of
the unit improves conditions for those prisoners
The High Support Unit in Mountjoy Prison has won an
The primary aim of the psychiatric in-reach team at waiting for admission to the Central Mental Hospital –
international World Health Organisation (WHO)
the HSE National Forensic Mental Health Service in these prisoners can now be cared for in much more
award. The Best Practice Award for Prison Mental
seeking to set up the HSU in Mountjoy was to reduce humane conditions”.
Health was presented at the international health
the frequency and duration of time spent by prisoners
body’s 2011 network meeting on October 5th in
in SOC cells, within Mountjoy Prison, through
Abano, Italy.
providing an alternative environment that is less
restrictive and provides increased observation and
interaction with staff.
The High Support Unit is staffed by trained prison
officers who expressed an interest in working in this
area. There is regular input by staff from the Central
Mental Hospital, which includes a weekly multi-
agency meeting between clinical and prison staff.
Each prisoner’s treatment plan, progress and future
placement is reviewed on a weekly basis.
The unit, which was initiated by the HSE’s National To-date over 70 prisoners have benefited from this The team from the National Forensic Mental Health
Forensic Mental Health Service in collaboration with facility. Many of these prisoners were mentally ill Service included Dr. Damian Mohan, Consultant
the Irish Prison Service, received the “WHO Health and are now able to access treatment much earlier in Forensic Psychiatrist, Dr. Yvette Giblin, Registrar in
in Prison – Best Practice Award” under the category more humane conditions: Forensic Psychiatry and Mr. Andy Kelly, Community
“Health Care services provided to Prisoners”. Psychiatric Nurse.
Mr. Enda Kelly, Senior Nursing Manager with the Irish
Mountjoy Prison’s 10-bed High Support Unit, which Most importantly, since the setting up of the HSU, Prison service and clinical lead for the project said,
opened in December 2010, provides a dedicated there has been a significant reduction in the “This award recognizes the collaborative effort of
area within the prison where mentally ill and frequency and duration of use of SOCs in Mountjoy everybody involved in this initiative - it wouldn’t have
vulnerable prisoners, who present with a risk of prison. The average monthly rate of occupancy of been possible to establish the High Support Unit
harm to self or to others, can be separated from the SOCs has fallen by 35% since the High Support Unit without the support of the, Governor Edward Whelan
general prison population and closely monitored in a became operational. and the willingness of a select group of highly
safer environment. motivated prison officers who expressed an interest
in training and working with prisoners with mental
Issue 6, November 2011
health needs”. He added, “The Award is for best The initiative has been cost neutral to both the in recent years with implementing some change
practice within the establishment, and recognises HSE and IPS with no net change in total staff around roster change, service development , which
the achievement of Mountjoy prison as a whole allocated to Mountjoy by either service. caused the service to freeze in time for
rather than any individual”. approximately 5 years .To address and unfreeze the
situation an initiative around ‘work life balance’
More information on the WHO Best Practice
The HSU has recently been visited by the Inspector under the mentorship of Billy Gallagher Partnership
Awards is available on:
of Prisons, Judge Michael Reilly. It is the inspector’s facilitator and his team was developed which allowed
http://www.euro.who.int/en/what-we-
intention to propose that the Irish Prison service staff and management to develop and grow in terms
do/health-topics/health-determinants/prisons-
should adopt the Mountjoy Prison HSU model as a of meeting around issues that had benefits for all.
and-health/news2/news3/2011/06/2011-best-
template for the other prisons within the service. This process set the tone for what has become a more
practice-awards
positive working environment and has now been given
Notes to editor: a more structured framework under the terms of the
Reasons for admission to the HSU Mental Health Service model of good Croke Park agreement.
A third (34%) of all patients accommodated on working as result of Croke Park agreement:
the HSU reported psychotic symptoms. A further Sligo/ Leitrim /South Donegal /West Cavan The Croke Park Agreement has facilitated and
29% were referred due to the immediate risk of A Vision for Change Chapter 9 enabled such working with the result Sligo Leitrim
self-harm. 19% were accommodated on the unit Mental Health Service is implementing Vision for
due to the need for various medical treatments Change and reconfiguring existing service to meet the
and increased observation. 9% of prisoners were needs of patients into the future. The process
referred for specialised treatment by the involved the reconfiguring and redeployment of
Addiction Psychiatry team. 8% of prisoners resources from existing high, medium & low support
presented with emotional distress in the client accommodation provided by the service in the
context of stressors. One prisoner was community to provision of independent
accommodated on the HSU due to the acute risk accommodation by local authorities/providers and
he posed to others. supported by appropriate health staff. It involved the
redeployment of staff to different locations to
Outcome of Assessment in the HSU facilitate change and continue to provide service in
The majority (30%) of patients accommodated an environment of reducing resources
on the HSU were diagnosed with a major mental
illness. 22% required short-term increased To ensure we as a service were in line with best
support but did not have a mental illness. A practice a full multi-disciplinary review of all long
further 11% were deemed to be feigning term residents/patients and their needs was
symptoms of mental illness in order to seek undertaken in and as a result patients are being more
refuge on the HSU. 6% were diagnosed with a appropriately placed in the community.
Backround
personality disorder and 3% of prisoners had a This process and positive engagement by staff
learning disability. represented has resulted in our service developing
Sligo Leitrim Mental Health Service while having a
two multidisciplinary community mental health teams
history of innovative change did encounter difficulty
with clinical team meetings and reviews of patients
Issue 6, November 2011
taking place in the community, coordinated on • The clients/patients • Local SLMHS staff provide cover for all
interim basis by Assistant Director of Nursing to • Families and relatives of clients/patients assisted admissions to the Acute Unit
benefit of patients, staff and service. • Staff Representatives of SIPTU,PNA.
Cost savings
Outcome: Obstacles overcome • Significant cost savings to service with
We have as result of good working facilitated by • Development of vision by all stakeholders increased provision in community
Croak Park reconfigured three supervised residences • Resistance to change • Agreed redeployment of nursing ,domestic,
which released resources to: • Ensuring optimum appropriate service for and paramedical staff to more appropriate
clients/patients community service
• Develop the provision of team base to • Client/patient distress at having to move • €40k p.a. cut from Admin overtime budget
enhance team functioning, ensure from home with installation of automated switchboard
appropriate treatment and care planning in • Provision of resource release to assist service and willingness of nursing staff to answer
community. remain within budget allocation and manages calls in the nursing offices outside 9.00 a.m. –
• Enhance Community Mental Health Nursing the impact of staff retirements and 5.00 p.m. Monday to Friday
Team with Community Mental Health Nurses moratorium. • Weekend/Bank Holiday allowances cut from
• Develop Liaison Mental Health Nursing in Admin budget as cover for Mental Health
Sligo General Hospital How it benefits clients Administer role abolished
• Enhance working with North Leitrim Mens • Enhanced service response /provision to • Reduction of Locum Consultant costs from
Group patients in most appropriate setting in line €250k p.a. to €50 p.a. as Consultants provide
• Enhancement of provision of Cognitive with V for C policy. cross cover for all duties except MDTs and
Behaviour Nurse Psychotherapy (CBT) • More appropriate independent OPDs
provided to Primary Care ( G Ps) accommodation for patients and facilities for
• Enhancement of Occupational Therapy service. For further information please contact:
• Automation of switchboard out of hours to • More appropriate responsive service for Ms Caroline Flynn P.N.A. Representative - Tel
release clerical resources to focus on patients and families 0860879397
provision of clinical support • Provision of Rehabilitation and Recovery Mr Padraig Peyton S.I.P.T.U. Representative-Tel
• Centralisation of account/financial reporting Multidisciplinary Team 0868506221
• Provision of Community based • Enhance Community Mental Health Nursing Ms Joy Synnott Administrator - 0719144834
Rehabilitation and Recovery Team with Community Mental Health Nurses Dr Owen Mulligan Executive Clinical Director -
Multidisciplinary Assertive Outreach Team 0719142111
• Develop Liaison Mental Health Nursing in Sligo
Mr Patrick Benson Director of Nursing-
General Hospital
Who was involved? 0872222835
• Enhance working with North Leitrim Mens
• The multidisciplinary team including Group
Medical i.e. Consultant Psychiatrist NCHD, • Enhancement of provision of Cognitive
Nursing, social Work, Behaviour Nurse Psychotherapy (CBT)
Occupational Therapy, provided to Primary Care ( GPs)
Administration • Enhancement of Occupational Therapy
Issue 6, November 2011
The Out & About Association supporting Gretta Crowley, Local Area Health Manager, HSE many lesbian, gay, bisexual and transgender (LGBT)
South, introduced Martin to the participants and people. This change has enabled LGBT people to
people suffering from Anxiety related facilitated the very lively question and answer session participate more fully and openly in their families,
conditions: A Vision for Change Chapter thereafter. their communities, their work and in society in
11 general. With the introduction of Civil Partnership for
OANDA was represented by Robert O’Connell and gay and lesbian couples this year and the government
Martin Rogan visits OANDA - A Cork based Martina McElligott and HSE South by Gretta Crowley, commitment to enact gender recognition legislation,
community mental health resource centre helping Ber Cahill, Cariosa Lynch and Aidan Warner. Ireland is becoming a more inclusive country for LGBT
People with Panic Attacks and Phobias. people, couples and families.
Martin Rogan visited the Out and About Association However, it’s clear from research in Ireland that
(OANDA) on 19 October at their headquarters in LGBT people can still experience stress related to
Bishopstown. their identity - often termed minority stress - which
can impact negatively on their mental health.
OANDA is a dedicated voluntary community mental Experiences such as concealing one’s LGBT identity,
health service that helps people who are afflicted homophobic bullying in school, negative reactions to
by anxiety related conditions. It operates as a coming out and past negative reactions to LGBT
community based resource set up under the people can put a strain on LGBT people’s mental
Government’s “Vision for Change” health policy. health and well-being.
Reach Out, the national strategy for suicide
prevention, identified LGBT people as a group
vulnerable to depression, self-harm and suicidal
For more Information please contact: behaviour because of their experience of
The Out & About Association, Top Floor, Wilton stigmatisation and marginalisation. Reach Out also
Park House, Bishopstown, Co Cork 021-4348728 / identified the need for more research on LGBT
087-7928579 mental health. With the support of the National
Office for Suicide Prevention, GLEN (Gay and Lesbian
Equality Network) and BeLonG To Youth Service
commissioned the Supporting LGBT Lives study. This
Positive Action for LGBT Mental Health: A study was conducted by the Children’s Research
Vision for Change Chapter 4 Centre, Trinity College Dublin, and the School of
In his keynote speech, Martin updated senior Education, University College Dublin.
members of the Cork HSE and Cork mental health By Odhrán Allen
practitioners present about the direction of “Vision GLEN Director of Mental Health Policy Supporting LGBT Lives is the most comprehensive
for Change” in current times. He enjoyed a very study of LGBT mental health and well-being in Ireland
lively question and answer session thereafter. The significant social change in Ireland in recent to date. Over 1,100 people participated in the online
years has had a very positive impact on the lives of
Issue 6, November 2011
survey and 40 in-depth interviews were carried out. have developed good self-esteem and are satisfied Community Foundation for Ireland and is run by a
Below are some of the key findings from the study: with their lives. Friends and family, but parents in network of seven regional volunteer-run helplines.
• Coming Out: Most young people know they are particular, play a crucial role in supporting young The LGBT Helpline website www.lgbt.ie is a great
LGBT at age 12 and start coming out at age 17. people as they come out and this support acts as a resource for LGBT people who are looking for local
The period between knowing you are LGBT and protective buffer against LGBT-specific stresses. support options or information. The website is also a
telling others can be particularly stressful for Forming a positive LGBT identity developing very useful resource for professionals, support
young people because of fear of rejection and positive coping strategies also helps people to deal workers, counsellors or others who want to know
isolation. For a significant minority of young with LGBT stresses. Professional support is another more about LGBT issues and support options available
LGBT people, the adolescent years are a time of critical factor. in Ireland for LGBT people.
particular vulnerability for depression, self-harm The Supporting LGBT Lives report identified a number
and suicidal behaviour. of recommendations for a comprehensive approach to The Supporting LGBT Lives report and other resources
• School: 58% reported homophobic bullying in LGBT mental health promotion and suicide prevention are available at www.glen.ie The LGBT Helpline
their schools, with 40% having been verbally work in Ireland across a number of sectors. number is 1890 929 539.
threatened by school peers and 25% physically
threatened. 34% reported homophobic comments With the support of the National Office for Suicide
by teachers, 20% missed or skipped school Prevention and HSE Health Promotion, the GLEN
because they felt threatened or were afraid of mental health programme is currently focused on
getting hurt because they were LGBT and 5% left implementing the recommendations of the Supporting
school early because of homophobic bullying. LGBT Lives which details an evidence-based approach
• Victimisation: 80% had been verbally threatened to LGBT mental health promotion and suicide
in public because they were LGBT while 40% had prevention in Ireland an Irish context. This work
been physically threatened. 25% had been includes building the capacity of mainstream agencies
punched, kicked or beaten in public at least and service providers and LGBT organisations to
once. 25% had been called abusive names at work better respond to the mental health needs of LGBT
and 10% missed work because they felt people in Ireland, through the provision of LGBT
threatened or were afraid of being hurt because training and the development of good practice
of their LGBT identity. guidelines. It also includes the development of Michael Murphy of RTE launching the LGBT Helpline
• Mental Health: 27% had self-harmed and 85% of services, supports and information/education
these did so more than once. 18% had attempted resources to improve the mental health and well-
suicide and 85% saw their first attempt as related being of LGBT people and to reduce their risk of
in some way to social and emotional stresses they suicidal behaviour.
experienced related to being LGBT. Over 1/3 of
those aged 25 years and under had thought One of these services is the national LGBT Helpline
seriously about ending their life within the past launched in November 2010 by the RTE newsreader Garda Liaison Inspectors (Mental Health) –
year. Michael Murphy. This confidential, non-judgemental
Education programme:-A Vision for Change
• Resilience: 81% of LGBT people are now helpline provides listening, support and information
to LGBT people, their family and friends 7 days a Chapter 15.1
comfortable with their identity and the majority
week. It was established with the support of the
Issue 6, November 2011
(retired) and Cathal Magee, CEO HSE . The MOU was
Staff from the Health Service Executive (HSE), developed collaboratively between the HSE and An
National Service User Executive (NSUE), and the Garda Síochána to provide an appropriate response in
Gardaí, delivered a one day education programme respect of the two agencies empowered by the
to Garda Liaison Inspectors (Mental Health) in the Mental Health Act 2001 to remove and return persons
Garda College, Templemore. The programme to an approved centre. Following this education
focused on the legal responsibilities of both agencies programme formal Liaison groups will be set up in
under section 13 of the Mental Health Act each of the mental health services to implement the
2001(removal and return or persons to an approved MOU and monitor the interface between the An Garda
centre) and the Memorandum of Understanding Síochána.
(MOU), developed by both agencies detailing how
this function is conducted. The ethos of both the A copy of the MOU can be downloaded from the MHS
MOU and the National Assisted Admission policy is e-Learning hub @ www.hseland.ie
the right of the person to dignity, bodily integrity,
privacy and autonomy. This was reinforced In addition to the programme delivered in
throughout the education programme. Templemore members of An Garda Síochána have
been invited to local two day Assisted Admission
Included in the programme was a review of the Training programmes in Ballinasloe (7) and Portlaoise
involuntary admission process of the 2001 Act, (6). This has proved a valuable exercise as the
Delivered by Amelia Cox HSE- and the National participating Gardaí meet the staff from the HSE who Choosing the right suicide prevention
Assisted Admission Policy delivered by Anthony will be on the Assisted Admission team and gain an training for you:
Fitzpatrick HSE-West. Professor Harry Kennedy understanding of the role of HSE staff involved in this A Vision for Change Chapter 15
Clinical Director, Central Mental Hospital delivered procedure. Likewise HSE staff gain an understanding
a very interesting session on the Criminal Law of the role or An Garda Síochána in relation to the AUTHOR: Anne Callanan, National Office for Suicide
(insanity) Act 2010 and Garda Philip Ryan delivered Assisted Admission/Return of a person/patient. A Prevention
a detailed session on the MOU. John Redican, further Assisted Admission programme will be
National Executive Officer, NSUE and Jennifer Kelly delivered in Naas in November and six members of An There has never been more choice around suicide
NSUE, delivered a session on the service users Garda Síochána will attend. prevention training in Ireland than there is now. This
experience of mental illness. This reinforced the article focuses on the issues you should consider when
need for a person centred approach to this function. Following on from the training programme seeking the right training programme.
The days information was then put to the test using participants are asked to ensure that local liaison
a number of case scenarios which replicated groups are set up between An Garda Síochána and the
potential situations where staff of the HSE and the HSE as per the Memorandum of Understanding
Gardaí have to remove or return a person to an between the HSE and An Garda Síochána.
Approved Centre.
The MOU was signed on the 15th of September 2010
by the Garda Commissioner Fachtna Murphy
Issue 6, November 2011
Examples of Suicide specific Training recent bereavement) would not attend a training
Level Type Name Audience course on suicide prevention. This training can be
1 Awareness Reaching General public; staff very emotionally challenging, and it is important that
out and volunteers who individuals are well informed of the content and
wish to know more demands of the training.
but have no 5. Willingness to take on the responsibility
background in this conferred by the training. For example, ASIST
area confers a significant responsibility to ask others if
2 Alertness safeTALK General public; staff they may be thinking of harming themselves, and to
and volunteers who act on that if the answer is ‘yes’. Not everyone is
are committed to comfortable with this role, and potential candidates
acting as a link need time to consider what is involved during and
between someone after a workshop.
who is suicidal and 6. Will the training be used by the individual? For
someone who can Considerations when selecting training programme example, it would be a waste of resources to train
provide help in a 1. How much of a problem is suicide within the someone in STORM who does not provide mental
crisis; often staff and client group? If suicide has not been a health care on a regular basis.
incorporated in an significant problem, but the agency simply wants to
organisation’s or be ready should it emerge, then general awareness A Final Note
community’s suicide training for most staff, with some trained in safeTALK Suicide prevention training is never enough in itself.
prevention policy should be sufficient to meet its needs. An agency Training is only one part of the whole picture, and
3 Interventi ASIST Caregivers who are which regularly experiences suicidal behaviour within agencies should also be seriously considering how to
on highly likely to its client group should aim to equip its staff with the address suicide from a preventative, intervention and
encounter skills to ensure that they can act competently and crisis response perspective. Only when this full
individuals who are appropriately. A mix of safeTALK and ASIST may be overview is taken, can a complete training needs
feeling suicidal right for this agency. analysis be conducted to realistically assess what is
4 Manageme STORM Professionals who 2. Core work of the agency. If the core work of staff needed.
nt are currently is around long-term mental health care for clients,
working with then STORM may be required by relevant staff. If the The training programmes are coordinated by the HSE
individuals on a work does not focus on mental health issues, a Resource Officers for Suicide Prevention and some
long-term basis, combination of awareness and safeTALK might be other partner agencies. A list of coordinators is
generally in a appropriate. available at www.nosp.ie .
mental health role 3. Previous experience/knowledge. A good rule of
thumb is to start at the beginning, unless the Contact ann.callanan@hse.ie for information on
individual has some knowledge and experience to training programmes
date.
4. Personal readiness. It is recommended that any
individual experiencing emotional difficulties (e.g.
Issue 6, November 2011
If you have an article(s) that you
would like included in the next issue
of A Vision for Change Advancing
Mental Health in Ireland please
forward to catherine.brogan@hse.ie
All articles must be submitted in
word format, with 250/300 words
per article, photos and contact
person for further information.
If you would like to advertise an
upcoming event in your area or
organisation please email
catherine.brogan@hse.ie
Next Issue Jan 2012. Please
send article(s) by January 16th