A Vision for Change Issue 7 February 2012 - Health Service Executive

A Vision for Change Chapter 3 

THE NATIONAL SERVICE USERS EXECUTIVE 

ANNUAL AWARDS ‘Second Opinions’ Report 

Three mental health services declared 

themselves “absolutely delighted” at the 

launch of the National Service Users Executive 

“Second Opinions” report and their 

announcement of their award winners as 

decided by the people who themselves use 

mental health services on an everyday basis. 

Ms Laverne McGuinness, National Director 

Integrated Services Performance & Financial 

Management, Health Services Executive 

launched the event, and Ms Kathleen Lynch 

T.D., Minister of State with responsibility for 

Disability, Older People, Equality & Mental 

Health presented the awards. 

The event, which also marked the sixth 

“birthday” of Vision for Change, since its 

adoption on 24 th January 2006, took place at St. 

Patrick’s University Hospital in Dublin. This is the 

third successive year that the National Service 

Users Executive (NSUE) has carried out a national 

client satisfaction survey. The overall picture 

was positive, with an increase in satisfaction 

levels as illustrated below by the answers to one 

of the survey questions as follows: 

Are you happy overall with the services provided 

to you? 

It is however noteworthy that there were also 

widespread variations between services in “yes” 

happiness ratings, ranging from very low to very 

high. 

The Chief Executive of NSUE, John Redican, said, 

“The results are comprehensive and the 

qualitative comments give an added depth and 

substance to the issues raised in the numerical 

analysis. The challenge is to combine these two 

sets of results in such a way that, as we move 

forward, we get the best of both worlds, and use 

this to maximum effect in order to achieve the 

changes in service provision that will provide for 

Issue 7, February 2012 

better outcomes for those using services. The 

combined results will therefore be used to 

influence service improvements. We have also 

used the information we received to select three 

awards; the “Best Overall Service” award, the 

“Most Effective Supports” award, and the “Most 

Improved Culture of Care” award. This is a way 

for our members to highlight their overall 

satisfaction with services. “ 

The Award winners were, Clifden mental health 

services for the best overall service, Mallow 

mental health services for the most effective 

supports and Carlow mental health services for 

the most improved culture of care. 

All three services responded positively, the 

representatives from Clifden said, “The award of 

Best Overall service is a great achievement for 

the staff of Clifden and West Galway Mental 

Health Services and it demonstrates the 

importance and value of mental health services 

in rural areas. It is also an important award for 

the service users and the community in Clifden. 

Both are at the heart of the Clifden services and 

have helped to shape and develop the service 

and the supports available. This is especially 

important as Clifden is over sixty kilometres 

from Galway city. “ 

An enormous contingent had travelled from 

Carlow, and their message was: “The Carlow 

Mental Health Service is so grateful to receive 

this really important acknowledgement “Most 

Improved Customer Care Award” from the 

members of the NSUE. The fact that the award is 

one which is adjudicated upon by service users 

throughout the country is perhaps the most

satisfying aspect of this acknowledgement. 

Service delivery within the Carlow Mental 

Health Service has always maintained an ethos 

which places the core principals of recovery at 

the very heart of its service delivery and to 

assist in this delivery we try to ensure that our 

customer is at the centre of all we do. This 

acknowledgement of our work tells us that we 

are on the right path towards the development 

of a flexible, responsive recovery based 

community mental health service and although 

we have some way to go it is really important 

to know that our customers are aware of the 

positive direction we are taking and have 

acknowledged this progress accordingly” 

Mallow’s response was similarly enthusiastic, 

consultant psychiatrist Harry Doyle saying, 

“This award is very much appreciated by both 

staff and users of Mallow and North Cork 

mental health services. We feel that it isd the 

recognition of the effortsof all staff in 

developing the active involvement of users in 

the serviceand putting users central to service 

provision. The success of our work depende on 

our relationship with service users and we see 

their expertise as critical to effective services.” 

All agreed that the event generated enormous 

energy and goodwill, and a large contingent of 

service users, their families and their friends 

from all over Ireland was in attendance. The 

main presentation on the day was both 

challenging and extremely humourous and was 

greeted with rapturous applause. 

Afterwards, Ms. Jennifer Kelly, chairman of 

NSUE, said, “I would like to sincerely thank St 

Patrick’s Hospital, who have been unequivocal in 

their support of NSUE, together with HSE South, 

for their sponsorship of this project and for 

whom we will be able to give feedback on their 

individual services. I would also like to 

acknowledge all of those who filled out our 

questionnaires, as well all of those who 

distributed them. I am extremely happy at the 

way things have gone and am already looking 

forward to next year, which I hope will be 

another success despite the gloomy economic 

forecasts.” 

The “best overall service” winners: Clifden 


NSUE Launches it’s eLearning Programme 

At the National Service Users Executive, we 

believe that lack of information, misinformation 

and misconceptions lie at the heart of many of 

the problems experienced by those who use 

mental health services, their families and their 


friends. We decided to attempt to address this 

with the introduction of an online learning 

programme, funded by Genio which we hope will 

be of practical benefit to all those people who 

participate in mental health services, and all 

who have an interest. 

We have attempted to make the questions 

relatively easy, so that all participants will feel 

able to attempt the courses. We hope that by 

linking the answers to reputable sources of 

information, this will encourage people to use 

these source materials in order to gain extra 

information or to resolve any other questions 

that they may have. 

The eLearning programme is divided into 9 

different modules or courses on a variety of 

topics which include Quality of Services, 

Information on the Mental Health Act, 

Discrimination and Acute Community Mental 

Health Services. The courses are deliberately 

brief and full of humour in order to encourage 

participation. Most of them consist of short

pieces of reading material together with links 

to reliable sources of information, followed by 

questions on the topic though some also have a 

video attached. Questions can be taken any 

number on times and, on successful 

completion, participants will receive a 

certificate by email. An evaluation section is 

also included and will form the basis of future 

updates. Participants can also discuss the 

content of the courses and any issues that may 

arise by posting their comments on the 

Facebook link on the site. 

NSUE hopes that its eLearning site will be both 

informative and enjoyable. It can be accessed 

from the website www.nsue.ie or directly from 

http://www.nsuelearningcentre.com. 

Vision for Change Chapter 12 

Geraldine’s Story of Recovery 

One of my earliest memories is of my parents 

hurling both physical and mental abuse at each 

other and there were many times my home 

resembled a war zone with neither side 

admitting defeat. Of course there are always 

casualties in a war and I was one of them. I 

grew up with all sorts of fears, phobias and 

obsession thoughts. I went through a stage of 

fearing going to school and at the age of 10 saw 

my first psychologist. The psychologist 

assessed that my home life had a huge bearing 

on my condition and that I was too skinny and 

should eat more – which I duly did. Life returned 

to some sense of normality but I still was fearful. 

I started work at 16 but still couldn’t shake off 

depressive thoughts and feelings of inadequacy 

in the workplace. Social situations were 

anticipated in dread rather than joy. I left home 

and worked abroad for a year thinking that 

everyone else was the problem and not me. 

Different places, different people but still ‘same 

old me’. 

Everything came to a head when my daughter 

was born. I was a single parent and suffered 

undiagnosed depression for six years before I 

sought medical help. This was the beginning of 

my recovery. I attended a psychiatrist for a year 

and with the help of medication and counselling 

I could see light at the end of the tunnel. During 

one of our sessions I asked him whether he could 

recommend a self-help group and it was then I 

learned of Recovery, a 4 step after care 

programme for people who have suffered from 

depression and related illnesses. I attended my 

first meeting in 1991 under the inspirational 

leadership of the late Gerry Burgess and have 

never looked back! I remember hearing a 

member’s example about ‘someone skipping the 

queue in the post office’ and how they managed 

to control their temperamental reaction by using 

the Recovery techniques. I knew I had come 

home! 

Recovery has changed my life. I love the 

structure of the method and the fact that 


members have to be ‘just average’ - such a 

relief after being a perfectionist for so long. I 

now have great confidence and no longer fear 

work or social situations as I know ‘I can lower 

my standards’ and that ‘it’s not the event but 

our reaction to it which give us the symptoms’. 

Since joining Recovery the dark days are gone 

and I have great joy in my life. My daughter has 

grown in to a fine, young, confident woman. I 

have been promoted in my job twice. I lead a 

Recovery group and was recently nominated to 

the Management Committee of Recovery Ireland. 

All of this I attribute to practicing the Recovery 

techniques. The greatest pleasure for me is to 

see new members learning and practicing the 

method because it brings so much equilibrium 

into all aspects of their lives. I only wish I had 

known about it when I was 18! 

Geraldine* 

For further information on this programme 

and for a list of meetings please log on to 

www.recovery-inc-ireland.ie


IAN first Organisational Review and Strategic 

Plan was launched by Minister Kathleen Lynch 

The Irish Advocacy Network Ltd was a major 

force in establishing service user involvement 

and introducing the concept of recovery and 

peer support within HSE mental health services. 

IAN first Organisational Review and Strategic 

Plan was launched by Minister Kathleen Lynch 

at the Radisson BLU Hotel, Dublin, Thursday 

15 th December, 2011. Attendees came from all 

over the island and included members, 

volunteers, staff and a number of 

representatives from statutory services and 

voluntary organisations. 

The review engaged a significant number of 

participants and a wide range of stakeholders. 

Strategic priorities included: 

1. To extend the delivery of peer advocacy to a 

wider range of service users in a variety of 

locations eg; adolescents/young people and 

community settings 

2. Continue to offer meaningful vocational 

opportunities that may result in voluntary peer 

support workers and peer advocates, and on to 

competitive employment 

3. Develop the profile of IAN and review the 

demand on peer advocacy services 

4. Produce regular reports on the nature and 

number of advocacy cases in order to inform a 

range of statutory bodies on the quality and 

consistency of their services 

5. Identify ways to enhance the development of 

staff and volunteers 

6. Continue to review governance procedures 

and evaluate the effectiveness of IAN’s services 

Colette Nolan, CEO of the Irish Advocacy 

Network comments: 

‘We are proud of our history and will continue to 

adapt to and be guided by the needs of the 

growing number of Irish citizens who request our 

services. We now have a strategic plan that will 

ensure we continue to deliver an independent 

person centred service in line with Vision for 

Change. We would like to thank everyone who 

has supported the organisation throughout the 


years, and are grateful to those who participated 

in the strategic plan. We look forward to 

another decade of delivering peer led services to 

our fellow citizens’. 

For further information contact 

colettebnolan@eircom.net 

Vision for Change Chapter 4 

Mental Health Promotion 

‘One Man Many Voices’ 

On 07/01/2012 the premiere of ‘One Man Many 

Voices’ was staged in Dublin as part of the First 

Fortnight Festival in association with SeeChange, 

In Your Face Productions and DETECT. 

DETECT is an Early Intervention for Psychosis 

Services offering rapid assessment of people 

with suspected first episode psychosis, 

psychological support, family education and 

assistance around lifestyle and employment. 

DETECT operates in South Dublin & North 

Wicklow, initially seed funded by the St. John of 

God order and now funded by the HSE.

One Man Many Voice is a one man play of 

40minutes duration devised and written by 

DETECT and In Your Face Productions. The aim 

of the play is to reduce stigma around mental 

illness by presenting a realistic portrayal of one 

man’s experience of psychosis, comparing the 

myth to the reality and allowing an audience to 

witness his eventual recovery. Despite support, 

empowerment and the instillation of hope this 

man’s recovery is not linear but instead offers 

realistic hope to the audience. 

The play was well received and provided a 

forum in which to discuss the concept of mental 

illness, psychosis and mental health services in 

Ireland. Current and former service users, 

their families and people working in mental 

health all took part in a frank, sometimes 

emotional discussion. 

We plan to stage this play in local theatres, 

Universities and at meetings held by mental 

health professionals in the coming year in an 

effort to reduce stigma by increasing awareness 

of mental health issues, educating people about 

a topic which sadly remains behind closed doors 

all too often. We hope to stimulate debate and 

create an expectation in the community for 

better, accessible, efficient mental health 

services in Ireland. 

This project will address key areas detailed in 

the Vision for Change policy document 

particularly in relation to Mental Health 

Promotion by bringing a message to those who 

have not suffered mental illness & addressing 

the needs of those at risk from or experiencing 

mental health difficulties. 

For more information: 

Maurice.bonar@sjog.ie 



Mental Health Irelands National Service 

User “EXPRESSIONS” Drama Project 

This Drama Project is a national collaborative 

initiative which will include forging links with 

the following partners from the statutory, 

community and voluntary sectors such as mental 

health service users, staff in the mental health 

services, the local voluntary mental health 

associations, and the arts officers of the local 

councils. Mental Health Ireland recognizes the 

important role the arts can play in the recovery 

of people with mental health difficulties and 

how increasing access to such cultural 

experience plays a vital role in this. MHI with 

their local mental health association structure 

throughout the country will select 8-10 groups to 

be involved in this project. Each piece of drama 

produced will be centred on the themes of 

stigma and/or recovery. A national event will be 

held where each group will have the opportunity 

to perform their play and to celebrate service 

user participation in reducing stigma through the 

use of the arts. 

The Target audience for this initiative will 

include; 

• People in Rural Communities

• Mental Health and Social Care 

professionals and students of these 

disciplines 

• Policy Makers 

• Community and Voluntary groups 

• Service users of the mental health 

services 

Drama Therapy has long been used as an 

adjunct therapy within Mental Health 

treatment and care plans. It rightfully has a 

place within the Recovery model of care based 

on its therapeutic benefits to all concerned. 

Drama therapy benefits many client populations 

and is used in a variety of settings. These 

include psychiatric hospitals, mental health 

facilities, day treatment centres, nursing 

homes, substance abuse treatment, schools, 

businesses, and correctional facilities. Some 

populations served include children with 

learning and social difficulties, psychiatric 

patients, substance abusers, 

The general aims of a Dramatherapy sessions 

include exploring ideas, issues and problems 

(eg. low self esteem, bullying) using drama 

derived activities; expressing and exploring 

feelings, developing spontaneity and 

imagination and creativity, improving self 

image and self confidence, developing social 

and relationship skills. 

Through the project we hope to Promote the use 

of Drama in the Mental health Services 

as a means of promoting health and wellbeing. 

Bring together a range of partners from the 

Statutory and Voluntary sector to work 

collaboratively on reducing stigma associated 

with mental health problems 

Promote the key message of the importance to 

challenge stigma and awareness of it’s impact on 

mental health 

We will hold a national event where each group 

involved in the project will have the opportunity 

to perform their play. This will also include 

celebrating service user participation in reducing 

stigma through the use of the arts. 

Ted Tierney Deputy CEO MHI. 


See Change - First Fortnight Festival 2012 

Ireland’s biggest and most ambitious programme 

of mental health-themed arts and cultural 

events, the “First Fortnight Festival 2012” took 

place during the first two weeks of 2012 and 


centered around Dublin’s cultural hub of Temple 

Bar. Staged in association with See Change, the 

festival used live music, spoken-word, theatre, 

film, photography, street and other visual arts to 

create open discussion and understanding of 

mental health problems and challenge stigma. 

See Change ambassador Claire Byrne hosted the 

festival’s ‘Soapbox Sessions’ event; an afternoon 

of mental health inspired comedy, music, prose 

and poetry performances by Diarmuid Gavin, 

Eileen Dunne, Mary McEvoy, Stephen James 

Smith, Caroline Casey, Paul Murray, Tony 

Bates, Dil Wickermashinghe and John 

Saunders. 

Various acclaimed and original art exhibitions 

were commissioned for the Festival as well as a 

series of thought-provoking street art. Una 

McKevitt’s ‘565+’ and DETECT’s ‘One Man, Many

Voices,” were two theatre pieces both 

exploring experiences with mental health 

problems that ran as part of the festival 

programme. 

The two-week festival programme was kicked 

off with a series of extremely well-attended 

live music and poetry evenings named the 

‘Therapy Sessions’ and rounded off by the a 

headline gig that saw chart toppers Royseven 

play to a sellout crowd in Dublin’s Button 

Factory on Saturday, 14 th January. 

Sorcha Lowry, 

Communications & Partnership Officer 

See Change 

38 Blessington Street 

Dublin 7 

www.seechange.ie 


Stress Control Classes - Kildare 

The introduction of Stress control classes in 

Kildare has proven a great success with more 

than 150 people attending the classes which 

were delivered in Newbridge and Athy recently. 

With support from a number of agencies the 

HSE Psychology Service in Kildare & West 

Wicklow delivered the classes. Having trained 

with Jim White, Clinical Psychologist from 

Glasgow, who developed the Stress Control 

classes, the Kildare based Psychologists took on 

the role of teachers to deliver the six week 

training programme. 

Thanks to funding from the Athy and the Naas, 

Newbridge & Kildare Mental Health Associations, 

free handouts to build on the material covered 

were provided to all those who attended. The 

handouts are simply written so that they can be 

easily understood by most adults. In addition a 

free relaxation CD was provided to each person 

who attended. 

The classes were open to all interested adults, 

with no exclusion criteria. The response from the 

public was amazing from the outset. Once the 

advertising began there were more than 200 

texts from people expressing an interest in 

attending. The administration of the programme 

was managed with support from the South 

Western Regional Drugs Task Force who 

responded to all those who texted. 

In an effort to accommodate as many as 

possible, the course in Athy was delivered as 

cover the cost of the venue) 

an evening class (with funding from Rapid to 

cover the cost of the venue) whereas the 

Newbridge class ran in the mornings. Staggering 

the starting dates allowed people to who missed 

one class to catch it in the other location. The 

numbers attending each class varied from 50 to 

75 people, with new members arriving to most 

sessions. Some of those who struggled to get the 

courage to attend earlier sessions were pleased 

to report having successfully attended for later 


sessions. In addition to the direct benefits to 

those who attended the classes, a number of 

those who attended, took extra materials and 

CD’s to give to family and friends whom they 

knew to be experiencing difficulties. 

Those who attended varied in age from “less 

than 20 years” to “over 65 years”. They came 

from a wide geographical area and identified 

themselves as being troubled by “anxiety”, 

“depression”, “pressure”, “worry” and “inability 

to relax”, “anger” and “financial difficulties”. 

On completing the six week course they reported 

having “a better understanding of stress”, 

“feeling more able to deal with stress” and a 

reduction in “the feeling of being under stress”. 

The classes were delivered by Clinical 

Psychologists Dr Gary Collins, Dr Deirbhile Lavin, 

Dr Tonya Madden and Dr Rosario Power. It is 

intended to deliver the classes in other areas- 

Naas and Baltinglass early next year and it is 

hoped to repeat the classes in Athy and 

Newbridge next autumn. 


michaelc@mentalhealthireland.ie 

KARE 

Athy & 

Naas/New 

bridge/ 

Promoting 

Inclusion for 

People with

A Vision for Change Chapter 15.7 

Vodafone to donate logo to Suicide or 

Survive charity for opening games in 

Dublin GAA Spring Series 

Vodafone Ireland Foundation partner ‘Suicide 

or Survive’ logo to feature on shirt in unique 

sponsorship initiative to raise awareness of 

mental health issues 

Monday, January 23rd, 2012: Vodafone and 

Dublin GAA were delighted to announce a 

unique initiative for the first games of the 

Allianz National Football and Hurling Leagues 

that delivered a timely boost for promotion of 

mental health issues in Ireland. 

The country’s largest total telecoms provider is 

to vacate its jersey sponsorship for the much 

anticipated opening Croke Park Spring Series 

football league clash with Kerry and hurling 

league meeting with Galway for the Suicide or 

Survive Charity (SOS) www.suicideorsurvive.ie. 

This is the first time a jersey logo will have 

been handed over by a sponsor to a charity for 

a competitive inter-county match. 

The undertaking, which will see the SOS logo 

replace Vodafone’s for the two games, was 

initiated by and is being promoted through the 

Vodafone Ireland Foundation, which provides 

funding annually to a number of Irish charities. 

SOS – an Irish charity focussed on breaking down 

the stigma associated with mental health and 

supporting those affected in getting access to 

quality recovery services appropriate for the 

individual - is one of Vodafone Ireland 

Foundation’s existing charity partners. 

The two match initiative – for the eagerly 

awaited football league opener against Kerry on 

Saturday night, February 4 th in Croke Park and 

the first hurling league game against Galway in 

Pearse Stadium on February 26 th - will be built 

around a ‘Talk, Listen, Change’ (TLC) theme. 

The objective is to encourage people enduring 

stress and other mental health challenges to 

open up about their difficulties, seek the support 

available and by doing so effect a positive 

change in their mental health. 


As part of the promotion, Vodafone and Dublin 

GAA are asking customers across all networks to 

donate €2 to the SOS charity to help fund its 

ongoing work in the area of mental health. 

Subscribers can make the donation by texting 

the word ‘SOS’ to 503000, with the entire 

proceeds going to the charity. 

Announcing the initiative, Vodafone Ireland 

Strategy Director Paul Ryan said: “Mental health 

issues are more prevalent in Irish society today 

than ever before and suicide is now the leading 

cause of death among young people. That shows 

how serious the problem is and the Dublin jersey 

is a great platform to raise awareness of these 

issues from. We are delighted to support the 

ongoing campaign around mental health issues 

by setting aside our logo for the Suicide or 

Survive charity for these games." 

Said Dublin GAA CEO John Costello: “We didn’t 

have to think twice when Vodafone came to us 

with the idea of swapping their logo for that of 

the Suicide or Survive Charity for these games. 

With one in four people experiencing mental 

health problems at some stage in their lives, it is 

essential that organisations like Dublin GAA and 

the GAA get behind efforts to encourage people 

to talk and look for the help that’s out there.” 

CEO and founder of SOS Caroline McGuigan 

described the joint Vodafone-Dublin GAA 

initiative as one of the most important 

developments since the organisation was

established. “This is a wonderful gesture by 

Vodafone and Dublin GAA. It's the biggest 

opportunity we have had as a charity to reach 

and educate people about mental health issues, 

not least breaking the stigma around them. 

Between confirmed suicides and undetermined 

deaths, it’s estimated that 600 plus people die 

to suicide each year. That’s a two people perday 

average, three times the number of deaths 

in 1980, for example, and three times the 

number of people killed on our roads.” 

The Dublin Spring Series in Croke Park will this 

year involve the footballers' opening Allianz 

League clash with Kerry on February 4 th , which 

has the Tyrone v Kildare game as a curtain 

raiser, plus two football and hurling Allianz 

League double headers. As with last year's 

Dublin Spring Series, the fixtures will include 

interval performances by some of the country's 

best known entertainers. Value is at the core 

of the Dublin Spring Series initiative, with the 

events very much priced for the family. Adults 

can attend all three events for just €30 while a 

child’s ticket for the three fixtures will cost 

just €10. Single match tickets are priced at €13 

and €5 respectively. 

The Dublin County Board has also embarked on 

an innovative revenue share scheme whereby 

€1 from every €3 generated from ticket sales by 

Dublin clubs will be returned to them. 


caroline@suicideorsurvive.ie 

A Vision for Change, Chapter 11, 

DETECT Early Intervention for Psychosis 

‘5 years on’ 

DETECT is an adjunctive service to the three 

community mental health services in the South 

Dublin and East Wicklow and serves a population 

of 375,000. Based on the International Early 

Intervention for Psychosis Clinical Guidelines, 

DETECT aims to reduce the unnecessary delays 

that people experience in receiving effective 

care, and provide treatment that is tailored for 

the early phase of a psychotic condition. This 

model has been shown to improve and 

accelerate recovery. The early intervention 

model consists of three basic components; a 

psychosis education campaign, a fast track 

assessment service, and specialised evidence 

based recovery orientated interventions. The 

interventions offered to all people diagnosed 

with a first episode psychosis consist of cognitive 

behavioural therapy, occupational therapy, and 

family/carer education. A joint treatment 

model operates, where DETECT provides specific 

components of the individual’s treatment for the 

first year after presentation in partnership with 

their Community Mental Health Team. The 

model as depicted in Figure 1 is relatively novel 


and has attracted interest from within and 

beyond Ireland. 

Figure 1 

On the 18 th January Minister Kathleen Lynch 

launched the Report which details the work the 

service has completed over the past 5 years and 

its impact. Evaluation of the service to date has 

shown that delays to treatment have been 

reduced; in the case of schizophrenia they have 

been halved from a median delay of 19 months 

in 2006, to 9 months in 2011. Furthermore 80% of 

local GPs find the service extremely/very useful. 

On average 37% of the people presenting to the 

service over the last 5 years have been treated 

as outpatients and people have lower levels of 

the more difficult to treat negative symptoms 

when they first present. For most people these 

gains are maintained, and it is extremely 

encouraging to see that one year after 

treatment, 60% have been working, i.e. in paid 

employment or studying, for more than half of 

the previous year and over 60% are meeting 

friends on a weekly basis. In her address the 

Minister highlighted the importance of early 

intervention approaches within modern mental 

health service provision and wished the service 

well for the future. The report can be 

downloaded at www.detect.ie

For Further information contact: 

Niall.Turner@sjog.ie 


Wellness and You 

This course is being developed and run by the 

local health group "Health Spoke". The Health 

Spoke committee is made up of a mixture of 

local residents and people who work in various 

community projects around Finglas. We want 

the course to take a pro-active and 

preventative approach to people's health. We 

would like to offer people a "taster" of different 

types of activities they can engage in that will 

have a positive effect on their health, both 

mental and physical. 

We hope to have 8 sessions in the course. The 

sessions will be: mindfulness, drumming, herbal 

medicine, nutrition, storytelling/folklore, Tai 

Chi, laughter yoga. The course will run from 

January 2012 to March 2012. It will take place 

from approximately 10am-1pm once a week. 

The course will be aimed at everyone who 

accesses St. Helena's Resource Centre so 

participants could range from 18yrs to 80yrs 

approx. 

Venue: St. Helena's Resource Centre, St. 

Helena's Road, Finglas, Dublin 11. 

Duration: Wednesday mornings, 10am- 

1pm, January-March. 

Cost: €5 per session. 

Contact: Teresa Nyland, A/ Team Leader in 

Community Development, Ballygall Health 

Centre, Finglas, Tel: 087-9183628 for further 

details. 


Community Support Team – Portumna 

Galway 

This development came about due to the closure 

of a 24hr supervised residence in Portumna. The 

landlord wished to terminate the contract with 

the HSE and we were not permitted to rent a 

similar residence. We had five residents in need 

of varying levels of support. Four of the 

residents required a high level of support and 

the fifth resident could manage with a reduced 

input. Without this development both service 

users and staff would have been transferred out 

of the area. The service users would most likely 

be facilitated outside of their own locality and 

the mental health service to the Portumna area 

would be greatly diminished due to the 

reduction in staffing levels. The sector team was 

not happy with this and there were grave 

concerns regarding the delivery of care as the 

area would now be without the facility of a 

24hour nursing service. Aligned to this change 

the service users had requested extended 

opening hours and weekend opening in the Day 

Centre. With these in mind negotiations began 


with the owner of the local retirement village 

and the solution is outlined below in bullet 

points for ease of reading. 

• Supervised residence closed on 31st July 

2011 

• Domiciliary team pilot ceased on 10th 

June 2011 

• 2 independent housing units rented by 

the service users of residence 

in the local retirement village (two 

bedrooms in each) 

• There is 1 (1bed) house on the same 

facility for respite purposes when needed 

by the local CMHT 

• 1 resident of the residence moved to a 

low support house in the area. 

• Day centre moved to a 7 day service with 

extended opening hours 

• A new nursing team was formed with 

current staff from supervised residence 

and the remaining staff member from the 

domiciliary intervention team. 

This new team is aligned to the day centre. It 

provided a high level of support initially to the 

service users who have moved to independent 

living and absorbed the case load of the 

domiciliary intervention team. It supports 

extended opening hours in the day centre. Each 

staff member has their own case load and takes 

referrals from the M.D.T. The staff have now 

much greater case loads with the MTAs not only 

now key working the four residents in the 

independent houses but also assisting when

equired in other areas. The nursing staff are 

now more involved in the provision of care 

throughout the sector and attend all clinical 

meetings. The Consultant Psychiatrist has 

facilitated the development of this service by 

providing much needed support to the team 

and indeed continues to offer advice and 

support. 

It provides an out of hour’s service for the 

mental health service in the sector. It is a rapid 

responding service to service users who need 

intensive periods of care in their home. It works 

closely with the local primary care teams in 

service delivery. 

• This new team is self staffing 24 hours 

daily 7 days a week with a recovery 

ethos. 

• It is being piloted for 1 year 

• At the end of the first year it is 

proposed to carry out research into 

its effectiveness. To this end we have 

been in contact with the Nursing and 

Midwifery Planning and Development 

Unit who have agreed to assist the team 

in this research. 

This plan not only provides an increased level 

of care to the community and facilitates service 

users to remain in their own locality but all this 

has been done with significant savings for the 

HSE. Those savings are in the region of 32,000 

per year. The seven staff (1 CNM2, 4 staff 

nurses and 2 Attendants) have increased their 

overall caseload, in the first 6 months, from the 

5 service users they cared for in the supervised 

residence and the occasional person in respite 

to 18 on day to day basis and they facilitate and 

provide therapeutic support to between 10 and 

15 clients on Saturdays and Sundays. 

Brian O’Malley 

Margaret Rudkins 

Assistant Director of Nursing 

09097-59885 

09097-59885 

086 8252400 

086 0476861 


Impact of different pack sizes of 

paracetamol in the United Kingdom and 

Ireland on intentional overdoses: A 

comparative study 

Paracetamol is commonly used in acts of 

intentional overdose. Overdosing on paracetamol 

may lead to liver damage, which if severe can 

require transplantation or can be rapidly fatal. 

As a result of many deaths and transplantations 

due to paracetamol induced hepatoxicity, 

legislation was introduced in the UK and Ireland 

to restrict the availability of paracetamol and 

thus intentional overdose. In 1998 paracetamol 

pack sizes in the UK were restricted to a 

maximum of 32 tablets in pharmacies and a 

maximum of 16 tablets in non-pharmacy outlets. 

Subsequently in 2001 in Ireland pack sizes were 

restricted to a maximum of 24 tablets in 

pharmacies and a maximum of 12 tablets in nonpharmacy 

outlets. 


The aim of the current study was to examine 

whether pack size reductions resulted in smaller 

overdoses of paracetamol in Ireland in 

comparison to the UK. The study investigated 

the number of paracetamol tablets consumed in 

non-fatal overdoses resulting in hospital 

presentation between 2002 and 2007, as 

recorded by the Multicentre Study of Self Harm 

in England (N=4858) and the National Registry of 

Deliberate Self Harm in Ireland (N=3509). 

The results illustrated greater proportions of 

younger individuals affected by paracetamol 

overdose in Ireland and conversely greater 

proportions of older individuals affected in 

England. There was no significant difference 

between the median number of tablets 

consumed in overdose in England (22 tablets) 

and Ireland (24 tablets). Independent of country 

there were differences by age, with significantly 

larger overdoses being consumed by older 

people. When alcohol was involved, significantly 

more paracetamol tablets were consumed, a 

pattern which in both countries was observed in 

men but not in women. 

In both countries the number of tablets taken 

differed significantly by gender, with larger 

overdoses in men than in women. As illustrated 

in Figure 1, the results indicated clear peaks in 

the numbers of overdoses which corresponded 

with the maximum pack sizes of paracetamol 

available in pharmacy and non-pharmacy outlets 

in England and Ireland. Thus in England there

were clear peaks at 32 and 16 tablets and in 

the Irish sample at 24 and 12 tablets. 

Figure 1 Distribution of tablets taken in 

paracetamol overdose in England and Ireland 

When the number of tablets consumed was 

categorised into pack equivalents used, relative 

to the respective country, the mean number of 

packs used was significantly greater in Ireland 

than in England. The largest proportion of 

overdoses in England involved only one pack 

(39%) and in Ireland involved three or more 

packs (37.9%). When both the Irish and English 

samples were confined to three age groups and 

compared, a small but significant difference in 

the median number of tablets consumed 

(England, median=24; Ireland, median=23) 

between the samples was found in the age 

group 35 and over in females only. In addition 

there were peaks in consumption in both 

samples at 10 tablets and multiples of 10 

tablets. 

The following conclusions can be drawn on the 

basis of the results: 

� The study clearly shows that individuals who 

take paracetamol in overdose tend to 

consume numbers of tablets related to 

available pack sizes. This pattern was 

observed not only for the number of tablets 

involved in overdoses reflecting maximum 

pack sizes but also for multiples of these 

packs sizes. 

� With more packs of paracetamol consumed in 

overdoses in Ireland questions have arisen 

relating to adherence to sales advice on 

paracetamol, purchasing patterns, patient 

attitudes to self poisoning and characteristics 

of hospital presentations. 

� The study shows limited evidence that 

smaller packs of paracetamol sold in pharmacy 

and non-pharmacy outlets may be associated 

with smaller overdoses in certain groups. 

However, the difference in pack size legislation 

between the UK and Ireland does not appear to 

have resulted in any significant differences in 

the numbers of paracetamol tablets or packets 

consumed in overdose. 

The National Office for Suicide Prevention in 

Ireland has established a Working Group to 

address issue of restricting and reducing access 

to means in a national and co-ordinated way in 

accordance with action 22 of the Reach Out 

National Strategy for Action in Suicide 

Prevention. 


Dr Ella Arensman 

National Suicide Research Foundation 

January 2012 

A Vision for Change 

An evaluation of the Mental Health Act 

Implementation Group (MHAIG) from the 

perspectives of a small sample of 

stakeholders in the Mental Health Act and 

within the MHAIG 

It is a well known fact that one in four people 

suffer with mental health issues during their 

lives. Continual monitoring of any type of 

legislation surrounding this issue is necessary to 

ensure it centres on the needs of the service 

user and related organisations. 

One such evaluation was carried out in 2011 and 

its findings are now being released which show 

that service user representation, 

multidisciplinary group dynamic and 

administration efficiency are key to effective 

group functioning in this regard. 

The Mental Health Act 2001 (MHA) has been 

described as the most significant legislative 

change for Mental Health Services (MHS) in 

Ireland for more than 60 years. Part 2 of the 

MHA was implemented on November 1, 2006 to 

complete its full implementation. This provided 

for the registration of approved centres and the 

automatic independent review of all involuntary

admission and renewal orders within a 21 day 

timeframe. Full implementation of the MHA 

presented a considerable challenge to the Irish 

MHS, the Mental Health Commission (MHC), the 

Health Services Executive (HSE) administration, 

clinical and professional staff. 

As a result, the Mental Health Act 

Implementation Group (MHAIG) was established 

by the Health Boards in July 2004. Since the 

groups inception, it has overcome many 

challenges and has developed expertise on the 

practical issues and major requirements of the 

MHA. At the end of last year, an evaluation of 

how the MHAIG was working was put in place 

and research centred around how it was 

performing. 

Research results were largely positive on how 

effective the MHAIG is. Service user 

representation on the group was found to be 

“integral” to what the MHAIG wanted to 

achieve. The research found that this direct 

involvement “brought a sense of the concrete 

reality of being a service user to discussions 

and guided policies and procedures 

accordingly.” 

The creation of a multidisciplinary group 

dynamic was found to have encouraged open 

and direct debate of topics. This effective 

functioning was fostered by strong, decisive 

and inclusive chairmanship which contained the 

pressures of the group and was seen as 

particularly valuable for the functioning of the 

MHAIG. 

Throughout the seven year existence of the 

MHAIG, administrative efficiency has enabled it 

immensely in terms of keeping communication 

lines to all related groups open. 

Finally, the research suggests that future HSE 

projects may benefit from incorporating these 

factors into the functioning of new groups which 

assist in the implementation of mental health 

policy and law. 

The research pointed out that, “our health 

services are increasingly at pains to find ways of 

working that are both efficient and progressive.” 

It further states that by, “drawing on multiple 

sources of clinical, managerial and 

administrative expertise and by placing the 

service user at the heart of its mission, the 

MHAIG has combined both of these qualities to 

represent a major achievement in health service 

policy implementation.” 


The MHAIG functions in both an advisory and 

operational capacity. The group comprises of 

multidisciplinary professional staff, such as HSE 

management along with service user 

representation. The MHAIG worked closely with 

service user groups while its sub-group on 

policies generated consistent guidance on the 

development and review of policies and 

procedures to conform to the Approved Centre 

Regulations (MHC, 2006). Legalities and court 

challenges resulting in legal amendments have 

been monitored since 2004 with resulting 

clarifications provided to all those working in the 

mental health areas by the MHAIG in liaison with 

the MHC, the HSE and service user groups. 

The research proposal was developed by three 

members of the MHAIG. The rationale for this 

proposal explained how important and timely 

this evaluation study was within the context of 

the Irish mental health system. It explained how 

implementation of the MHA and its subsequent 

published Regulations, Rules and Codes of 

Practice provided challenges to all stakeholders. 

While there is numerous documentation 

surrounding mental health management both 

nationally and internationally, the research aim 

was to show how an interdisciplinary group of 

HSE professionals with service user 

representation could achieve joint agreed goals 

with regard to the requirements of the MHA. 

For further information contact Amelia Cox, 

MHAIG amelia.cox@hse.ie

Rita Donovan 

We acknowledge with great sadness in this 

issue the death of our colleague Rita Donovan 

on 3 rd January 2012. Rita’s name and voice 

was familiar to many in mental health 

services around the country from her work in 

the Office of the Assistant National Director 

for Mental Health. She was particularly 

associated with the Mental Health Act 

Implementation Group and related work. Her 

graciousness in her dealings with colleagues, 

service users and the general public coupled 

with her courage and determination in the 

face of adversity were a source of inspiration 

to all who knew her. Such was her positive 

approach to life that only those of us who had 

regular contact with her were aware of the 

significant health challenges she battled with 

in recent times. She is sadly missed. Our 

thoughts and prayers are with her bereaved 

family, her husband Nilsson, her boys Adam 

and Ciarán, her parents Anne and Michael, 

her sisters Marie and Clare and her brother 

Declan. 


Please Talk - UCD initiative goes Nationwide 

PleaseTalk was initiated in 2007 following the 

deaths of a number of students in UCD by 

suicide. The deaths of these students were 

particularly worrying in the context of increasing 

youth suicide rates in the population generally. 

The PleaseTalk service targets 550,000 students 

in Ireland and Northern Ireland by directly 

engaging them on individual third level campuses 

through current student welfare structures, such 

as Students’ Unions, Student Support Officers 

and Chaplaincy Services. 

The service has two main elements: 

1. A core pro-active campaign message that 

“talking is a sign of strength”, which 

urges students to talk to someone if 

they’re having problems in any area of 

their life. 

2. The PleaseTalk website, 

www.PleaseTalk.org, provides a directory 

of support services available to students 

on campuses throughout Ireland 

The service is operated in a partnership between 

Inspire Ireland (www.inspireireland.ie) and the 

HSE National Office of Suicide Prevention. 

Inspire Ireland also delivers ReachOut.com 

(www.reachout.com), an online service to help 

young people through tough times. Our vision is 

that by 2015 every third level student is aware 


of both PleaseTalk.org and the PleaseTalk 

message that “talking is a sign of strength”. 

Since 2007 PleaseTalk has partnered with 32 

colleges throughout Ireland (including colleges in 

Northern Ireland) and continues to grow. 

If you’re interested in more information please 

contact the PleaseTalk Coordinator Vincent Mc 

Carthy – vincent@inspireireland.ie. 


Professional Management of Aggression and 

Violence (PMAV) 

Performance & Development are delighted to 

announce Fifteen nurses based in Mental Health 

and Intellectual Disability Services in Cork & 

Kerry were conferred in November 2011 with BSc 

in the Professional Management of Aggression 

and Violence(PMAV). In striving to reduce risk to 

Service Users and Staff and to further promote 

quality standards, this nationally endorsed 

programme was introduced in the HSE South in 

January 2010 and completed in June 2011. The 

programme provided students with the 

opportunity to acquire the theoretical and 

practical knowledge necessary to prepare them 

to be proficient instructors in the Professional 

Management of Aggression and Violence. They 

are now competent to assess, design, plan, 

deliver and evaluate instruction for various 

groups of staff with a response that is service

specific, needs assessed, fit for purpose and 

relevant to clinical 

setting within which it is delivered. In addition 

to proactive training, instructors are competent 

to design specific training responses to issues 

which emerge in service settings integrating 

training provided in line with professional care 

practice, health & safety, risk management and 

corporate policy. 

Speakers at the Ceremony (pictured) included 

Gretta Crowley, Operations Manager with 

responsibility for Mental Health Services who 

officially opened the ceremony. Michael 

Bambrick, DON, West Cork Mental Health 

Services, John Redican, CEO, National Service 

Users Executive, Tony Leahy, (Keynote Speaker) 

National Planning Specialist, Mental Health, Dr 

Edel Healy, Head of School of Health & Science, 

DKIT. Family, Managers, Service User 

Representatives, HR Partners and Union 

representatives, were in attendance to 

congratulate the achievements of the Graduates. 

Michael Bambrick, 

DON West Cork, 

027 52970 


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 before Friday 

23 rd March 2012 

All articles must be submitted in word 

format, with a maximum of 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 Friday 23 rd 

March 2012.

A Vision for Change Issue 7 February 2012 - Health Service Executive

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