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Geographical barriers to mental health service care among individuals with an intellectual disability in the Republic of Ireland
- Authors:
- RAMSAY Hugh, et al
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 13(4), 2016, pp.261-268.
- Publisher:
- Wiley
People with an intellectual disability (ID) are more likely to experience mental health difficulties than others. The United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD) states that health services should be provided close to people's own communities. This article examines differences in access to psychiatry services for those with an ID according to geography, in the context of a small European country (Republic of Ireland). The sample consisted of 753 individuals aged 40 and over with ID in the Republic of Ireland, with data collected from the Intellectual Disability Supplement of the Irish Longitudinal Study on Aging (IDS-TILDA). The primary outcome of interest was attendance with any psychiatrist and the primary independent variables were area of residence (health service region and degree of county urbanicity). Logistic regression was used to analyse associations, unadjusted and then controlling for age group, gender and level of ID. Secondary analysis examined factors associated with anti-psychotic prescription without psychiatrist supervision. Treatment by a psychiatrist was associated with both health region (p = 0.029) and degree of urbanicity (p = 0.015) before controlling for group differences but only the health region was significantly associated after controlling for age, gender and level of ID. Antipsychotic use without a psychiatrist was associated with degree of urbanicity (p = 0.036) but not with health service region (p = 0.989). Geographic factors are associated with access to mental health services among those with ID in the Republic of Ireland. This may be partly due to movement of people with ID away from their area of origin, highlighting the need for locally tailored specialist ID mental health teams and for further research into barriers to treatment. Additional work in other countries will further understanding of similar roles of geographic factors in mediating mental health services access. (Edited publisher abstract)
Designing youth mental health services for the 21st century: examples from Australia, Ireland and the UK
- Authors:
- McGORRY Patrick, BATES Tony, BIRCHWOOD Max
- Journal article citation:
- British Journal of Psychiatry, 202(s54), January 2013, pp.s30-s35.
- Publisher:
- Cambridge University Press
Despite the evidence showing that young people aged 12–25 years have the highest incidence and prevalence of mental illness across the lifespan, and bear a disproportionate share of the burden of disease associated with mental disorder, their access to mental health services is the poorest of all age groups. A major factor contributing to this poor access is the current design of our mental healthcare system, which is manifestly inadequate for the unique developmental and cultural needs of our young people. If we are to reduce the impact of mental disorder on this most vulnerable population group, transformational change and service redesign is necessary. Three recent and rapidly evolving service structures from Australia (Headspace, an enhanced primary care model for youth mental healthcare), Ireland (Jigsaw) and the UK (Youthspace developed by Birmingham and Solihull Mental Health Foundation Trust), are presented that have each worked within their respective healthcare contexts to reorient existing services to provide youth-specific, evidence-based mental healthcare that is both accessible and acceptable to young people. (Edited publisher abstract)
Youth engagement with an emerging Irish mental health early intervention programme (Jigsaw): participant characteristics and implications for service delivery
- Authors:
- O'REILLY Aileen, et al
- Journal article citation:
- Journal of Mental Health, 24(5), 2015, pp.283-288.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Background/Aims: The transition to adulthood represents a critical period which influences mental health problems, but access to and utilisation of mental health services by young people is poor. Jigsaw is a response to the challenge of transforming how young people access mental health support and attain positive outcomes. This article presents an overview of the characteristics of young people engaging with this service. Method: Data about young people who engage with Jigsaw are captured through an online system designed to record salient clinical, case management, service delivery, and outcome information. Participant characteristics are summarised to portray the young people who engaged with the service for the first time during 2013 (N = 2420). Results: The majority of young people engaging with Jigsaw were female, aged 15-17 years, and were referred by their parents. Over half were in full-time education, although many 21-25-year-olds were unemployed. Young people presented with a range of difficulties which varied by age and gender. They reported high levels of distress, with age and gender having a significant impact on their well-being. Conclusions: This study provides emerging evidence to support the need for an early intervention component within the system of mental health care. (Publisher abstract)