Despite a substantial epidemiological literature on the incidence of psychotic disorders in Ireland, no systematic review has previously been undertaken. Such evidence can help inform understanding of need for psychosis care.

We conducted a prospectively registered systematic review (PROSPERO: CRD42021245891) following PRISMA guidelines. We searched four databases (Medline, PsycInfo, Web of Science, Embase) for papers containing incidence data on non-organic psychotic disorders, in people 16–64 years, published between 1950 and 2021 in the general adult population. We conducted duplicate screening, risk of bias assessments, and extracted data to a standardised template. We undertook a narrative synthesis for each major diagnostic outcome. Random effects meta-analyses were conducted for comparisons with ≥5 incidence rates.

Our search yielded 1975 non-duplicate citations, of which 23 met inclusion criteria, containing incidence data ascertained between 1974 and 2016 (median study quality: 5/8; interquartile range: 4–6). Incidence of all psychotic disorders (N = 4 studies) varied from 22.0 (95%CI: 17.3–28.0) in Dublin to 34.1 per 100,000 person-years (95%CI: 31.0–37.5) in Cavan and Monaghan. The pooled incidence of schizophrenia (N = 6 studies, N = 8 settings) was 20.0 per 100,000 person-years, though with imprecision around this estimate (95%CI: 10.6–37.5; I2: 97.6%). Higher rates of most outcomes were observed in men. There was consistent evidence of raised rates in more deprived and fragmented social environments, but no clear pattern by rural-urban status.

Patterns of incidence of psychotic disorders in Ireland are broadly consistent with the wider literature from the Global North. Findings could help identify populations at higher risk of psychosis in Ireland.

Given the evidence that drinking patterns and self-harm hospital presentations have changed during COVID-19, this study aimed to examine any change in self-harm and suicide-related ideation presentations, together with any possible contribution made by alcohol or substance misuse, to Irish Emergency Departments in 2020, compared with 2018 and 2019.

A population-based cohort with self-harm and suicide-related ideation presenting to Irish hospitals derived from the National Clinical Programme for Self-Harm was analysed. Descriptive analyses were conducted based on sociodemographic variables and types of presentation for the period January to August 2020 and compared with the same period in 2018 and 2019. Binomial regression analyses were performed to investigate the independent effect of demographic characteristics and pre/during COVID-19 periods on the use of substances as contributory factors in the self-harm and suicide-related ideation presentations.

12,075 presentations due to self-harm and suicide-related ideation were recorded for the periods January–August 2018–2020 across nine emergency departments. The COVID-19 year was significantly associated with substances contributing to self-harm and suicide-related ideation ED presentations (OR = 1.183; 95% CI, 1.075–1.301, p < 0.001). No changes in the demographic characteristics were found for those with self-harm or suicide-related ideation across the years. Suicide-related ideation seemed to be increased after May 2020 compared with previous years. In terms of self-harm episodes with comorbid drug and alcohol overdose and poisoning, these were significantly increased in January–August 2020, compared with previous timepoints (χ2 = 42.424, df = 6, p < 0.001).

An increase in suicide-related ideation and substance-related self-harm presentations may indicate longer term effects of the pandemic and its relevant restrictions. Future studies might explore whether those presenting with ideation will develop a risk of suicide in post-pandemic periods.

Globally, problem gambling prevalence is estimated at between 0.1% and 5.8%. Problem gambling can have many negative consequences; including on physical, and psychological health, and social functioning. There is a need to better understand treatment uptake as only a small proportion seek treatment. This is the first Irish national study using routinely gathered health surveillance data to describe treated problem gambling. Results will inform service policy and planning.

An analysis of episodes treated for problem gambling collected by the National Drug Treatment Reporting System was undertaken. Included were episodes entering treatment between 2008 and 2019 (n = 2999). Variables of interest included service types accessed, demographics, socioeconomic information, referral and assessment details, current problems (up to five) and treatment history.

The majority (93.8%) were male. One fifth (20.9%) lived with dependent children, 7.4% were homeless. There were high levels of employment (35.4%) and formal education qualifications; half (53.8%) had completed second or third level education. Problem gambling frequently co-occurred with problem use of other substances (47.3%), which was most commonly alcohol (85.6%), followed by cannabis (32.3%), cocaine (28.0%) and benzodiazepines (10.9%). The majority were treated at inpatient settings (56.1%) with many self-referrals (46.3%).

This study provides insights into treated problem gambling nationally. Monitoring and surveillance can play a crucial role in measuring the successful efforts and help inform planning and treatment. The findings may have implications for treatment pathways.

To evaluate if having an early intervention service (EIS), which is embedded within a home-based treatment team (HBTT), is associated with (1) shorter duration of untreated psychosis (DUP), (2) lower rates of hospital admissions at first presentation, (3) a lesser number of hospital admissions within 6 months of presentation and (4) a reduced mean bed usage for the first 6 months.

The files of those who presented with a first-episode psychosis (FEP) to the South Lee Mental Health Service from January 2016 to February 2017 were identified and a retrospective case review was carried out. The demographics, clinical characteristics and hospital admissions were compared for those admitted to either the EIS or community mental health teams.

Forty patients were assessed. DUP was found to be longer for those who presented to the EIS (U = 121, p = 0.03). There were fewer admissions at first presentation (χ2 (1) = 6.51 p = 0.01), fewer admissions within the first 6 months of presentation (χ2 (1) = 5.56 p = 0.02) and less bed usage overall (U = 131, p = 0.047) for those who presented to the EIS.

The study provides a baseline clinical and demographic profile of patients with FEP in an Irish mental health service and demonstrates current pathways to care. EIS embedded within an HBTT was associated with fewer hospital admissions and less bed usage. It is unclear whether these findings may have occurred due to the EIS or due to the benefits provided by an HBTT.

The Health Service Executive (HSE) Quality Improvement Division (2016) report states that young people who identify as transgender are one of the highest risk groups for suicidal ideation, self-harm, and completed suicides and may require significant input in Irish Child and Adolescent Mental Health Services (CAMHS). This research represents the first exploration of CAMHS staff’s capacity within an Irish mental health service to support transgender youth by considering their knowledge about and confidence in working with these youth.

A multi-method design was used to evaluate the knowledge and confidence levels of CAMHS clinicians in supporting transgender youth and to identify what factors would enable them to conduct this work. A questionnaire and a survey about supporting transgender youth were distributed to all clinicians in five Irish-based CAMHS services (N = 71), using an online platform. Additionally, semi-structured interviews were conducted with six clinicians. Quantitative, content, and thematic analyses were performed.

CAMHS staff reported limited knowledge and experience about supporting transgender youth. Findings indicated that both of these factors undermined their confidence in supporting these youths. Clinicians expressed a need for additional clinical education delivered through expert consultation, presentations, and learning from ‘experts by experience’.

CAMHS clinicians need and want further clinical education about supporting transgender youth and their families. Recommendations are made for enhancing the knowledge, confidence, and competence of CAMHS clinicians using methods identified as acceptable by clinicians, in order to best support these youths.

To examine if the COVID-19 pandemic is associated with a differential effect over a 2-year time period in relation to its psychological and social impact on patients with established anxiety disorders.

Semi-structured interviews were conducted with 21 individuals attending the Galway-Roscommon Mental Health Services in Ireland with an ICD-10 diagnosis of an anxiety disorder. Interviews occurred at three time-points over a 2-year period to determine the impact of the COVID-19 pandemic and associated restrictions on anxiety and depressive symptoms, social and occupational functioning, and quality of life.

No statistical difference in symptomatology was noted between the three time-points in relation to anxiety symptoms as measured utilising psychometric rating scales (Beck Anxiety Inventory (BAI), Hamilton Anxiety Rating Scale (HARS) or Likert Scale measures). The greatest impact of COVID-19 at all time-points related to social functioning and quality of life. Significant variability was noted for individual participants. Qualitative analysis noted a tentative optimism for the future in the setting of vaccination and societal re-opening. Fear of re-emerging anxiety symptoms with the removal of societal restrictions was noted.

No significant overall change in symptomatology or functioning over time was noted for individuals with pre-existing anxiety disorders, however variability was demonstrated, with some individuals describing ongoing anxiety, social isolation and concern for their future. A strong theme of hope for the future and less concern regarding the COVID-19 pandemic was evident; however tailored supports including the utilisation of tele-psychiatry is suggested, particularly for those experiencing increased anxiety with the removal of societal restrictions.