Staff working in mental health services provide care for individuals with a variety of difficulties, which can pose treatment challenges. Perceived lack of progress in patients can engender uncomfortable feelings within the clinician, such as frustration, ‘heartsink’ and ‘feeling stuck’. The aim of this study was to explore the phenomenon of ‘feeling stuck’ amongst NCHDs in psychiatry.

A total of 30 participants were recruited from three psychiatric hospitals to complete a 15-item questionnaire. The survey was designed to pursue a thematic analysis. Participants were asked to complete the survey anonymously, either online or paper version. The analysis was carried out by two researchers using open coding, with themes finalised through collective discourse.

Three themes were elicited from the data. The central theme – ‘causes of feeling stuck’ – consisted of three subthemes (patient, doctor and system factors). Participants were adept at describing patient and system factors, but reflected on doctor factors, such as countertransference, less often and in less detail. Other themes, explored in less detail by respondents, were ‘the experience of feeling stuck’ and ‘responses to feeling stuck’, with participants tending to seek solutions to, rather than an understanding of, these feelings.

Trainee psychiatrists can clearly identify the situations where they are ‘stuck’ with clinical interactions. In spite of clinical supervision and reflective practice groups, they desire further training in managing these scenarios. NCHDs would benefit from further training, using these ‘stuck’ interactions as material, to further develop their understanding of the underlying factors in both themselves and their patients.

In Ireland, regularly reviewed Individual Care Plans (ICPs) for inpatients at all acute psychiatric inpatient units are a requirement of the Mental Health Act 2001. In this study, we comprehensively evaluated and compared opinions of key stakeholders in relation to the ICP as a care delivery tool.

We employed a descriptive survey design. Questionnaires were distributed to 123 stakeholders (patients and mental health professionals (MHPs)) to evaluate and compare opinions regarding the impact of the ICP in relation to healthcare delivery and health outcomes, and regarding the structure and frequency of use of the ICP.

Ninety-eight stakeholders (80%) completed study questionnaires. Stakeholders (patients (58%) and MHPs (85%)) reported that the ICP assisted in healthcare delivery. However, different attitudes between groups were noted in relation to whether the ICP contributed towards healthcare outcomes, with 64% of patients, but only 41% of MHPs reporting that the ICP positively contributed to mental healthcare outcomes. Some free-text comments described patient dissatisfaction with the role of the ICP for healthcare delivery, and MHP dissatisfaction that the ICP was time-consuming and did not significantly enhance standard patient care.

Whilst the implementation of the ICP is generally viewed positively by both patients and MHPs, considerable dissatisfaction by MHPs was also noted with certain aspects of how the ICP was delivered in practice. Practical adjustments to the implementation of ICP in order to build more positive stakeholder experiences appear warranted and worthy of further research.

The objective of this study was to understand the variables or study habits that inform study in undergraduate and postgraduate students attending Trinity College Dublin.

A descriptive, cross-sectional anonymous online survey was used to gather data to explore student study habits. Survey 1 was completed by participants in April 2019 and survey 2 was completed by participants in April 2020, during the COVID-19 restrictions.

A total of 1557 participants completed survey 1 in 2019, and 1793 participants completed survey 2 in 2020. In both surveys a majority reported using caffeine, library study, sleep pattern adjustment and excercise to aid academic performance. Survey 2 participants reported COVID-19 resulted in increased difficulty studying (91%). In particular loss of structure and routine was negatively impacted by the pandemic (92%), and increased feelings of stress were reported (75%).

Our study suggests a potential role of the college environment as a target for the implementation of interventions to promote student learning, healthy study habits and well-being. The global pandemic has resulted in additional challenging demands for universities to serve an essential role in supporting college students study habits.

As Ireland confronts the many challenges of broadening the introduction of early intervention services (EIS) for first episode psychosis (FEP) as national policy, this article describes Carepath for Overcoming Psychosis Early (COPE), the EIS of Cavan–Monaghan Mental Health Service, and presents prospective research findings during its first 5 years of operation.

COPE was launched as a rural EIS with an embedded research protocol in early 2012, following an education programme for general practitioners (GPs). Here, operational activities are documented and research findings presented through to late 2016.

During this period, 115 instances of FEP were incepted into COPE, 70.4% via their GP and 29.6% via the Emergency Department. The annual rate of inception was 24.8/100,000 of population aged > 15 years and was 2.1-fold more common among men than women. Mean duration of untreated psychosis was 5.7 months and median time from first psychotic presentation to initiation of antipsychotic treatment was zero days. Assessments of psychopathology, neuropsychology, neurology, premorbid functioning, quality of life, insight, and functionality compared across 10 DSM-IV psychotic diagnoses made at six months following presentation indicated minimal differences between them, other than more prominent negative symptoms in schizophrenia and more prominent mania in bipolar disorder.

COPE illustrates the actuality of introducing and the challenges of operating a rural EIS for FEP. Prospective follow-up studies of the 5-year COPE cohort should inform on the effectiveness of this EIS model in relation to long-term outcome in psychotic illness across what appear to be arbitrary diagnostic boundaries at FEP.

The aim of the present study was to evaluate the levels of possible internet addiction, gaming addiction, gambling addiction and associated mental health difficulties in a secondary school population in Ireland.

An online survey containing questions related to internet addiction, gaming addiction, gambling addiction and associated mental health difficulties was administered to secondary school adolescents in Ireland. Participants were self-selecting and answered questions on the characteristics of each topic and screening questionnaires for addiction to each behaviour, as well as their respective effects on mental health.

A total of 234 children participated in the survey (156 males; aged 12–18 years; average age of 14.2 years; S.D. 1.60). Internet addiction as assessed using the Chen Internet Addiction Scale was present for between 11.5% and 22.6% and levels of gaming addiction as assessed using by the Internet Gaming Disorder Scale–Short Form was present for between 0.5% and 1.6%. Weak positive correlations were found between time spent on the internet and time spent gaming with internet addiction and gaming addiction, respectively. There were weak positive correlations between higher internet addiction scores, higher gaming addiction scores, and increased depression and anxiety scores. Using the South Oaks Gambling Screen–Revised for Adolescents, two participants were classed as ‘at-risk’ for gambling addiction and one participant was classed as a problem gambler.

The present study examined behavioural addictions and their effects on mental health on a self-selecting sample of schoolchildren at two schools in Ireland. A low number were identified as being at risk or problem gamblers.

This study aimed to identify risk and protective factors for mental health across student cohorts to guide mental health provision.

Cross-sectional data from the My World Survey 2-Post Second Level (MWS2-PSL) were used. The sample consisted of N = 9935 students (18–65 years) from 12 third-level institutions (7 out of 7 universities and 5 out of 14 Institute of Technologies (IoTs)) across Ireland. Key outcomes of interest were depression, anxiety and suicidality. Risk factors included drug/alcohol use, risky sexual behaviours and exposure to stressors. Protective factors included coping strategies, help-seeking, resilience, self-esteem, life satisfaction, optimism and social support. These factors were profiled by degree type (undergraduate, postgraduate taught, postgraduate research), access route, and institution type (IoT, university). Chi-square tests of Independence and one-way ANOVAs compared groups on key risk and protective factors.

A total 71% of respondents were female, 85% were aged 23 or under and there was a 2.2% response rate in IoTs versus 10.6% in university students. Undergraduates demonstrated higher levels of depression, anxiety, self-harm and suicidal ideation than postgraduates. Undergraduates showed higher risk and lower protective factors than postgraduates. Students attending Institutes of Technology reported higher levels of depression and anxiety, lower protective and higher risk factors than university students.

In this sample of students, undergraduates, especially those attending Institutes of Technology, were at increased risk of mental health difficulties. Findings suggest the need to tailor interventions to meet cohort needs, and consider the differing vulnerabilities and strengths across student cohorts. Due to limitations of this study, such as selection bias, further research is warranted.

The aim of the present study was to explore how adults who self-harm experience family relationships.

A phenomenological design was employed to examine the dynamic relationship between self-harm and family systems. Semi-structured interviews were conducted with six female adults who attend a community mental health service and engage in self-harm. Transcripts were analysed using Interpretative Phenomenological Analysis (IPA).

Four superordinate themes emerged from the data and two subordinate themes emerged within each superordinate theme: family interactive patterns (subordinate themes: enmeshed patterns and culture of ‘getting on with it’), searching for meaning (subordinate themes: expressing emotional turmoil and engrained worthlessness), relating to others (subordinate themes: guilt and feeling misunderstood) and journey towards life without self-harm (subordinate themes: acceptance and family support).

Findings emphasise the role of family systems in understanding self-harm in adults. The study highlights the need for family-based interventions for family members who support adults that self-harm.

To examine levels of psychological distress among higher education students in Ireland overall and across a range of personal, higher education, and socioeconomic characteristics, prior to the COVID-19 pandemic.

A cross-sectional online survey of college students in Ireland was undertaken in 2018. Data on 5201 students from 13 higher education institutions (HEIs) were analyzed. Stress, anxiety, and depression symptom scores based on the Depression, Anxiety and Stress Scale (DASS-21) were calculated and reported, with statistical testing used to compare across groups.

Overall, 29.6% and 19.1% of respondents were classified in the mild to moderate and severe to extremely severe range for depression respectively. The corresponding proportions were 25.9% and 20.7% for anxiety, and 24.5% and 14.8% for stress. Differences across groups included higher levels of psychological distress for transgender and female students compared to males (p < 0.01), for gay/lesbian/bisexual students compared to heterosexuals (p < 0.01), for undergraduates compared to postgraduates (p < 0.01), for students from intermediate/technical/service/unskilled social classes compared to professional/self-employed social classes (p < 0.01), and for those with financial difficulties compared to those without financial difficulties (p < 0.01).

Rates of psychological distress were high amongst college students in Ireland prior to the COVID-19 pandemic, with substantial differences across groups. Due to study limitations, such as possible selection bias, the findings need replication. Further research is needed to determine the impact of the pandemic on the prevalence of mental illness in this population.

Consumer satisfaction is considered one of the most important measures of service quality in child mental health; however, there is limited understanding of factors that influence satisfaction. The objective of this study was to investigate key factors influencing satisfaction with care (SWC) in ADMiRE, a specialist service for young people (YP) with attention deficit hyperactivity disorder (ADHD).

Parents/carers (n = 67) and YP > 9 years (n = 44) attending ADMiRE completed an anonymous Experience of Service Questionnaire (ESQ), a quantitative/qualitative measure of service user satisfaction. Parents/carers also completed symptom severity rating scales. Data were analysed to determine (i) overall SWC, (ii) the relationship between parent- and youth-reported SWC and (iii) the impact of symptom severity on SWC. Thematic analysis of qualitative ESQ data was completed.

Parents/carers were significantly more satisfied than YP (p = 0.028). Symptom severity did not impact significantly on parent/carer satisfaction. YP with severe hyperactive/impulsive and inattentive ADHD symptoms were significantly less satisfied with care than those with less severe ADHD symptoms (p = 0.022 and p = 0.017 respectively). Factors related to the therapeutic alliance were identified as being particularly important to both parents/carers and YP.

This is the first Irish study that has investigated the impact of symptom severity on service user satisfaction in a child mental health service. The results highlight the different perspectives of YP and parents and provide novel insights into the impact of symptom severity on service user satisfaction. The importance of the therapeutic alliance should not be underestimated in future development of services.

To explore the degree of COVID-19-related stress among college students enrolled in higher level institutions and identify socio-demographic and psychosocial factors that may predict, or be associated with, higher levels of pandemic-related distress.

Data were obtained from a cross-sectional survey completed by 321 college students primarily recruited from Universities in Ireland. Ages ranged between 18–21 years (n = 176) and 22–25 years (n = 145). Participants answered some demographic questions before completing scales assessing their experience of childhood adversity, their present resilience and levels of psychological distress, as well as their COVID-19-specific stress.

Multiple regression analysis revealed that students who were female, who had chronic illness, who experienced monetary concerns and who expressed psychological distress experienced greater stress related to COVID-19.

Findings suggest that certain categories of college students may be at higher risk for experiencing poor mental health during a global pandemic. Higher level institutions should consider this when designing and delivering support services aiming to promote student mental health and alleviate mental distress.

Previous literature has highlighted high rates of burnout among doctors and nurses in healthcare settings. Non-clinical and support staff such as administrative, housekeeping and managerial staff are also exposed to the stressors of a health care setting, but fewer studies report on their experiences. Therefore, the aim of this research is to examine occupational stress in all staff working in Child and Adolescent Mental Health Services (CAMHS) in Ireland and identify risk and protective factors.

Fifty-nine clinical and non-clinical staff (44% response rate) were surveyed. Participants completed the Copenhagen Burnout Inventory (CBI) and the Effort Reward Imbalance scale, as well as survey-specific questions.

Both clinical and non-clinical staff were found to experience moderate or high rates of work-related, personal and patient-related burnout (57.6%, 52.2% and 50.8%, respectively). Univariate general linear modelling showed an association between total CBI scores and effort reward index (B = 64 306, t = 3.430, p = 0.001); overcommitment (B = 1.963, t = 3.061, p = 0.003); and an unwillingness to work in CAMHS (B = 28.429, t = 3.247, p = 0.002).

Pre-pandemic levels of stress were high among clinical and non-clinical staff surveyed. Given the anticipated increased demand on CAMHS post COVID-19, urgent action is needed to protect all staff from intolerable levels of occupational stress and burnout.

Objective structured clinical examinations (OSCEs) play a pivotal role in medical education assessment. The Advanced Clinical Skills (ACS) OSCE examines clinical skills in psychiatry, general practice, obstetrics and gynaecology and paediatrics. This study examined if the 2020 ACS OSCE for fourth year medical students attending the National University of Ireland, Galway, was associated with any significant result differences compared to the equivalent 2019 OSCE. Additionally, we assessed students’ satisfaction and explored any organisational difficulties in conducting a face-to-face OSCE during the COVID-19 pandemic.

This study compared anonymised data between the 2019 and 2020 ACS OSCEs and analysed anonymised student feedback pertaining to the modified 2020 OSCE.

The mean total ACS OSCE result achieved in 2020 was statistically higher compared to the 2019 OSCE [62.95% (SD = 6.21) v. 59.35% (SD = 5.54), t = 6.092, p < 0.01], with higher marks noted in psychiatry (p = 0.001), paediatrics (p = 0.001) and general practice (p < 0.001) with more students attaining honours grades (χ2 = 27.257, df = 3, p < 0.001). No difference in failure rates were found. Students reported feeling safe performing the 2020 OSCE (89.2%), but some expressed face-mask wearing impeded their communication skills (47.8%).

This study demonstrates that conducting a face-to-face OSCE during the pandemic is feasible and associated with positive student feedback. Exam validity has been demonstrated as there was no difference in the overall pass rate.

An increasing number of young people are experiencing mental health difficulties and schools have been identified as environments that can support them. However, it is unclear how students feel about the current supports in school and whether they are used. The aim of this study is to explore the perceptions of young people in Irish post-primary schools regarding mental health and well-being supports in schools.

An online survey was conducted with (n=109) young people to determine the perceptions of mental health and well-being supports in post-primary Irish schools. Using a convenience sampling method, an online survey was distributed via gatekeepers in local youth and sporting groups. Data collection was completed using the Barriers to Seeking Help-brief version (BASH-B) and additional tailored questions.

Qualities like being ‘trustworthy’ and ‘a good listener’ were reported as key for adults to be considered a good support in schools. Current mental health and well-being supports were not considered adequate with 65.1% of the participants feeling ‘somewhat supported’ and 22.9% feeling ‘not at all supported’.

Better advertising of mental health support services should be implemented in schools to promote awareness. This study can inform the development of such services which are urgently needed.

The Health Service Executive National Clinical Programme for Eating Disorders (NCPED) launched a Model of Care for Eating Disorder Services in Ireland in 2018. Currently, one adult and two child and adolescent eating disorder services are operational out of a total of sixteen recommended. The three objectives of this paper are to describe the early (1) referral pattern, (2) level of service activity and (3) the level of service user satisfaction.

Monthly submitted service activity data from each service to the NCPED between March 2018 and October 2020 were retrospectively analysed. One hundred and fifty-nine carers and service users completed an experience of service questionnaire (ESQ). A descriptive analysis of referral pattern, level of service activity and ESQ was performed. A thematic analysis was performed on three qualitative questions on the ESQ.

There was substantial referral numbers to eating disorder services by 18 months (n = 258). The main referral source was community mental health teams. The majority (n = 222, 86%) of referrals were offered an assessment. The most common age profile was 10–17 years of age (n = 120, 54.1%), and anorexia nervosa was the most common disorder (n = 96, 43.2%). ESQ results demonstrate that most service users were satisfied with their service, and the main themes were carer involvement, staff expertise, therapeutic alliance and service access.

This preliminary service activity and service user satisfaction data highlight several issues, including trends when setting up a regional eating disorder service, potential pitfalls of pragmatic data collection and the need for adequate information-technology infrastructure.

Challenging transitions, increased stress and mental ill health can affect students’ academic performance and their capacity to remain in higher education. Prevention and early treatment of mental health problems in college students is therefore a key public health priority, nationally and internationally. Developing a range of evidence-based interventions targeting the mental health of students is critical. We examined the feasibility and acceptability of a new universal time use and well-being intervention, the ‘Everyday Matters: Healthy Habits for University Life’ digital badge (EMDB), a co-curricular micro-credential for first-year college students.

This study used a single-arm, pre–post design for first-year undergraduate students. The EMDB comprised eight 1-hour lunchtime sessions on brain development and time-use habits across the 24 hours of the day including sleep, self-care, leisure, study and work. Validated measures of occupational competence and value, mental well-being, sleep health, mindset, self-compassion and gratitude were completed, along with an evaluation questionnaire.

Eight first-year undergraduate students completed the demographic questionnaire and pre- and post- measures, with one additional student completing only the evaluation questionnaire. There was significantly improved levels of well-being, self-compassion and growth mindset following the intervention. Many of the challenges reported by participants related to occupational issues such as managing finances and having a satisfying routine. Participants appreciated the practical relevance and scientific underpinnings of the programme content. The sense of belonging within the group and having insightful conversations with other group members were particularly valued by participants.

This study offers preliminary evidence that an occupational therapy based universal time-use and well-being intervention was feasible to deliver and acceptable to first-year undergraduate students. The results of this study and the participant acceptability support further development and evaluation of the EMDB intervention.

The association between illicit substance use by third-level education students and their mental and physical health is well documented. The aim of this scoping review was to determine factors that contribute to student motivations to reduce or stop their use of illicit substances, and to elaborate on factors that may be pertinent for student-focused behaviour change interventions for substance use.

We searched eight databases in March 2021 using search terms based on ‘students’, ‘illicit substance use’, and ‘motivations’. We identified 86 research articles that reported on third-level education students’ illicit substance use and included reasons or motives for their use.

After full-text screening, three studies were eligible for inclusion in the qualitative synthesis. The majority of studies described motives for abstention but did not describe motivation for reducing or stopping current patterns of use of illicit substances.

Few studies have examined motivations of third-level education students to decrease or cease substance use. Promising avenues for research on motivations to change substance use behaviour include the social contextual factors, perceived effects on social relationships, and actions of friends and family to prompt contemplations of change.

Studies on patient-student relationships have to date largely focused on student attitudes. This study explores attitudes of patients with psychiatric illness in Ireland, towards medical students. Patients’ experience of consent for student involvement is an area of concern in previous studies and is also quantified here.

This was a mixed-methods cross-sectional survey of Irish adult psychiatric patients. Quantitative analysis was carried out using SPSS 22 (Statistical Product and Service Solutions, Version 22, IBM). Differences on Likert score between groups (male/female, hospital site, past experience with students/ no experience) were analysed using ordinal logistic regression with a p-value below 0.05 being significant. Qualitative data were analysed by thematic analysis using OpenCode 4.03

A total of 340 patients completed the survey. The mean age (sd) was 44.8 (16.3). 52.8% were female, 75.2% were outpatients. 24.3% had never met a medical student. Most patients were comfortable seeing students, but preferred students being passive observers. Patients with previous student experience had higher comfort levels and more positive attitudes. Although most patients (63.7%) strongly agreed they had been asked for consent, only 49.3% felt they had been given sufficient information. Qualitative data revealed preference for adequate information and notice of involvement. Patients felt pressured by student presence in certain circumstances.

Psychiatric patients are comfortable with students but many feel inadequately informed. Patients recognise the benefits of interacting with students. More information is needed regarding circumstances in which patients give consent to involvement with students