Objectives: To estimate the prevalence of psychiatric morbidity, substance misuse problems and related health and social problems among women prisoners newly committed and a cross-section remanded and sentenced in the Irish prison population. In 2002 women represented 10.7% (1043) of all persons committed to the Irish Prison system, and 3.3% (104) of the daily average number of persons in custody. We surveyed psychiatric morbidity in these two groups to assess the need for psychiatric services for women prisoners, and to compare Irish morbidity with an international average.

Method: We interviewed 94 newly committed women prisoners within 72 hours of committal, representing approximately 9% of female committals per year. We also interviewed a cross sectional sample of 92 women, representing approximately 90% of all women in custody. Mental illness and substance misuse was measured using the SADS-L, SODQ and a structured interview.

Results: Five (5.4%) of the committal and 5 (5.4%) of the cross-sectional sample had a psychotic illness within the previous six months. 8 (8.5%) of the committals and 15 (16.3%) of the women in the cross-sectional sample had a major depressive disorder in the last six months. 8 (8.6%) committals and 14 (15.2%) in the cross-sectional sample had an anxiety disorder within the last six months. 61 (65.6%) of the women interviewed at committal and 61 (65.2%) of the cross-sectional sample had a substance misuse problem in the last six months.

Conclusions: There is a high prevalence of mental illness and substance misuse problems amongst women newly committed to prison and in a cross section of those remanded or sentenced in prison in Ireland. We found evidence of a cycle of deprivation and institutionalisation. These findings highlight the need for the integration of community and forensic psychiatric services, and for ongoing collaboration with drug services.

Background: This is the first epidemiologically representative cross-sectional study of psychiatric morbidity using research diagnostic instruments in sentenced prisoners in Ireland.

Objective: To estimate the prevalence of psychiatric morbidity and psychiatric service requirements.

Method: We interviewed 340 men serving a fixed sentence (14.6% of total) and 98 men serving a life sentence (82% of total). Prisoners were drawn from 15 different prisons using a random stratified sampling method. Mental illness and substance misuse was measured using the SADS-L, SODQ and a structured interview to generate ICD-10-DCR diagnoses.

Results: We found a high prevalence of mental illness. Our six month prevalence for psychosis (2.7%) was similar to an international meta-analysis. We found a significantly higher prevalence of psychosis in life sentenced prisoners (6.1%) compared to fixed sentenced prisoners (1.8%). Drugs and alcohol problems were very prevalent.

Conclusions: Using the six month prevalence figures found for psychosis, we estimate that there are approximately 79 sentenced male prisoners with a severe mental illness who would require treatment in hospital additional to current provision. We discuss the relationship between drug availability and the prevalence of severe mental illnesses in prisons.

Aims: The aim of this research is to evaluate a seven week abstinence-based drug treatment programme and to use this to assist policy makers in the planning and provision of future programmes.

Methods: Design: Seventy-nine clients were interviewed at two stages. Stage I, prior to the treatment programme, stage II, immediately after the treatment programme. A selected group of 20 clients were followed-up and interviewed at stage III, up to 24 months after the treatment programme.

Setting: All clients were prisoners at Mountjoy Prison, Dublin Ireland.

Participants: Seventy-nine male prisoners were recruited. A sample of 20 of the original cohort of 79 was selected using a snowball sampling method approximately 24 months following treatment. This latter sample of 20 clients consisted of eight prisoners who had re-offended and returned to prison, three prisoners who were still in prison serving their original sentence and nine prisoners who were out of prison. These 20 also participated in a more detailed quantitative and qualitative survey.

Measurements: In order to measure prisoner's criminogenic attitudes and needs the Crime Pics II instrument was used. This is a semantic differential scale which measures attitudes toward offending behaviour. It includes a problem checklist which can be used to measure change over time.

Results: An 82% follow-up rate was achieved on the original group of 79 clients, similarly a follow-up rate of 100% was also achieved for the selected group of 20 clients who were interviewed three times. Regardless of category of client, findings demonstrate an improvement over time for the outcome variables, general attitude to offending, anticipation of re-offending and perception of current life problems. However, the study failed to demonstrate any significant change for the outcome variables victim hurt denial and evaluation of crime as worthwhile.

Conclusions: These results were short lived for many prisoners, who failed to sustain the gains made. Interviews with the cohort of 20 who underwent stage III interviews possibly suggest that those clients who did not receive continuity of treatment post programme, in terms of case management and structured treatment did not fare as well as those who did.

Objectives: Over the past three decades, major changes have taken place internationally in the type of residential accommodation provided for people with intellectual disabilities but these appear to be less evident in Northern Ireland.

Method: A census was undertaken of all persons in any form of residential placement using a range of existing databases to identify the population, with a short questionnaire completed for each resident.

Results: Around 440 persons lived in hospitals and 1,970 in some other form of provision but mostly in large congregated settings such as residential care homes and nursing homes. This was more marked in certain Health and Social Service Boards than in others. Most places are provided by the private sector although voluntary organisations and housing associations now manage around one-third of places. People living in hospitals reportedly had different characteristics to those in all other settings while those in nursing homes tended to require greater personal care. However the characteristics of people living in residential homes, supported living arrangements and village communities were broadly comparable. Around one in 10 persons were deemed to benefit from a move; mostly from residential homes to more independent living arrangements.

Conclusions: Compared to Britain and the Republic of Ireland there is an under-provision of residential placements in Northern Ireland. To date, funding from outside of health and social services has been the main driver for the type of accommodation provided. The implications for future policy and provision are discussed.

Objective: Media portrayals of mental illness and psychiatry have a considerable impact on public perceptions of mental health issues. This paper aims to focus on portrayals of psychiatry and psychiatrists in four contemporary Irish feature films in order to make wider points on this theme.

Methods: Contemporary Irish feature-films that made substantial reference to psychiatry, psychiatrists or mental health in Ireland were identified though electronic searches and consultation with the Film Institute of Ireland. Selected films were viewed. Electronic searches were performed in the medical and film literatures, with broad search terms related to film, psychiatry, psychiatrists or mental health in Ireland. Additional books and papers were identified by tracking back through references and consulting with colleagues.

Results: The portrayal of psychiatrists in film is closely related to the development of both twentieth century psychiatry and twentieth century cinema. In common with recent European films, certain recent Irish films have tended to show psychiatrists as sympathetic, humane individuals (with some notable exceptions). While there have been a number of portrayals of dissocial personally disorder and various states of chronic alienation in recent Irish film, there have been fewer portrayals of psychosis or learning disability. Recent Irish films emphasise the role of alcohol in causing and perpetuating psychological distress. They generally provide unflinching portrayals of the effects of psychological distress and alienation, suicide and substance abuse at individual, family and community levels; nonetheless, there is still a regrettable tendency for films to associate mental illness with dissocial behaviour.

Conclusions: The portrayal of mental health issues in film presents both challenges and opportunities to film-makers, mental health service-users and general audiences alike. It is to be hoped that the recent trend towards realistic explorations of mental health issues in many European films continues into the future. Increased research in this area would help clarify the role of cinema in shaping public understandings of mental illness, and may also help identify additional ways of addressing stigma in the future.

We describe a 63 year old male with serotonin syndrome, presenting with choreoathetosis. Differentiating this syndrome from neuroleptic malignant syndrome remains a challenge. It is important to be aware of drugs that can potentially precipitate this syndrome.