Abstract

Irish Travellers are a minority ethnic group within the Irish state with a distinct culture and set of traditions. Travellers experience mental health inequalities, high rates of mental ill health, and structural and individual barriers to mental health supports. A Traveller Mental Health Liaison Nurse (TMHLN) was introduced in a healthcare region in Ireland to provide greater mental health-related support to Travellers. This paper presents a description of the TMHLN role following a multi-stakeholder evaluation. The research design was descriptive qualitative and the findings are reported using COREQ criteria. Thirty-four key stakeholders were interviewed individually or as part of focus groups. Thematic analysis generated two broad themes: the role context, and the specific activities of the role. Mental health nursing experience and understanding of local issues and services were key, as was use of language, building trusting relations, creating the metaphorical, and having the physical, space for working. Specific activities involved in-reach and outreach work, including one-to-one mental health support provision, delivery of education/training sessions to Travellers and service providers, (re)establishing links to specialist services, integrated and interagency working, and promoting cultural competency. The findings set out a role with a greater emphasis on the use of recovery technologies, having an emphasis on psychosocial interventions and self-care, and less focus on biomedical technologies, signs and symptoms, and clinical outcomes. This study contributes to knowledge on the role of a MHLN as this relates to working with marginalized minority groups.

Highlights

  • Irish Travellers were formally recognized in 2017 as a distinct ethnic group within the State, but have, for centuries, been an indigenous minority group in Irish society with a distinct language, value system, and customs and traditions (Abdalla et al 2010; Daly 2017)

  • The results are presented under two broad themes (i) the wider context of/for the role, and (ii) Traveller Mental Health Liaison Nurse Activities

  • The Traveller Mental Health Liaison Nurse (TMHLN) had extensive experience both as a Mental Health Nurse employed in acute mental health and of working in the community, with families and disadvantaged groups, including Travellers, and of interagency working

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Summary

Introduction

Irish Travellers were formally recognized in 2017 as a distinct ethnic group within the State, but have, for centuries, been an indigenous minority group in Irish society with a distinct language, value system, and customs and traditions (Abdalla et al 2010; Daly 2017). Despite a lack of recent Irish prevalence data on mental health issues among the Traveller Community, studies on Traveller/Gypsy1 [mental] health, in Ireland, and in the UK, found up to two and a half times higher rates of reported poor mental health among samples of the Traveller/Gypsy population compared to samples of the general population (Abdalla et al 2010; Goward et al 2006; McGorrian et al 2013; Parry et al 2004; Van Cleemput & Parry 2001). Inequalities in income, health, educational attainment, and employment between Travellers and the general population are stark (Brady & Keogh 2016; Central Statistics Office 2017; Watson et al 2016). Issues more local to Travellers lives that impact on mental health include changes in family structure and rituals (Watson et al 2016), gender roles and responsibilities (Abdalla et al 2010; Hodgins et al 2006), and age (Pavee Point 2015)

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