Mental Health Services In Ireland Research Articles

“I don't think I can help you anymore.” Sex workers' experiences of accessing mental health services in Ireland

AbstractThis paper is based on a study funded by the National Office for Suicide Prevention (NOSP), exploring sex worker mental health through a qualitative study of eighteen sex workers living and working in the Republic of Ireland and with participants from service provider organizations. This paper utilizes and adapts the concept of minority stress to explain how it is the social world that contributes to difficulties in managing mental health, not just for the LGBTQ+ community but explicitly for sex workers, through intersectional stigma and discrimination. Ireland introduced the Criminal Law Amendment Act (2017) based on the Nordic model of client criminalization, which sought to prosecute those that purchase sex while reducing the legal culpability of sex workers. The paper explores how the mental health of sex workers living and working under the law is impacted and the difficulties negotiating access to mental health services once participants disclose their sex work.

Parents' Experiences of Accessing Mental Health Services for Their Adolescents With Mental Health Challenges: A Scoping Review.

To analyse the literature on parents' experiences of accessing mental health services with their adolescents for mental health challenges in Ireland. Health systems globally have inadequately addressed mental health service needs resulting in notable gaps between population needs and access to adolescent mental health services. This scoping review followed Arksey and O'Malley's six-stage framework and PRISMA-ScR reporting guidelines. Five electronic databases SocINDEX, MEDLINE, CINHAL, Scopus and EBSCO were searched and reference lists screened 2015-2024. Twenty-three studies were included. Applying Braun and Clarke's thematic analysis identified three themes: adolescent community mental health services for adolescents with mental health challenges, accessing mental healthcare services via emergeny departments for adolescents with mental health challenges and parents' experiences of accessing mental health services for their adolescents with mental health challenges. Parents' experiences of accessing mental health services for their adolescents are not fully understood, and further research is required to map key concepts to inform practice and policymaking. The findings from this scoping review highlight challenges for adolescent mental health services in Ireland and internationally. Heightening awareness of these issues is necessary to improve the clinical practice of nurses. This was a scoping review study.

“It Feels like You’re Just Clawing Your Way Through”: Young Adults’ Experiences of Transitioning from Child and Adolescent to Adult Mental Health Services in Ireland

Transitioning from child to adult services is a significant event for young adults. The study aimed to explore the experiences of young adults who transitioned from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) in Ireland. Semi-structured interviews were conducted with six young adults and analysed according to interpretative phenomenological analysis. Interpretations were subsequently viewed through the lens of transition theory. Findings indicate that the transition presents major challenges for young adults and can cause a deterioration in mental health, in the context of multiple concurrent life transitions, discontinuity of care, a dramatic culture shift in AMHS, and experiences of impersonal care. Participants expressed their view that AMHS clinicians did not know how to approach their treatment due to a lack of available options or diagnosis-specific expertise, leading these individuals to question the validity of their suffering; this is a novel finding in the context of previous transition research. The utility of transition theory in developing a CAMHS-AMHS transition framework is demonstrated.

Antipsychotic prescribing: national findings of children and adolescents attending mental health services in Ireland.

Antipsychotic prescribing trends vary internationally, albeit off-label use remains high (i.e., target symptoms). We aim to describe antipsychotic use, target conditions, target symptoms and dosing regimens in children and adolescents in Ireland. We used a sampled cohort from a national audit of children and adolescents attending mental health services with predefined inclusion and exclusion criteria from Jul-2021 to Dec-2021 who were prescribed at least one psychotropic medication and up to and including 17-years of age (n = 3528). Each service provided anonymised data. We described the frequency of antipsychotic medication, medication type, target condition, target symptom and medication doses. We used multivariable logistic regression, adjusted with available co-variates to assess the association of being prescribed an antipsychotic medication. Twelve percentage (n = 437) were prescribed an antipsychotic and 16-17-years (n = 211, 48.3%) was the most common age category. The commonest reason for prescribing an antipsychotic was target symptoms (i.e., off-label use) (n = 329; 75.%) and of these symptoms, agitation (n = 77/329; 25%) and irritability (56/239; 25%) were the most common. Quetiapine (n = 127; 29%) was the most common antipsychotic, followed by risperidone (n = 125; 28.6%), aripiprazole (n = 107; 24.5%), and olanzapine (n = 66; 15.1%). In adjusted analysis, having a psychotic disorder ((adjusted-odds-ratio) aOR: 39.63, CI 95%, 13.40-117.22), bipolar disorder (aOR: 16.96, CI 95%, 3.60-80.00), autism spectrum disorder (aOR: 3.24, CI 95%, 2.45-4.28) or aggression symptoms (aOR: 16.75, CI 95%, 7.22-38.89) was associated with prescribing an antipsychotic medication. This is the first study in children and adolescents that describes the target conditions and target symptoms for antipsychotic use in Ireland. Our results show a high proportion of antipsychotic prescribing based on target symptoms rather than target condition or diagnosis.

Predictors of inpatient suicide in an Irish psychiatric service, a longitudinal case-control study.

Inpatient suicide remains difficult to predict. This study aimed to identify individual patient predictors to help identify those at greater risk. This case-control study was undertaken in an independent mental health service in Ireland. Cases were drawn from all admissions to the service between March 2004 and February 2019. Controls were matched for date of admission. Univariate and multivariate analyses were conducted. Thirty-three cases of inpatient suicide were compared to 132 controls. The inpatient suicide rate was 76.2 per 100,000 admissions. The rate of inpatient suicide fell in line with national rates despite less restrictive practices being implemented in the service. Males accounted for 66% of cases. Hanging was the most common method of suicide overall and among male patients, and drowning was the most common among females. Male gender, tertiary referral, an adverse psychosocial event during admission, a period of absence without leave and expressing hopelessness were identified as independent risk factors for inpatient suicide. Substance use, involuntary detention, family history of suicide, and number of previous admissions were not significant. While not highly sensitive, a period of absence without leave, tertiary referral and hopelessness are important predictors of inpatient suicide risk that treating teams should consider in care planning.

Exploring the non-vocational outcomes of the individual placement and support (IPS) employment model

Purpose Individual Placement and Support (IPS) is an evidence-based employment model, effective in supporting individuals with severe mental health difficulties to gain competitive employment. Irish mental health policy recognises its value and IPS is being rolled out in a national programme. Employment is recognised an important contributor to mental health recovery and social inclusion. However, research on IPS has tended to focus on competitive job outcomes. The purpose of this study was to explore the non-vocational outcomes of IPS in an Irish context. Design/methodology/approach A qualitative research approach was used to interview participants taking part in IPS within community mental health teams. Twelve interviews were included in the data analysis process which was informed by a thematic analysis approach. Findings Participants experienced increased confidence and positivity, both within a work context and whilst job seeking. More purposeful time use, participation in activities and engagement with society were also experienced by those employed and those at the job search stage of IPS. Originality/value This study contributes to the literature about the non-vocational benefits of IPS within an Irish context, highlights the mental health recovery benefits of taking part in IPS and supports the need for ongoing development of IPS throughout mental health services in Ireland.

Examining the psychometric properties of the headspace Youth (mental health) Service Satisfaction Scale in a mental health service in Ireland.

Evaluating service quality and satisfaction is central to the provision of accessible and developmentally appropriate youth mental health services. However, there are limited suitable measures and a lack of published evidence on the psychometric properties of measures to assess young people's satisfaction with youth mental health services. The headspace Youth (Mental Health) Service Satisfaction Scale (YSSS) was designed and implemented to assess young people's satisfaction with headspace mental health services in Australia. This study examined the reliability and factor structure of the YSSS in a youth mental health service in Ireland. The sample comprised 1449 young people (66.2% female) aged 12-25 years (M = 16.48, SD = 2.97). Participants completed the YSSS after their final brief intervention session through Jigsaw-The National Centre for Youth Mental Health. Confirmatory factor analysis (CFA) was performed on one- and four-factor models to test findings from previous studies. Reliability was also examined. CFA supported a single-factor structure of the YSSS, and all items were suitable for inclusion. The internal consistency of the measure was deemed acceptable (α = 0.89). Findings suggest that the YSSS is a reliable measure for monitoring satisfaction with youth mental health services in an Irish context. The measure demonstrated a unidimensional construct of satisfaction. These findings support the broader application of the YSSS and add to existing knowledge on measuring satisfaction within youth mental health services.

Clients’ Experiences of Eye Movement Desensitization and Reprocessing Therapy

This study aimed to explore clients’ unique phenomenological experiences of eye movement desensitization and reprocessing (EMDR) and their meaning-making regarding this therapeutic approach within the context of an adult mental health service in Ireland. Interpretative phenomenological analysis was employed to collect and analyze data from six interviews with individuals who had completed an EMDR intervention. Three Group Experiential Themes were identified: “Trapped in trauma—self-disorganization,” “Being ‘in’ the process of processing,” and “Moving on—adaptive resolution of trauma.” The study provides an in-depth insight into clients’ experiences of EMDR in terms of the many processes and outcomes, and clinical implications are discussed.

Quarantweens - the impact of COVID-19 restrictions on preteen health and wellbeing in Ireland

Abstract Background The COVID-19 pandemic has been dubbed the “biggest public health crisis since the Second World War”. In Ireland, schools were closed for 141 days, dramatically altering the day to day lives of children in Ireland. This research aimed to evaluate the overall wellbeing of schoolchildren in Ireland and capture the prevalence and factors contributing to poor mental health. Methods A cross-sectional study was performed based on data from the Growing Up in Ireland COVID-19 web survey of the ’08 Infant cohort. Mental Health Inventory-5 scores were used to assess children at risk of mental health disorders. Logistic regression examined associations between various demographic and psychosocial factors and risk of mental health disorders. Results This study included 2,867 primary caregiver- child dyads. Almost 25% of 12/13-year-olds were at risk of mental health disorders (MHDs). An adjusted logistic regression model found associations between being at higher risk of MHDs and factors such as reduced physical activity levels (OR 1.35, 95% CI 1.10-1.66), spending less time outdoors (OR 1.48, 95% CI 1.18-1.85), increased screen-time (OR 1.35, 95% CI 1.09-1.67) and increased arguments with PCGs (OR 3.44, 95% CI 2.78-4.27). Having a trusted adult confidante reduced the risk of MHD (OR 0.25, 95% CI 0.14-0.45). Conclusions The prevalence of 12/13-year olds at elevated risk of MHD was high, indicating an urgent need for enhancement of child and adolescent mental health services in Ireland. Physical activity, time outdoors and supportive relationships with primary caregivers were positively associated with reduced MHD risk. Key messages • Children were impacted by the COVID-19 restriction measures in a way that was disproportionate to their risk. • To reduce the risk of poor mental health outcomes for a generation of “quarantweens” we need to place children front-andcentre of our response as we recover from COVID-19.

Burnout in mental health services in Ireland during the COVID-19 pandemic.

Burnout is a consequence of chronic occupational stress. Specific work-related factors may contribute to burnout experienced by those working in mental health services (MHS), many of which have increased since the COVID-19 pandemic. To examine personal, work- and patient-related burnout among MHS staff in Ireland during the COVID-19 pandemic, and explore the impact of work-related conditions on burnout. We conducted a cross-sectional survey of three MHS across Ireland utilising a study-specific questionnaire, the Copenhagen Burnout Inventory and the Effort-Reward Imbalance scale. Of 396 participants, 270 (70.6%) were female. Moderate and high personal burnout was experienced by 244 (64.1%) participants; work-related burnout by 231 (58.5%) participants and patient-related burnout by 83 (21.5%) participants. Risk factors for both personal and work-related burnout were female gender, urban service, time spent outside main responsibilities, overcommitment, high score on the Effort-Reward Imbalance scale and intention to change job. Being younger, with high workload and deterioration of personal mental health during the pandemic was associated with higher personal burnout, whereas a lack of opportunity to talk about work-related stress contributed to work-related burnout. Fewer factors were associated with patient-related burnout, namely overcommitment, working in urban services and poorer physical and mental health during the COVID-19 pandemic. High levels of personal and work-related burnout were found among mental health workers. The weak association with COVID-19-related factors suggest levels of burnout predated the pandemic. This has implications for MHS given the recognised additional work burden created by COVID-19.

Sustaining a therapeutic environment within mental health in-patient settings during COVID-19. Results of a Delphi study

AimDevelop a strengths-based, person-centred, trauma-informed and recovery-oriented framework to mitigate any potential increase in conflict resulting from the implementation of C19 restrictions. BackgroundGuidance addressing the unique challenges posed by Covid-19 within mental health in-patient settings, including how to support those whose distress may present as behaviour that challenges including violence and self-harm, remains urgently needed. Methodology/approachA Delphi design involving four iterative stages was adopted. Stage 1 involved a review and synthesis of COVID-19-related public health and ethical guidance and a narrative literature review. A formative operational framework was then developed. Stage 2 sought to establish the face validity of the framework through engagement with frontline and senior staff in mental health services in Ireland, Denmark and Netherlands. Stage 3 investigated the content validity of the final framework through a plenary presentation and discussion of the framework at a scientific symposium of the European Violence in Psychiatric Research Group (EViPRG, 2020). Stage 4 sought expert appraisal of the framework using a structured evaluation completed by a panel of eighteen multidisciplinary experts from nine countries, including four academics, six clinicians and eight holding dual clinical/academic appointments to assess content validity. ResultsThe guidance adopts the widely advocated approach to support those whose distress may present as behaviour services find challenging in identifying the need for primary, secondary, tertiary and recovery measures. It emphasizes person-centred care while integrating specific Covid-19 public health requirements into service planning. It also aligns with contemporary best practice in in-patient mental health care, incorporating the principles of Safewards, the core values of trauma-informed care, and an explicit on recovery. ConclusionThe guidance developed has face and content validity.

Zoom up your mood - a pilot study examining the efficacy of video-conferencing versus face-to-face delivery of group CBT for depression for out-patients attending a secondary mental health service in Ireland.

Cluain Mhuire is a secondary adult mental health service based in Ireland. The COVID-19 pandemic resulted in many services moving online, including our coping with depression group. A shortened, online version of the face-to-face group was piloted; however, analysis showed that it was not as effective as the longer face-to-face group. Thus, a 12-session, 2.5-hour online group CBT (gCBT) was subsequently run to directly compare the online therapy with the original face-to-face group. The primary objective of the study is to evaluate the effectiveness of a 12-week gCBT programme adapted to videoconferencing in reducing self-reported symptoms of depression and anxiety and enhancing quality of life (QoL). Results will be compared with the same group programme delivered face-to-face. This is a between-groups, naturalistic treatment outcome study. Pre and post measures include the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and the World Health Organisation Quality of Life Scale (WHOQoL-Bref). A mixed between-within subjects analysis of variance was performed to assess the impact of the three interventions (face-to-face, 8-session online and 12-session online) on participant scores; 112 participants (65 women, 47 men) were recruited (mean age=41.85, SD=13.08). All three interventions significantly improved depression, anxiety and QoL scores. There was no significant difference between the treatment groups. Attendance was highest in the 12-session online group, followed by the 8-session online group and 12-session in-person group. These results add to the growing evidence supporting the effectiveness of internet-delivered gCBT in reducing depressive symptoms.

Parents’ experiences of an assistant psychologist enhanced primary care mental health service in Ireland

ABSTRACT Objective The aim of this study was to provide evidence of the acceptability of the primary care psychology services that have been enhanced by the employment of assistant psychologists in Ireland to the parents of children with psychological difficulties. Method Data were collected from a sample of 74 parents who responded to quantitative and qualitative questions on the experience of service questionnaire. Reflexive thematic analysis was used to analyse the questionnaire responses. Results On average 88% of participants selected ‘certainly true’ in response to the statements in the experience of service questionnaire statement they were ‘Totally satisfied’. Three major themes were developed; ‘communication is more than talking’, ‘structure can facilitate or impede’, and ‘emotional reactions’. ‘Communication is more than talking’ is organised around communication The ‘structure can facilitate or impede’ acknowledges that systems influence psychological supports. ‘Emotional reactions’ captured parents’ experiences, such as joy, frustration, and solidarity. Discussion The results demonstrate that the newly enhanced mental health service is acceptable to parents. Their voices provide ideas about what helps and hinders their experience of care.

Developing Specialist Perinatal Mental Health Services: the door of opportunity.

The development of Specialist Perinatal Mental Health Services in Ireland in recent years (2018-2021) is described. The paper highlights the role of unexpected opportunity in advancing this much needed service for women, infants and their families. It also emphasises the need for funding combined with an implementation mechanism to ensure that the service emerging is true to the Model of Care designed and is available in a uniform manner to women nationally.

Prevalence of Treatment Resistant Psychoses in a Complete National Forensic Mental Health Service: A Dundrum Forensic Redevelopment Evaluation Study (D-FOREST)

IntroductionTreatment resistant schizophrenia and other treatment resistant psychotic disorders are believed to be over-represented in forensic patient clusters. The true rates of treatment resistant psychoses in secure forensic hospitals remain unexplored.ObjectivesThis study aimed to ascertain the prevalence of treatment resistant psychoses within a complete national forensic mental health service. In addition, the study sought to examine the relationships between treatment resistance for psychotic symptoms and treatment resistance in other domains, such as offending behaviour.MethodsThis is a cross-sectional study of a complete cohort of patients admitted to the National Forensic Mental Health Service in Ireland during the period 01/11/2021 to 31/01/2022. All inpatients at the time of the study were included. Demographic details, data appertaining to diagnosis, medication, measures of risk (HCR-20), recovery (DUNDRUM toolkit), functioning (GAF), and symptoms (PANSS) were collated. Data were gathered as part of the Dundrum Forensic Redevelopment Evaluation Study (D-FOREST).ResultsThe sample consisted of 170 patients. Majority (n=162) 95.3% were male. The majority (n=116), 68.2%, were admitted from prisons, while a smaller number (n=35), 20.6%, were admitted from other psychiatric facilities. The insanity defense (n=94) 55.3% was the most common legal status, followed by unfit to plead (n=16) 9.4%. The commonest diagnosis was schizophrenia (n=97) 57.1%, followed by schizoaffective disorder (n=27) 15.9% and autism spectrum disorder (n=5) 2.9%. The mean age at admission was 35.52 years and the median age was 34.37 ± 9.43 SD.Of the total sample, 25.9% of patients were on more than 1000 mg per day chlorpromazine equivalent (CPZE) doses. Those whose psychotic symptoms required treatment with CPZE doses over 1000 mg per day scored poorly on DUNDRUM-3 programme completion, DUNDRUM-4 recovery scale, HCR-20 historical, HCR-20 clinical, HCR-20 risk, HCR-20 dynamic, and had poorer overall functioning (all P<0.001) than those who required lower antipsychotic doses. On binary logistic regression, correcting for age and gender, the only variable that remained significant was GAF (adjusted odds ratio = 0.979, 95% CI 0.962-0.996, P=0.014). In forward entry model regression, only the DUNDRUM-4 recovery scale (odds ratio = 1.13, 95% CI 1.07-1.19, P<0.001) and GAF (adjusted odds ratio = 0.979, 95% CI 0.962-0.996, P<0.001) were significant. This model had a robust forward and backward likelihood ratio.ConclusionsRates of treatment resistant psychoses in forensic hospital groups are indeed elevated. Overall functioning on GAF and recovery across a wide range of components in the DUNDRUM-4 scale are the best predictors of treatment resistant psychosis.Disclosure of InterestNone Declared

Using a Safety Planning Mobile App to Address Suicidality in Young People Attending Community Mental Health Services in Ireland: Protocol for a Pilot Randomized Controlled Trial.

Over 700,000 people die by suicide annually, making it the fourth leading cause of death among those aged 15-29 years globally. Safety planning is recommended best practice when individuals at risk of suicide present to health services. A safety plan, developed in collaboration with a health care practitioner, details the steps to be taken in an emotional crisis. SafePlan, a safety planning mobile app, was designed to support young people experiencing suicidal thoughts and behaviors and to record their plan in a way that is accessible immediately and in situ. The aim of this study is to assess the feasibility and acceptability of the SafePlan mobile app for patients experiencing suicidal thoughts and behaviors and their clinicians within Irish community mental health services, examine the feasibility of study procedures for both patients and clinicians, and determine if the SafePlan condition yields superior outcomes when compared with the control condition. A total of 80 participants aged 16-35 years accessing Irish mental health services will be randomized (1:1) to receive the SafePlan app plus treatment as usual or treatment as usual plus a paper-based safety plan. The feasibility and acceptability of the SafePlan app and study procedures will be evaluated using both qualitative and quantitative methodologies. The primary outcomes are feasibility outcomes and include the acceptability of the app to participants and clinicians, the feasibility of delivery in this setting, recruitment, retention, and app use. The feasibility and acceptability of the following measures in a full randomized controlled trial will also be assessed: the Beck Scale for Suicide Ideation, Columbia Suicide Severity Rating Scale, Coping Self-Efficacy Scale, Interpersonal Needs Questionnaire, and Client Service Receipt Inventory. A repeated measures design with outcome data collected at baseline, post intervention (8 weeks), and at 6-month follow-up will be used to compare changes in suicidal ideation for the intervention condition relative to the waitlist control condition. A cost-outcome description will also be undertaken. Thematic analyses will be used to analyze the qualitative data gathered through semistructured interviews with patients and clinicians. As of January 2023, funding and ethics approval have been acquired, and clinician champions across mental health service sites have been established. Data collection is expected to commence by April 2023. The submission of completed manuscript is expected by April 2025. The framework for Decision-making after Pilot and feasibility Trials will inform the decision to progress to a full trial. The results will inform patients, researchers, clinicians, and health services of the feasibility and acceptability of the SafePlan app in community mental health services. The findings will have implications for further research and policy regarding the broader integration of safety planning apps. OSF Registries osf.io/3y54m; https://osf.io/3y54m. PRR1-10.2196/44205.

A qualitative evaluation of an exercise practitioner in an outpatient child and adolescent mental health service.

Physical activity interventions can confer a range of physical and mental health benefits among young people with mental disorders. In some contexts, such as Ireland, integrated physical activity is not easily available within child and adolescent mental health services. Therefore, an interagency pilot intervention was established in a child and adolescent mental health service in Ireland with the integration of a novel exercise practitioner into the multidisciplinary mental health team. A qualitative evaluation was conducted to understand the impact of the pilot intervention and to understand issues of implementation that arose throughout. In-depth qualitative interviews with service users' parents/guardians (N = 3) and a single focus group with existing service providers (N = 3), framed by the RE-AIM framework were conducted to evaluate the pilot intervention. Data were analysed using thematic analysis to explore themes. Three overarching themes were identified. These were as follows: (i) Making changes toward healthier physical activity behaviours; (ii) An intervention of therapeutic holism; and (iii) The integrated service delivery. This research provides insight on the value of a novel integrated exercise practitioner in outpatient young persons' mental health services in Ireland, indicating an enhanced and complimentary therapeutic service. These findings will be helpful for integrating Exercise Practitioners in this setting going forward.

Examining Predictors of Psychological Distress Among Youth Engaging with Jigsaw for a Brief Intervention.

Risk factors for psychological distress among help-seeking youth are poorly understood. Addressing this gap is important for informing mental health service provision. This study aimed to identify risk factors among youth attending Jigsaw, a youth mental health service in Ireland. Routine data were collected from N = 9,673 youth who engaged with Jigsaw (Mean age = 16.9years, SD = 3.14), including presenting issues, levels of psychological distress, age, and gender. Confirmatory Factor Analysis identified thirteen factors of clustering issues. Several factors, including Self-criticism and Negative Thoughts, were strongly associated with items clustering as psychological distress, however these factors were poorly predictive of distress as measured by the CORE (YP-CORE: R2 = 14.7%, CORE-10: R2 = 6.9%). The findings provide insight into associations between young people's identified presenting issues and self-identified distress. Implications include applying appropriate therapeutic modalities to focus on risk factors and informing routine outcome measurement in integrated youth mental health services.

'Finding my Hard Hat': Reflections of recovery from a service user and caring professional.

What is known on the subject? Lived experience narratives of recovery can provide an insight and subtlety where academic papers can often fall short. There is a need for people who work in mental health services to address and take care of their own psychosocial needs. What the paper adds to existing knowledge? This paper provides a unique insight into a care professional's recovery from mental ill health. Looked at through this dual lens of service user and care professional provide the reader with a rich narrative from the perspective of both sides of the caring role. What are the implications for practice? People who work in caring roles need to be vigilant of their own needs and the impact that the work can have on them. Safety protocol for managing one's own mental health should be a requirement for people within the caring profession. Introduction This is an account of my experiences becoming unwell and accessing general and mental health services in Ireland. Aim It is hoped that this lived narrative of my recovery will shed light on accessing mental health services from a dual lens; that of service user and social worker. Method It traces this experience from initial contact with my general practitioner, to admission to a secure psychiatric ward where recovery slowly began. Results It is also hoped that reading my experiences of recovery and some of the insights shared will help those in the nursing or social care profession consider how they may be affected by their work. Discussion It is important to note that this account views my experiences within a neurobiology framework and this might not align to other people's experiences. However, my narrative of help-seeking is complex and includes multiple points where I uncover insights and encounter different healthcare professionals.

Attitudes Towards Mental Health Services During the COVID-19 Pandemic: Findings from a Nationally Representative Sample of Irish Adults.

This study sought to determine the public’s attitudes towards mental health services during the COVID-19 pandemic and examine the sociodemographic and psychological factors associated with these attitudes to gain an understanding of the best course of action to increase favourable attitudes. Data from the Republic of Ireland arm of the COVID-19 Psychological Research Consortium (C19PRC) study was used to fulfil the objectives of this study. Participants were asked to indicate their level of agreement with statements regarding mental health services and the COVID-19 pandemic. Levels of agreement were then scored, and the relationships between attitude scores and sociodemographic and psychological factors were evaluated utilizing hierarchical multiple regression analysis. Sociodemographic factors associated with positive attitudes towards mental health were older age, experience with mental health treatment, and experience with internalizing distress. These factors should be considered when developing strategies to increase favourable public attitudes towards mental health services in Ireland.