Enough is Enough - Food Poverty Scoping Exercise

In March 2015, over 80 people, representing food banks, churches, advice services, community organisations, statutory agencies and universities attended the ‘Enough is Enough’  launch event in City Church, Belfast to examine the rising demand for emergency food across the city.The ‘Enough is Enough’ project aims to harness the expertise of health and social care professionals, city councillors, advice workers, food banks, community and faith based organisations and strategic bodies across Belfast to collectively address the issue of food poverty. This scoping study lays the foundation for developing an action plan to tackle food poverty in Belfast in collaboration with the community, voluntary and statutory sectors.The Belfast Food Network (BFN) commissioned the project with funding from the Public Health Agency. The research was carried out by Jenny McCurry, who also wrote the report, on behalf of Advice NI.  The project was initiated and developed by Dr Elizabeth Mitchell, Institute of Public Health in Ireland, in her role as convener of the BFN Food Poverty Working Group (BFN/FPWG). Thanks are due to Kevin Higgins, Head of Policy, Advice NI, and Kerry Melville, Co-ordinator, BFN, for their involvement in the project.The BFN is a founding member of the pioneering Sustainable Food Cities Network (SFC). Therapidly growing BFN was established in March 2014 to work with partners to establish a successful Sustainable Food City in Belfast.ACCESS AUDIO AND VIDEO FROM THE EVENT

Craigavon & Banbridge Community HSS Trust - Primary Care Mental Health Services Triage Pilot Scheme (PDF 266 KB)

Craigavon & Banbridge Community HSS Trust's final report on Primary Care Mental Health Services Triage Pilot Scheme. Part of the Department's redesign of community nursing project.

A Study of Drug Prevention Services for Young People

To investigate the range and utilisation of community based drug prevention services using the Belfast Youth Development Study data, along with in depth interviews and documentary analysis. It is hoped the research will inform local policy.This resource was contributed by The National Documentation Centre on Drug Use.

A Survey of NHS Services for Opiate Dependents in Scotland

The aim of this study was to investigate the range of opiates available within the Scottish NHS for patients with opiate dependancy and to assess the process underlying clinical decision-making. Clinicians, representitives of drug action teams and NHS personnel were apporached and semi-structured phone conversations were the primary means to elicit information. Whilst methadone is almost universally prescribed in Scotland, buprenorphine, dihydrocodeine (not currently licensed for opiate dependance management), lofexidine and naltrexone are also used. Alternative therapies are variably used.This resource was contributed by The National Documentation Centre on Drug Use.

A vision for change: Report of the Expert Group on Mental Health Policy (2006)

This report, the first comprehensive review of mental health policy since 'Planning for the Future' was published in 1984, makes a series of recommendations for the mental health services, including the closure of all psychiatric hospitals and re-investment of the resources into a community-based mental health service.This resource was contributed by The National Documentation Centre on Drug Use.

A Study on the Feasibility of the Inclusion of General Practitioners and Prisons in the National Drug Treatment Reporting System: Plan for the Implementation of the NDTRS in Prison and GP Services

The Drug Misuse Research Division of the Health Research Board operates the National Drug Treatment Reporting System (NDTRS). The system is used to provide epidemiological information on treated problem drug misuse in Ireland and informs policy makers, researchers and the general public. The NDTRS collates data from participating treatment centres in all Health Board areas, however a gap in information exists in that drug misusers in treatment units within prisons and those treated by General Practitioners are not included. This study aims to determine the feasibility of including these two groups to increase coverage of the NDTRS and outlines preliminary steps for their inclusion.This resource was contributed by The National Documentation Centre on Drug Use.

Primary medical care in Irish prisons

An industrial dispute between prison doctors and the Irish Prison Service (IPS) took place in 2004. Part of the resolution of that dispute was that an independent review of prison medical and support services be carried out by a University Department of Primary Care. The review took place in 2008 and we report here on the principal findings of that review.   This study utilised a mixed methods approach. An independent expert medical evaluator (one of the authors, DT) inspected the medical facilities, equipment and relevant custodial areas in eleven of the fourteen prisons within the IPS. Semistructured interviews took place with personnel who had operational responsibility for delivery of prison medical care. Prison doctors completed a questionnaire to elicit issues such as allocation of clinician's time, nurse and administrative support and resources available.   There was wide variation in the standard of medical facilities and infrastructure provided across the IPS. The range of medical equipment available was generally below that of the equivalent general practice scheme in the community. There is inequality within the system with regard to the ratio of doctor-contracted time relative to the size of the prison population. There is limited administrative support, with the majority of prisons not having a medical secretary. There are few psychiatric or counselling sessions available.   People in prison have a wide range of medical care needs and there is evidence to suggest that these needs are being met inconsistently in Irish prisons.This resource was contributed by The National Documentation Centre on Drug Use.

Effective services for substance misuse & homelessness in Scotland: The recommendations of the Advisory Group on Homelessness and Substance Misuse

The Group makes 12 recommendations for actions covering the two key themes of strategic and organisational responses, and service design and delivery. It calls for: * A joint strategic response at national level to be developed * A joint strategic response at a local level to be developed (responsibility sitting with Alcohol and Drug Partnerships (ADPs) * Recognition of the importance of investing to save over the long term * A joint operational response at local level to be developed * More flexible approaches in rural and island areas * Service development and commissioning to be based on evidence of good practice * An individual’s priorities to be the starting point for the design and delivery of services and support * Ongoing evaluation of services in this field to be managed through the ADP planning and monitoring processes * Targeted service user participation and involvement to be supported * Training across homelessness, housing, alcohol and drug fields to be supported in statutory and commissioned services * The stigmatisation of these populations to be addressed at a local and national level.This resource was contributed by The National Documentation Centre on Drug Use.

Third annual report of child and adolescent mental health services (CAMHS)

16,080 Irish children (1.55% of population under 18 yrs.) availing of Community Child and Adolescent Mental Health Services   7,849 new cases were seen by community CAMHS teams between October 2010 and September 2011,compared with 7,561 in the previous 12 months   45% of referrals are seen within 1 month of referral and 69% within 3 months   Numbers waiting for CAMHS services down by 20%   61 multi-disciplinary Child and Adolescent Mental Health Services teams in place .This resource was contributed by The National Documentation Centre on Drug Use.

Mental health services for homeless: patient profile and factors associated with suicide and homicide.

This study aimed to establish a profile of users of the mental health service for homeless in Cork, comparing this group with those attending a General Adult Service. The homeless group were significantly more likely to be male (89% v 46%), unemployed (96% v 68%), unmarried (98% v 75%) and under 65 (94% v 83%). Diagnostically, there was a significantly higher prevalence of schizophrenia (50% v 34%); personality disorder (37% v 11%) and substance dependence (74% v 19%) in the homeless service users. They were more likely to have a history of deliberate self harm (54% v 21%) and violence (48% v 10%). Severe mental illness has a high prevalence in the homeless population, with particularly high levels of factors associated with suicide and homicide. Poor compliance and complexity of illness lead to a requirement for significant input from multidisciplinary mental health teams members.This resource was contributed by The National Documentation Centre on Drug Use.

Dual diagnosis in mental health inpatient and day hospital settings.

Many mental health patients also have substance misuse problems, so mental health service staff need to be skilled to provide simple prevention and treatment interventions, assisted by drug and alcohol specialists. This guidance covers the assessment and clinical management of patients with mental illness being cared for in psychiatric inpatient or day care settings who also use or misuse alcohol and/or illicit or other drugs*. It also covers organisational and management issues to help mental health services manage these patients effectively. The key message is that the assessment and management of drug and alcohol use are core competences required by clinical staff in mental health services. The guidance aims to: â?¢ encourage integration of drug and alcohol expertise and related training into mental health service provision; â?¢ provide ideas and guidance to front-line staff and manages to help them provide the most effective therapeutic environments; â?¢ help mental health services plan action on dual diagnosisâ? .This resource was contributed by The National Documentation Centre on Drug Use.

Whole-person care: from rhetoric to reality. Achieving parity between mental and physical health.

The report presents evidence on a range of factors affecting disparity between mental and physical health, and includes case studies and examples of good practice to illustrate some of the key issues and solutions. It should be seen as the first stage of an on-going process over the next 5"10 years that will deliver parity for mental health and make whole-person care a reality. It builds on the Implementation Framework for the Mental Health Strategy in providing further analysis of why parity does not currently exist, and the actions required to bring it about. A parity approach should enable NHS and local authority health and social care services to provide a holistic, whole person response to each individual, whatever their needs, and should ensure that all publicly funded services, including those provided by private organisations, give people's mental health equal status to their physical health needs. Central to this approach is the fact that there is a strong relationship between mental health and physical health, and that this influence works in both directions. Poor mental health is associated with a greater risk of physical health problems, and poor physical health is associated with a greater risk of mental health problems. Mental health affects physical health and vice versa. The report makes a series of key recommendations for the UK government, policy-makers and health professionals. Recommendations include: The government and the NHS Commissioning Board should work together to give people equivalent levels of access to treatment for mental health problems as for physical health problems, agreed standards for waiting times, and agreed standards for emergency/crisis mental healthcare. Action to promote good mental health and to address mental health problems needs to start at the earliest stage of a person's life and continue throughout the life course. Preventing premature mortality " there must be a major focus on improving the physical health of people with mental health problems. Public health programmes must include a focus on the mental health dimension of issues commonly considered as physical health concerns, such as smoking, obesity and substance misuse. Commissioners need to regard liaison doctors (who work across physical and mental healthcare) as an absolute necessity rather than an optional luxury. NHS and social care commissioners should commission liaison psychiatry and liaison physician services to drive a whole-person, integrated approach to healthcare in acute, secure, primary care and community settings, for all ages. Mental health services and mental health research must receive funding that reflects the prevalence of mental health problems and their cost to society. Mental illness is responsible for the largest proportion of the disease burden in the UK (22.8%), larger than that of cardiovascular disease (16.2%) or cancer (15.9%). However, only 11% of the NHS budget was spent on NHS services to treat mental health problems for all ages during 2010/11. Culture, attitudes and stigma " zero-tolerance policies in relation to discriminatory attitudes or behaviours should be introduced in all health settings to help combat the stigma that is still attached to mental illness within medicine. Political and managerial leadership is required at all levels. There should be a mechanism at national level for driving a parity approach to relevant policy areas across government; all local councils should have a lead councillor for mental health; all providers of specialist mental health services should have a board-level lead for physical health and all providers of physical healthcare services should have a board-level lead for mental health. The General Medical Council (GMC) and Nursing and Midwifery Council (NMC) should consider how medical and nursing study and training could give greater emphasis to mental health. Mental and physical health should be integrated within undergraduate medical education.This resource was contributed by The National Documentation Centre on Drug Use.