A Review of Harm Reduction Approaches in Ireland and Evidence from the International Literature

This report examines international literature on harm reduction and also presents primary research in health services in Ireland on approaches to harm reduction. The aim of harm reduction efforts is to minimise the risks stemming from shared use of drug-use paraphernalia, such as needle exchange programmes. One of the criticisms of Irish drug services is that the restricted opening hours and limited number of exchange services may contribute to continued sharing of needles among drug users. The report points out that other non-injecting paraphernalia such as spoons are also associated with the risk of contracting diseases, yet services do not as yet focus on them. The report notes that specific risk factors that contribute to risky drug practices include youth, a shorter injecting history, confinement to prison, homelessness and being involved in a sexual relationship with another intravenous drug user. The report suggests that harm reduction practices can be introduced into a prison population without a subsequent increase in drug consumption rates. The provision of consumption rooms and the prescription of heroin are also discussed, with the report noting that legislation would have to altered to implement these new strategies.This resource was contributed by The National Documentation Centre on Drug Use.

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 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.

The Irish alcohol misuser in England: Ill served by research and policy? Some suggestions for future research opportunities.

Inequalities in the physical and psychological health of the first- and second-generation Irish subjects have been well documented. Despite the fact that the Irish alcohol misuser is subject to a number of unhelpful stereotypes, the research concerning alcohol misuse in the Irish is surprisingly sparse. What little exists indicates that Irish alcohol misusers tend to fit the profile of the "chronic alcoholic." Specifically, they tend to be older (45 years +) and to have impaired physical and psychological health. Not surprisingly this is accompanied by poor longitudinal outcomes. Furthermore, alcohol problems worsen as a result of migration (this phenomenon is not restricted to the UK). Alcohol and drug services are now frequently merged, and policy is directed towards the visible young illicit drug user. This paper argues that inadvertently Irish alcohol misusers are discriminated against as a result. Future avenues of research are outlined to provide services and policy makers with data to plan services taking full account of the needs of Irish alcohol misusers.This resource was contributed by The National Documentation Centre on Drug Use.

A study of cocaine use in Northern Ireland 2009.

This study explored the patterns of cocaine use and the lifestyles of users in Northern Ireland with the aim of providing the Department of Health, Social Services and Public Safety (DHSSPS) and treatment service providers with a better understanding of cocaine use in Northern Ireland. This primarily qualitative study was conducted in two phases. In Phase I a â?~Community Assessment Processâ?T was conducted to gain an understanding of the experiences of drug treatment professionals to cocaine use in Northern Ireland. In phase II 40 in-depth interviews were conducted with cocaine users. The study identified two types of cocaine user, these are recreational or socially integrated users and those referred for drug treatment who as a group was socially marginalized users. For the purposes of this study these users will be referred to as either recreational or treatment users. The demographic profiles of each type of user differed in a number of important respects. The recreational users were typically young, educated and anchored to a largely conventional lifestyle and whose pattern of non-work activities involved partying and drug use. Treatment users, on the other hand, generally had low level educational qualifications and were typically unemployed and living on state benefits. A number of the treatment users were either living in a hostel at the time of interview or had experienced homelessness at some time in their life. None of the recreational users reported any experience of homelessness. These distinctions, as well as differences between the groups in terms of their drug use patterns, preferences and practices, strongly suggest that in unravelling the nature of cocaine use and cocaine problems there is a need to look beyond the drug itself.This resource was contributed by The National Documentation Centre on Drug Use.

Implementing A vision for change: moving towards a modern, quality and responsive mental health service. Carlow / Kilkenny / South Tipperary.

The key element of the HSE South’s Programme is to enhance and develop community mental health services in Carlow, Kilkenny and South Tipperary, to enable the service user to remain in the community to the greatest extent possible. HSE South has prioritised the implementation of the change programme and has allocated more than €20m capital funding and over €1.75m revenue funding to support this comprehensive development programme. Speaking at the briefings Mr. Pat Healy, Regional Director of Operations, HSE South said, “When this plan is delivered, clients will have access to the highest standards of services in all three counties, which should significantly improve these clients’ treatment programmes and quality of life. The National Service Users Executive are supporting the change programme, which is of immense importance to HSE South. The programme heralds the enhancement and development of community mental health services, the closure of old long stay institutions, the separation of North and South Tipperary acute inpatient mental health services and development of appropriate acute inpatient services, for the extended catchment area, in line with the national strategy for mental health “A Vision for Change”. The programme also acts on recommendations of the Mental Health Commission.”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.

Centre Food Services

The catering section, at present, offers the following: The Resource Centre accommodates classes in Healthy Eating. In the near future we hope to offer Cookery Classes in Healthy Eating, and low income meals: teaching adults and children the importance of a healthy-balanced diet which is within a low income budget; showing them how to cook these meals; supervising groups while they cook a selection of dishes which incorporate the low cost, balanced diet Initiative Type Community Food Centres Meals on Wheels Nutrition Education and Training Programmes Location Dublin 10

Age Discrimination in Mental Health Services

The UK government is considering the introduction of legislation to outlaw age discrimination in the provision of public services. The Department of Health commissioned a short piece of research to explore the extent of age discrimination in mental health services. �� Three broad issues are addressed in this report: inequalities between adult and older people�۪s mental health services; inequalities between adults and older people with mental health problems in their use of health and social care services;and knowledge about the likely single equalities legislation in current services and the possible costs of implementation. The report does not examine differences in outcomes.

National Audit of the Organisation of Services for Falls and Bone Health of Older People

This report presents the results of the second national audit which examines the organisation of services provided to older people for falls prevention and bone health. Falls and fractures are a common and serious problem affecting older people, with high levels of personal and financial cost. National guidelines, supported by the research evidence, require the provision of integrated services for falls and fracture prevention and treatment. Effective commissioning is needed to produce such high quality services.��This audit was commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the second cycle of audits on services for the prevention of falls and fractures in older people. It follows the first organisational audit, performed in 2005, and the clinical audit of 2007. All were audited against specific standards from the National Service Framework for Older People (NSF) and guidance from the National Institute for Health and Clinical Excellence (NICE). Since the first audit, indicators have been added or updated in line with new guidance including that on falls prevention of inpatients following the National Patient Safety Agency (NPSA) report on slips, trips and falls in hospital (2007). For the first time, the audit also looks specifically at falls and fracture prevention in mental healthcare and a sample of care homes.

An Integrated Work Force Planning Strategy For The Health Services 2009 - 2012

Workforce planning identifies the composition of the workforce required to deliver health service goals. It encompasses a range of human resource activities aimed at the short, medium and long-term. Workforce planning that is integrated with service and financial planning offers the best opportunity for linking human resource decisions to the strategic goals for the health services. Systems and structures are required to support and develop workforce planning activities

Dementia Care Services UK Market Briefing 2009

This brand new market briefing adds to the growing national debate on the future of dementia care services, making use of a unique and extensive L&B survey (2008) of over 6,000 care homes in the UK which provide care for people with dementia. It builds on the findings of the Alzheimer’s Society’s Dementia UK report (2007) and the national strategy for dementia Living Well with Dementia (2009) to identify market opportunities and provide essential guidance and information with regard to planning and developing new and existing services.Key issues, facts and figures highlighted in the report include:Dementia care is a multi-billion pound market in the UK and this market is set to grow considerably.��Dementia care in care homes dominates the sector in terms of current market value.��The use of dementia home care – though significantly smaller than the equivalent market in care homes – is set to rise markedly in the future.A significant proportion of residents for whom dementia is a known cause of admission are receiving care in settings which are not dedicated to dementia care.The new national dementia strategy for England, Living Well with Dementia should provide the strongest impetus yet for growth in the market for specialist dementia care.Growing awareness surrounding inappropriate use of anti-psychotic drugs on people with dementia in care homes may have a major operational impact on some homes if controls are increased and could substantially increase costs.Despite evidence of increasing dementia specialisation, there are, as yet, no organisations to emerge with full service dementia expertise and integrated care pathways.The supply of dedicated dementia services varies dramatically by region and locality, reflecting local and regional priorities and commissioning strategies.The design and layout of care homes for people with dementia is key and there is an increasing consensus around what constitutes best practice and ‘dementia friendly design’ .Care home fees for dementia are generally higher than fees for frail elderly residents.The report is essential reading for senior executives and managers within any organisation committed to, or considering involvement in, the dementia care sector, including for-profit, 'third sector' and public sector agencies.For further information, please contact:��Market ReportsTel.��020 7833 9123 orEmail��info@laingbuisson.co.uk��Download Full Brochure including Order Form��Download Contents and Tables�� Featured item on home page:��no��

Measuring deprivation in health services research, with particular reference to analysis of cancer incidence, mortalilty and survival

This report reviews various measures of deprivation in order to be able to monitor socio-economic inequalities in cancer incidence, survival and service provision in the future.