Diminuição do risco de infecção pelo vírus da imunodeficiência humana (VIH) em pacientes em hemodiálise no estado do Rio de Janeiro, Brasil

Os estudos iniciais sobre a soroprevalência de anticorpos anti-VIH-1 (Ac-VIH) em unidades de hemodiálise no Estado do Rio de Janeiro (RJ) foram feitos em 1985. Os números alarmantes, próximos a 14%, foram atribuídos à má qualidade do sangue obtido de "doadores profissionais" em troca de comida ou dinheiro. Recentemente uma série de medidas foram adotadas na tentativa de reduzir o tráfico de sangue. Nossa investigação objetivou avaliar o impacto destas na soroprevalência de Ac-VIH em duas unidades satélites no RJ. A Clínica Segumed foi uma das unidades estudadas em 1985. Em 1987 realizamos um segundo levantamento no mesmo grupo estudado previamente. A Casa de Saúde Grajaú, inaugurada em 1986 com a maioria dos pacientes novos em diálise, foi estudada em 1988. O teste ELISA HIV-1 foi utilizado como rastreamento. Os resultados positivos foram confirmados com Western blot. Os resultados na Segumed mostraram uma grande diferença entre os dois levantamentos (14,4% vs 3,6%). Os dois casos positivos em 1987 estavam entre os identificados em 1985. Nenhum paciente se infectou entre os dois levantamentos apesar de não se utilizarem medidas de isolamento para os portadores de VIH e do uso de transfusões ter aumentado no período. Na CS Grajaú apenas dois casos foram encontrados (soroprevalência 2,4%) embora um já fosse conhecido desde 1985 quando vivia com um transplante. Uma revisão de estudos semelhantes no RJ e São Paulo parece revelar uma tendência à diminuição das taxas nos últimos anos. Nós concluímos que a chance de contaminação com VIH é atualmente reduzida nos centros estudados e pode estar caindo globalmente no RJ. É possível que a maior vigilância, e até fechamento de bancos de sangue, tenha resultado na melhora da qualidade do sangue no RJ.

Effects of a mental health training program on health care worker's knowledge and attitude and practice in Belize

ABSTRACT This study was conducted to assess mental health knowledge, attitude and practices among health care workers in Belize before and immediately after a competency based training program in mental health. A baseline Knowledge, Attitudes and Practices (KAP) survey was given to health personnel, mainly nurses, working primary and secondary care. The intervention was a 13-week face-to-face training course for health care professionals with the objective of increasing their competency in mental health and reducing stigma. After the training a post intervention KAP survey was conducted among the original respondents. 88 health care workers completed the baseline survey and 61 of those respondents completed the post-intervention questionnaire. The results showed that the level of knowledge of the participants had improved by the training intervention and that in general, the intervention was effective in correcting some misconceptions about mental illness and reducing stigmatizing attitudes among the participants.

Analysis of mental health service financial models with a particular emphasis of Ireland

ABSTRACT: Financing is a critical factor in ensuring the optimal development and delivery of a mental health system. The primary method of financing worldwide is tax-based. However many low income countries depend on out-of-pocket payments. There is a report on Irish Health Care funding but none that deals exclusively with mental health care. This paper analyses the various financial models that exist globally with respect to financing the mental health sector, examines the impact of various models on service users, especially in terms of relative ‘financial burden’ and provides a more detailed examination of the current mental health funding situation in Ireland After extensive internet and hardcopy research on the above topics, the findings were analysed and a number of recommendations were reached. Mental health service should be free at the point of delivery to achieve universal coverage. Government tax-based funding or mandatory social insurance with government top-ups, as required, appears the optimal option, although there is no one funding system applicable everywhere. Out-of-pocket funding can create a crippling financial burden for service users. It is important to employ improved revenue collection systems, eliminate waste, provide equitable resource distribution, ring fence mental health funding and cap the number of visits, where necessary. Political, economic, social and cultural factors play a role in funding decisions and this can be clearly seen in the context of the current economic recession in Ireland. Only 33% of the Irish population has access to free public health care and the number health insurance policy holders has dramatically declined, resulting in increased out-of-pocket payments. This approach risks negatively impacting on the social determinants of health, increasing health inequalities and negatively affecting economic productivity. It is therefore important the Irish government examines other options to provide funding for mental health services.

Mental health care assessed based on structure, process and outcome : a retrospective cohort study

RESUMO: As doenças mentais são comuns, universais e associadas a uma significativa sobrecarga pessoal, familiar, social e económica. Os Serviços de Saúde Mental devem abordar de forma adequada as necessidades dos pacientes e familiares tanto ao nível clínico como também ao nível social. O presente estudo foi realizado num período de grande transformação nos sistemas de saúde primário e de saúde mental em Portugal, num Departamento de Psiquiatria desenvolvido com base nos princípios da OMS. Os objectivos incluem a caracterização: 1) das Unidades Funcionais do Departamento; 2) dos pacientes internados pela primeira vez no internamento de agudos; 3) da utilização dos serviços nas equipas comunitárias após a alta; e 4) da avaliação de alguns dos indicadores de qualidade do departamento, com recurso ao modelo de Donabedian sobre a articulação entre a Estrutura-Processo-Resultados. Metodologia: Foi escolhido um estudo de coorte retrospectivo. Todos os pacientes internados pela primeira vez entre 2008 e 2010 foram incluídos no estudo. Os seus processos clínicos e a base de dados do hospital onde são registados todos os contactos que estes tiveram com os profissionais de saúde mental foram revistos de forma a obter dados sociodemográficos e clínicos, durante o período do estudo e após a alta. Os instrumentos utilizados foram o WHO-ICMHC (Classificação Internacional de Cuidados de Saúde Mental), para caracterizar o Departamento, o AIESMP (Avaliação Inicial de Enfermagem em Saúde Mental e Psiquiatria) para recolha dos dados sociodemográficos, e o VSSS (Escala de Satisfação com os Serviços de Verona) de forma a avaliar a satisfação dos pacientes em relação aos cuidados recebidos. A análise estatística incluiu a análise descritiva, quantitativa e qualitativa dos dados. Resultados: As Unidades Funcionais do Departamento revelaram níveis elevados de articulação e consistência com as necessidades de cuidados psiquiátricos e reabilitação psicossocial dos pacientes. Os 543 pacientes admitidos pela primeira vez eram maioritariamente (56.9%) mulheres, caucasianas (81.2%), com diagnóstico de perturbações do humor (66.3%), internadas voluntariamente (59.7%), e uma idade média de 45.1 anos. Estas eram significativamente mais velhas, mais frequentemente empregadas, casadas/coabitar e tinham uma prevalência mais elevada de perturbações do humor, comparativamente aos homens. O internamento compulsivo era mais significativo nos homens (54.7%). A taxa de abandono no pós-alta (4.2%) e a taxa de reinternamentos (2.9%) na quinzena após a alta revelaram-se inferiores aos padrões na literatura internacional. De forma global, a satisfação dos pacientes com os cuidados de saúde mental foi positiva. Conclusões: Os cuidados prestados mostraram-se eficazes, adaptados e baseados nas necessidades e problemas específicos dos pacientes. A continuidade e a abrangência de cuidados foram difundidos e mantidos ao longo do processo de cuidados. Este Departamento pode ser considerado um exemplo de como proporcionar tratamento digno e eficiente, e uma referência para futuros serviços de psiquiatria.-------------- ABSTRACT: Mental health disorders are common, universal, and associated with heavy personal, family, social and economic burden. Mental health services should be aimed at adequately addressing patients’ and families’ needs at clinical and social level. The current study was carried out at a time of great transformation in the health and mental health systems in Portugal, in a Psychiatric Department developed taking in consideration the WHO principles. The objectives included characterizing: 1) the Psychiatric Department’s different units; 2) the patients admitted for the first time to the inpatient unit; 3) their use of community mental health services after discharge; and 4) assessing some of the department’s quality indicators, with resource to Donabedian’s Structure-Process-Outcome model. Methodology: A retrospective cohort design was chosen. All the firstly admitted patients in the period between 2008 and 2010 were included in the study. Their clinical records and the hospital’s database which registers all of the contacts the patients had with the mental health professionals during the study period, were reviewed to retrieve sociodemographic and clinical data and information on follow-up. The instruments used were the WHO International Classification of Mental Health Care (ICMHC) to characterize the department, the Initial Nurses’ Assessment in Mental Health and Psychiatry (AIESMP) for patients’ sociodemographic data, and the Verona Service Satisfaction Scale (VSSS) to assess patients’ satisfaction with care received. Statistical analysis included descriptive, quantitative and qualitative analysis of the data. Results: The Department’s Functional units revealed high levels of articulation, and were consistent with patients’ needs for psychiatric care and psychosocial rehabilitation. The 543 patients firstly admitted were mainly (56.9%) female, Caucasian (81.2%), diagnosed with mood disorders (66.3%), voluntarily admitted (59.7%), and with a mean age of 45.1 years. Female patients were significantly older, more frequently employed, married/cohabiting and had a higher prevalence of mood disorders when compared to males. Involuntary admission was more significant in males (54.7%). Dropout rates during follow-up (4.2%) and readmission rates (2.9%) in the fortnight following discharge were lower than standards in international literature. Overall patients’ satisfaction with mental health care was positive. Conclusions: The care delivered was effective, adapted and based on the patients’ specific needs and problems. Continuity and comprehensiveness of care was endorsed and maintained throughout the care process. This department may be considered an example of both humane and effective treatment, and a reference for future psychiatric care.

Draft for a Mental Health strategy Lebanon

RESUMO: O Líbano é um pequeno país na costa leste do Mar Mediterrâneo, com uma população de aproximadamente 4.350.000 pessoas, incluindo 1,5 milhões de refugiados, 400 mil dos quais são palestinos atendidos pela UNRWA (Agência das Nações Unidas de Socorro aos Refugiados da Palestina) (UNHCR, 2013; OMS, 2010a). Desde 2012, um excedente de 1.000.000 refugiados sírios cruzaram a fronteira com o Líbano, representando um aumento populacional de aproximadamente 25%. Além disso, entre 1975 e 1990, a violenta guerra civil pela qual o Líbano passou, destruiu grande parte da infra-estrutura do país, incluindo os serviços de saúde. O sector da saúde, mais especificamente os serviços de saúde mental, é majoritariamente privado. Serviços especializados em Saúde Mental estão disponíveis em três hospitais psiquiátricos privados, e em 4 unidades psiquiátricas de hospitais gerais, que estão localizados centralmente em torno da capital, Beirute. O Líbano é um dos dois únicos países da região que não tem uma Política de Saúde Mental e um dos seis países que não têm uma Legislação em Saúde Mental. Nos últimos anos, a Saúde Mental está sendo colocada no topo da agenda nacional, apesar das contínuas questões políticas e de segurança. Baseando-se nas informações acima, um projecto de estratégia em Saúde Mental, conduzido pelo Ministério da Saúde e apoiado pela OMS, foi escrito para servir como um guia para trabalhar em diferentes aspectos relacionados tanto em saúde mental quanto em organização dos serviços, revisão de legislação, financiamento e proteção dos direitos humanos básicos dos usuários do serviço. Esta tese descreve o processo pelo qual o projecto de estratégia nacional de Saúde Mental foi desenvolvido, seus principais componentes, os próximos passos a serem tomados para a sua implementação, os desafios e as oportunidades para implementá-lo e propõe alguns passos iniciais a serem tomados em primeiro lugar.----------ABSTRACT: Lebanon is a small country on the eastern shore of the Mediterranean Sea with a population of approximately 4,350,000 including 1,500,000 refugees, 400,000 of whom are Palestinians served by UNRWA (the United Nations Relief and Works Agency for Palestine Refugees) (UNHCR, 2013; WHO, 2010a). Since 2012 an excess of 1,000,000 Syrian refugees have crossed the border into Lebanon accounting for approximately 25% increase in the population. In addition, from 1975 to 1990 Lebanon underwent a violent civil war that had also destroyed much of the country infrastructure including health services. The health sector, more so the mental health services, is mostly private. Specialized Mental Health services are available at three private mental hospitals, and 4 psychiatric units within general hospitals, which are located centrally around the capital, Beirut. Lebanon is one of only two countries of the region that does not have a Mental Health policy and one out of the six countries that does not have a Mental Health legislation. In recent years, Mental Health is getting placed higher on the national agenda despite the ever continuing political and security issues. Based on the above, A Mental Health strategy draft, lead by the Ministry of Health and supported by WHO, was written to serve as a guide to work on different aspects related to Mental Health from service organization, to the revision of legislation, financing and the protection of the basic human rights of service users. This thesis describes the process through which the national Mental Health draft strategy was developed, its main components, the next steps to be taken for its implementation, the challenges and the opportunities to implementing it and proposes a few initial steps to be taken first.

Primeiro registro sinantrópico de Loxosceles laeta (Nicolet, 1849) (Araneae, Sicariidae) no Município do Rio de Janeiro, Estado do Rio de Janeiro

Loxosceles laeta é a espécie de aranha-marrom de maior importância médica, causando acidentes de maior gravidade, além de apresentar hábito sinantrópico. No presente trabalho, é apresentado o primeiro registro sinantrópico de Loxosceles laeta no Município do Rio de Janeiro, RJ, Brasil, a partir de encontro e coleta ocasional de espécimes, no período de agosto de 2005 a junho de 2009. A espécie foi registrada em um prédio do Museu Nacional/UFRJ, localizado no parque da Quinta da Boa Vista, área urbana na Zona Norte da Cidade do Rio de Janeiro. O foco foi considerado localizado e restrito. Loxosceles laeta é adaptável às condições climáticas da região metropolitana do Rio de Janeiro, o que torna possível o estabelecimento de novos focos da espécie e a ocorrência de loxoscelismo na região.

Assessing the community needs of mental health residential care service users in Republic of Moldova

RESUMO: Background: Problemas de saúde mental são um grande problema clínico e social na República da Moldávia, representando uma quota significante de deficiência, sendo classificada no top cinco das dez linhas na hierarquia das condições. A taxa de incidência tem sido crescente na República da Moldávia, atingindo cerca de 15.000 por ano (14,655 em 2011), ou seja, 411,4 por 100 mil habitantes, e uma taxa de prevalência de 97.525 pessoas em 2011, ou seja, 2,737.9 por 100 mil habitantes. Sistema de atendimento psiquiátrico fornece serviços de saúde mental escassos a nível da comunidade, visando principalmente terapia hospitalar, centralizada, através de uma rede de três hospitais psiquiátricos, com 1.860 camas e 4 sanatórios psico- neurológicos com 1890 camas, assim alimentando-se a estigmatização do paciente. Objetivos: O objetivo deste estudo foi a avaliação das necessidades individuais dos beneficiários e do seu nível de autonomia dentro de cuidados residenciais, para o planeamento de reformas de saúde mental e desinstitucionalização na República da Moldávia. Este estudo foi encomendado pelo Ministério do Trabalho, Proteção Social e da Família e pelo Ministério da Saúde, com o apoio da Organização Mundial da Saúde, para determinar o cumprimento eficaz do artigo 19 da Convenção da ONU. O estudo tem os seguintes objetivos: Avaliar o nível de autonomia dos residentes nos hospitais psiquiátricos e sanatórios psico-neurológico, usando uma amostra representativa de 10 por ce nto do número total de pacientes/residentes e comparação cruzada; Para avaliar quatro sanatórios psico-neurológicos para adultos e três hospitais psiquiátricos; Para desenvolver recomendações para o planeamento da desinstitucionalização das pessoas com problemas de saúde mental e colocação na comunidade com base nos resultados do estudo. Metodologia e resultados: O estudo fez uso de duas ferramentas globais: questionário para a avaliação individual dos residentes do estabelecimento de saúde mental, e questionário de avaliação institucional. Todos os entrevistados foram divididos em quatro categorias conforme com o grau de dependência e preparação de viver de forma independente na comunidade. Apenas 1,2% dos entrevistados de PNHB eram totalmente dependentes de terceiros ou serviços especializados, tornando-se a categoria 4, que necessitam de cuidados e apoio contínuo. No PH esta categoria de pessoas é ausente. Conclusões: A condição dos entrevistados foi pior em PNBH que em PH. No entanto, ainda, aqueles que estão prontos para ser desinstitucionalizados correspondem com a maior parte dos entrevistados. Todos os hospitais tinham o consentimento do utente para admissão e tratamento, enquanto não houve consentimento qualquer em PNBH. É bastante óbvio que tanto os hospitais como também a sistema de assistência residencial não atingem a sua finalidade, o que significa que a maioria dos utentes pode ser desinstitucionalizados, sem qualquer terapia de suporte.------------------ABSTRACT: Background: Mental health problems are a major clinical and social issue in the Republic of Moldova,accounting for a significant share of disability and ranking in top five of the ten lines in the hierarchy of conditions. The incidence rate has been growing in the Republic of Moldova to reach approximately 15 thousand a year (14,655 in 2011), i.e. 411.4 per 100 thousand population, and a prevalence rate of 97,525 thousand people in 2011, i.e. 2,737.9 per 100 thousand population. Psychiatric care system provides for scanty mental health services at community level, aiming mainly at centralized hospital-based therapy through a network of three psychiatric hospitals tallying up 1,860 beds and 4 psycho-neurological boarding houses with 1,890 beds, thus fuelling up patient stigmatization. Objectives: The purpose of this study was to assess the individual needs of beneficiaries and their level of autonomy within residential care for the planning of mental health system reforms and deinstitutionalization in the Republic of Moldova. This study was commissioned by the Ministry of Labour, Social Protection and Family and by the Ministry of Health, with the World Health Organization support, to provide for effective enforcement of article 19 of the UN CRPD. The study pursued the following goals: To evaluate the level of autonomy of the psychiatric hospital and psycho-neurological boarding house residents by using a representative sample of 10 per cent of the total number of patients / residents and cross-comparison; To evaluate four psycho-neurological boarding houses for adults and three psychiatric hospitals; To develop recommendations for planning the deinstitutionalization of people with mental health problems and community placement based on the study findings.Methodology and results: The study made use of two global tools: questionnaire for individual assessment of mental health facility residents, and institutional assessment questionnaire. All interviewees were divided into four categories by one’s degree of dependence and readiness to live independently in the community. Only 1.2% of respondents from PNHB were fully dependent on a third party or specialized services, making up category 4, requiring continuous care and support. In PH this category of people is absent.Conclusions: The condition of respondents was worse in PNBH than in PH. However, yet, those ready to be deinstitutionalized accounted for most of respondents there. All hospitals had the resident’s consent to admission and treatment, whereas there was no consent in PNBH whatsoever. It is quite obvious that both the hospitals and residential care system do not achieve their intended purpose, meaning that the majority of residents may be deinstitutionalized without any support therapy.

Producción de información para las políticas públicas: observatorio de salud mental y derechos humanos en la provincia de córdoba. Documented information and indicators for the pubic policies in mental health: human rights obseratory in córdoba

El problema que enfrenta la institucionalidad estatal argentina es que existe un serio déficit de información no solamente en el momento de evaluar un resultado, sino ya al momento de diseñar la política. Las estadísticas oficiales de hechos vitales, salud y educación son difundidas en el mejor de los casos con un año de atraso. La información de indicadores de salud por su nivel de desagregación no permite conocer las realidades locales. Es posible constatar la falta de información sobre las medidas tomadas para asegurar el cumplimiento de las obligaciones del Estado en lo relativo a políticas y programas de salud mental. Del mismo modo que los organismos internacionales determinan los deficits de los sistemas de atención a la salud mental a través de las brechas de tratamiento y aun cuando no se dispone de estimaciones precisas se habla de brechas de información, que expresarían la distancia entre la información necesaria y la efectivamente disponible (OPS, 2009). Desde el mes de diciembre de 2007 se conforma la Mesa de Trabajo Permanente en Salud Mental y Derechos Humanos, con el objeto de instalar en agenda la necesidad de contar con una legislación que brinde el marco normativo para la transformación del sector. En los meses de octubre y noviembre de 2010 se aprobaron sendas leyes de salud mental en la Provincia de Córdoba y a nivel nacional. Ambas proponen la transformación progresiva en los sistemas de atención a los problemas de salud mental de la población. Desde la Mesa de Trabajo Permanente en Salud Mental y Derechos Humanos se afirma que la legislación es un marco necesario pero no suficiente, en tanto se constata que las princiales violaciones a los derechos humanos se producen en situaciones concretas. El presente proyecto nace de la necesidad de contar con un sistema de información que permita conocer la transformación de los servicios de salud mental en la provincia de Córdoba a partir de la sanción de la ley 9848 de Salud Mental en el mes de octubre de 2010. Una vez logrado este objetivo legislativo, se pretende monitorear la gestión con la formulación de los siguientes interrogantes: ¿a través de qué indicadores medir, evaluar y monitorear si la producción de los servicios de salud mental se lleva adelante desde la perspectiva del enfoque de derechos sancionada en el marco normativo vigente?; ¿cuáles son los indicadores que desde dicha perspectiva los organismos estatales de producción de servicios deben elaborar para el compromiso de acción y la rendición de cuentas frente a la ciudadanía? ¿cuáles son los indicadores que la ciudadanía debe reclamar a los fines de monitorear el cumplimiento de dichos compromisos? La puesta en marcha del Observatorio de Salud Mental y Derechos Humanos permitirá analizar las políticas y programas de salud mental desde la perspectiva de los derechos humanos y avanzar en el monitoreo de la producción de los servicios de salud mental. Objetivo General: analizar y hacer visible el cumplimiento de los objetivos sancionados en la ley 9848 de Salud Mental a través de la observación, el monitoreo y la incidencia en las políticas de salud mental de la provincia de Córdoba. Metodología: la construcción de indicadores de derechos humanos para la salud mental. El Observatorio de Salud Mental y Derechos Humanos pretende dar cuenta de las transformaciones que van a ocurrir a partir de la sanción de la ley 9848. Los resultados esperados están ligados a la producción y difusión de información sistematizada sobre las transformaciones en salud mental, a la vigilancia y el análisis del efecto/impacto de las políticas e incidir en las decisiones. El Observatorio pretende reconocer e integrar la información disponible y proponer indicadores que den cuenta de la situación inicial al momento de la implementación de los marcos normativos y permitir el monitoreo de las transformaciones emergentes. This project stems from the need for an information system designed to show the transformation of mental health services in the province of Cordoba after the enactment of the Mental Health Act 9848 in October 2010. Once achieved this legislative objective is to monitor the management with the formulation of the following questions: through which indicators to measure, evaluate and monitor whether the production of mental health services are carried forward from the perspective of rights-based approach enacted in two laws?, What are the indicators from that perspective the production agencies should develop services for the commitment to action and accountability to the public? What are the indicators that the public should demand that the purpose of monitoring compliance with these commitments? The launch of the Centre for Mental Health and Human Rights will review the policies and mental health programs from the perspective of human rights and progress in monitoring the production of mental health services. General Objective: to analyze and highlight the achievement of the objectives sanctioned by the Mental Health Act 9848 through the observation, monitoring and impact on mental health policy in the province of Cordoba. Methodology: building human rights indicators for mental health Mental Observatory Health and Human Rights aims to account for the changes that will occur after the enactment of Law 9848. The expected results are linked to production and dissemination of systematic information about changes in mental health, surveillance and analysis of the effect / impact and influence policy decisions. The Centre aims to recognize and integrate the available information and propose indicators that account for the initial situation at the time of implementation of regulatory frameworks and allow monitoring of change emerging.

V3 peptide binding pattern and HIV-1 transmission route in Rio de Janeiro

To characterize antibody binding to a panel of V3 loop peptides representing diverse HIV-1 neutralization epitopes, 149 HIV-1 infected individuals from Rio de Janeiro (RJ) were investigated. Results were analyzed with respect to risk factors for infection and other epidemiological and clinical data. Peptide reactivity was not associated with sex, clinical status, CD4 counts, antigenemia or ß2-microglobulin serum level. A segregation of peptide reactivity according to route of infection was encountered. This finding suggests that more then one viral strain may be circulating in RJ, in subjects with different risk factors for HIV-1 infection. An investigation of prevalent HIV-1 genotypes, serotypes and immunotypes may be of importance for the design and selection of potential vaccines to be used in Brazil as well as for the selection of populations to be included in future vaccine efficacy trials.

Lista dos exemplares tipos de Ceratopogonidae (Diptera: Nematocera) depositados na Coleção Entomológica do Instituto Oswaldo Cruz, Rio de Janeiro, Brasil

A list of all type specimens of the Family Ceratopogonidae, present in the Entomological Collection of Instituto Oswaldo Cruz, Rio de Janeiro, RJ, Brazil is presented. This list includes the genera Bahiahelea, Culicoides, Dasyhelea, Downeshelea, Forcipomyia, Leptoconops, Mallochohelea, Monohelea, Neobezzia, Palpomyia and Sphaerohelea.

Review of the Operation of the Mental Health Act 2001

The Mental Health Act 2001 replaces the Mental Treatment Acts 1945-61 which provided the statutory framework for the detention of people with mental illness and the administration of psychiatric services for over 50 years.The 2001 Act was introduced on a phased basis to allow for the necessary preparatory work to be undertaken. In March 2002 sections 1 to 5, 7, and 31 to 55 were commenced with effect from the 5 April 2002 (Establishment Day). This allowed for the establishment of the Mental Health Commission and the Inspector of Mental Health Services to replace the Inspector of Mental Hospitals. The Mental Health Act 2001 replaces the Mental Treatment Acts 1945-61 which provided the statutory framework for the detention of people with mental illness and the administration of psychiatric services for over 50 years. The 2001 Act was introduced on a phased basis to allow for the necessary preparatory work to be undertaken. In March 2002 sections 1 to 5, 7, and 31 to 55 were commenced with effect from the 5 April 2002 (Establishment Day). This allowed for the establishment of the Mental Health Commission and the Inspector of Mental Health Services to replace the Inspector of Mental Hospitals. Click here to download PDF 202kb

Facilitation Process Concerning the Difficulties in Implementing A Vision For Change in the South Tipperary and Carlow Kilkenny Catchment Area Mental Health Service

Facilitation Process Concerning the Difficulties in Implementing A Vision For Change in the South Tipperary and Carlow Kilkenny Catchment Area Mental Health Service Click here to download PDF 4.27MB

Interim Report of the Steering Group on the Review of the Mental Health Act 2001

Interim Report of the Steering Group on the Review of the Mental Health Act 2001 There is a commitment in the Programme for Government to review the Mental Health Act 2001. In line with this, Minister Lynch appointed a Steering Group to review the Mental Health Act 2001. Their report is now with an Expert Group. The review takes accounts of the significant changes in thinking about the delivery of mental health services that have taken place in the last ten years (including the introduction of the UN Convention on the Rights of People with Disabilities (CRPD), the shift to community based services, the adoption of a recovery approach in every aspect of service delivery and the involvement of service users as partners in their own care and in the development of the service). Click here to download PDF 471kb

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.

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.