Shaping the Future of Mental Health Policy and Legislation in Northern Ireland: The Impact of Service User and Professional Social Work Discourses

This paper explores the complex interrelationship between service user and professional social work discourses and provides a critical commentary on their respective contributions to the recent review of mental health policy and legislation in Northern Ireland. The analysis indicates that dominant trends in mental health care, as mediated through service structures and institutional identities, have tended to prioritize the more coercive aspects of the social work role and reinforce existing power inequalities with service users. It is argued that such developments underline the need for a ‘refocusing’ debate in mental health social work to consider how a more appropriate balance can be achieved between its participatory/empowering and regulatory/coercive functions. Whilst highlighting both congruence and dissonance between respective discourses, the paper concludes that opportunities exist within the current change process for service users and social workers to build closer alliances in working together to reconstruct practice, safeguard human rights and develop innovative alternatives to a traditional bio-medical model of treatment.

Models of Mental Health

A good understanding of the different theoretical models is essential when working in the field of mental health. Not only does it help with understanding experiences of mental health difficulties and to find meaning, but it also provides a framework for expanding our knowledge of the field.

As part of the Foundations of Mental Health Practice series, this book provides a critical overview of the theoretical perspectives relevant to mental health practice. At the core of this book is the idea that no single theory is comprehensive on its own and each theory has its limitations. Divided in to two parts, Part I explores traditional models of mental health and covers the key areas: bio-medical perspectives, psychological perspectives and social perspectives, whilst Part II looks at contemporary ideas that challenge and push these traditional views. The contributions, strengths and limitations of each model are explored and, as a result, the book encourages a more holistic, open approach to understanding and responding to mental health issues.

Together, these different approaches offer students and practitioners a powerful set of perspectives from which to approach their study and careers. Each model is covered in a clear and structured way with supporting exercises and case studies. It is an essential text for anyone studying or practising in the field of mental health, including social workers, nurses and psychologists.

Regress? React? Resolve?: An evaluation of mental health service provision in Northern Ireland

Report prepared for Action Mental Health by Queen’s University Belfast

Heterotopias of mental health care: The role of space in experiences of distress, madness and mental health service use.

The change from an institutional to community care model of mental health services can be seen as a fundamental spatial change in the lives of service users (Payne, 1999; Symonds & Kelly, 1998; Wolch & Philo, 2000). It has been argued that little attention has been paid to the experience of the specific sites of mental health care, due to a utopic (idealised and placeless) idea of ‘community’ present in ‘community care’ (Symonds, 1998). This project hence explored the role of space in service users’ experiences, both of mental health care, and community living. Seventeen ‘spatial interviews’ with service users, utilising participatory mapping techniques (Gould & White, 1974; Herlihy & Knapp, 2003; Pain & Francis, 2003), plus seven, already published first person narratives of distress (Hornstein, 2009), were analysed using thematic analysis (Braun & Clarke, 2006). Mental health service sites are argued to have been described as heterotopias (Foucault, 1986a) of a ‘control society’ (Deleuze, 1992), dominated by observation and the administration of risk (Rose, 1998a), which can in turn be seen to make visible (Hetherington, 2011) to service users a passive and stigmatised subject position (Scheff, 1974; 1999). Such visible positioning can be seen to ‘modulate’ (Deleuze, 1992) participants’ experiences in mainstream space. The management of space has hence been argued to be a central issue in the production and management of distress and madness in the community, both in terms of a differential experience of spaces as ‘concordant’ or ‘discordant’ with distress, and with movement through space being described as a key mediator of experiences of distress. It is argued that this consideration of space has profound implications for the ‘social inclusion’ agenda (Spandler, 2007; Wallcraft, 2001).

Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group.

BACKGROUND: Invasive fungal diseases are important causes of morbidity and mortality. Clarity and uniformity in defining these infections are important factors in improving the quality of clinical studies. A standard set of definitions strengthens the consistency and reproducibility of such studies. METHODS: After the introduction of the original European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group definitions, advances in diagnostic technology and the recognition of areas in need of improvement led to a revision of this document. The revision process started with a meeting of participants in 2003, to decide on the process and to draft the proposal. This was followed by several rounds of consultation until a final draft was approved in 2005. This was made available for 6 months to allow public comment, and then the manuscript was prepared and approved. RESULTS: The revised definitions retain the original classifications of "proven," "probable," and "possible" invasive fungal disease, but the definition of "probable" has been expanded, whereas the scope of the category "possible" has been diminished. The category of proven invasive fungal disease can apply to any patient, regardless of whether the patient is immunocompromised, whereas the probable and possible categories are proposed for immunocompromised patients only. CONCLUSIONS: These revised definitions of invasive fungal disease are intended to advance clinical and epidemiological research and may serve as a useful model for defining other infections in high-risk patients.

Pharmacogenomics of HIV Therapy: Summary of a Workshop Sponsored by the National Institute of Allergy and Infectious Diseases

Approximately 1 million people in the United States and over 30 million worldwide are living with human immunodeficiency virus type 1 (HIV-1). While mortality from untreated infection approaches 100%, survival improves markedly with use of contemporary antiretroviral therapies (ART). In the United States, 25 drugs are approved for treating HIV-1, and increasing numbers are available in resource-limited countries. Safe and effective ART is a cornerstone in the global struggle against the acquired immunodeficiency syndrome. Variable responses to ART are due at least in part to human genetic variants that affect drug metabolism, drug disposition, and off-site drug targets. Defining effects of human genetic variants on HIV treatment toxicity, efficacy, and pharmacokinetics has far-reaching implications. In 2010, the National Institute of Allergy and Infectious Diseases sponsored a workshop entitled, Pharmacogenomics A Path Towards Personalized HIV Care. This article summarizes workshop objectives, presentations, discussions, and recommendations derived from this meeting.

Capacity to Attend to the Needs of Persons with Dual Diagnoses in the Criminal Justice System: Views of Mental Health and Criminal Justice Professionals

Currently, individuals with intellectual disabilities are overrepresented within the Criminal Justice System (Griffiths, Taillon-Wasmond & Smith, 2002). A primary problem within the Criminal Justice System is the lack of distinction between mental illness and intellectual disabilities within the Criminal Code. Due to this lack of distinction and the overall lack of identification procedures in the Criminal Justice System, individuals with disabilities will often not receive proper accommodations to enable them to play an equitable role in the justice system. There is increasing evidence that persons with intellectual disabilities are more likely than others to have their rights violated, not use court supports and accommodations as much as they should, and be subject to miscarriages of justice (Marinos, 2010). In this study, interviews were conducted with mental health (n=8) and criminal justice professionals (n=8) about how individuals with dual diagnosis are received in the Criminal Justice System. It was found that criminal justice professionals lack significant knowledge about dual diagnosis, including effective identification and therefore appropriate supports and accommodations. Justice professionals in particular were relatively ill-prepared in dealing effectively with this population. One finding to highlight is that there is misunderstanding between mental health professionals and justice professionals about who ought to take responsibility and accountability for this population.

Significance of Time Scales in Nonlinear Dynamical Analysis of Electroencephalogram Signals

We propose to show in this paper, that the time series obtained from biological systems such as human brain are invariably nonstationary because of different time scales involved in the dynamical process. This makes the invariant parameters time dependent. We made a global analysis of the EEG data obtained from the eight locations on the skull space and studied simultaneously the dynamical characteristics from various parts of the brain. We have proved that the dynamical parameters are sensitive to the time scales and hence in the study of brain one must identify all relevant time scales involved in the process to get an insight in the working of brain.

The Effect of Mental Health Problems on Children’s Ability to Discriminate Amongst Thoughts, Feelings and Behaviours

Many young children appear to have skills sufficient to engage in basic elements of cognitive behaviour therapy (CBT). Previous research has, however, typically used children from non-clinical populations. It is important to assess children with mental health problems on cognitive skills relevant to CBT and to compare their performance to children who are not identified as having mental health difficulties. In this study 193 6 and 7 year old children were assessed using a thought–feeling–behaviour discrimination task [Quakley et al. Behav. Res. Therapy 42 (2004) 343] and a brief IQ test (the WASI). Children were assigned to groups (at risk, borderline, low risk) according to ratings of their mental health made by their teachers and parents on the Strengths and Difficulties Questionnaire [Goodman, J. Am. Acad. Child Adolescent Psych. 40 (2001) 1337]. After controlling for IQ, children ‘at risk’ of mental health problems performed significantly less well than children with a ‘low risk’ of mental health problems. Before receiving CBT, children’s meta-cognitive development should be assessed and additional help provided to those with meta-cognitive difficulties.