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.

A comparative study in two secondary schools aimed at improving their energy management: Archbishop McHale College Tuam, Coláiste Cholmcille Indreabhánn

Climate change is a crisis that is going to affect all of our lives in the future. Ireland is expected to have increased storms and rain throughout the country. This will affect our lives greatly unless we do something to change it. In an attempt to try and reduce the impacts of climate change, countries across the world met to address the problem. The meeting became known as the Kyoto Protocol. The Kyoto protocol set out objectives for each developed country to achieve with regards to carbon emissions to the same levels as 1990 levels. Due to the economy in Ireland being at a low point in 1990, Ireland was given a target of 13% carbon emissions above 1990 levels. In order to meet targets Ireland produced two energy papers, the green paper and the white paper. The green paper identified drivers for energy management and control; they were security of energy supply, economic competitiveness and environmental protection. The white paper produced targets in which we should aim to achieve to try and address the green papers drivers. Within the targets was the plan to reduce energy consumption in the public sector by 33% by 2020 through energy conservation measures. Schools are part of the public sector that has targets to reduce its energy consumption. To help to achieve targets in schools initiatives have been developed by the government for schools. Energy audits should be performed in order to identify areas where the schools can improve their current trends and show where they can invest in the future to save money and reduce the schools overall environmental footprint. Grants are available for the schools for insulation through the energy efficiency scheme and for renewable energy technologies through the ReHeat scheme. The promotion of energy efficient programs in schools can have a positive effect for students to have an understanding. The Display Energy Certificate is a legal document that can be used to understand how each school is performing from an energy perspective. It can help schools to understand why they need to change their current energy management structure. By improving the energy management of the schools they then improve the performance on the Display Energy Certificate. Schools should use these tools wisely and take advantage of the grants available which can in the short to long term help them to save money and reduce their carbon footprint.

A comparison of environmental licensing systems in operation in the wood panel manufacturing industry in the Northern Hemisphere

The objective of this thesis is to compare and contrast environmental licensing systems, for the wood panel industry, in a number of countries in order to determine which system is the best from an environmental and economic point of view. The thesis also examines the impact which government can have on industry and the type of licensing system in operation in a country. Initially, the thesis investigates the origins of the various environmental licensing systems which are in operation in Ireland, Scotland, Wales, France, USA and Canada. It then examines the Environmental Agencies which control and supervise industry in these countries. The impact which the type of government (i.e. unitary or federal) in charge in any particular country has on industry and the Regulatory Agency in that country is then described. Most of the mills in the thesis make a product called OSB (Oriented Strand Board) and the manufacturing process is briefly described in order to understand where the various emissions are generated. The main body of the thesis examines a number of environmental parameters which have emission limit values in the licenses examined, although not all of these parameters have emission limit values in all of the licenses. All of these parameters are used as indicators of the potential impact which the mill can have on the environment. They have been set at specific levels by the Environmental Agencies in the individual countries to control the impact of the mill. Following on from this, the two main types of air pollution control equipment (WESPs and RTOs) are described in regard to their function and capabilities. The mill licenses are then presented in the form of results tables which compare air results and water results separately. This is due to the fact that the most significant emission from this type of industry is to air. A matrix system is used to compare the licenses so that the comparison can be as objective as possible. The discussion examines all of the elements previously described and from this it was concluded that the IPC licensing system is the best from an environmental and economic point of view. It is a much more expensive system to operate than the other systems examined, but it is much more comprehensive and looks at the mill as a whole rather than fragmenting it. It was also seen that the type of environmental licensing system which is in place in a country can play a role in the locating of an industry as certain systems were seen to have more stringent standards attached to them. The type of standard in place in a country is in turn influenced by the type of government which is in place in that country.

Population genetic structure of brown crab (Cancer pagurus) in Irish waters

The brown crab (Cancer pagurus) fishery in Ireland is one of the most important financially and socio-economically, with the species worth approximately €15m per year in the first half of the decade. Only mackerel (Scomber scombrus) and Dublin Bay prawn (Nephrops norvegicus) are of greater value. Despite this, very little research has been conducted to describe the stock structure of brown crab on a national scale. In this study a country-wide assessment of genetic population structure was carried out. Sampling was conducted from commercial fishing boats from 11/06 to 04/08 at seven sample sites representing the central Irish brown crab fisheries, with one sample site from the UK also included in the study. Six microsatellite markers, specifically developed for brown crab, were used to assess genetic diversity and estimate population differentiation parameters. Significant genetic structuring was found using F-statistics (Fst = 0.007) and exact tests, but not with Bayesian methods. Samples from the UK and Wexford were found to be genetically distinct from all other populations. Three northern populations from Malm Head and Stanton Bank were genetically similar with Fst estimates suggesting connectivity between them. Also, Stanton Bank, again on the basis of Fst estimates, appeared to be connected to populations down the west coast of Ireland, as far south as Kerry. Two Galway samples, one inside and one outside of Galway Bay, were genetically differentiated despite their close geographic proximity. It is hypothesised that a persistent northerly summer current could transport pelagic larvae from populations along the southwest and west coasts of Ireland towards Stanton Bank in the North, resulting in the apparent connectivity observed in this study.

A study of the interaction between national and corporate culture in a selection of Irish based companies

This research studies the phenomenon of national and corporate culture. National culture is the culture the members of a country share and corporate culture is a subculture which members of an organisation share (Schein, 1992). The objective of this research is to reveal if the employees within equivalent Irish and American companies share the same corporate and national culture and to ascertain if, within each company, there is a link between national culture and corporate culture. The object of this study is achieved by replicating research which was conducted by Shing (1997) in Taiwan. Hypotheses and analytical tools developed by Shing are employed in the current study to allow comparison of results between Shing’s study and the current study. The methodology used, called for the measurement and comparison of national and corporate culture in two equivalent companies within the same industry. The two companies involved in this study are both located in Ireland and are of American and Irish origin. A sample of three hundred was selected and the response rate was 54%. The findings from this research are: (1) The two companies involved had different corporate cultures, (2) They had the same national culture, (3) There was no link between national culture and corporate culture within either company, (4) The findings were not similar to those of Shing (1997). The implication of these findings is that national and corporate culture are separate phenomena therefore corporate culture is not a response to national culture. The results of this research are not reflected in the finding’s of Shing (1997), therefore they are context specific. The core recommendation for management is that, corporate culture should take account of national culture. This is because although employees recognise the espoused values of corporate culture (Schein, 1992), they are at the same time influenced by a much stronger force, their national culture.

The role of biomass and biorefineries in a sustainable future

Some o f the biggest issues facing humanity in the 21st century include energy security, global warming and resource scarcity. These issues will affect every nation and Ireland is no exception. There is much research underway to uncover technologies that will allow the world to overcome such problems, but none offer the flexibility o f biomass. Unlike other sustainable technologies, which offer a solution to one or at most two o f the above problems, biomass as demonstrated by the author, can play a part in mitigating all o f the above problems. It has been known for some time that biomass can be used in various ways as a form o f renewable energy, but with the development o f biorefineries biomass can be used to produce material as well as fuel products. In this report the author has looked at the viability and benefits o f biomass, bioenergy and biorefining in Ireland. The author has demonstrated that such technologies when implemented correctly are sustainable from an economic, environmental and societal point o f view. The author has shown in this thesis that abundant supplies o f biomass make bio re fineries a viable business opportunity in Ireland and has shown how a number o f biorefinery scenarios have the potential to be extremely profitable. The author has evaluated the profitability o f material product-based bio re fineries as well as fuel productbased configurations. The author demonstrated that value-added co-products help to make bio refineries profitable even when excise-relief is not granted on bio fuels. In this thesis the author has revealed some o f the problems that bioenergy and biorefineries have had to overcome to date and examines challenges that remain for bioenergy and biorefining, and looks at the future opportunities for bio fuels. This report concludes that biomass and biorefining has exciting business potential while offering unique opportunities to mitigate the problems o f the future.

Health Impact Assessment: A baseline report for Ireland and Northern Ireland

Report of the findings of the Institute's Health Impact Assessment (HIA) work programme in 2001, in order to (a) record the baseline of HIA awareness, activity and thinking in Ireland and Northern Ireland and (b) identify the issues around its implementation.

Counting the Cost of Diabetes on the Island of Ireland

A new report published by the Institute of Public Health in Ireland (IPH) and released on Monday 9 July 2007, predicts a 26% increase in diabetes in Northern Ireland and a 37% increase in the Republic over the ten year period (2005-2015). The new report entitled, Making Diabetes Count: What does the future hold? is the second such report from the authors - The Irish Diabetes Prevalence Working Group.

Inequalities in Perceived Health

A report on the All-Ireland Social Capital and Health Survey. This is the first report in Ireland, North or South, which measures and identifies systematically the connections between perceived health and an extensive range of demographic and socio-economic characteristics and lifestyle behaviours. The concept of social capital and the ways in which social capital may be an important determinant of health is receiving increased attention from policy-makers. The Institute of Public Health in Ireland produced a report in 2004 based on its All Ireland Social Capital and Health Survey. The report explores how people feel about their health and highlights how this is linked with perceptions of the local social environment as well as to demographic and socio-economic circumstances and lifestyle behaviours.

All-Ireland Health Data Inventory. Part 1: Metadata for key data sources, version 1.0

The All-Ireland Health Data Inventory. Part 1 is a catalogue of key sources of health data in the Republic and Northern Ireland. It includes relevant datasets from the major information reviews, conducted in the North and South, in the past few years. Information is essential for informed decision making and service provision. This inventory draws together information sources to facilitate such decision making. The inventory is intended as a resource for health professionals, researchers and the general public, providing the first phase of a ‘one-stop’ catalogue of health data. The datasets have been catalogued using an expanding numbering system which will allow for the inclusion of future resources. The Institute of Public Health in Ireland is in the process of expanding the Inventory to include further data sources.

Screening for health impacts in Local Area Planning in Donegal County Council (2004)

In 2004 an interagency team consisting of members the North Western Health Board and Donegal County Council commissioned the IPH to conduct a HIA screening exercise on planning policy in Donegal. This involved an overview of literature, analysis of policy documents, contact with Planning Officers and observation of public consultation meetings. Following completion of the final report, the intention is to produce a user-friendly template to enable planners to incorporate a health dimension into their decision making.

Ireland and Northern Ireland's Population Health Observatory (INIsPHO)

Ireland and Northern Ireland's Population Health Observatory (INIsPHO) is housed in  The Institute of Public Health in Ireland (IPH) and is part of the Association of Public Health Observatories (APHO). The Observatory supports those working to improve health and reduce health inequalities by producing, disseminating and supporting the use of relevant health knowledge and strengthening the research and information infrastructure on the island of Ireland.

DETERMINE Working Document #1 'Policies and actions addressing the social determinants of health inequalities: examples of activity at EU member state level in Europe'

The Institute of Public Health in Ireland (IPH) is a partner in the European project DETERMINE, building on its previous involvement in the Closing the Gap project in 2004-2006. In the first year of the project (2007-2008) 15 DETERMINE partners identified policies and actions that have taken place within countries, and at the EU level, to address Social Determinants of Health Inequalities. These policies and actions were identified via a questionnaire, which also identified structures and tools/mechanisms being used in the country to support a 'health in all policy' approach.

Public Health in Europe - The Irish Connection

This background paper details the work undertaken by the Institute to explore the potential for international collaboration in order to contribute to public health development in Ireland. It makes specific reference to the European Commission's proposal for a new programme of community action in the field of public health for 2001-2006.

Food Security on the island of Ireland: are we sleep walking into a crisis?

IPH has developed a discussion paper on food security on the island. This makes the case that health is and needs to be central to food and agricultural policy. Population health, food systems and agricultural production are intimately linked.  A clear framework on food security is needed in both parts of the island of Ireland and this offers a key opportunity for cooperation. This article has been published in the latest edition of The Journal of Cross Border Studies in Ireland - No 6 launched on 8 March 2011.