Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 31
Filter
1.
Ir J Psychol Med ; : 1-12, 2022 Oct 26.
Article in English | MEDLINE | ID: covidwho-2087072

ABSTRACT

Referrals to Child and Adolescent Mental Health Services (CAMHS) have increased in recent years. Services are already under-resourced and the adverse psychological impact of Covid-19 is likely to increase demand. Accordingly, an understanding of prevalence of mental health (MH) disorders among youth is imperative to help inform and plan services. AIM: To establish prevalence of MH disorders among youth (under 18) in Ireland. METHOD: A systematic review using pre-defined search terms in PubMed, PsycInfo, Embase and CINAHL was conducted. Empirical studies conducted in Ireland, in youth and focusing on MH disorders were included. RESULTS: From a total of 830 papers identified, 38 papers met inclusion criteria. Significant variation in rates of MH disorders was evident based on study methodology. Screening questionnaires for general psychopathology reported rates of 4.8-17.8% scoring above clinical cut-offs, with higher rates for ADHD (7.3%). Studies examining depression ranged from 4% to 20.8%, while rates for 'current' MH disorder, determined by semi-structured interview, were 15.5%, while 'lifetime' rates varied from 19.9% to 31.2%. Fewer than half (44%) of those identified as 'in need' of specialist MH services were accessing CAMHS. CONCLUSION: Data on MH disorders among Irish youth is limited, and studies showed significant variance in rates, making service planning difficult. There is an urgent need for serial epidemiological surveys, with clear operational criteria for clinically impairing MH difficulties. Such studies are essential to understand potential demand and service planning. This is most urgent given the expected increased demand post Covid-19.

2.
Ir Med J ; 115(8): 653, 2022 Sep 15.
Article in English | MEDLINE | ID: covidwho-2083474

ABSTRACT

Aim Explore the impact of COVID-19 on numbers and clinical profile of Eating Disorder (ED) presentations to a specialist ED program pre- and during COVID-19. Methods Retrospective chart review of referrals pre- COVID-19 (January 2018 - February 2020) and during COVID-19 (March 2020 - August 2021) were compared. Results 128 youth were assessed with significantly higher rates of referrals each month during COVID-19 compared to pre- COVID-19 (3.78 vs. 2.31, p = 0.02). Youth referred during COVID-19 showed a higher rate of % Ideal Body Weight (IBW) loss (4.8% = vs. 2.6%, p = < 0.001) and had a shorter duration of illness pre-referral (4.8 months vs. 7.4 months, p = 0.001). Fewer youth during COVID- 19 (19% vs. 43%, p = 0.011) were prescribed psychotropic medication. Many youth (80%), self-declared COVID-19 as a contributory factor in the development of their ED. Conclusion This study supports the growing consensus of a COVID-19 specific impact on ED services with higher rates of referrals, youth presenting with a faster pace of weight loss and earlier referral to specialist services. Whether this represents a true increase in EDs or an overall increase in CAMHS referrals with a faster transfer to ED services requires further exploration.


Subject(s)
COVID-19 , Feeding and Eating Disorders , Child , Adolescent , Humans , Retrospective Studies , Feeding and Eating Disorders/epidemiology , Referral and Consultation , Weight Loss
3.
Ir J Psychol Med ; : 1-5, 2022 Aug 08.
Article in English | MEDLINE | ID: covidwho-1984326

ABSTRACT

Since the emergence of the COVID-19 pandemic, there has been increased interest in identifying ways of protecting the mental well-being of healthcare workers (HCWs). Much of this has been directed towards promoting and enhancing the resilience of those deemed as frontline workers. Based on a review of the extant literature, this paper seeks to problematise aspects of how 'frontline work' and 'resilience' are currently conceptualised. Firstly, frontline work is arbitrarily defined and often narrowly focused on acute, hospital-based settings, leading to the needs of HCWs in other sectors of the healthcare system being overlooked. Secondly, dominant narratives are often underpinned by a reductionist understanding of the concept of resilience, whereby solutions are built around addressing the perceived deficiencies of (frontline) HCWs rather than the structural antecedents of distress. The paper concludes by considering what interventions are appropriate to minimise the risk of burnout across all sectors of the healthcare system in a post-pandemic environment.

4.
Irish Journal of Medical Science ; 191(SUPPL 1):S30, 2022.
Article in English | EMBASE | ID: covidwho-1866672

ABSTRACT

Mental illness in young people is a growing concern, with an estimated 10-20% of adolescents suffering from mental illness worldwide.1 In Ireland, referrals to CAMHS (Child and Adolescent Mental Health Services) have increased by 26% in recent years.2 These services are already under-resourced leading to long waiting lists. The adverse psychological impact of Covid-19 has disproportionately affected youth and is likely to result in increased demand for CAMHS. Given these circumstances, an understanding of pre-Covid-19 prevalence of mental illness among youth in Ireland is imperative to help inform & plan services. The aim of this research is to report on prevalence of mental illness in youth (aged 0-18) in Ireland. A systematic review using pre-defined search terms in PubMed, PsycInfo, Embase and CINAHL was conducted. Studies included youth population health empirical studies conducted in Ireland, focusing on mental illness. From a total of 624 papers identified, 43 papers were selected by Title/ selection, and 38 following full paper review. 2 nationally representative studies (Growing Up in Ireland & My World Survey) identified 10-15% to be 'at risk' by one-stage screening. A two-stage study (Challenging Times) reported rates of 'any' mental health disorder in 15% of adolescents, with other studies reporting on specific disorders. Although data on mental illness among Irish youth is limited, available data of illness and risk suggest rates similar to international levels. Attention needs to be given post Covid-19 to regular reliable data collection, and dedicated CAMHS funding to allow best use of a scarce resource.

5.
Irish Journal of Medical Science ; 191(SUPPL 1):S12, 2022.
Article in English | EMBASE | ID: covidwho-1866663

ABSTRACT

Clinicians have noticed a significant increase in cases of youth with an eating disorder (ED) presenting since the beginning of the COVID-19 lockdown, with younger cases attending and presenting with atypical features. The overall aim of the study is to explore the effect of COVID-19 on presentations to an eating disorder team in a child and adolescent mental health service (CAMHS) setting. A retrospective chart review was completed of all initial multidisciplinary assessment notes of patients with ED referred to a CAMHS specialist ED service between 1st January 2018 and May 31st 2021. Data was compared over the study time periods pre-COVID and during- COVID. When comparing the pre-COVID cohort to the during-COVID cohort, there was a greater proportion of autism spectrum disorder (ASD) and other ED diagnoses than anorexia nervosa (AN) in the during-COVID cohort. Mention was made of COVID having had a significant negative effect on the young person in 80% of cases presenting during COVID. The mean duration of weight loss was 7.4 months pre-COVID and 4.4 months during-COVID (P value: <.001). The effects of lockdown restrictions during the pandemic have triggered EDs in some young people. Youth with EDs referred to specialist ED services during the COVID-19 pandemic exhibit a shorter duration of weight loss and are more likely to receive an ED diagnosis other than AN. Further research is required to better understand the effects of the COVID-19 pandemic on ED illness on a sample representative of youth with ED.

6.
Int Rev Psychiatry ; 34(2): 128-139, 2022 02 17.
Article in English | MEDLINE | ID: covidwho-1860625

ABSTRACT

Increases in youth psychiatric presentations to out-patient and emergency department settings during COVID-19 have been reported. This study, using data from five hospitals in Ireland, examines changes in the number and type of paediatric admissions during COVID-19 (March 2020 - February 2021) compared to the previous two years. ICD-10 classification was used to establish admissions with mental, behavioural, neuro-developmental disorders and psychosocial reasons (MBN-PS). Overall hospital admissions fell by 25.3%, while MBN-PS fell by only 2.6%, mostly during an initial lockdown. Admissions for MBN-PS increased in July-August (9.2%), increased further in September-December (28.3%), returning to pre-COVID-19 levels in January-February 2021. Significant increases were observed among youths with anorexia nervosa (47.8%), other eating disorders (42.9%), and admissions for anxiety (29.6%), with these effects relating to females only. Although admissions for self-harm increased (3%) and rates of ASD admissions reduced (17%), these were not statistically significant. The disproportionate increase in admissions for MBN-PS compared to medical admissions suggests an adverse effect of COVID-19 on youth mental health, for females in particular, and supports previous reports of a pandemic specific increase in eating psychopathology. Combined community and acute service delivery and capacity planning are urgently needed given the prior underfunding of services pre-pandemic.


Subject(s)
COVID-19 , Adolescent , COVID-19/epidemiology , Child , Communicable Disease Control , Female , Hospitals, Pediatric , Humans , Pandemics , Patient Admission
7.
Ir J Psychol Med ; : 1-7, 2022 Apr 11.
Article in English | MEDLINE | ID: covidwho-1783883

ABSTRACT

BACKGROUND: Previous literature has highlighted high rates of burnout among doctors and nurses in healthcare settings. Non-clinical and support staff such as administrative, housekeeping and managerial staff are also exposed to the stressors of a health care setting, but fewer studies report on their experiences. Therefore, the aim of this research is to examine occupational stress in all staff working in Child and Adolescent Mental Health Services (CAMHS) in Ireland and identify risk and protective factors. METHOD: Fifty-nine clinical and non-clinical staff (44% response rate) were surveyed. Participants completed the Copenhagen Burnout Inventory (CBI) and the Effort Reward Imbalance scale, as well as survey-specific questions. RESULTS: Both clinical and non-clinical staff were found to experience moderate or high rates of work-related, personal and patient-related burnout (57.6%, 52.2% and 50.8%, respectively). Univariate general linear modelling showed an association between total CBI scores and effort reward index (B = 64 306, t = 3.430, p = 0.001); overcommitment (B = 1.963, t = 3.061, p = 0.003); and an unwillingness to work in CAMHS (B = 28.429, t = 3.247, p = 0.002). CONCLUSION: Pre-pandemic levels of stress were high among clinical and non-clinical staff surveyed. Given the anticipated increased demand on CAMHS post COVID-19, urgent action is needed to protect all staff from intolerable levels of occupational stress and burnout.

8.
Irish Medical Journal ; 115(1), 2022.
Article in English | EMBASE | ID: covidwho-1717262

ABSTRACT

Despite low rates of Covid-19 infection and mortality, children and adolescents have experienced disproportionate restrictions on their personal, social and academic life. Among youth in Ireland, reports of increased attendances by primary care counselling services have been mirrored by increased presentations to emergency departments and specialist mental health services, most notably self-harm and eating disorders. Following an immediate post lock down reduction, emergency department presentations by children for acute mental health care and referrals to child and adolescent mental health services (CAMHS) showed a sustained increase throughout 2020. Urgent action is needed to invest in CAMHS post pandemic to prevent any further increase in psychiatric illness among youth. We all share this collective responsibility to insist of government commitment to our youth.

9.
Ir J Psychol Med ; : 1-13, 2021 Apr 29.
Article in English | MEDLINE | ID: covidwho-1461927

ABSTRACT

OBJECTIVES: The novel coronavirus 2019 (COVID-19) has spread worldwide threatening human health. To reduce transmission, a 'lockdown' was introduced in Ireland between March and May 2020. The aim of this study is to capture the experiences of consultant psychiatrists during lockdown and their perception of it's impact on mental health services. METHODS: A questionnaire designed by the Royal College of Psychiatrists was adapted and circulated to consultant members of the College of Psychiatrists of Ireland following the easing of restrictions. The questionnaire assessed the perceived impact on referral rates, mental health act provision, availability of information technology (IT), consultant well-being and availability of personal protective equipment (PPE). Thematic analysis was employed to analyse free-text sections. RESULTS: Response rate was 32% (n = 197/623). Consultants reported an initial decrease/significant decrease in referrals in the first month of lockdown (68%, n = 95/140) followed by an increase/significant increase in the second month for both new (83%, n = 100/137) and previously attending patients (65%, n = 88/136). Social isolation and reduced face-to-face mental health supports were among the main reasons identified. The needs of children and older adults were highlighted. Most consultants (76%, n = 98/129) felt their working day was affected and their well-being reduced (52%, n = 61/119). The majority felt IT equipment availability was inadequate (67%, n = 88/132). Main themes identified from free-text sections were service management, relationship between patients and healthcare service and effects on consultants' lives. CONCLUSIONS: The COVID-19 pandemic has placed increased pressure on service provision and consultant wellness. This further supports the longstanding need to increase mental health service investment.

10.
Irish Journal of Medical Science ; 190(SUPPL 4):S143-S143, 2021.
Article in English | Web of Science | ID: covidwho-1407695
11.
Irish Journal of Medical Science ; 190(SUPPL 4):S143-S143, 2021.
Article in English | Web of Science | ID: covidwho-1407693
12.
Irish Journal of Medical Science ; 190(SUPPL 4):S144-S145, 2021.
Article in English | Web of Science | ID: covidwho-1407692
13.
Irish Journal of Medical Science ; 190(SUPPL 4):S152-S152, 2021.
Article in English | Web of Science | ID: covidwho-1407691
14.
Irish Journal of Medical Science ; 190(SUPPL 4):S151-S152, 2021.
Article in English | Web of Science | ID: covidwho-1407687
16.
Irish Journal of Medical Science ; 190(SUPPL 4):S145-S145, 2021.
Article in English | Web of Science | ID: covidwho-1407685
17.
J Eat Disord ; 9(1): 96, 2021 Aug 09.
Article in English | MEDLINE | ID: covidwho-1350156

ABSTRACT

BACKGROUND: Childhood-onset Anorexia Nervosa (AN) is recognised to be atypical in presentation, both in terms of extent and nature of eating pathology, exercise and compensatory behaviours with many falling short of full diagnostic criteria. Failure to consider an eating disorder diagnosis in youth who present with extreme weight loss may have serious immediate and long term implications. However, failure to consider other non-organic causes of weight loss may be equally detrimental to the child's health. CASE PRESENTATION: This case reports on the acute presentation of a 12-year old boy, who presented to hospital in a severely malnourished state eight weeks into lockdown. To compensate for Covid-19 induced restrictions on sporting activity, this boy had followed a self-imposed daily schedule of arduous exercise, without increasing his nutritional intake. This report examines the clinical features suggestive of AN and other differential diagnosis. A discussion on the specific diagnostic differential of exercise addiction and challenges faced by youth during Covid-19 restrictions are presented. CONCLUSION: Accepting that AN may present atypically in pre-pubertal youth, it is important that clinicians maintain an open mind in youth presenting without goal directed weight loss. Although weight loss was significant in this case, it was due to an excessive exercise regime. This may have commenced as a coping strategy in response to Covid-19 restrictions but subsequently became excessive and impairing in nature. The collateral damage of Covid-19 mandated restrictions, aimed at containing the spread of the virus, are evident in this case. Clinicians need to be alert to potentially maladaptive coping strategies and unusual or altered pathways of presentation, especially in younger children during these challenging times.

18.
Irish Medical Journal ; 114(5), 2021.
Article in English | EMBASE | ID: covidwho-1332741

ABSTRACT

Aims To determine changes in mental health (MH) attendance at Emergency Departments (ED) by children aged five to 15 during the COVID-19 pandemic. Methods Analysis of MH presentations during the first year of the pandemic compared with prior year for three public paediatric EDs serving the greater Dublin area with a paediatric population of 430,000. Results Overall, ED attendance during the 12 months to 28th February 2021 was 34.3% below prior year, while MH presentations were 8.9% above prior year. MH attendances initially decreased by 26.8% (2020: 303;2019: 414) during the first four months of the pandemic (March to June), lower than the corresponding decrease of 47.9% for presentations for any reason (2020: 11,530;2019: 22,128). However, MH presentations increased by 52.4% in July and August (2020: 218;2019: 143), and by 45.6% in September to December (2020: 552;2019: 379), dropping 28.1% below prior year in January (2021: 87;2020: 121) before returning to prior year levels in February 2021 (2021: 107;2020: 106). Conclusion Following the initial COVID-19 lockdown, ED presentations by children for acute MH care increased significantly over prior year, with this increase sustained throughout 2020. Long-term stressors linked to the pandemic may be leading to chronic MH problems, warranting increased funding of MH services as part of the response to COVID-19.

19.
Irish Medical Journal ; 114(1):1-7, 2021.
Article in English | EMBASE | ID: covidwho-1158703

ABSTRACT

Aims To explore the feasibility and identify the perceived barriers and enablers of developing an ECHO programme for CAMHs in Ireland. Methods The study adopted a qualitative research design incorporating a CAMHS:ECHO seminar and workshops with (N=29) healthcare professionals working in primary care/ mental health services. Participant consent was received, and thematic analysis conducted on rapporteur notes. Results Clinicians reported a high-level of interest in the project. Perceived opportunities included potential reduction in CAMHS waiting lists, opportunity for shared care of ADHD, improved time management, clinical skills, and access to advice on referrals. Perceived challenges included the issue of clinical governance, increased GP workload and the issue of incentives. Conclusion Barriers to successful rollout of an ECHO model in CAMHS were outweighed by perceived benefits and enablers identified by participants. Given the increased use and acceptability of telepsychiatry during COVID-19, coupled with the positive support offered by attendees, consideration should be given to more formally piloting CAMHS:ECHO.

20.
Ir J Psychol Med ; : 1-12, 2021 Mar 24.
Article in English | MEDLINE | ID: covidwho-1147814

ABSTRACT

OBJECTIVES: Increasing numbers of youth experience mental illness, and also require and benefit from specialist child and adolescent mental health services (CAMHS). Worldwide, such services are underfunded and under-resourced, and services in Ireland are no different. It is vital that existing services are regularly reviewed for both efficacy and acceptability. Our objective was to review published studies evaluating service user satisfaction with CAMHS in Ireland and CAMHS therapeutic efficacy. METHODS: MEDLINE, PsycINFO and CINAHL databases were systematically searched. Studies were included if they reported on service user satisfaction or an evaluation of CAMHS in Ireland. RESULTS: From an initial 125 articles identified, 15 studies meet the inclusion criteria: four reporting on overall CAMHS satisfaction, three on satisfaction where a specific diagnosis was present, while eight evaluated various interventions offered. Whilst most service users perceived services to be satisfactory, important issues relating to accessibility were present. Evidence of efficacy was present for a small number of interventions, but studies were limited by methodological issues. CONCLUSIONS: There is a dearth of studies evaluating CAMHS in Ireland. The extant literature suggests a positive experience once accessed, but long waiting times and poor collaboration are seen to limit services users' experience. More robust methodologically sound studies are urgently required. Given the expected increased demand linked to the current COVID-19 pandemic, coupled with the resultant compromised financial position, it is essential that scant resources are appropriately directed.

SELECTION OF CITATIONS
SEARCH DETAIL