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The Royal College of Psychiatrists Improving the lives of people with mental illness

Northern Ireland CPD Blog

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23/06/2016 11:04:55

Upcoming Talk

Aligning Priorities: Personalising medicine in the Treatment of Depression in Primary Care

Dr Paul Barr, Assistant Prof of Health Policy & Clinical Practice

Dartmouth Institute for Health Policy & Clinical Practice, USA

Wednesday 29th June at 1-2pm

Ground floor Seminar Room, ICSA, RVH site

 

 

Paul is an Assistant Professor in The Dartmouth Institute for Health Policy & Clinical Practice (TDI) and a recent recipient of the Gordon and Betty Moore Foundation Early Career Investigator Award. He received his PhD in Health Services Research at QUB

 

Paul’s interests involve developing and implementing minimally disruptive, scalable solutions to increase patient and family engagement in decision making and care management, with a focus on primary care and mental health. Paul's recent work includes the development, psychometric analysis and implementation of CollaboRATE, a 3-item patient reported measure of shared decision making, opportunities and challenges involved in sharing audio recordings of clinical encounters with patients and the development of one page decision aid to guide treatment decision making for individuals with depression. 

 

In this presentation Paul will present his research to date in the field of depression care, reporting findings from national survey of individuals with depression and clinicians who treat depression, uncovering the information that matters most to these two populations when deciding on a treatment for depression and the recent development and testing of a decision aid to improve patient engagement in their care. 

 

 

09/06/2016 14:06:19

New Research Group

 

As a part of the reorganisation of Queens University a number of new research groups have been established. Dr O'Neill and Dr Mulholland are members of the Centre for Evidence and Social Innovation. This new centre will provide a focus for mental health research across medicine, sociology, psychology and other disciplines at Queens University Belfast. We will use this blog site to inform you of any upcoming events around the launch of the new centre. It's worthwhile keeping an eye on the QUB website as well as there may be events which could be useful for CPD.

 

Dr Tony O'Neill

Chair, RCPsychNI CPD Committee

 

 

31/05/2016 10:33:13

Spring Meeting

Friday 13th could be considered unlucky by some, but for those of us fortunate enough to attend the RCPsych in NI Spring Meeting at Clifton House on Friday 13th May 2016, a number of interesting presentations and thought-provoking topics were on the cards.

The day began with a talk from Professor Max Marshall, Medical Director of Lancashire Care NHS Foundation Trust, on the benefits of mental health trusts. 

Lancashire Care NHS Trust was formed in 2006, as local mental health services within Lancashire joined together to form one single mental health Trust, and gained Foundation status in 2007. The Trust currently provides services to a population of around 1.4 million people, has 7000 employees and sees 460,000 patients per year. 

Professor Marshall outlined his views on the potential benefits of dedicated mental health trusts: the attraction, retention and development of best staff and leaders, greater influence in the health economy, improved efficiency through economies of scale, availability of capital and the ability to support specialist services and research.

Next up was Dr Jon Wilson, Consultant Psychiatrist from Norfolk and Suffolk NHS Foundation Trust, gave an interesting talk on a novel youth mental health service in Norfolk, where 0-25 year olds make up approximately 1/3 of the local population. It was noted by services there that difficulties existed surrounding patients transitioning from Child and Adolescent Mental Health Services to Adult Mental Health Services. A youth service was piloted on three sites for 12 months, providing services to 14-25 year olds and following the success of this pilot, the Norfolk Youth Mental Health Service was developed.

After lunch Professor Steven Cooper updated us on the British Association for Psychopharmacology Guidelines on the management of weight gain, metabolic disturbances and cardiovascular risk associated with psychosis and antipsychotic drug treatment. This was particularly relevant as life expectancy in people with psychosis is reduced by up to 20 years compared with that of the general population.

Professor Cooper summarised key recommendations including on lifestyle interventions, switching to antipsychotic agents known to be less likely to cause weight gain and possible adjunctive treatment with metformin after lifestyle interventions have been ineffective.

Professor Gerry Leavey then gave a talk on ‘Understanding Suicide and Help-Seeking in Urban and Rural Areas in Northern Ireland’. Overall there was no significant difference between urban and rural suicide rates. In depth individual interviews were conducted with family members bereaved by suicide and also with GPs.

Stigma associated with mental health problems was highlighted, as well as the reluctance by some patients to accept a mental health diagnosis. Other factors identified by GPs as barriers to care were long waiting lists, bureaucracy and difficulties in making direct contact with psychiatric services.

Dr Katy Connelly, ST5, followed with a summary of findings from the ‘GAIN Regional Audit of Assessments for Admission under the Mental Health NI Order 1986’. This audit found that there were some delays in relation to bed availability and conveyance of patients to hospital.  The main recommendation arising was the development of regional interface groups.

Dr Gavin Lavery, Clinical Director of the HSC Safety Forum, addressed the question ‘How do we improve quality of care?’. Dr Lavery described the process of quality improvement as ‘making what is possible, actual’ and encouraged attendance at the Mental Health Collaborative.

The meeting came to a close with the RCPsych in NI Annual General Meeting.

Overall I found the day fascinating, covering a wealth of diverse but overlapping subjects, ranging from the development of new resources and the novel use of existing services to updates on current guidelines and quality improvement.

A well-run event, which I wouldn’t hesitate to recommend to any colleagues in the future!

Dr Joy Patterson

ST4 Psychiatry

 

 

04/04/2016 15:49:07

Peer Reviewing for Psychiatric Journals

 

Royal College of Psychiatrists

Introduction to Peer Reviewing for Psychiatric Journals

Wednesday 4 May 2016

RCPsych, 21 Prescot Street, London, E1 8BB

 

BOOK ONLINE

 

Course fee:£125 | 5CPD points

 

One month left to book your place on our popular Introduction to Peer Reviewing for Psychiatric Journals course.

 

This will be an interactive workshop. It will consist of a brief introduction to peer reviewing in a single lecture format. Groups of 4-6 will be formed and an experienced reviewer will guide the group. During the initial sessions they will be “walked” slowly through a review of a simple paper. This will be followed by research of increasing levels of complexity. Reviewing different types of paper such as original research, reviews etc. will also be touched upon. Each tutor will be a recognised name in psychiatry in order to ensure that the highest standards of reviewing are presented.

Further info>>

 

Learning objectives

1.       To feel confident making a decision whether to accept or decline an invitation to peer review

2.       To understand the bounds of professionalism in relation to: confidentiality, constructive criticism, and  appropriate time scales within which to review an article

3.       To appreciate the relative advantages and disadvantages of blind versus open peer review

4.       To feel confident in one's approach to the peer review of original research, audit, narrative and/or systematic reviews, and editorials.

5.       To appreciate the importance of delimiting the extent of one's expertise in relation to key components of the manuscript (for example, statistical analysis)

 

 

 

 

04/04/2016 15:14:46

Global Health Symposium

 

Inaugural QUB Global Health Symposium

Friday 22 April 2016

International speakers from policy and academic sectors

Hosted by the Centre for Public Health, Queen's University Belfast

Held at Riddel Hall, Belfast

To register your interest please email cph@qub.ac.uk

 

Global Health - "The area of study, research and practice that places a priority on improving health and achieving equity in health of all people worldwide"

 

 

 

 

 

29/03/2016 10:05:51

Functional Neurological Disorders Conference 2016

 

Friday 11 March 2016 saw the Wellington Park Hotel, Belfast host the first interdisciplinary conference held in Northern Ireland on functional neurological disorders.  It was very well attended, attracting over 140 delegates from a broad range of specialties including physiotherapy, neurology, psychology, psychiatry, occupational therapy and general medicine.

 

Mr Andrew Dawson of the Department of Health, Social Services and Public Safety, kicked off proceedings discussing the importance of the conference, highlighting the need to continue to raise awareness and reducing the stigma still prevalent in mental health.

 

Breaking down stigma has been a goal of the functional disorder service led by Dr Jon Stone, Consultant Neurologist at the West General Hospital in Edinburgh.  In his talk he highlighted that functional/psychological presentations are the second most common reason to see a neurologist.  Interestingly, data he presented reflect that functional symptoms are just as disabling but more distressing than those due to ‘organic’ illness.  

 

Potentially stigmatising dogmas aren’t limited to the public, they’re endemic in our professional fields and a number of these were highlighted.  Rather than a diagnosis of exclusion, Dr Stone argued that we should be making the diagnosis of functional neurological disorders on positive grounds, identifying positive signs and sharing them with patients.  In other words, telling them what it is rather than what it isn’t.  As both Dr Stone and Dr Alan Carson, Consultant Neuropsychiatrist and Lead Clinician at the Royal Edinburgh Hospital, demonstrated in their talks, Hoover’s Sign is an example of a positive sign that can be easily elicited and explained to the patient. 

 

Effective explanation in itself is a vital part of management, with speaker Mr Glenn Nielsen, Clinical Doctoral Research Fellow and Physiotherapist at the UCL Institute of Neurology, characterising it as “probably the most important part of my treatment”.  In pursuit of this, http://www.neurosymptoms.org/ is an indispensable free self-help website developed by Dr Stone that explains functional and dissociative symptoms for patients, also useful for healthcare professionals.  

 

The mythology surrounding functional disorders was further scrutinised.  As Dr Carson put it, “repressed psychic conflict doesn’t explain why functional symptoms develop”.  Some may have identifiable psychological triggers, however as Dr Stone explained, patients without comorbid psychological illness can develop functional disorders, and that triggers can also be physical, for example migraines or minor injuries.  Patients may become “stuck” with this trigger and it can assume some characteristics of a habit.  And further eroding the functional/organic divide, he highlighted evidence to suggest hypoactivity in the right temporoparietal junction in some with functional disorders, an area known to be involved in the sense of agency.  Dr Carson also relayed data that indicates increased amygdalal hyperactivity in patients with conversion disorder, as well as abnormal connectivity between the amygdala and the prefrontal cortex.

 

In his presentation on physical rehabilitation for functional motor symptoms, Mr Nielsen provided a valuable opportunity for the audience to see on video multiple depictions of functional motor disorders as well as providing insight on the subtle cues that can guide diagnosis.  As he highlighted, a significant body of evidence suggests that physiotherapy is a central component of, and many experts consider it first-line to, managing functional motor disorders.  Developing strategies that normalise and retrain movement is key.  Fundamental to the approach is to acknowledge that symptoms are real and moreover not under the patient’s control.

 

Dr Jason Price, Consultant Clinical Neuropsychologist at the James Cook University Hospital in Middlesbrough, presented a variety of models that could be used to conceptualise functional disorders, encompassing possible mechanisms underlying them including neurological, psychodynamic, emotional regulation and sensory processing.  Dr Carson and Dr Price also provided a very interesting account of a Bayesian model for functional motor and sensory symptoms.  On a basic level, it attempts to account for symptom induction, modification and their involuntary nature by exploring the relationship between areas including beliefs, experiences and expectation.

 

Dr Price argued that services for these disorders need to be embedded into medical pathways as patients tend to dislike being referred to mental health services.  In his talk on clinical service models, Dr Phil Yates, Consultant Clinical Psychologist and Neuropsychologist at the Devon NHS Trust, presented a pioneering example of such a service in Devon where an integrated service model has demonstrated a positive outcome for patients.  Moreover, access to an integrated non-epileptic attack disorder service has been shown to reduce hospital admission rates to neurology.

 

While there isn’t an integrated functional neurological disorder service in Northern Ireland (at least yet), there is a service user special interest group and in the final session of the day, we heard accounts from patients themselves describing their own experience with functional disorders and the sometimes tortuous journey to diagnosis.  The following are some sobering quotes:

 

“Tests were helpful, negative results were fantastic but I was still left not knowing what I had”

 

“When I was told that there was no neurological condition and that it was to do with my mood…this told me nothing…I was really scared”

 

“The printed info I got were from a non-Trust website…it made me feel my condition isn’t important…I felt like a pariah”

 

[Regarding referral to psychology and psychiatry]

“I was annoyed…I felt I was mad”

 

“When I finally got told this is a condition…that this is what I had…I felt I was actually listened to”

 

“I want the respect, dignity and the same care as other patients”

 

As Dr Stone emphasised, we should try to avoid thinking of functional disorders as falling within either the realm of psychiatry or neurology.  These disorders arguably expose the arbitrariness of the neurology/psychiatry uncoupling.  An increased understanding of this group of illnesses could further bridge this divide.

 

 

Dr Ajwad Mobayed

Psychiatry Registrar

 

29/02/2016 12:10:13

Centre of Excellence NI

 

The Centre of Excellence for Public Health Northern Ireland

 

                                                                Seminar Series

                                                 Invites you to attend a Lecture by

 

Professor Jody Sindelar

                              Institute of Social and Policy Studies, Yale University

 

"Good Solutions to Bad Behaviour: How to improve Health Habits"

 

Professor Jody Sindelar is a Yale professor and health economist. At Yale she also has appointments at the School of Public Health, Department of Health Policy and Management, Institution for Social and Policy Studies (ISPS), Medical School and Economics Department.

Her research and policy expertise include the economics of addictions- tobacco, alcohol, illicit drugs and over-eating and obesity. More recent approaches use behavioural economics to design interventions to mitigate harms associated with addictions. Methods used range from econometric analysis of large datasets to field studies to online experiments.

 

4.00pm on Thursday 24th March 2016

Canada Room/Council Chambers, Lanyon Building, QUB

Everyone welcome

Tea/Coffee will be provided

If you plan to attend please register your intent with coe@qub.ac.uk

 

 

01/02/2016 09:07:17

MedFest 2016

 

MEDFEST: FRAMING TRAUMA – CONFLICT AND MEDICINE

 

WEDNESDAY 17th FEB 2016 

Reception from 14:30 

Event 15:00 - 17:00

Queens Film Theatre, 20 University Square, Belfast

 

Medfest is a medically themed film festival run by UK Psychiatry trainees. It aims to increase interest in Psychiatry and to inspire others through the use of film. Each Spring, Medfest screens short films and film extracts to audiences across the UK, and is now established as an internationally recognised event with forty-six events held globally last year.

 

This year's event considers the depiction of conflict-related trauma in film and its relationship with healthcare and medicine. Since WW2 psychiatrists and mental health practitioners have become increasingly aware of the emotional consequences of war, consequences that can be long-­lasting, difficult to treat, and inter-generational.

 

A select panel of experts will guide discussion of the film clips shown and encourage audience opportunity to reflect on the impact of conflict in a variety of contexts on both physical and mental well-­being together with the role of both medicine and mental health care in these situations.

 

Excerpts will include: Declan Keeney's Theatre of Witness production ‘We Carried Your Secrets’; the Academy Award nominated documentary ‘The Act of Killing’ (Joshua Oppenheimer); Laurent Becue-Renard's critically acclaimed 'Of Men and War'; and Jan Haaken's 'Mind Zone: Therapists Behind the Front Lines'. 

 

Sir Simon Wessely (President of the Royal College of Psychiatrists) will join a group of panelists to discuss some of the issues provoked by these films.

 

For more information see Medfest

or contact medfest2016@gmail.com

QUB What's On Guide (p.13)
Facebook Page

 

 

15/01/2016 10:38:20

Medicine, Health and Welfare

 

The Institutions and Ireland series of workshops take a look at 'Medicine, Health and Welfare' - further details below:

 

  

Trinity College Dublin and Making Ireland present the first of three 

interdisciplinary workshops in the Institutions & Ireland series

 

Medicine, Health, and Welfare

Friday, 5 February 2016

Trinity Long Room Hub, Arts & Humanities Research Institute

 

Keynote Speaker: Dr Rhona Mahony, Master, National Maternity Hospital

 

The first in this series of interdisciplinary workshops will investigate the role of the institutions of medicine, health, and welfare in “making” Ireland. Four interdisciplinary panels of medical practitioners, historians, sociologists, and literary scholars will discuss the role of institutions in Ireland, past and present. Panels include architecture of the state, patient care, gender and sexuality, and childbirth.

 

To register for the event please click here.

All welcome, admission is free.

 

 

 

 

07/01/2016 10:30:46

Therapy Wars

Interesting psychology article from The Guardian discussing CBT and psychoanalysis:

Therapy wars: the revenge of Freud

"Cheap and effective, CBT became the dominant form of therapy, consigning Freud to psychology’s dingy basement. But new studies have cast doubt on its supremacy – and shown dramatic results for psychoanalysis. Is it time to get back on the couch?"

 

Please feel free to leave a comment on the article below.

 

Dr Tony O'Neill

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