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

Northern Ireland monthly update

 

Latest Monthly Report 

March 2018

 

CH

(Clifton House brighter evenings……with thanks to Dr Joe Kane)

2 March: Belfast Live gave further coverage to Chair, Dr Gerry Lynch and his comments on Mental Health underfunding in Northern Ireland, as well as to the February Westminster lobbying trip.

2 March: Dr Deirdre Shields, our Chair of Old Age Psychiatry Faculty, submitted a Report from local Faculty to Central Faculty.

2 March: The Department for Communities having commissioned Walter Rader to undertake an independent review of how the Personal Independence Payment (PIP) assessment is working in Northern Ireland, the Department consequently led a Consultation for the Independent Review of the Assessment Process (NI), A Call for Evidence: Personal Independence Payment. Chair of RCPsych in NI Dr Gerry Lynch and staff met to draft response to the Call for Evidence associated with this. Input was also received from Drs Heather Mills and Paddy Moynihan derived from their experience of the particular problems associated with the assessment process for Patients with an eating disorder and with psychosis/milder common psychological/emotional problems. Our overall response was subsequently submitted on 13 March before the 16 March deadline. This had been drafted by the Chair with the assistance of Drs Paddy Moynihan and Heather Mills, as well as Mr Noel McKenna and Mr Robert Milligan (our Carer and Service User representatives) and Staff.

 

6 March: Chair and Vice Chair respectively of our Child and Adolescent Faculty, Drs Richard Wilson and Mark Rodgers attended an important and informative event showcasing the research potential and policy relevance of administrative data, entitled “Prevalence and Predictors of Antidepressant Prescribing in Northern Ireland” at The Boardroom, Ulster University at Belfast Campus, 25-51 York St, Belfast. The background to the event was as follows: The Antidepressant Social Prescribing Project (ADSoPP) is an ongoing research collaboration between Ulster University and Aware N.I., facilitated by the Administrative Data Research Centre in Northern Ireland. They were releasing their initial results and sharing these with key stakeholders. Their initial results reported on-

  • The population rates of antidepressant prescribing in Northern Ireland 2011-2015;
  • Differences in prescribing across the lifespan;
  • Variation in prescribing in urban and rural areas;
  • The association between prescribing and deprivation;
  • Physical health status and antidepressant prescribing. 

Professor Mark Shevlin Chief Investigator, led the discussion on the research findings and Tom McEneaney Head of Business Development at Aware N.I., closed the event. Afterwards Dr Rodgers commented:
The discussion on the initial results of this research was promising – the project uses existing data sets with the aim of developing a more comprehensive understanding of the socioeconomic context of antidepressant prescribing in Northern Ireland. Ultimately this potentially translational research will assist social prescribing – a way of linking people in with non-medical supports, for example, targeted intervention programmes for depression”.

 

7 March: Staff attended Annual Refresher Training in the College’s role in reviewing Job Descriptions at our Central Office in Prescot Street, London chaired by the Registrar Dr Adrian James.

7 March: Vice Chair of RCPsych in NI Dr Michael Doherty and Chair of our Liaison Faculty Dr Jo Minay attended a Mental Health Nursing Workshop organised by the Department of Health at the Pavilion, Stormont Estate, Belfast on behalf of the College. Chair for the event was Dr Ian McMaster and Deputy Chair was Rodney Morton, Deputy Chief Nursing Officer. The half day workshop had been designed for those professions/stakeholders who routinely interface with Mental Health nurses in order to seek views on identified potential key clinical roles/functions for Mental Health nurses going forward over the next decade. A key aim of the workshop, as well as considering how various disciplines/stakeholders might interface with nurses carrying out their roles, was also to inform future undergraduate/postgraduate education, training and supervision which Nurses might require in support of such changes. This is part of a wider consultation review being carried out by the Department of Health.

 

8 March: Dr Margaret du Feu attended an event organised by the Speaker of the Northern Ireland Assembly to celebrate International Women’s Day 2018 at Parliament Buildings which comprised a light supper followed by an exclusive showing of ‘Shrieking Sisters’, a play by Maggie Cronin and Carol Moore. ‘Shrieking Sisters’ tells the fascinating and lesser known story of Ulster and Irish suffragettes in the early years of the 20th century. Following the play, Radio and TV presenter Marie-Louise Muir hosted a panel debate with experts in the field of female empowerment including: Paula Bradley MLA, Chair of the Northern Ireland Assembly Women’s Caucus; the playwright and actress Maggie Cronin; leading feminist historians Dr Margaret Ward and Dr Myrtle Hill and Young Women’s Development Worker Emma Johnston. 

Stormont

 
Afterwards Dr du Feu commented:
The performance was great. Extracts were read from correspondence between and about pioneering women from all over Ireland who campaigned for the vote. Historical photos were put on a screen with music and a commentary. Many of the women were imprisoned and also force fed when on hunger strike. Grim indeed! There was a panel discussion and I had the opportunity to point out that many women in Northern Ireland still do not have equality and that equal rights should not only apply to women who can walk, hear and see; there were hard of hearing, blind and disabled women there - and I got a big ovation! The interpreters and I had the opportunity afterwards to talk with Paula Bradley MLA.”  

 

9 March: The Department for Communities commissioned independent review of how the Personal Independence Payment (PIP) assessment is working in Northern Ireland, was also the subject today of a meeting between our Service user representative Robert Milligan and Staff. Robert gave his input into the draft response to the Call for Evidence associated with this. Our Carer representative Noel McKenna contributed his views by subsequent email.

9 March: Good news for us locally is that Mr Noel McKenna, our local Carers Representative who sits on our local Executive Committee, has additionally been appointed as acting Co-Chair of the Central RCPsych Carers Committee until June 2019.

 

12 March: National Confidential Inquiry into Suicide and Homicide (NCISH), whose work is funded work through HQIP by the four UK Departments of Health to reduce suicide rates, held a meeting at the Pavilion, Stormont Estate, Belfast.  This was as part of promoting their engagement across all UK jurisdictions. Professor Louis Appleby, Professor Nav Kapur and Dr Cathryn Rodway from NCISH all came to discuss how they can best support Northern Ireland in the future, specifically what would be of most benefit/value to us in terms of our policy priorities and strategies. Representatives from DoH, Trusts and the HSCB/PHA Commissioning Team were all in attendance. Due to Dr Gerry Lynch’s unavailability to attend, the College was represented by Dr David Bell, who has provided a comprehensive reflection on the meeting.

D Bell

L-R:  Dr David Bell, Professors Louis Appleby, Nav Kapur, Dr Ian McMaster DoH, Briege Quinn PHA and Gerard Collins DoH  

Northern Trust Director of Mental Health, Oscar Donnelly also attended as well as member attendees including Drs Rick Bunn and Pat McMahon.

Professor Appleby’s analysis of the available NI data drills into the detail behind the number of suicides here so as to hopefully inform future policy and improvements across the board in this area.

 

12 March: Staff attended Extraordinary Briefing via Skype from Chief Executive on new College Proposed Values and Behaviours.

12-16 March: We joined in with the RCGP in NI sponsored #Dear Colleague campaign via social media. Tweets highlighting good interface working between primary and secondary care were sent out on a daily basis during the course of the week from the RCPsych in NI Twitter Account, with input provided by Drs Neta Chada, Julie Anderson, Richard Wilson, Scott Payne and Gerry Lynch. These featured respectively Southern Health and Social Care Trust primary care mental health liaison meeting with local GPs to iron out, discuss and flag issues; joint training work on the MRCPsych course with GPs as a way of ensuring better future working at the interface; existing Northern Health and Social Care Trust CAMHS joint working with Paediatric colleagues to inform more Child Mental Health being carried out closer to the Patient in partnership with GPs; Western Health and Social Care Trust Community Detoxification Pathway between GPs, Community Alcohol Detoxification Nurses, Damien & Ramona hostels, acute hospitals & Addictions Inpatient (Asha) Unit where necessary – award winning and the only such NI service and with Public Health Agency recommendation for its replication regionally; Causeway area Psychiatrist and Team Leaders regularly meeting with GP colleagues to discuss matters of mutual concern.

 

13 March: Staff attended a meeting at Belfast Waterfront Conference Centre to finalise logistical arrangements with Staff there for next week’s Spring Conference.

13 March: Dementia Conference Planning Meeting at Antrim Area Hospital re 17 May 2018 event at Hilton Hotel - was attended by Chair and Staff.

 

14 March: Addictions Faculty met in Clifton House chaired by new Faculty Chair Dr Billy Gregg.

 

20 March: Dr Michael Doherty met with retired members at a meeting hosted by Dr Alec Lyons. Present were Drs Sean Egan, Ron Galloway, Alec Lyons and Bill Norris who were each Chairs of the Northern Ireland Section of the Irish Division at various times during the 1980s and 1990s; Dr Lyons was a previous Chair of the Irish Division. Dr Michael Doherty reported a very enjoyable meeting with the four, for whom he had either been their Honorary Secretary of the NI Section or had worked under their supervision as a Trainee, stretching back nearly four decades! They discussed recent developments in mental health services, the role of the Psychiatrist and reflected on the past. They hope to arrange another meeting during the Summer with Dr Gerry Lynch.

Sue Bailey

21 March: College President, Professor Wendy Burn, hosted her first President’s Lecture outside of London and the venue was Riddel Hall, Stranmillis, Belfast with guest speaker, College Past President Dame Sue Bailey offering a whirlwind talk to rapturous applause at the end - on the theme of “Back to the future – on the road less travelled”. Sue stated that she was speaking partly as current Chair of the Children and Young People’s Mental Health Coalition, trying to improve the mental health of young people in the UK. The following themes were explored by Sue: Psychiatry has been the road less travelled and maybe it is time for the rest of health and medicine to listen now – hence the title. The challenge is to improve the trust and belief in children and young people’s mental health care, from the perspective of the rest of medicine. We cannot talk about mental health without talking about parity – which in itself is a road only recently travelled, with parity of esteem above all being a mindset. Human rights and values based practice should be at the heart of mental health services for children and young people. Every specialty in psychiatry should become a values based practice. Throughout our lives our mental and physical life are affected by the conditions and circumstances in which we live. The social identity approach provides better ways of seeing health. She asked whether it was time to put aside the mind/body dualism when it comes to child mental health care? Mental Health needs to collaborate with the rest of medicine. We need eccentric thinking - not to sit under the bell curve. How can we transform child healthcare by 2035? One idea offered was that dysfunctional families have a lot to teach us. Interesting too was Sue’s view of 18 year olds going from CAMHS to Adult care - as being a “lost in transition” problem which goes beyond mental health and extends to education, social care etc. Our professionals need to be ready to listen to the end user.  “What does it take to be a leader? Emotional intelligence, emotional intelligence and more emotional intelligence”. Sue enquired as to whether as health workers we are truly working in partnership with patients and populations. “The hard bit is shared decision making” - the patient can have very different aims and perspectives. As regards talking about emotional resilience to nursery school children, Sue was not keen on making it mandatory in school but thought that ways should be tried to get conversations going through health visitors. Afterwards, Sue expressed her gratitude for “the warm reception and the great hospitality” shown to her in Belfast and to Wendy “for inviting me to do this”. Central College staff supported local College staff at this event.

21 March: Dr Michael Doherty attended the UUK Task Force meeting on Student Mental Health and the interface with the Health Service.

 

22 March: Dr Michael Doherty and Chair of RCPsych in Scotland, Dr John Crichton, met with College Chief Executive Paul Rees to discuss issues around the planned devolution of councils within the College – on the fringes of the Spring Conference.

MCA

22 March: Our Spring Conference at Belfast Waterfront Hall entitled “From Theory to Practice”, took as its focus the Mental Capacity Act (NI) 2016 and attracted a record attendance of 170 delegates extending beyond our membership into the legal profession and others. We were supported also by the attendance of the President, The Registrar Dr Adrian James, Chair of RCPsych in Scotland Dr John Crichton, Drs Clem Maddock, Tony Zigmond and Julian Sheather (BMA), as well as the Chief Executive Paul Rees and a number of Central College staff. Dr Keira Walsh has provided a reflection on the day

For follow up study, available here are the Presentations AM & PM

 

Delegates

Lots of very positive feedback was received, a flavour of which is given here:
“A great two days for the College with an inspirational Presidents lecture and what feels like a landmark Conference on the implementation of the MCA 2016.”

“I left feeling enlightened & greatly empowered, not least by Tony Zigmond's positive endorsement of NI pioneering patient centred approach with this fusion legislation.”

“Many thanks for hosting such a wonderful conference last week- the hospitality and educational programme were superb.”

It was a milestone day for the MCA. Congratulations on a very successful meeting and another important milestone on the way to implementation. Thanks to your leadership the College remains the major driver for reform. And that should be obvious to DoH officials.”

“The welcome I received was fabulous. I hope the delegates thought the conference was valuable and you all thought it a success. I remain as impressed as ever with what you’re achieving.”

“It certainly was very interesting and you all did a great job of hosting!”

“Great day learning about the 2016 Act - thank you - a real trailblazer - the future of mental health law but remaining challenges of forensic disposals and fluctuating capacity – as well as Under 16s.”

 

Left to right: Drs Adrian James, Clem Maddock, Margaret du Feu, Helen Toal, Paddy Moynihan, Richard Wilson, Professor Wendy Burn, Drs Maria McGinnity and Adrian East, Bernadette Hamilton, Professor Roy McClelland, Dr Gavin Davidson, Taryn McKeen, Drs Gerry Lynch and Tony Zigmond

 

27 March: Staff attended a Dementia Conference Planning Meeting at Hilton Hotel, Templepatrick associated with the forthcoming event on 17 May 2018 being held there.

27 March: Dr Gerry Lynch and Staff met with Dr Ian McMaster at Clifton House to discuss ongoing DoH plans and developments.

27 March: Dr Peter Sloan met with Bernadette Hamilton and staff at Clifton House to plan ahead for completion of the work on an update of the GAIN (Guidelines & Audit Implementation Network) guidance to the Mental Health (NI) Order 1986, being done at the request of the Regulation and Quality Improvement Authority. 

 

28 March: Staff met with Northern Ireland Association for the Study of Psychoanalysis (NIASP) counterpart to share expertise in advance of an October 2018 event being organised by NIASP.

28 March: Perinatal Faculty Sub Group met in Clifton House to plan for their Multidisciplinary Meeting at Malone House on 13 April at which the local Faculty, chaired by Dr Julie Anderson, will also be formally launched. (In addition to Dr Julie Anderson, confirmed local speakers now include Drs Julie Anderson, Ciaran Mulholland, Janet Wilson, Jo Minay, David Mongan, Keira Walsh and Michael McMorran along with Mrs Theresa Nixon of RQIA, Shona Hamilton (Royal College of Midwives) and Una Turbitt, Assistant Director of Public Health Nursing for Children and Young People – as well as Dr Roch Cantwell, Perinatal Health Service NHS Greater Glasgow and Clyde and Professor Ian Jones, Professor of Psychiatry and Honorary Consultant Perinatal Psychiatrist at Cardiff University).

28 March: Staff participated in a College Divisions and Devolved Nations Team Meeting via Skype, which took as its focus both Patient and Carer involvement in the College (with address by Richa Kataria, Head of Membership Operations) and the new College website (with address by Sush Chivukula, South Eastern Division Coordinator).

28 March: Staff took part in Fire Training organised and hosted by our Landlord in Clifton House, Belfast Charitable Society.

 

30 March and 2 April: College was closed for Easter Holidays.

 


February 2018

 

Clifton House

Clifton House in February 2018 “Sun” taken by Dr Joe Kane

29 January – 2 February: We hosted a collaborative group comprising Drs Caroline Donnelly, Peter Sloan and Roinin McNally, together with Bernadette Hamilton representing Social Work, who met all week in Clifton House to work on an update of the GAIN (Guidelines & Audit Implementation Network) guidance to the Mental Health (NI) Order 1986 at the request of our Regulation and Quality Improvement Authority. Patrick Convery of RQIA was also involved in this work. 

SAS

2 February: We hosted the SAS & Affiliate Management Development Programme chaired by Committee Chair and Vice Chair Drs Liz Dawson and Adele Swindles (pictured front row centre and left). The theme was “Staying Well and Valuing Experience” - with invited speakers Dr Ros Ramsay (Specialist Advisor Psychiatrist Support Services) and Dr Jan Birtle (College Mentoring Lead) joining with local speakers Dr Conor Barton, Dr Emma Carroll (Consultant Clinical Psychologist) and Gill Smith (Northern Trust Quality Improvement Team member).The successful all day event in Clifton House took a very practical theme by reflecting on mental health in Doctors, resilience in medical careers, mentoring and Quality Improvement. Liz and Adele have provided a detailed reflection in our CPD Blog.

2 February: RCPsych in NI Chair Dr Gerry Lynch and Staff held a Planning meeting to consider next week’s Mental Health Vision think in.

2 February: Psychotherapy Faculty, chaired by Dr Janet Corry, held their regular meeting at Shimna.

 

5 February: We contributed to a Press Release issued today by Aware to mark Children’s Mental Health Week running from 5-11 February 2018, with the theme this year of “being ourselves”, which is all about celebrating our uniqueness and thereby promoting a positive self-image.

5 February: RCPsych Insight magazine 3rd edition Winter 2018 launched with quote from Dr Gerry Lynch on page 3 referencing his pending trip to Westminster on 20 February. Dr Lynch said: “It is imperative that mental health policy and service development doesn’t stagnate in the absence of a devolved administration. Given the underfunding of mental health care in Northern Ireland, new policies and reforms must be driven forward.”

5-7 February: Dr Maggie McGurgan, as Chair of our Public Engagement Committee, commented on Children’s Mental Health Week (running from 5-11 February), good mental health and awareness issues as part of our collaborative work with Aware. This included contribution to the Press Release mentioned above, which was featured in the Down News, as well as interviews given to Downtown/Cool FM News and Frank Mitchell for his morning programme on U105.

 

6 February: Forensic Faculty held their first meeting of the year in Clifton House chaired by Dr Adrian East. Discussions included Staffing, low secure care, Mental Capacity Act (NI) 2016 and Trainee issues.

 

Girdwood

7 February: Dr Gerry Lynch hosted an all morning session in Girdwood Community Hub, Belfast for the Chairs/representatives of our Faculties, Groups, Service Users and Carers with a view to working on a Vision for Mental Health services in Northern Ireland. The wide-ranging discussion concluded that we should take as a focus the principles common to all services from infant through to Older Age. Once identified, the plan would be to compare them with NICE Guidance and in that way develop a Vision which might lead to greater cohesion and effectiveness within existing services, as well as identifying gaps which need filled in certain areas. It was clear that there is an urgent need for a more consistent and coherent approach across all the Trusts, with the development of a common use of language and terminology, with Trusts cooperating and sharing information. The presence of multiple overlapping strategy documents, but the lack of a clear commissioning approach based on those strategies, was also noted. It is hoped that a further meeting will take place in May on this, once the groundwork is complete.

 

9 February: Drs Gerry Lynch and Joe Kane met with Professor Cherie Armour at the University of Ulster Coleraine’s newly established Institute of Mental Health Sciences. Afterwards Dr Lynch reflected: “In a useful exchange, involvement of the profession in the research agenda of the Institute was discussed. Co-operation is the key to building capacity in research in mental health and the multidisciplinary approach taken by the Institute is particularly welcome, as is the emphasis on Service User involvement and public engagement. Further meetings are planned. There may be exciting opportunities for Trainees to become involved in research projects and to participate in training events planned by the Institute.”

 

14 February: Dr Gerry Lynch hosted one of his regular meetings with the Trust Medical Managers to discuss the College’s agenda where specifically relevant to the work of the Trusts. Invited guests were Chair and Vice Chair respectively of our Child and Adolescent Faculty, Drs Richard Wilson and Mark Rodgers, who addressed the meeting in order to highlight transition issues between CAMHS and Adult services. This proved to be a very worthwhile exchange in terms of learning as between different Trusts. As a result, the effectiveness of Transition Panels already operated by some Trusts will be promoted, as will the need for flexibility at the interface. It is also hoped to give focus to the recent Report entitled “Improving Mental Health Pathways and Care for Adolescents in Transition to Adult Services in Northern Ireland (IMPACT)” in a future College event.

 

16 February: Dr Richard Wilson chaired the Child and Adolescent Faculty’s first meeting of 2018 in Clifton House. Further planning for the forthcoming joint event with Ulster Paediatric Society on 2 May featured heavily in the Agenda.

16 February: Dr Gerry Lynch and Vice Chair of RCPsych in NI Dr Michael Doherty travelled to Dublin along with staff, to meet counterparts in the College of Psychiatrists of Ireland to discuss the challenges posed by Brexit and the possibilities for increased working together between our members in Northern Ireland and the College of Ireland’s members in the Republic of Ireland. Afterwards Dr Gerry Lynch commented: “We had a very productive meeting in Dublin with Drs John Hillery and William Flannery and College of Psychiatrists of Ireland staff. We agreed that it would be useful to focus on specialist areas where pooling of expertise and knowledge would be particularly useful because of the relative scarcity of resources and services on both sides of the Border. These would include eating disorders, neuropsychiatry, perinatal psychiatry, dual diagnosis, early intervention and personality disorders.  We also discussed the importance of Chairs of the Colleges' respective Faculties building and maintaining contacts.”

16 February: Forensic Faculty Chair Dr Adrian East was interviewed at Clifton House by the BBC NI Spotlight team for a forthcoming broadcast.

16 February: Paper co-authored by Dr Joe Kane was published in the Alzheimer’s Research and Therapy publication entitled “Clinical prevalence of Lewy Body Dementia”. Prevalence in a case series across nine secondary care services over an 18-month period was investigated, to determine how commonly Dementia with Lewy Bodies (DLB) and Dementia in Parkinson’s Disease (PDD) are diagnosed and reviewed within two regions of the UK. Catch up with the conclusions.

 

19 February: Intellectual Disability Faculty held their first meeting of the year in Clifton House with their newly appointed Chair Dr Arun Subramanian. Topics discussed included communication, information sharing/confidentiality/patient safety and workforce. The academic presentations were very much welcomed by the members.

19 February: Dr Gerry Lynch was interviewed at Clifton House by Damien Edgar, Special Correspondent for Downtown Radio/Cool FM on the eve of his trip to Westminster to lobby NI MPs regarding Northern Ireland’s mental health needs. The interview with Dr Lynch led their news coverage on 20 February.

 

20 February: Dr Mark Rodgers was interviewed by the Fixers Team for ultimate broadcast in April 2018 on UTV Live connected with the ‘#Me Too’ campaign.  A group of young girls in Portstewart are making a film called ‘What Makes You Uncomfortable’.  It starts with examples such as dogs barking, nails scraping on a blackboard etc, but then details incidents of sexual harassment.  All of the speakers have personal experience of such harassment and Dr Rodgers was interviewed on the attendant psychiatric effects.

Gerry

20 February: Dr Gerry Lynch (pictured far right arriving at Westminster with from left to right David Babington CEO of Action Mental Health, Siobhan O’Neill Professor of Mental Health Sciences at University of Ulster, Valerie Sullivan Interim CEO of Cause and Dr Iris Elliott Head of Policy and Research Mental Health Foundation) travelled to Westminster as part of an overall NI Mental Health sector delegation for a meeting hosted by Sir Jeffrey Donaldson MP entitled “An afternoon reception on Mental Health in Northern Ireland:  Without a local Executive and Assembly, what now for Mental Health Policy and Funding?” With Central College staff also on hand, Committee Room 19, which was packed for the event, heard in turn from Sir Jeffrey, David, Iris and Dr Lynch– before being opened up for more general discussion, which included with Michelle Gildernew MP and Baroness May Blood (pictured below table centre and to right).

 

M Gildernew

Dr Lynch acknowledged that,
“while we have made progress under the Bamford vision, we urgently do need a new strategy: We need a clear 5-10 year strategy- what do we want mental health services to look like in 5-10 years' time? I think we do have policies, we do monitor what changes have been made through Bamford, but I get a sense we need a clear forward vision of where we want mental health services to be over the course of the next 5-10 years.  Such a strategy must address promotion of mental health, it must address prevention, but it also must deliver evidence based care pathways for people who have mental illness, for people who have schizophrenia, bi-polar disorder, severe depressive episodes, dementia, younger people with ADHD, with emerging psychosis, at risk mental states, dual-diagnosis, substance misuse and severe mental illness. In particular, a business case for improving the management of the physical health care of patients with severe mental illness must be progressed. We have to acknowledge the relative underfunding of mental health, with the spend on mental health as a proportion of the overall health budget being lower in NI compared to the rest of the UK. The Bengoa Report and the subsequent 'Delivering Together' document focus on the reform of acute services but are disappointing in their lack of mention of mental health. Any funding flowing from the Confidence and Supply agreement between the Conservatives and the DUP is very welcome to help us begin to develop services such as early intervention in psychosis or perinatal mental health, which are widely available in other parts of the UK, but the funding is non-recurrent and must be put in the context of a coherent and progressive strategy for mental health to be delivered along with the reforms of the Bengoa report.” 

 

Gerry

The event exceeded all our expectations and College involvement enjoyed pretty much blanket coverage here in Northern Ireland as follows: Downtown/Cool FM News, Irish News, News Letter, Belfast Live, Derry Journal, ITV News, BBC NI News, BBC Radio Ulster and the Guardian.

The outcomes are that the issue of mental health in NI was to be subsequently raised by the DUP with the PM. We are to hopefully get a meeting with Secretary of State for NI, Karen Bradley MP soon and there may well be an invite to the NI Affairs Committee as well, with a cross party commitment from MPs at Westminster to move issues along. 

Dr Lynch (pictured above left with Sir Jeffrey Donaldson and David Babington to his right) looks forward to continuing to put the Clinician case on behalf of our Service Users and Carers at subsequent follow up meetings and to continuing to work closely with the third sector to pursue and bring about meaningful progress. Dr Lynch explained:
The initiative has certainly brought welcome focus to the critical issues facing services here and it highlighted the benefit of taking a collaborative approach in order to maximise the message”.

The event was also attended by Alastair Campbell (pictured below far right with Sir Jeffrey and Gerry from left to right), who retains a strong interest in Northern Ireland and in particular its mental health needs, being an Honorary Fellow of the College.

22 February:
Dr Ciaran Mulholland represented the College on UTV Live and gave the local College response to the Review just published in The Lancet entitled,“Comparative efficacy and acceptability of 21 Antidepressant Drugs for the acute treatment of adults with major depressive disorder: a Systematic Review and Network Meta-Analysis”.

23 February: Drs Ryan O’Neill, Mark Rodgers and Conor Barton attended at Clifton House for Induction Training as Regional Advisor and 2 Specialty Representatives respectively with outgoing Regional Advisor Dr Gerry Loughrey and with Staff. Dr Lynch was on hand also to thank Dr Loughrey for his work over many years, to wish Dr O’Neill well for the future in the role and to thank Dr O’Neill and Drs Rodgers and Barton for their commitment to these important College responsibilities.

23 February: Our Mental Capacity Act Working Group met with Taryn McKeen from DoH at Groundwork, Duncairn Gardens, Belfast, to work through hypothetical scenarios from practice with her – with a view to us influencing the Code of Practice for the new Act and making it hopefully as user friendly and real clinical life based as possible. This is our third such meeting with DoH, previous meetings having been with Tomas Adell (whose role has now been taken over by Taryn). Taryn took away from the meeting a number of points for further clarification in the draft Code as it continues to evolve. Taryn also confirmed that the formal consultation on the draft Code will hopefully launch around the Summer of this year, with training plans underway thereafter and only the requisite Regulations dependent upon an active Assembly.

 

26 February: Dr Richard Wilson attended a special screening of “Heads Up” at the Omniplex in Carrickfergus. The film was produced by students from Richard’s Alma Mater, Carrickfergus Grammar in order to both explore stigma surrounding youth mental health and help other students develop resilience in mental health. This was done through an exciting project under the Northern Area Mental Health Initiative (The Initiative), which is led by Cookstown and Western Shores Area Network (CWSAN), in partnership with both Action Mental Health and Nexus NI. Afterwards Dr Wilson commented:
“This was an excellent production by Junior School pupils at Carrickfergus Grammar School. The series of short films went right to the heart of current issues and influences possibly affecting the mental health and wellbeing of young people. The student creators hit the material head on and made insightful, and in my view, correct connections with the expectations and demands of modern life which underlie many of the situations highlighted - eg high expectation, low tolerance of difference and pressure to perform. It would bring added value if Policy Makers, Service Leaders and Professional Bodies could lend weight and support to this brilliant production by promoting both evidence based practice and by truly involving young people in the design and delivery of child centred services in the widest sense. I fully enjoyed the welcome from my Alma Mater and not least the popcorn provided!”

 

27 February: Perinatal Faculty Sub Group met in Clifton House to plan for their Multidisciplinary Meeting at Malone House on 13 April at which the local Faculty, chaired by Dr Julie Anderson, will also be formally launched. Confirmed local speakers now include Drs Gerry Lynch, Julie Anderson, Ciaran Mulholland, David Mongan, Kiera Walsh and Michael McMorran along with Mrs Theresa Nixon of RQIA – as well as Dr Roch Cantwell, Perinatal Health Service NHS Greater Glasgow and Clyde and Professor Ian Jones, Professor of Psychiatry and Honorary Consultant Perinatal Psychiatrist at Cardiff University.

27 February: Staff received College Training in the General Data Protection Regulation which will come into force on 25 May. The implications for local College work will be discussed with Dr Lynch.

 

28 February: Public Engagement Committee chaired by Dr Maggie McGurgan met in Clifton House and in addition to the agenda business, the Committee was addressed by Michael Boyd (Director of Football Development) and Ian Stewart (Grassroots Development Manager) from the Irish Football Association to discuss involvement in mental health promotion in collaboration with the IFA.

28 February: Staff took part in a Divisions Team Meeting via Skype with Central College which included a presentation from Central College staff working on the new College Insight publication.

….and finally during February: Dr Michael Doherty, as elected member of the College’s Central General Adult Faculty, worked on developing the Faculty’s contribution to the overall College response to the Green Paper for England and Wales entitled “Transforming Mental Health provision for Children and Young People”. Dr Doherty indicated that the document highlights some very important developments for schools and colleges with the establishment of Mental Health Support Teams and Mental Health Leads in schools who will link with CAMHS services. It will enable earlier identification of children with mental health issues and there is also a section on young adults going to University and into the workplace. This latter issue links with another of Dr Doherty’s roles as College representative on the Universities UK Task Group on Mental Health Services in Higher Education.  

…..also the College Centre for Quality Improvement (CCQI) have now agreed with NHS England and the Healthcare Quality Improvement Partnership (HQIP) to run the National Clinical Audit of Psychosis (NCAP – similar to the National Audit of Schizophrenia carried out in recent years), which Professor Steve Cooper will lead on locally and which involves all 5 Trusts in Northern Ireland.

 


January 2018

 

As a New Year begins, it can be a time for reflection on the past...and this historical photograph captures the scene from Clifton House in days gone by...

 

Frederick Street

2 January: College office re-opened after the Christmas and New Year break.

 

5 January: Chair Dr Gerry Lynch met with Dr Niall Corrigan, as well as Dr John Simpson and Pat Convery from Regulation & Quality Improvement Authority, to discuss the Part 2 Doctor training needs arising out of recent surveys on this topic – and also the forthcoming Joint Conference between the College and RQIA scheduled for 19 January.

 

10 January: Perinatal Faculty was represented by the attendance of Dr Janine Lynch at the Maternity Strategy Implementation Subgroup on Perinatal Mental Health at the Public Health Agency Headquarters in Belfast.

10 January: Staff participated in Policy and Campaigns Liaison Group Central College Meeting via Skype from Clifton House.

10 January: Carer representative Noel McKenna participated in Co-ordination Group for the RCPsych Championing Autism Programme 2018 via tele-conference.

 

11 January: Policy Lead Dr Peter Trimble and Staff participated in Policy and Public Affairs Committee Central College Meeting via tele-conference from Clifton House – with Dr Trimble reporting in particular on the Mental Capacity Act (NI) 2016, Brexit and the negative effects of our current political impasse on policy progress.

 

12 January: Dr Gerry Lynch attended Central College Council meeting at 21 Prescot Street, London where, amongst other things, the review of the Mental Health Act in England and Wales was discussed. Many office holders from the College centrally will be coming to our Spring Conference event in Belfast Waterfront Hall on 22 March, which takes our Act as its theme. The question of financial capacity assessments being increasingly requested (or directed), was also discussed. This is an issue in GB as well as here in NI and is something which the President is taking forward. In addition, the plan to change the regulations so that the devolved nations will have a representative on the Board of Trustees is being taken forward. Dr Lynch regards this as a very welcome development.

12 January: SAS & Affiliates Group held their first meeting of the New Year chaired by Dr Liz Dawson and focussing particularly on development of SAS Doctor careers and forging links with SAS Doctors working within other specialties in order to maximise learning opportunities. Final preparations were also made for the forthcoming SAS Doctor Conference which is to be held within Clifton House on 2nd February 2018 and will feature a number of excellent speakers from across the UK.

12 January: CAMHS Faculty Chair Dr Richard Wilson met with staff to plan the Joint UPS/RCPsych in NI Annual Learning event 2018. This year’s focus will be Adolescent Psychiatry. The keynote Speaker will be Dr Elaine Lockhart (Glasgow) who led her Adolescent Mental Health Liaison Team to victory in the 2017 RCPsych Awards (beating our local CAP Eating Disorder team in the process...so concrete evidence, says Dr Wilson, of no sour grapes whatsoever!) It is hoped to have contributions from local Adolescent mental health specialists in a diverse programme focussing on topics such as Gender Identity, Acute CAP & Substance Use. The Conference will hopefully take place in early May at Riddel Hall, Stranmillis, Belfast - with full programme available in due course.

12 January: Psychiatrists in Private Practice Special Interest Group (PIPSIG) held their first meeting of the New Year chaired by Dr John Sharkey, following which the meeting approved by Central PIPSIG and originally proposed for March 2018 has been moved to Thursday and Friday 20 & 21 September 2018. To be held in the Ulster Reform Club Belfast, Dr Sharkey anticipates that this will be of broad interest to all Psychiatrists, as its main emphasis will be on the preparation of Psychiatric reports of all sorts. Senior legal figures and Psychiatrists will present on a range of topics - likely to include Medicine during the Troubles, Incapacity legislation, the psychological effects of sexual abuse - amongst other subjects.  A number of local Solicitors and Barristers have agreed to present their experience of Psychiatric Reports under the title of "Psychiatric Reports: the Good, the Bad and the Ugly". The membership of PIPSIG NI grows year by year and provides a continuing forum for colleagues to discuss the challenges their work presents. Meetings occur four Friday afternoons per year. One of the group prepares a presentation, which usually provokes lively discussion at each meeting. For those wishing to join, please contact Dr John Sharkey at yekrahsj@gmail.com.

 

Belfast Telegraph

12 January: “How I Became a….” section of the Belfast Telegraph featured Trainee Psychiatrist Dr David Mongan. This forms part of the local participation in Central College’s Choose Psychiatry campaign.

 

15 January: Vice Chair Dr Michael Doherty attended NICVA Briefing on NI Budget 2018-2020 and heard Department of Finance Budget Director Julie Thompson outline the situation. Essentially funding for Northern Ireland comes from the block grant plus Rates and other miscellaneous sources. Not only is our average rate the lowest in the UK, but we have no separate water charges either. It seems that the block grant is not increasing by enough each year to keep pace with inflation. For example, the block grant is to increase by 0.7% in 2018-2019, whereas inflation is much higher than that, leaving us with a deficit of 0.9%. The block grant is then frozen for 2 years after that, leaving us with a deficit initially of 2.4%, and what will happen thereafter is unclear. All of this is creating a considerable downward pressure on funding, which either a Devolved Minister or a Direct Rule Minister will have to decide how to deal with in terms of local revenue raising. This raises topics such as charging for water separate from the rates, town centre/hospital car parking charges (both new and increased), scrapping free prescriptions/various elderly benefits etc. Dr Doherty afterwards commented that the meeting was “sobering” in terms of the funding reality and deficit.

 

17 January: MRCPsych Class re convened for 2018 with Dr Conor Barton teaching the students today.

 

18 January: Staff attended a meeting with Policy colleagues to discuss a proposition that local Medical Royal Colleges come together to work in greater partnership and improve interfaces, in the absence of funding for a local Academy. A fuller explanation of the long-term aim of this interface work is available.

Belfast Castle

19 January: The annual Joint RCPsych in NI and RQIA Part II and Part IV Consultant Psychiatrist Workshop was held in Belfast Castle and attracted a large attendance. Proceedings were opened by Olive Macleod OBE, Chief Executive of RQIA. The audience then heard from former Chair Dr Philip McGarry on how to address risk in Psychiatric practice. Philip concluded that what to do is to deliver comprehensive, good quality care for all patients and to focus on good history, examination, biopsychosocial formulation and treatment plan – and ensure easy accessibility. 

Belfast Castle RQIAThis was followed by Northern Trust Divisional Medical Director Dr Uzma Huda addressing the strengths and constraints of Rapid Assessment Interface & Discharge (RAID) in her Trust. Immediate developments include Delirium care pathway in Direct Assessment Unit, initiative to reduce re-attendances to the Emergency Department, detection and intervention pathways for medically unexplained systems, embedding of alcohol screening in the acute environment and establishment of brief intervention pathway. Longer term aims include the impact of improved detection on mental health services, further development of Mental Health liaison (e.g. primary care), better services for ARBI and embedding of Alcohol Disorder Care Pathway. Following refreshments, current Chair Dr Gerry Lynch and ST6 Dr Niall Corrigan presented the interesting findings from the recent survey on Part II Training and Regulation, which gave rise to a very active and constructive discussion led by Drs Lynch and Corrigan, along with Dr John Simpson and Patrick Convery both representing RQIA. The morning concluded with a moving and instructive personal perspective provided by Hamish Elvidge, Founder of the Matthew Elvidge Trust, with follow up discussion led by Dr Lynch. Pictured below left to right are Dr Philip McGarry, Olive Macleod, Dr Gerry Lynch, Dr Uzma Huda, Dr Lourda Geoghegan, Hamish Elvidge, Dr John Simpson and Patrick Convery.

Hamish told the moving story of his son’s death by suicide and the lack of family involvement at any stage in his care. He also spoke of the preoccupation with completing risk assessment forms, to the potential detriment of care. As the Coroner said: “they ticked the risk assessment, but did not look into his eyes”. He stressed that even when authority has not been given to share information, professionals can still listen to families. In his view, we do not need new legislation, but simply professionals need better training in how to involve families. A conversation opener could be: “Should we contact someone and should we do it now together?” He called for a change in practice, with more families involved in assessment and care. Fundamentally, he was asking for the Consensus Statement to be implemented. He asked, in conclusion, that 3 things be done:

  1. Review how trusted friends and family can be involved in P’s assessment, treatment and care;
  2. Review how consent is sought;
  3. Implement the Consensus Statement.

A discussion around the importance of professional curiosity about a patient harming followed.

Dr Lynch agreed to circulate the 2014 Information Sharing and Suicide Prevention Consensus Statement, which is available here for your perusal.

 

22 January: Staff participated in a Lunch and Learn by Skype led by Central Professional Standards Department, which is the College Department which our local College staff sit within. The topic was the College’s Perinatal Project and the session was led by both staff member Dee Noonan and also by Dr Liz McDonald.

 

25 January: Dr Claire Potter, CT3 Psychiatrist, was an invited speaker as part of the South Eastern Regional College's Resilience programme held at their Space Conference Centre in Bangor. The programme, co-facilitated by the mental health charity AWARE NI, was delivered to educators within the SERC and Dr Potter's talk focused on what resilience is, why it is needed and methods to improve resilience. Her presentation was described as “excellent” and the Conference was a great success. This is a continuation of the College’s much valued collaboration with Aware.

C PotterClaire Potter

 

 

 

 

 

 

 

 

 

26 January: Dr Gerry Lynch and Dr Michael Doherty met with Drs Saleem Tareen, Jo Minay and Stephen Moore at Clifton House re our further input into the You in Mind process. Afterwards, Dr Lynch said: I would like to thank Saleem, Jo and Stephen for their patience, tenacity and persistence in this complex, controversial and slow moving process.  Having met with officials recently to express our extreme disquiet about the You in Mind documentation, after which we agreed to work with others to try to make the process work for patients and clinicians, I would encourage members to discuss this issue with your colleagues from other disciplines in your places of work- the documentation will be expected to be used by all professionals working in mental health services.”

26 January: Dr Gerry Lynch and Dr Michael Doherty hosted a meeting in Clifton House with Mark Lee from DoH in relation to accessing mental health services from primary care - and also involving Drs Deirdre Shields, Paddy Moynihan, Rowan McLean and Saleem Tareen. Dr Lynch commented: “This was a useful meeting in which we emphasised the importance of NOT diverting resources from secondary care, but rather expanding capacity both in primary and secondary care.  We also discussed the importance of an integrated approach to the management of chronic severe mental illness across primary and secondary care - and the fact that prevention and early intervention also occurs in secondary care (for example, in CAMHS and early intervention in psychosis). We have concerns about the lack of emphasis on mental health in the ‘Delivering Together‘ transformation programme, so this meeting with Mark Lee from DoH who is leading on the development of the Primary Care transformation programme work stream, was very opportune. This was a useful preliminary discussion and a further meeting will be held, with Rodney Morton also to be present.”

26 January: Dr Gerry Lynch and Dr Michael Doherty met with Professor Gerry Leavey from University of Ulster who is keen to involve College members, particularly Trainees, in various research projects. Dr Lynch said: “There are several potential opportunities in the pipeline and I will be keeping members posted”.

26 January: Dr Gerry Lynch also had an opportunity to meet and discuss with Dr Margaret du Feu the shortage of interpreters, particularly those with specialist experience in mental health. Dr Lynch said: “This is an important rights issue which I hope to raise at a meeting next month with NI MPs in Westminster.”

POA

26 January: Our Psychiatry of Old Age Faculty Joint Annual meeting with the British Geriatrics Society took place at Riddel Hall, Queen’s University, with depression and dementia as the main focus for speakers. Delegates heard from Dr Chris Kelly on options for treatment of Depression, followed by a useful Case Presentation from Dr Louise Alexander, COE, Specialist Trainee from Western Trust. Dr Stephen Todd, Consultant Physician, COE, Western Trust later addressed improving quality of life for those with dementia in Nursing Homes, which was followed up with learning derived from a very practical Audit of anticholinergic use in new patients attending Memory Clinics presented by Dr Liz Dawson. A Psychiatry of Old Age Faculty Meeting took place at the conclusion of this very useful afternoon event.          

 

26 January: Deaf Child and Adolescent Mental Health group met in Clifton House chaired by Dr Holly Greer.

 

29 January – Friday 2 February: Bernadette Hamilton representing Social Work, together with Drs Caroline Donnelly, Peter Sloan and Roinin McNally spent the week at Clifton House working intensively on the update of the GAIN Guidelines for use of the Mental Health (NI) Order 1986, assisted by Patrick Convery of RQIA and staff. This project is at the request of RQIA.

29 January: Dementia Conference Planning Meeting at Antrim Area Hospital re 17 May 2018 event at Hilton Hotel - was attended by Chair and Staff.

 

30 January: Perinatal Faculty Sub Group met in Clifton House to plan for their Multidisciplinary Meeting at Malone House on 13 April at which the local Faculty, chaired by Dr Julie Anderson, will also be formally launched.

 

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Dr Gerry Lynch

Dr Gerry Lynch, Chair RCPsychNI

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