The Future of Psychiatry in a Global Context
Winter Conference 2023
16th - 17th November 2023
Sheraton Hotel, Athlone
13 Internal/External CPD Credits
(7 Thursday, 6 Friday)
From 08:00 | Hoey Suite
08:00 – 09:00 | Burke Suite
COFFEE & POSTER EXHIBITION
09:00 – 09:10 | Hoey Suite
Dr Lorcan Martin, President, College of Psychiatrists of Ireland
THE FUTURE OF PSYCHIATRY
Chaired by Dr Myles Doyle & Dr Fizna Fysal
09:10 – 09:30
THE FUTURE OF PSYCHIATRY IN A GLOBALISED WORLD
PROFESSOR NORMAN SARTORIUS, FORMER DIRECTOR OF MENTAL HEALTH, WORLD HEALTH ORGANISATION AND FORMER PRESIDENT OF THE WORLD PSYCHIATRIC ASSOCIATION AND THE EUROPEAN PSYCHIATRIC ASSOCIATION
The presentation will discuss the major socio-economic trends influencing the future of health care and then refer to changes in the principles of medicine observed already now.
The second part of the presentation will list priorities which should be considered in thinking about ways to organize health care in the years to come.
09:30 – 10:10
THE FUTURE OF PSYCHIATRY IN A GLOBAL CONTEXT – THRIVING IN DIVERSITY
DR MARISA CASANOVA-DIAS, PRESIDENT, PSYCHIATRY SECTION OF UEMS & CLINICAL ACADEMIC PSYCHIATRIST, CARDIFF UNIVERSITY
Our world is diverse and interconnected, and it’s important that we work together to improve mental health care. The UEMS Section of Psychiatry is committed to this goal by setting standards for postgraduate training and continuing education for psychiatrists in Europe. We develop evidence-based guidelines for training and service-related matters; establish standards for professional development and promote harmonization of professional standards. This session will provide an overview of the diverse training and practices across Europe and the measures we take to learn from and improve upon them.
10:10 – 10:50
WORKFORCE WELLBEING – CHALLENGES & SOLUTIONS IN THE POST COVID WORLD
PROFESSOR SUBODH DAVE, DEAN OF EDUCATION, ROYAL COLLEGE OF PSYCHIATRISTS UK & PROFESSOR OF PSYCHIATRY, UNIVERSITY OF BOLTON
Workplace health and safety has been woven into law in most places in the world and hard hats are now a mandatory feature on building sites across the world. However, the focus of these safety features has been on physical health safety and psychological safety has largely been ignored. This is best illustrated in healthcare, where, despite the fact that most workers are likely to encounter significant morbidity, distress and even mortality in their professional life, there is no equivalent of a psychological hard hat. Post-Covid, there has been a spotlight on workforce stress, burnout, moral injury and mental illness and more tragically also on suicides related to workforce related factors. The talk will highlight the need for proactive investment in workforce wellbeing and in creating psychological safe spaces and the role that we can play as Psychiatrists in helping achieve and maintain workforce wellbeing.
10:50 – 11:00
11:00 – 11:30 | Burke Suite
NCHD ORAL PRESENTATION COMPETITION
Chaired by Professor David Cotter
THE MASKEY IMPACT SURVEY: THE IMPACT OF THE MASKEY REPORT, PUBLISHED FOLLOWING AN INDEPENDENT REVIEW OF SOUTH KERRY CAMHS ON CHILD AND ADOLESCENT PSYCHIATRISTS WORKING IN IRELAND
DR LAURA BOND, UNIVERSITY COLLEGE DUBLIN
11:45 – 12:00
THE MICROBIOTA-GUT BRAIN AXIS IN SOCIAL ANXIETY DISORDER
DR MARY I. BUTLER, MERCY UNIVERSITY HOSPITAL, CORK
12:00 – 12:15
AMID MAGIC AND MENACE: PSYCHIATRISTS’ ATTITUDES TO PSILOCYBIN THERAPY
DR ANDREW GRIBBIN, NATIONAL DRUG TREATMENT CENTRE, DUBLIN
12:15 – 12:30
A COMPARISON OF RATE AND METHODS OF PROBABLE SUICIDE FOR 2 YEARS PRE AND POST THE ONSET OF THE COVID-19 PANDEMIC
DR DYLAN MANNIX, ADULT ACUTE MENTAL HEALTH UNIT, UNIVERSITY HOSPITAL GALWAY
12:30 – 12:45
SIMULATION BASED EDUCATION FOR MEDICAL EMERGENCIES IN PSYCHIATRY: A QUALITATIVE EVALUATION OF THE IMPLEMENTATION OF AN INTERPROFESSIONAL WORKSHOP FOR PSYCHIATRY MEDICAL AND NURSING STAFF
DR EIMEAR MCMAHON, DEPARTMENT OF PSYCHIATRY, MATER MISERCORDIAE HOSPITAL, DUBLIN
12:45 – 13:00
PSYCHIATRISTS – “A LOT OF THEM ARE QUITE NORMAL.” ATTITUDES OF FINAL YEAR MEDICAL STUDENTS TOWARDS PSYCHIATRY IN THE IRISH MIDWEST
DR ROBERT SCROOBY, WEST CLARE CAMHS, QUIN ROAD BUSINESS PARK, ENNIS, CO CLARE
13:00 – 14:00 | La Provence Restaurant
14:00 – 15:15
PARALLEL SESSIONS – PART 1
SESSION 1 | CHAIRED BY DR ATIQA RAFIQ
DISEASE MODIFYING TREATMENTS FOR ALZEIMER’S: IS IRELAND READY FOR THEM?
PROFESSOR IRACEMA LEROI, TRINITY COLLEGE DUBLIN
Until 2021, there was no licenced treatment to delay or slow the progression of the neurodegeneration that characterises Alzheimer disease. However, over the past decade, evidence supporting the potential for dementia prevention through risk reduction has increased, alongside a growing pipeline of medications with the potential for disease modification, targeting the very earliest stages of AD, mild cognitive impairment (MCI) and the mild stage dementia. Of the current ongoing trials of nearly 130 agents for AD worldwide, about 80% are classified as DMT, as opposed to symptomatic therapies for cognitive enhancement or management of neuropsychiatric symptoms. Current potential ‘disease modifying treatments’ (DMTs) for AD include human monoclonal antibody-based agents targeting beta amyloid, two of which have recently received regulatory approval from the FDA in the USA. While promising for the treatment of AD in Ireland, the complexity of drug eligibility, administration, cost, and safety of the DMTs necessitates adopting new models of treatment and care pathways for AD. This presentation will introduce this new class of treatments and discuss the outcomes of a working group which was convened to consider the implications of and health system readiness for DMTs for AD in the Irish context.
SESSION 2 | CHAIRED BY PROFESSOR HENRY O’CONNELL
Grace Suite 2 & 3
EVOLUTION AND PSYCHIATRY SIG
PROFESSOR HENRY O’CONNELL, CHAIR OF EVOLUTION AND PSYCHIATRY SPECIAL INTEREST GROUP
AN EVOLUTIONARY PERSPECTIVE ON ADHD
DR ANNIE SWANEPOEL, CONSULTANT CHILD AND ADOLESCENT PSYCHIATRIST, SET CAMHS LEARNING DISABILITY, NORTH EAST LONDON FOUNDATION TRUST
ADHD is now recognised to be a common neurodevelopmental disorder, which raises the question of why it was not eliminated through natural selection. In this talk, we will consider the evidence for ADHD being a “disorder” and raise the question of whether it can be more accurately seen as being at the end of a spectrum of neurodiversity, which has adaptive advantages in certain situations. People with ADHD are caught in an evolutionary mismatch in which the current environment of sedentary work which requires concentration does not fit with the environment in which humans evolved. An evolutionary perspective on ADHD can help psychiatrists understand and help people with ADHD with more compassion and more skill.
THE ONLY SIG WITH A ‘STACK: THE FOUNDATIONS OF A MONTHLY COLLABORATIVE ‘JOURNAL’ ON EVOLUTION & PSYCHIATRY
DR GURJOT BRAR, VICE CHAIR OF EVOLUTION AND PSYCHIATRY SPECIAL INTEREST GROUP
SESSION 3 | CHAIRED BY PROFESSOR PAUL FEARON
Grace Suite 1
HOW TO DO CLINICAL RESEARCH
PROFESSOR PAUL FEARON, PROFESSOR MARY CLARKE, PROFESSOR GERALDINE MCCARTHY, DR AOIFE O’CALLAGHAN, DR SEAN NAUGHTON
This session will explore the practical issues around how to successfully commence, sustain and complete clinical research in the context of working in a clinical post, whether at trainee or at senior level. The session will also consider the evolving, increasingly important relationship between research ethics committees (and how to navigate them successfully), available infrastructure and your research.
15:15 – 15:45 | Burke Suite
15:45 – 17:00
PARALLEL SESSIONS – PART 2
SESSION 4 | CHAIRED BY DR MARY SCRIVEN
MANAGING A CONSULTANT PRACTICE – PREVENTING BURN-OUT
DR DECLAN MURRAY & DR PATRICK DEVITT
A satisfied career in Psychiatry requires, above all, organisation and prioritisation skills. We discuss basic principles and then workshop various thorny scenarios from everyday practice. We expect that attendees will come away with a renewed sense of focus and optimism.
SESSION 5 | CHAIRED BY DR MARY DAVOREN
Grace Suite 2 & 3
THE DUNDRUM FORENSIC REDEVELOPMENT EVALUATION STUDY (D-FOREST). EVALUATING THE PATIENT BENEFIT OF THE MOVE OF THE NATIONAL FORENSIC MENTAL HEALTH SERVICE (NMHS) TO THE PORTRANE CAMPUS, DUBLIN
DR MARY DAVOREN, DR M. UMER WAQAR, DR MOHAMED ALSAFFAR, DR BABAFEMI OGUNNAIKE, DR SEAN MURRAY & DR AISLING O’REILLY
The Dundrum Forensic Redevelopment Evaluation Study (D-FOREST) is a prospective study of patient benefit from the move of the National Forensic Mental Health Service to a new modern campus in Portrane, Co. Dublin.
This workshop will present the methodology and early results of the D-FOREST study, focusing on acuity of mental health needs on admission, physical health concerns and the patient experience.
Introduction to the D-FOREST study – Dr Mary Davoren.
Rates of admission, urgency of need for admission and the need for restrictive practices after admission to the CMH – Dr M. Umer Waqar.
Self-rated measures of programme completion and recovery among the patient group of the NFMHS – Dr Mohamed Alsaffar.
Repeated measures of overweight and obesity among patients in the NFMHS – Dr Babafemi Ogunnaike.
Structured measures of insight into schizophrenia among patients in the NFMHS – Dr Sean Murray.
Self-rated measures of ward atmosphere and quality of life before and after the move to the CMH Portrane campus – Dr Aisling O’Reilly.
Treatment Resistant Psychoses in the National Forensic Mental Health Service population – Dr M. Umer Waqar.
Discussion and questions
Grace Suite 1
WORKSHOP: AN INTRODUCTION TO LEARNING HEALTH SYSTEMS
DR TOM FOLEY, CONSULTANT CHILD & ADOLESCENT PSYCHIATRIST, DONEGAL MENTAL HEALTH SERVICES
In this session, we will explore how to create services and whole health systems that have the capability to learn from every patient who is treated. With hospitals deploying Electronic Health Records and a new national Integrated Community Case Management System in procurement, how can we bring IT and Quality Improvement together to create a Learning Health System? What does a Learning Health System look like and how might it apply in mental health services? We will discuss the importance of complexity in improving services, describe the building blocks of a Learning Health System and offer advice on how to get started.
17:00 – 17:10 | Hoey Suite
ANNOUNCEMENT OF THE MEDICAL STUDENT POSTER COMPETITION PRIZE
19:00 – 19:30 | Grace Suite 2 & 3
CSCST & EXAM AWARDS CEREMONY
19:30 – 20:00 | Siege Suite
20:00 – LATE | Hoey Suite
CPSYCHI CONFERENCE DINNER
Followed by musice from the House DJ until late.
Dinner ticket required, pre-booking essential.
09:20 – 09:30 | Hoey Suite
Professor Mary Cannon, Vice President, College of Psychiatrists of Ireland
Chaired by Professor Colm McDonald
09:30 – 10:00
IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE: IMPACT FACTOR AND HOW JOURNAL PUBLICATIONS CAN MAKE IMPACT
PROFESSOR ANNE DOHERTY, CONSULTNST LIAISON PSYCHIATRIST, MATER MISERICORDIAE HOSPITAL AND SOCIAL MEDIA EDITOR, IJPM AND PROFESSOR JOHN LYNE, ASSOCIATE PROFESSOR, RCSI, CONSULTANT PSYCHIATRIST, WICKLOW MENTAL HEALTH SERVICES AND EDITOR-IN-CHIEF, IJPM
This session will discuss recent developments in the Irish Journal of Psychological Medicine, including the relevance of journal impact factor. The session will also focus on how research published in journals can influence and have impact on clinical practice, service development and mental health policy.
HOW SHOULD PSYCHIATRY RESPOND TO ITS CRITICS -WITH VEHEMENCE OR CONCILIATION?
PROFESSOR SIR ROBIN MURRAY, INSTITUTE OF PSYCHIATRY, KINGS COLLEGE LONDON
Psychiatry is often criticised, for example for the continued use of ECT, preoccupation with the minutia of DSM/ICD diagnoses, excessive use of medications or compulsory treatment. The critics include pseudo religious groups such as the Scientologists with whom dialogue is impossible. Others with extreme views include radical psychologists who consider that their profession should take over the care of most of the mentally ill from psychiatrists. However, significant criticism also comes from user groups, other mental health professionals, Hearing Voices groups, psychiatric historians, and even from fellow psychiatrists such as those in “Critical Psychiatry”. This criticism can, at times, be vitriolic – see the website for “Mad in America” (and its offspring “Mad in the UK”).
Psychiatry sets out to provide care for those with mental health problems i.e. to provide a service to them. Service industries (e.g. hotels, airlines), generally survey their consumers to assess their satisfaction or otherwise. However, the orthodox psychiatric response to criticisms of care has often been to discount sceptics as ill-informed, paranoid, or simply misled. Some psychiatrists have attempted to have dialogue with the critics, not always successfully. This presentation will consider the options, bearing in mind that bad experience of psychiatric care drives patients away, and that companies that lose touch with their customers tend to go out of business.
10:45 – 11:15 | Burke Suite
11:15 – 12:45 | Hoey Suite
GLOBAL MENTAL HEALTH – REACHING OUT
Chaired by Dr Hiberet Tessema Belay & Dr Zahra Legris
11:15 – 11:40
GLOBAL MENTAL HEALTH SPECIAL INTEREST GROUP LAUNCH
DR HIBERET TESSEMA BELAY, CONSULTANT PSYCHIATRIST, CONNOLLY HOSPITAL, BLANCHARDSTOWN
11:40 – 12:00
OPPORTUNITIES IN GLOBAL MENTAL HEALTH (ZAMBIA)
PROFESSOR JOHN SHEEHAN, ASSOCIATE CLINICAL PROFESSOR, UNIVERSITY COLLEGE DUBLIN
International psychiatry is of increasing importance in modern Ireland. With globalisation and attendant migration, Ireland has become a multicultural, multiethnic society. As part of an initiative of the SIG in Global Mental Health, four Irish psychiatrists recently visited Zambia in southern Africa to explore the possibility of collaboration between the CPsychI and the mental health services of Zambia. At present, the services in Zambia are underdeveloped with just eleven psychiatrists covering the population of 20 million people. The needs are great. The CPsychI could assist in the training of psychiatrists in Zambia, particularly using on-line technologies, and at the same time, learn about international psychiatry. Such an arrangement could be of mutual benefit.
12:00 – 12:30
THE SCOTLAND-MALAWI MENTAL HEALTH EDUCATION PROJECT – SUCCESSES AND LESSONS LEARNED
DR ROBERT STEWART, UNIVERSITY OF EDINBURGH
The Scotland Malawi Mental Health Education Project (SMMHEP) was established in 2008 as a partnership between UK psychiatrists and the College of Medicine, University of Malawi (now Kamuzu University of Health Sciences). With funding largely from the Scottish Government, SMMHEP has successfully supported the development of mental health education in Malawi. Over 100 psychiatrists have volunteered to deliver undergraduate psychiatry teaching, and a postgraduate psychiatry programme has been established, with 4 psychiatrists graduated and 6 more in training. Other activities include an annual mental health conference, training of 500 primary care health workers, establishing a quality improvement team in Malawi’s main psychiatric hospital, and publishing of a practical manual for frontline health workers. In this presentation I will describe the history of this hugely rewarding partnership, as well as flagging up some of the challenges and lessons learned, with the aim of encouraging other similar projects and partnerships.
12:30 – 12:45
PROFESSOR ANNE DOHERTY, DR FIONA FENTON & PROFESSOR FIONA MCNICHOLAS
12:45 – 13:00 | Hoey Suite
ANNOUNCEMENT OF PRIZES
NCHD Oral, NCHD Poster & Medical Student Poster Competition
IJPM John Dunne and Ada English Medals
13:00 – 14:00 | La Provence Restaurant
14:00 – 16:15 | Hoey Suite
Chaired by Dr Tom Foley
PSYCHOTROPIC PRESCRIBING AND PATIENT SAFETY; “SPOTLIGHT ON CHILD AND ADOLESCENT PSYCHIATRY” LEARNINGS FROM RECENT EXPERIENCES IN CAMHS
DR COLETTE HALPIN, CONSULTANT CHILD PSYCHIATRIST & INDEPENDENT CHAIR, EXPERT AUDIT TEAM
DR SUZANNE MCCARTHY, SENIOR LECTURER IN CLINICAL PHARMACY, UCC & MEMBER EXPERT AUDIT TEAM
DR ORLA HEALY, DIRECTOR, NATIONAL CLINICAL DIRECTOR OF QUALITY AND PATIENT SAFETY, HSE
DR AMANDA BURKE – CONSULTANT CHILD PSYCHIATRIST, EXECUTIVE CLINICAL DIRECTOR AND NATIONAL CLINICAL LEAD FOR CHILD AND YOUTH MENTAL HEALTH
January 2022 saw the publication of the Maskey Report on the “Look Back Review into CAMHS” in South Kerry. It highlighted serious and concerning deficits in patient care, governance and administration of the service in the local area. This has prompted intense unprecedented focus on CAMHS in the whole country by the political system, the media, the public and many stakeholders. As a result, An Taoiseach and the Minister of State for Mental Health directed that national Audits of prescribing, COGs and an experience of service study be carried out. The first ever inspection of Community CAMHS by the Inspector of Mental Health services was also carried out with a subsequent damning report, published in July 2023, resulting in a call for immediate regulation of CAMHS.
Central to all of this is the core concern of “patient care and safety” in every area of the services, with an emphasis on prescription of psychotropics and monitoring for adverse effects.
In this session, we will present results of the first ever audit of psychotropic prescribing of this scale in Ireland, “National Audit of Prescribing in CAMHS” (February 2023), the importance of audit in patient safety, the role of the National Centre for Clinical Audit, and explore potential future directions.