To determine the distribution, functioning and perceived impact of home-based treatment (HBT) teams for acute mental disorders on the island of Ireland.

A 28-item questionnaire exploring the structure, staffing and operation of HBT teams was emailed to all clinical directors of mental health services in Ireland (n=26) and Northern Ireland (NI) (n=5). Quantitative data was analysed using the Survey Monkey package, while free-text responses to open questions were analysed for thematic content.

In total, 11 of 16 (68%) mental health services in Ireland and four of five (80%) in NI confirmed the presence of HBT teams. For 80% of respondents the primary function of HBT was as an alternative to inpatient admission. All NI respondents reported provision of a 24/7 HBT service. A 7 day a week service was reported by 82% of Republic of Ireland respondents. In total, 70% of respondents reported a gate-keeping role for their teams. Staffing levels and multidisciplinary representation varied widely. Most respondents perceived HBT as improving patient/carer experience and cost-effectiveness.

Our findings suggest that the implementation of the HBT model in Ireland has not fulfilled the aspirations set out in mental health policy in both Irish jurisdictions. Many areas have no HBT services while wide variations in staffing levels and functioning persist. However, mental health services with established HBT teams appear convinced of their positive impact. An All-Ireland forum on HBT may help to define the model in an Irish context and standardise its future resourcing, operation and evaluation.

Homelessness causes huge distress to a vulnerable population and great concern to wider society. The aim of this study was to reflect the prevalence of mental disorder within a subset of the homeless population in Dublin.

Long-term rough sleepers in Dublin were identified by the relevant non-statutory agency (Dublin Simon Community’s Rough Sleepers Team). The authors attempted to assess all the identified individuals employing traditional clinical methods.

We managed to assess 16 of the 22 identified individuals. We detected no formal disorder in ~30%, severe mental illness in ~30% and either alcohol or substance misuse in another ~30%. We detected dual diagnosis (co-occurrence of severe mental illness and alcohol or substance misuse) in 10%.

Most but not all long-term rough sleepers in Dublin had a formal mental disorder identified. Just under one-third had a severe mental illness. This suggests that individualised patient centred health and social care will be required on a case by case basis in the long-term rough sleeping population.

Culturomics is the study of behaviour and culture through quantitative analysis of digitised text. We aimed to apply a modern technique in this field to examine trends related to the history of psychiatry. In doing so, we aimed to explore the nature of the Google Ngram methodology.

Using Google Ngram Viewer, we studied Google’s corpus of over 4% of all published books and explored relevant trends in word usage.

An exponential growth in the use of ‘psychiatry’ between 1890 and 1984 was identified. ‘Sigmund Freud’ was mentioned more frequently than all other prominent figures in the history of psychiatry combined. Mentions of ‘suicide’ increased since 1820. The impact of several DSM editions is discussed.

This study demonstrated the potential application of the Ngram methodology to the study of the history of psychiatry. The role of textual analysis in this field merits careful, constructive consideration and is likely to expand with technological advances.

Home-based crisis team (HBCT) in North Cork was established in 2013 to provide short term, intensive home treatment to people who are experiencing acute mental health problems, with the aim of averting hospital admission wherever possible or supporting patients discharged from hospital.

A retrospective descriptive study design was adopted to describe the activities of the North Cork HBCT over a 1 year period. Data were analysed using R version 3.4.0 for Windows.

A total of 388 patients were referred to the HBCT in 2015, of which 328 required assessments. General practitioners (GPs) made 56% of all referrals. The most common referral reason was low mood (40%). Stepped-up care to the psychiatric inpatient unit was required for 12.4% of patients, 62% were discharged to the outpatient clinic for routine follow-up.

Many common psychiatric presentations can be managed at home with the support of the HBCT although hospital admission is required for significant numbers.

To systematically review studies from Irish prisons that estimate the prevalence of major mental illness, alcohol and substance misuse, and homelessness at the time of committal.

Healthcare databases were searched for studies quantifying the point prevalence for each outcome of interest. Searches were augmented by scanning of bibliographies and searches of governmental and non-governmental websites. Proportional meta-analyses were completed for each outcome.

We found eight, six and five studies quantifying the point prevalence of major mental illness, substance misuse, and homelessness respectively. Considerable heterogeneity was found for each subgroup (except psychosis where substantial heterogeneity was observed) and random effects models were used to calculate pooled percentages. The pooled percentage for psychotic disorder was 3.6% [95% confidence interval (CI) 3.0–4.2%], for affective disorder 4.3% (95% CI 2.1–7.1%), for alcohol use disorder 28.3% (95% CI 19.9–37.4%), for substance use disorder 50.9% (95% CI 37.6–64.2%) and for those who were homeless on committal 17.4% (95% CI 8.7–28.4%).

Estimates for the prevalence of psychotic illness and substance abuse amongst Irish prisoners are in keeping with international estimates of morbidity in prisons, whilst those for affective disorders are lower. The prevalence of homelessness in committal to Irish prisons is higher than some international estimates. Rates for psychoses, alcohol and substance misuse as well as homelessness in Irish prisons are significantly higher than the general population prevalence of these vulnerabilities. A need for service development is discussed.