Objectives: To describe the drug history and co-existing psycho-social problems among under-19 year olds accessing treatment for opiate dependency, including methadone maintenance, and examine for any gender differences.

Method: A descriptive study of under-19 years assessed at the largest drug treatment clinic in Dublin, Ireland, between October 2000 and September 2006. Data was obtained through review of case notes, assessment questionnaires and urine drug screens.

Results: Eighty-six young people were included. Their mean age was 16.8 years. Forty-six (54%) were female. Only 26 (30%) reported an intact family of origin. Twenty-three (27%) had been in care. Mean age for first use of any illicit drug was 12.4 years, and for heroin was 14.8 years. The mean age of leaving school was 14.4 years; 42 (49%) first tried heroin after leaving school. Forty-one (48%) had a history of homelessness. Forty-four (51%) had previously injected; 26 (30%) were currently injecting. Fifty-six (65%) had not been screened for blood-borne diseases; twenty-one (24%) subsequently tested positive for hepatitis C. Thirty-eight (48%) had previous convictions; 33 (38%) were facing charges. Forty-five (52%) had previously seen a psychiatrist; nine (11%) had received inpatient psychiatric treatment. Boys were more likely to leave school early, have a substance-abusing sibling, and to have a past conviction. Girls were more likely to have a partner, and have taken a deliberate overdose.

Conclusions: This study highlights the multiple and complex needs of teenagers abusing opiates. Services seeking to meet their needs will require a broad range of interventions and excellent interagency co-operation.

Objective: Media portrayals of mental illness and psychiatry have a considerable impact on public perceptions of mental health issues. This paper aims to focus on portrayals of psychiatry and psychiatrists in four contemporary Irish feature films in order to make wider points on this theme.

Methods: Contemporary Irish feature-films that made substantial reference to psychiatry, psychiatrists or mental health in Ireland were identified though electronic searches and consultation with the Film Institute of Ireland. Selected films were viewed. Electronic searches were performed in the medical and film literatures, with broad search terms related to film, psychiatry, psychiatrists or mental health in Ireland. Additional books and papers were identified by tracking back through references and consulting with colleagues.

Results: The portrayal of psychiatrists in film is closely related to the development of both twentieth century psychiatry and twentieth century cinema. In common with recent European films, certain recent Irish films have tended to show psychiatrists as sympathetic, humane individuals (with some notable exceptions). While there have been a number of portrayals of dissocial personally disorder and various states of chronic alienation in recent Irish film, there have been fewer portrayals of psychosis or learning disability. Recent Irish films emphasise the role of alcohol in causing and perpetuating psychological distress. They generally provide unflinching portrayals of the effects of psychological distress and alienation, suicide and substance abuse at individual, family and community levels; nonetheless, there is still a regrettable tendency for films to associate mental illness with dissocial behaviour.

Conclusions: The portrayal of mental health issues in film presents both challenges and opportunities to film-makers, mental health service-users and general audiences alike. It is to be hoped that the recent trend towards realistic explorations of mental health issues in many European films continues into the future. Increased research in this area would help clarify the role of cinema in shaping public understandings of mental illness, and may also help identify additional ways of addressing stigma in the future.