Users voices: Are drug problems too complex and dynamic for single magic bullet solutions?

EMCDDA (European Monitoring centre for Drugs and Drug Addiction) has recently published a Fact sheet (No 9/2012) which contains “quotations gleaned from interviews with substance users in 16 countries over the period 1993–2012”.

They chose to use my qualitative study* to include in their report. See p.14:

Others talk about the value of support from people facing similar problems. For example, clients in therapeutic communities describe the highly valued psychosocial support gained from peer relations in the community. For example a Slovakian drug user said:

Back then, I deemed the relationships with lads (drug users) outside as important, but now, when I lost everything and I have only them (those in the therapeutic community), I value the relationships here. 

[male, Client in therapeutic community, slovakia]

Read more about my study here: http://janklimas.blogspot.ie/2012/06/trust-usual-suspect-in-old-story-of.html

Read the full EMCDDA report here: http://www.emcdda.europa.eu/news/2012/fs-9

*Klimas, J. (2010), ‘Interpersonal relationships during addiction and recovery: A qualitative exploration of the views of clients in therapeutic community’. Proceedings of the Annual Symposium of the Society for the Study of Addiction, York, UK. Online at: http://www.addiction-ssa.org/ssa_24.htm

Youth Mental Health Conference: Press release (#Acamh2012)

Youth mental health is a key health priority in Ireland; early intervention, engagement and innovation are central to its promotion.

The Third National Research Conference in Ireland on Youth Mental Health will focus on this key theme. Hosted by the Association for Child and Adolescent Mental Health (ACAMH) and Graduate Entry Medical School, University of Limerick (UL), it will present insights, perspectives, and valuable updates.

Ian Kelleher, Winner of the the 2011 Eadbhard O’Callaghan Youth Mental Health Research Award with Professor Mary Cannon, RCSI.

The day’s key aim of encouraging research by under- and postgraduate students and trainees will again provide the platform for presentation of projects and, importantly, recognise the most excellent piece of research work with the award of “Annual ACAMH Youth Mental Health Research Prize”, in memory of the late Professor Eadbhard O’Callaghan and in recognition of his outstanding contribution to mental health in young people. In an innovative development, young people will be highly involved with the organisation and delivery of the conference.

Conference organising committee chair, Walter Cullen (UL Professor of General Practice and GP) states: ‘UL, the Midwest region and ACAMH are delighted to come together to host this important meeting – mental health is a major challenge for our population’s national health, especially here in the Midwest, and this conference will showcase some of the excellent work being carried out by colleagues, associations and health agencies to address this issue. We are especially honoured that the prestigious Eadbhard O’Callaghan Memorial Prize will be awarded for work presented on the day’.
Speaking at the announcement of the programme for this year’s conference, Mary Cannon, RCSI Professor of Psychiatry and Secretary of ACAMH Special Interest Group on Youth Mental Health states “we hope to showcase research and innovation relevant to youth mental health. Our first two conferences promoted interaction between all stakeholders, especially researchers and young people, and dialogue between young people, researchers and policy makers will remain at the forefront of this year’s programme”.

The conference will be opened by Dan Neville T.D (Deputy Mental Health Spokesperson), and Don Barry, President, UL. Confirmed keynote speakers include Ella Arensman (Director of Research, National Suicide Research Foundation), Bob Illback (Deputy CEO, Headstrong), Eric Taylor (Emeritus Professor of Child Psychiatry, King’s College London Institute of Psychiatry), Mary Clarke (Clinical Lead, DETECT), and Ian Daly (HSE Mental Health Clinical Lead).

Interactive Workshops invite delegates to explore in greater depth, the key themes of ‘Disadvantage and its Impact on Youth Mental Health’ (UL-based Orla Muldoon, Professor of Psychology, Sarah Jay, Post-Grad Scholar and Jan Klimas, Postdoctoral Researcher and Cochrane Fellow) and ‘Technology and Youth Mental Health’ (Director of Programmes and Policy Derek Chambers and Research & Evaluation Officer Fenella Murphy, Inspire Ireland; Aleisha Clarke, Health Promotion Research Centre, NUI; and Gavin Doherty, TCD School of Computer Science and Statistics). In addition, Colman Noctor (Psychotherapist, St Patrick’s University Hospital) will launch ‘The Way Forward, Young People and their Parents’ Experiences of Youth Mental Health Services’.

Further information:
Walter Cullen, Professor of General Practice, UL. [email protected]
Ingrid King, Executive Director, ACAMH [email protected]; www.acamh.org.uk
Mary Cannon, Dept Psychiatry RCSI; Secretary, ACAMH Special Interest Group: [email protected]

Facebook: http://www.facebook.com/events/392553024142420/
Twitter: #Acamh2012

Submitting ethics for new research: killing so many trees

Ethical principles, ethics committees and research

This has been a busy week from an ethics perspective. All research should be ethical and adhere to the ethical guidelines. The gatekeepers for the ethical principles are usually ethical committees, institutional review boards or panels. Researchers submit their proposals for approval to the committees and they decide whether the proposed research is in line with the universally accepted principles of ethical research. For example: Research carried out on humans should be in compliance with the Helsinki Declaration (http://www.wma.net/en/30publications/10policies/b3/index.html).

In Ireland, we have 25 committees/ boards who can provide ethical approval and we submitted two applications for ethical approval to two different committees this week:
1. Are psychosocial interventions for problem alcohol use effective among problem drug users in primary care (PINTA): A Controlled before-and-after feasibility study
2. Prospective audit of characteristics of opioid overdoses in an emergency ambulance service
…so many trees going to the ethics.

As usual, we submitted the ethics application on the last day of the deadline.
I wasn’t even sure if the cyclist courier would take it on a bike to the addressee, because the package had surely over 2 kilos. Fingers crossed.

Final programme: Promoting Youth Mental Health through Intervention, Engagement and Innovation (#Acamh2012)

Download conference programme here

 

Final PROGRAMME & REGISTRATION
3rd National One-Day Research Conference on Youth Mental Health
Promoting Youth Mental Health through Intervention, Engagement and Innovation
Friday 28 September 2012; Carlton Castletroy Park Hotel, Limerick

Programme: Morning 

08.30
Registration and Pre-Conference Refreshments
09.15
09.30
Welcome Address  Professor Don Barry, President, University of Limerick
Opening Address    Dan Neville TD, Deputy Spokesperson on Health
09.45
10.45
11.15
12.00
13.00
Plenary One             Trends in self harm and suicide among young people in Ireland: Implications for intervention and prevention programmes: Dr Ella Arensman, Director of Research, National Suicide Research Foundation, NHSRI, University College Cork
Plenary Two             Emerging Evaluation Findings: Jigsaw Early Intervention Model of Youth Mental Health Supports: Bob Illback, Deputy CEO, Headstrong, The National Centre for Youth Mental Health
Morning Coffee and Viewing of Poster Presentations
Guest Speaker:        Research Perspectives on Attention Deficit Disorder Among Young Adults: Eric Taylor, FRCP FRCPsych FMedSci, Emeritus Professor, King’s College London Institute of Psychiatry
Parallel Research Presentations: 4 presentations per session x 3 parallel sessions (12 presentations in total)
Lunch

Programme: Afternoon

14.00
Afternoon Workshops
Delegates to select one of the following Streams (kindly note: every effort will be made to accommodate requests, but this cannot always be guaranteed depending on numbers; please therefore indicate on booking form first and second preferences)
Workshop One:     Role of technology in promoting youth mental health: Derek Chambers and  Fenella Murphy, Inspire (workshop) Inspire Ireland; Dr Aleisha Clarke, Health Promotion Research Centre, NUI; and Dr Gavin Doherty, School of Computer Science and Statistics, TCD
Workshop Two:     Disadvantage and its Impact on Youth Mental Health: Orla Muldoon, Orla Muldoon, Professor of Psychology, UL; Sarah Jay, IRCHSS Post-Grad Scholar, UL, and Jan Klimas, Postdoctoral Researcher / Cochrane Fellow, Graduate Entry Medical School, UL
15.00
Report launch:     The way forward, young people and their parents experiences of youth mental health   services: Colman Noctor, Psychotherapist, Willow Grove Adolescent Service, St Patricks University Hospital
15.15
Plenary Three:       Why Research Matters: Mary Clarke, Detect / HSE
Plenary  Four:       The Policy Perspective: Ian Daly, HSE
16.15
Research Prize        EADBHARD O’CALLAGHAN ANNUAL YOUTH MENTAL HEALTH PRIZE: presented by Mrs Virginia O’Callaghan
16.45
Closing Address:      Walter Cullen, Professor of General Practice, Graduate Entry Medical School, University of
Limerick and Chair, SIG Research Conference Committee (tbc)
Closing Reception

 

*  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  *  * 
    Registration Form
To reserve your place to attend this Conference hosted by ACAMH’s Early Intervention SIG (28 September 2012) please complete the form below and return to:
National Events and Initiatives, ACAMH, St Saviour’s House, 39-41 Union Street, London SE1 1SD; Tel: 00 44 (0) 207 403 7458; Fax: 00 44 (0) 207 403 7081;  email: [email protected]
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The conference is now on Facebook and Twitter (#Acamh2012).

Research-into-practice: US drugs expert talks in Ballyfermot

program changer

 

“You can get much farther with a kind word and a gun than you can with a kind word alone.”
Al Capone in the Untouchables (1987)
It’s Friday afternoon, July 6th, and a dozen of eager addiction professionals wait seated in a circle. Some of them come to the Cherry Orchard Hospital each last Friday of the month. It’s the time of their regular journal club. One of them leisurely raises and picks up a slide clicker lying on the desk in front of the room. It’s Professor Dennis McCarty, an expert who dropped by the hospital while on his holidays in Ireland.
Dennis McCarty is a Professor in the Department of Public Health and Preventive Medicine at Oregon Health & Science University in Portland, Oregon (www.ohsu.edu). He is the Co-Principal Investigator for the Western States Node of the National Drug Abuse Treatment Clinical Trials Network (CTN). The CTN tests the implementation of research findings in community treatment programs. Dr McCarty also leads the national evaluation for the Network for Improvement of Addiction Treatment (NIATx); a Robert Wood Johnson Foundation and Centre for Substance Abuse Treatment initiative designed to improve access and retention in alcohol and drug abuse treatment using process and quality improvement techniques. His experience combines policymaking and research. Between 1989 and 1995, Dr McCarty directed the Massachusetts Bureau of Substance Abuse Services for the Massachusetts Department of Public Health. He has a PhD in Social Psychology from the University of Kentucky.
Among the many interesting topics that Dr McCarty covered in his talk was the integration of addiction related care into general practice systems. To change the poor-performing systems, and to provide a better integrated care, NIATX uses a powerful process improvement tool – PDSA (www.NIATx.net). The Plan-Do-Study-Act model allows changes to be implemented over short time periods, which can improve the success of the implemented projects (1). As part of the PDSA process, organisations ‘set improvement goals, pilot test changes, and assess outcomes using demonstrated performance measurement tools’ (2, 3). A figure of the Plan-Do-Study-Act rapid change cycles is shown below.
Figure 1 PDSA model
© 2009 G. Duffy, J. Moran, and W. Riley
An example of a successful implementation project, realised by the Oregon group, is the SBIRT primary care residency initiative (www.sbirtoregon.org). SBIRT stands for Screening, Brief Intervention, and Referral to treatment, and is successfully applied in the area of managing problem alcohol use in primary care settings across US. An Irish group led by Prof Walter Cullen (University of Limerick) was inspired by this initiative and started research collaboration with Dr McCarty on a newly funded project in Ireland. The project, which starts in 2013, aims to determine whether SBIRT-modelled intervention can reduce the proportion of people with problem alcohol use among people who are also addicted to other substances and attend primary care.
Among problem drug users, previous work conducted by members of this team, highlighted that: (a) problem alcohol use is common, (b) that primary care has an important role in its identification / treatment, (c) that brief interventions are feasible, and (d) that comprehensive, many-sided interventions may enable screening & brief interventions for problem alcohol use. The trial will be conducted in two regions with very deprived areas, Dublin South West and the Midwest region and will involve distributing best practice guidelines to GPs, practice visits and training of practitioners. The project will be overseen by experts responsible for research, planning and delivery of addiction treatment/ primary care in Ireland with collaborators in the UK and US.
Dr McCarty finished his talk with a famous quote by Al Capone, printed above; noting that a successful change sometimes requires powerful mechanisms to get the reformative message across. The staff who attended this CME-accredited (continued medical education) event was psychiatrists, registrars, addiction counsellors and nurses. It wouldn’t be possible to organise this meeting without the support from Dr Eamon Keenan (Clinical Director, HSE Addiction services Mid Leinster) and Ms Catherine Blake who helped with the organisation and catering.
Notes