The aim of this study was to investigate the nature and extent of deliberate self-harm (DSH) amon... more The aim of this study was to investigate the nature and extent of deliberate self-harm (DSH) amongst those attending national crisis centres in Ireland, and to assess clients' views of the service. A secondary analysis was undertaken of a large data set of clients presenting with DSH (n=823). Clients were predominantly female, under 25 and with self-cutting widely reported (73%). DSH co-occurred with suicidal ideation (SI) (42%) and/or a suicide attempt (SA) (35%). Males were significantly more likely to present with more severe problems, and to use more dramatic methods of DSH; more severe presenting issues were also significantly associated with a history of having friends who engage in DSH. The treatment completion rate was 36%. Clients reported overwhelmingly positive views about the service. This is the first study in Ireland to provide insights into a 'hidden population' of people who engage in DSH. A need for greater awareness of DSH and its links to suicidal ideation/behaviour is indicated.
Little is known about the impact of Critical Incidents (CIs) on the lives of ambulance personnel.... more Little is known about the impact of Critical Incidents (CIs) on the lives of ambulance personnel. One-to-one interviews were conducted with 27 participants who had experienced CIs during the previous 12 months in order to: assess the nature and impact of CIs on health and well-being; examine attitudes toward support services; and explore barriers to service use. The results showed that incidents involving children, suicides, and grotesque mutilation were the most distressing. Participants reported a wide range of physical and mental health problems including sleep difficulties, angry outbursts, irrationality and feelings of alienation. Key themes included: low support service uptake due to fears relating to confidentiality and machismo; a perceived lack of concern and support from management; and a need for professional counselling and stress awareness training. Emergency Medical Controllers (EMCs) also reported a number of difficulties unique to their role. The findings suggest that exposure to CIs has a significant impact on health and well-being; this has important implications for recognizing and appropriately addressing the health and training needs of ambulance personnel, including the effective management of Critical Incident Stress.
International Journal of Mental Health, Sep 1, 2001
The incidence and prevalence of homelessness in the European Union countries have increased over ... more The incidence and prevalence of homelessness in the European Union countries have increased over the last two decades; and, currently, the European Observatory on Homelessness (set up by FEANTSA * and funded by the European Commission to conduct research into homeless ness in Europe; www.feantsa.org) estimates that there are approximately three million homeless Europeans. Furthermore, a significant proportion of this population is comprised of people with mental health problems. Some investigators have reported that people with enduring mental health problems form up to one-third of many homeless populations (see below). It seems timely and appropriate, therefore, that a special issue of the International Journal of Mental Health should be devoted to research about social exclusion issues specifically relating to homelessness and mental health in major European cities and regions. This special issue begins with a paper by Carmelo Vazquez and Manuel Munoz, who report that the prevalence rate of homelessness in Spain is considered to range from 11,000 to 45,000 people (equivalent to between 2.75 and 11.25 per 10,000 of the population). One of the important points noted by Vazquez and Munoz, and by the other contributors as well, is the lack of consistency in the way homelessness is defined. Clearly, the absence of an agreed-upon definition poses methodological difficulties for the conduct of epidemiological research designed to assess the nature and extent of homelessness. This point should be kept in mind when reading about the studies reported here. It is likely that the prevalence rates in Europe are higher than current estimates, given the "hidden" nature of homeless ness and the
Background Evidence for parenting programs to improve wellbeing in children under three is inconc... more Background Evidence for parenting programs to improve wellbeing in children under three is inconclusive. We investigated the fidelity, impact, and cost-effectiveness of two parenting programs delivered within a longitudinal proportionate delivery model (‘E-SEE Steps’). Methods Eligible parents with a child ≤ 8 weeks were recruited into a parallel two-arm, assessor blinded, randomized controlled, community-based, trial with embedded economic and process evaluations. Post-baseline randomization applied a 5:1 (intervention-to-control) ratio, stratified by primary (child social-emotional wellbeing (ASQ:SE-2)) and key secondary (maternal depression (PHQ-9)) outcome scores, sex, and site. All intervention parents received the Incredible Years® Baby Book (IY-B), and were offered the targeted Infant (IY-I)/Toddler (IY-T) program if eligible, based on ASQ:SE-2/PHQ-9 scores. Control families received usual services. Fidelity data were analysed descriptively. Primary analysis applied intention...
Background Mental disorders have become a public health crisis. Early prevention is key. Parentin... more Background Mental disorders have become a public health crisis. Early prevention is key. Parenting programmes are effective for children aged ≥ 3 years; however, there is a lack of evidence of their effectiveness for children aged ≤ 2 years. Objectives To establish if the model named Enhancing Social–Emotional Health and Well-being in the Early Years (E-SEE) Steps can (1) enhance child social emotional well-being and establish whether or not it is cost-effective at 20 months of age when compared with services as usual; and (2) be delivered as a proportionate universal model with fidelity. Design A pragmatic two-arm randomised controlled trial and economic appraisal, with an embedded process evaluation to examine the outcomes, implementation and cost-effectiveness of the intervention, and intervention uptake, compared with services as usual. The study had an external pilot phase (which was originally planned as an internal pilot). Setting The intervention was delivered in community s...
During the past three decades, there has been increasing interest in mindfulness and mindfulness ... more During the past three decades, there has been increasing interest in mindfulness and mindfulness interventions due to a wealth of theoretical and empirical research linking them with positive psychosocial, cognitive and health outcomes (Keng, Smoski, & Robbins, 2011). The core features of mindfulness, namely awareness and non-judgmental acceptance of a person’s moment-to-moment experience, are regarded as potentially effective antidotes against common forms of psychological distress, such as rumination, anxiety and anger; these often involve maladaptive tendencies to avoid, suppress, or over-engage with one's distressing thoughts and emotions (Kabat-Zinn, 1990; Keng, et al., 2011).
Abstract Trauma-related social, emotional and behavioral difficulties (SEBD) 1 are common among c... more Abstract Trauma-related social, emotional and behavioral difficulties (SEBD) 1 are common among children in foster care and are the primary reason for placement breakdown. SEBD in foster children – and especially in the context of unstable and troubled relationships with both foster and biological parents - affects the child’s future functioning and has substantial cost implications in terms of public service utilization. The aim of this study was to assess the utility and perceived effectiveness of the 18-week Incredible Years parenting program (IYPP) 2 which was delivered, on an exploratory basis, to both biological and foster parents (including kinship and non-relative care) of 23 foster children (aged 3-10 years). Biological and foster parent pairs (n = 46) were assessed at pre-intervention and at 6-month follow up, using measures of child SEBD, parenting stress, competencies, and quality of child-parent/carer relationships. One-to-one interviews and a focus group were also undertaken with a subset of biological parents (n = 12), foster carers (n = 11) and Social Work clinicians (n = 5) who delivered the program; the findings were analyzed using grounded theory. Both biological and foster parents reported statistically significant improvements in child SEBD, parent-child relationships, and in parenting stress and competencies. The qualitative findings highlighted further benefits for families, such as an increased number of access visits between biological parents and children and improved relationships with Social Work clinicians. Several factors were identified as important when implementing the IYPP with foster children, including: potential difficulties in engaging both foster and biological parents within the Social Work infrastructure; making appropriate adaptations to program principles, and integrating delivery with a trauma-informed approach. These findings contribute to the growing body of evidence that the IYPP could add value to the standard training and supports for foster parents, children and biological parents.
International journal of emergency services, Nov 7, 2016
Purpose Much has been written about the impact of emergency service work on personnel, but very l... more Purpose Much has been written about the impact of emergency service work on personnel, but very little is known about the lives of personnel once they have retired. The purpose of this paper is to explore the experiences and assess the quality of life (QoL) of emergency service retirees (ESRs) and to ascertain the possible longer term effects of emergency service work. Design/methodology/approach A series of one-to-one interviews was conducted with ESRs (n=10). These were then transcribed and analysed using interpretative phenomenological analysis. Findings A number of key emergent themes and associated sub-themes were identified from the analysis including: retirement as a major life change; potential impact of working role and unique aspects of emergency service work; trauma; and health and ageing more generally. Overall, the findings highlight the unique experiences of ESRs and the potential longer term impact of emergency service work on QoL in retirement. Originality/value In an under-researched area, the findings point towards a need to improve the transition to retirement for ESRs and, in particular, to enhance available supports, information and guidance for retirees, both prior to and following retirement.
The aim of this study was to investigate the nature and extent of deliberate self-harm (DSH) amon... more The aim of this study was to investigate the nature and extent of deliberate self-harm (DSH) amongst those attending national crisis centres in Ireland, and to assess clients' views of the service. A secondary analysis was undertaken of a large data set of clients presenting with DSH (n=823). Clients were predominantly female, under 25 and with self-cutting widely reported (73%). DSH co-occurred with suicidal ideation (SI) (42%) and/or a suicide attempt (SA) (35%). Males were significantly more likely to present with more severe problems, and to use more dramatic methods of DSH; more severe presenting issues were also significantly associated with a history of having friends who engage in DSH. The treatment completion rate was 36%. Clients reported overwhelmingly positive views about the service. This is the first study in Ireland to provide insights into a 'hidden population' of people who engage in DSH. A need for greater awareness of DSH and its links to suicidal ideation/behaviour is indicated.
Little is known about the impact of Critical Incidents (CIs) on the lives of ambulance personnel.... more Little is known about the impact of Critical Incidents (CIs) on the lives of ambulance personnel. One-to-one interviews were conducted with 27 participants who had experienced CIs during the previous 12 months in order to: assess the nature and impact of CIs on health and well-being; examine attitudes toward support services; and explore barriers to service use. The results showed that incidents involving children, suicides, and grotesque mutilation were the most distressing. Participants reported a wide range of physical and mental health problems including sleep difficulties, angry outbursts, irrationality and feelings of alienation. Key themes included: low support service uptake due to fears relating to confidentiality and machismo; a perceived lack of concern and support from management; and a need for professional counselling and stress awareness training. Emergency Medical Controllers (EMCs) also reported a number of difficulties unique to their role. The findings suggest that exposure to CIs has a significant impact on health and well-being; this has important implications for recognizing and appropriately addressing the health and training needs of ambulance personnel, including the effective management of Critical Incident Stress.
International Journal of Mental Health, Sep 1, 2001
The incidence and prevalence of homelessness in the European Union countries have increased over ... more The incidence and prevalence of homelessness in the European Union countries have increased over the last two decades; and, currently, the European Observatory on Homelessness (set up by FEANTSA * and funded by the European Commission to conduct research into homeless ness in Europe; www.feantsa.org) estimates that there are approximately three million homeless Europeans. Furthermore, a significant proportion of this population is comprised of people with mental health problems. Some investigators have reported that people with enduring mental health problems form up to one-third of many homeless populations (see below). It seems timely and appropriate, therefore, that a special issue of the International Journal of Mental Health should be devoted to research about social exclusion issues specifically relating to homelessness and mental health in major European cities and regions. This special issue begins with a paper by Carmelo Vazquez and Manuel Munoz, who report that the prevalence rate of homelessness in Spain is considered to range from 11,000 to 45,000 people (equivalent to between 2.75 and 11.25 per 10,000 of the population). One of the important points noted by Vazquez and Munoz, and by the other contributors as well, is the lack of consistency in the way homelessness is defined. Clearly, the absence of an agreed-upon definition poses methodological difficulties for the conduct of epidemiological research designed to assess the nature and extent of homelessness. This point should be kept in mind when reading about the studies reported here. It is likely that the prevalence rates in Europe are higher than current estimates, given the "hidden" nature of homeless ness and the
Background Evidence for parenting programs to improve wellbeing in children under three is inconc... more Background Evidence for parenting programs to improve wellbeing in children under three is inconclusive. We investigated the fidelity, impact, and cost-effectiveness of two parenting programs delivered within a longitudinal proportionate delivery model (‘E-SEE Steps’). Methods Eligible parents with a child ≤ 8 weeks were recruited into a parallel two-arm, assessor blinded, randomized controlled, community-based, trial with embedded economic and process evaluations. Post-baseline randomization applied a 5:1 (intervention-to-control) ratio, stratified by primary (child social-emotional wellbeing (ASQ:SE-2)) and key secondary (maternal depression (PHQ-9)) outcome scores, sex, and site. All intervention parents received the Incredible Years® Baby Book (IY-B), and were offered the targeted Infant (IY-I)/Toddler (IY-T) program if eligible, based on ASQ:SE-2/PHQ-9 scores. Control families received usual services. Fidelity data were analysed descriptively. Primary analysis applied intention...
Background Mental disorders have become a public health crisis. Early prevention is key. Parentin... more Background Mental disorders have become a public health crisis. Early prevention is key. Parenting programmes are effective for children aged ≥ 3 years; however, there is a lack of evidence of their effectiveness for children aged ≤ 2 years. Objectives To establish if the model named Enhancing Social–Emotional Health and Well-being in the Early Years (E-SEE) Steps can (1) enhance child social emotional well-being and establish whether or not it is cost-effective at 20 months of age when compared with services as usual; and (2) be delivered as a proportionate universal model with fidelity. Design A pragmatic two-arm randomised controlled trial and economic appraisal, with an embedded process evaluation to examine the outcomes, implementation and cost-effectiveness of the intervention, and intervention uptake, compared with services as usual. The study had an external pilot phase (which was originally planned as an internal pilot). Setting The intervention was delivered in community s...
During the past three decades, there has been increasing interest in mindfulness and mindfulness ... more During the past three decades, there has been increasing interest in mindfulness and mindfulness interventions due to a wealth of theoretical and empirical research linking them with positive psychosocial, cognitive and health outcomes (Keng, Smoski, & Robbins, 2011). The core features of mindfulness, namely awareness and non-judgmental acceptance of a person’s moment-to-moment experience, are regarded as potentially effective antidotes against common forms of psychological distress, such as rumination, anxiety and anger; these often involve maladaptive tendencies to avoid, suppress, or over-engage with one's distressing thoughts and emotions (Kabat-Zinn, 1990; Keng, et al., 2011).
Abstract Trauma-related social, emotional and behavioral difficulties (SEBD) 1 are common among c... more Abstract Trauma-related social, emotional and behavioral difficulties (SEBD) 1 are common among children in foster care and are the primary reason for placement breakdown. SEBD in foster children – and especially in the context of unstable and troubled relationships with both foster and biological parents - affects the child’s future functioning and has substantial cost implications in terms of public service utilization. The aim of this study was to assess the utility and perceived effectiveness of the 18-week Incredible Years parenting program (IYPP) 2 which was delivered, on an exploratory basis, to both biological and foster parents (including kinship and non-relative care) of 23 foster children (aged 3-10 years). Biological and foster parent pairs (n = 46) were assessed at pre-intervention and at 6-month follow up, using measures of child SEBD, parenting stress, competencies, and quality of child-parent/carer relationships. One-to-one interviews and a focus group were also undertaken with a subset of biological parents (n = 12), foster carers (n = 11) and Social Work clinicians (n = 5) who delivered the program; the findings were analyzed using grounded theory. Both biological and foster parents reported statistically significant improvements in child SEBD, parent-child relationships, and in parenting stress and competencies. The qualitative findings highlighted further benefits for families, such as an increased number of access visits between biological parents and children and improved relationships with Social Work clinicians. Several factors were identified as important when implementing the IYPP with foster children, including: potential difficulties in engaging both foster and biological parents within the Social Work infrastructure; making appropriate adaptations to program principles, and integrating delivery with a trauma-informed approach. These findings contribute to the growing body of evidence that the IYPP could add value to the standard training and supports for foster parents, children and biological parents.
International journal of emergency services, Nov 7, 2016
Purpose Much has been written about the impact of emergency service work on personnel, but very l... more Purpose Much has been written about the impact of emergency service work on personnel, but very little is known about the lives of personnel once they have retired. The purpose of this paper is to explore the experiences and assess the quality of life (QoL) of emergency service retirees (ESRs) and to ascertain the possible longer term effects of emergency service work. Design/methodology/approach A series of one-to-one interviews was conducted with ESRs (n=10). These were then transcribed and analysed using interpretative phenomenological analysis. Findings A number of key emergent themes and associated sub-themes were identified from the analysis including: retirement as a major life change; potential impact of working role and unique aspects of emergency service work; trauma; and health and ageing more generally. Overall, the findings highlight the unique experiences of ESRs and the potential longer term impact of emergency service work on QoL in retirement. Originality/value In an under-researched area, the findings point towards a need to improve the transition to retirement for ESRs and, in particular, to enhance available supports, information and guidance for retirees, both prior to and following retirement.
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Papers by Professor Sinead McGilloway