Service user perspective vital in psychiatry

College of Psychiatrists of Ireland, Spring Meeting, Lyrath Estate Hotel, Kilkenny, 7-8 April 2022 

The perspectives of patients, family members, and carers are strongly emphasised within the CPI and permeate the ethos of the College, according to the CPI Vice-President, Dr Lorcan Martin. 

Dr Martin told the Medical Independent that in psychiatry: “We would put a very strong emphasis on involving the patients in, not only conferences, but training for junior doctors in terms of ongoing medical education for consultants.” 

Service users are also involved in continuous professional development events. 

He added patient experience is important “no matter what area you’re looking at in medicine”, but it particularly applies to psychiatry. 

At their Spring Meeting in early April, the College invited speakers who interact with the mental health services: Four service users with diagnosed mental illnesses; one social worker; and one mother of a patient with autism. 

The mother, Ms Helen Norris, opened the ‘Barriers to mental health care for adult autistic people: Challenges and possible solutions’ session, which covered the factors that inf luence mental illness of those with autism, the access that they have to services, and the barriers that may exist within these services. Social worker, Mr Edward Marcus, who works with people who have autism and mental health issues, also spoke at this session. 

“It’s very useful from the point of view of getting people familiar with particular areas or conditions” to inform psychiatrists, who might not be very familiar with the area, about their experience, according to Dr Martin. He added that psychiatrists are then able to use this information in their clinical practice. 

Prof Brian Lawlor, Deputy Executive Director, Global Brain Health Institute, said at the meeting: “Our patients really do tell us everything we know and I think we need to listen very carefully to them. Generally speaking, the person and the family will usually give you the diagnosis if you listen.” 

The final session of the meeting, on the interplay between mental and physical illness, was suggested by the CPI’s REFOCUS (Recovery Experience Forum of Carers and Users of Services) group. REFOCUS is made up of eight people with experience of mental health services, eight of their family members or carers, and eight psychiatrists. 

Dr Martin said it can be very important to not just hear from patients, but also their carers and family members to see what was found useful and what was unhelpful. 

Concerning safeguarding in relation to service user participation, Dr Martin also said: “With mental illness, people can sometimes be very vulnerable and it would be very important to make sure someone has the capacity to make the decision to become involved in something like this.” 

However, this can be mitigated by medication. 

People with ADHD are more likely to die in an accident, according to a 2013 study in the Pediatrics journal. People with ADHD also have higher rates of unintentional injury, according to a 2019 JAMA Network Open journal study. 

The 2021 World Federation of ADHD International Consensus Statement noted that “people with ADHD are at increased risk of low quality-of-life, substance use disorders, accidental injuries, educational underachievement, unemployment, gambling, teenage pregnancy, difficulties socialising, delinquency, suicide, and premature death”. 

The statement added that these comorbidities can be reduced with ADHD medication. 

Dr McMonagle highlighted the two-day course run by the UK Adult ADHD Network, which equips psychiatrists to diagnose a nd then prescribe for ADHD.