3. 20 th Century Mental Health Care

4. 21 st Century Health Care

5. In Health Care Politics the debate is still dominated by questions of location Primary Care Vs Community Care Vs Residential Care Vs Secondary Vs Regional Centre of Excellence

6. Hospital Care

7. Home Care

8. Community Care

9. Residential Care in “Castlebeck”

10. Primary Care

13. Mental Health Vs Mental Health Disorder

14. Home Work Balance

15. The Existential Question?

16. Complexity of Mental Health Diagnosis Co-morbidity of Anxiety and Depression 32% of OCD patients have depression 31% of SP patients have depression GAD 59% of GAD patients have depression 50% of panic disorder patients have depression 49% of PTSD patients have depression Source: National Comorbidity Survey 69,400 patients 34% of specific phobia patients have depression Panic Disorder Specific Phobia PTSD Social Phobia OCD Depression

18. Low High Certainty Consensus High Low CHAOS STANDARDISATION ZONE OF COMPLEX JUDGEMENT Consensus Chaos Standardize Zone of Complex Judgment Low High Certainty High Low

19. Obsessive Compulsive Disorder

20. “ There's a very strong view with a lot of people that depression and mental illness is not a medical condition, that it's part of life's events that people get depressed or get unhappy. Years ago people were unhappy, they weren't depressed, they weren't given the name depressed…I was aware that unlike other areas of health like cholesterol, diabetes, or coronary care, where you can measure the results of taking medication, in mental health, it is impossible to measure, scientifically, the results ” Minister Tim O`Malley, Pharmacist and Minister for Mental Health Irish Medical News , November 2006

24. “ Arguably by the standards of 1901, no-one outside of the Cancer Care Unit and ICU is sick. Modern infections or fractures are treated within a week. Myocardial infarcts are surveilled and thombolysed or stented. The age curve in hospital has changed dramatically and one century later our illnesses are completely different. Modern illnesses were unseen in 1901, because these disorders were either already fatal, or like Diabetes, untreatable. No one who attends an Orthopaedic Surgeon with knee pain would be accused of malingering, if there is a demonstrable irregularity on MRI, but that same patient would not have been admitted in 1901. They would have been dismissed as a waste of time unless their leg was infected or broken off. Mental health suffering is exactly the same. Active treatment in all its professional and societal forms (Psychotherapy, Pharmacology, Milieu, a more tolerant welfare state) has enabled community care for Mental Disorder. We now witness service users with more subtle illnesses or illnesses at earlier stages, but that doesn’t mean mental health suffering is not real. These are not sicknesses if you judge them by the standards of 1901 or those who operate today within those standards”. Dr Ross Dunne TCD/HRB Research Fellow

31. National Cancer Strategy

33. No New Drugs, No Silver Bullets and No More Money

34. Team Work in Health Care

39. MHM Phase 1

40. MHM Phase 2

44. St Patrick's TCD- Evolution

45. St. Patrick’s University Hospital Services

48. No. Of Admissions

50. Average Length of Stay

51. Occupancy and Readmission

53. Clinical Global impression scores for 83 patients CGI Outcome Scale Patients treated with ECT for 3-4 weeks (6-8 sessions)

54. Clinical global impression scores for 83 patients Patients treated with ECT for 3-4 weeks (6-8 sessions) Outcome Baseline *For example 11 patients who started out moderately ill were judged “much better” after ECT Very much better Much better Minimally better No change Minimally worse Much worse Borderline ill 1 Mildly ill 2 Moderately ill 11* 5 1 Markedly ill 2 16 6 3 Severely ill 3 15 8 5 Extremely ill 2 2 1

55. Nothing acts faster than Anadin

58. Service User Satisfaction

59. Compliance with Mental Health Commission Regulations and Standards

60. St Patrick's Dean Clinic Network

63. Wellness and Recovery Centre

66. Deliberate Self Harm

68. Financial Information 2004-2011

69. Cost per Treatment Episode