Carers and Supporters Information Guide - St Patrick's Mental ...
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Carers and
Supporters
Information
Guide
Contents
Foreword 2
Section One:
About this guide 3
Section Two:
About St Patrick’s Mental Health Services 7
Section Three:
The Inpatient or Homecare journey 12
Stage 1: Admission to hospital 14
Stage 2: Inpatient and Homecare 16
Stage 3: Medication 21
Stage 4: Discharge 21
Stage 5: Post discharge supports 22
Section Four:
Some practical matters 23
Section Five:
Supporting you 28
Section Six:
Support groups and additional information 34
1
Foreword
Making the decision to I wish to congratulate all of those who were
seek help for a mental involved in preparing this guide and who have
health difficulty is a driven this project from concept to completion.
courageous and often
SUAS is an essential part of the services provided
life changing choice.
by SPMHS and all its members give their time
It requires self-belief
voluntarily. Their experiences, wisdom and vision
and determination
are apparent throughout this guide. Since 2005
and also the support
SUAS has played a significant role in transforming
of those who are
SPMHS into the human rights, person-centred
closest to us.
organisation it is today.
These are the
International research supported by our everyday
people who are
experience confirms that those who experience
there throughout the
mental health difficulties should expect to
recovery journey supporting, re-energising and
recover and lead fulfilling lives. In this guide,
encouraging. Sometimes these are the people
we emphasise that carers and supporters
who make the difference by reinforcing the
should also believe in this expectation of
impact of formal therapy and treatment.
recovery.
I am very pleased to welcome this revised edition
I know that this guide will provide carers with
of The Carers and Supporters Information Guide.
vital information and reinforcement for the
This practical and accessible guide, originally
valuable and challenging commitment that
developed in 2015 and updated in 2021, was
they make for the benefit of others.
written by our Service Users and Supporters
(SUAS) Council for supporters of those in the care
of St Patrick’s Mental Health Services. This new Paul Gilligan
edition has been updated to reflect a number of Chief Executive Officer
changes to our services, particularly those brought
about as a result of the COVID-19 pandemic.
The guide highlights how best to support a
person throughout their recovery journey,
but also gives some practical advice for carers,
relatives and friends on how they can nurture
their own wellbeing.
2
Section One
About this guide
3
We, the members of St Patrick’s We are very aware that being involved with a
mental health service for the first time can be a
Mental Health Services’ (SPMHS)
challenging experience for everyone concerned.
Service Users and Supporters (SUAS)
We hope that this information booklet will be a
Council, have written this guide for
helpful guide for you when supporting someone
those supporting people with mental on their path to recovery.
health difficulties. We hope this This guide was originally developed by SUAS
guide will help you as you support in 2015 and it has been updated in 2021. The
someone’s journey to recovery. updated version includes reference to the public
health restrictions that were introduced in 2020
The guide has been reviewed and approved by in response to the outbreak of COVID-19. These
SPMHS governance structures. restrictions may change in line with the public
SUAS is a voluntary group of former service users health situation and therefore you should check
and carers who advocate on behalf of all those the SPMHS website for the most up-to-date
who use the hospital’s mental health services. information about the restrictions currently
in place.
Getting started with
this guide
Who is this guide for?
This guide aims to be a tool for the carers of
people who are treated by SPMHS, especially This guide is aimed at carers and family
those who are coming into contact with the members of service users who are attending
services for the first time. SPMHS, particularly where they have been
admitted to hospital. SPMHS also provides
There are a number of different headings in the a community and outpatient care pathway
guide so that you can quickly find the sections through its network of Dean Clinics and its
that are of most interest to you. Wellness and Recovery Centre, which
We have tried to provide information that provides day patient care. All services can
will help you understand how SPMHS works, be accessed remotely or in-person,
especially the inpatient journey, and to answer depending on what public health
the kind of frequently asked questions that our restrictions are in place.
family members and supporters have as well SUAS believe that having a guide for carers
as listing the kinds of questions you might ask and family members that is written in Plain
SPMHS staff. English will help you to better understand
We have also included some information about your loved one’s hospital journey. We hope
ways you can support yourself during this time. you find this guide helpful, at what we know
Mental Health Ireland have produced a very can be a challenging time.
helpful booklet for carers and family members We welcome feedback on this guide and
which you might find useful. any suggestions for improvements or
changes.
You can contact SUAS by:
• email: SUAS@stpatsmail.com, or
• In writing: SUAS, PO Box 136,
James’s Street, Dublin 8.
4
Words used in this guide Sometimes, providing this type of support may
have an impact on your own employment,
In this guide we use some terms that you relationships, social life, physical or mental health,
might find helpful for us to explain here. or all of these things. It is important that you take
care of yourself. There are several self-help or
When we are talking about the person who is
support groups and services available to help and
in SPMHS’ care, we talk about:
these are listed in Section Six of this booklet.
• service user
If you are a carer you may have found yourself
• loved one.
feeling confused when the person you care for
When we talk about the person who supports develops a mental health difficulty. This response
a service user who is receiving treatment provided is very common, and we hope that this guide may
by SPMHS, we use the terms: help you with some of the issues that may arise
• carer for you.
• caregiver
• family member
• relative Should you have any worries or concerns
• supporter. about your safety and wellbeing as a carer
or supporter, the multidisciplinary team
Am I a carer? involved in treating the service user can
be contacted for advice and to assist with
You might not think of yourself as a carer. access to specialist services that may be
However, as a family member or friend who is helpful.
doing their best to support someone you are Experience of any form of abuse in
close to, and who is going through a very hard relationships is not acceptable and
time, you are in the broadest sense a carer. SPMHS staff are available to provide
There are a number of ways to define a carer. information and support to ensure the
You are a carer if you spend a lot of time safety and wellbeing of both service
supporting someone in your family, or a friend, users and their families.
who needs help in dealing with a mental health
difficulty, and you are an important part of that
person’s support system.
Carers may be:
• husbands/wives or partners
• children
• siblings
• housemates
• parents
• close friends.
Carers provide ongoing support, which may be
in a social, emotional, physical and/or financial
capacity.
Recovery Festival and Family Fun Day 2019 at St Patrick’s
University Hospital
5
Young carers Safeguarding at SPMHS
In some cases, the service user may be a parent SPMHS has a number of policies in place to
with a mental health difficulty, and their young protect people through out their lifespan. These
son or daughter (under 18 years of age) is acting in include policies to protect vulnerable adults, older
a caring role in the family home during this time. persons and those subjected to domestic violence
and coercive control.
The child protection and welfare policy promotes
safety and wellbeing for children. This policy
directly reflects the Children First Act 2015.
During the course of treatment it is very common
for people to speak about traumas that they
experienced in the past. It is often important for
their recovery to deal with this trauma. However,
it is also essential that any child protection
concerns that may arise from a disclosure about
past abuse is referred to the statutory services
so that the safety of children they may have
contact with now is established.
As part of the SPMHS admission, the staff will
identify where a young person is providing care.
In these circumstances, they will work with
your loved one to help and support
their family.
More information can be found at
familycarers.ie.
6
Section Two
About St Patrick’s Mental
Health Services
7
St Patrick’s Mental Health Services
(SPMHS) is Ireland’s largest
independent, not-for-profit mental
health service provider. It provides
community and outpatient care
through its Dean Clinics and day
patient services through its Wellness
and Recovery Centre.
SPMHS also offers a Homecare service and remote
access to its services through phone, video and
online channels.
SPMHS provides multidisciplinary inpatient and Recovery
homecare services through its three approved
SPMHS’s philosophy is that with proper treatment,
centres:
and in cooperation and partnership with various
mental health professionals, people can and
• St Patrick’s University Hospital (SPUH) do get well and recover from mental health
• St Patrick’s, Lucan (SPL) also called difficulties.
St Edmundsbury Hospital (SEH)
In fact, recovery is central to everything that
• Willow Grove Adolescent Unit
SPMHS does. SPMHS bases its recovery
(WGAU).
programmes on the Wellness and Recovery Action
Plan (WRAP®) principles developed by Mary
Ellen Copeland, a US Mental Health and Wellness
pioneer.
The recovery programmes are not specific to any
one diagnosis, but help an individual develop
their own wellness plan including:
• identifying triggers
• having someone available to support them
THE ROAD TO
RECOVERY
• planning for crisis, should it reoccur.
STARTS WITH
A SINGLE
STEP
8
Family recovery Speaking about mental
Recovery is not confined to the experiences of the health difficulties with
person availing of care and treatment. It can be, others
and often is, a journey that all members of their
family, carers and supporters undertake as well. For many people, speaking openly about their
mental health in a way that’s free of stigma can
As mentioned earlier in this booklet, Mental
be very empowering. However, it is important to
Health Ireland have produced a resource for
remember that mental health difficulties, as with
family and carers with lots of helpful information
other health matters, are by their nature personal
for people supporting someone who is
and it is up to the person themselves as to how,
experiencing a mental health difficulty.
when and with whom, they wish to speak about
You can access their website here.
mental health issues.
As a family member, carer or friend, you can
It is helpful to establish with your loved one
visit the free drop-in Information Centre located
who they are comfortable with knowing about
opposite reception in St Patrick’s University
their mental health so that you can respond
Hospital (SPUH). The Information Centre can
appropriately if another friend or family member
provide information about mental health issues,
asks after them.
support services and educational materials.
While being able to speak openly with family
You can also access the free Support and
members, partners and those closest to us is vital
Information telephone and email service.
to mental health, this should be done in a way
See Section Six in this guide for more that respects the wishes and preferences of the
information. person who is experiencing the mental health
difficulties.
Establishing these preferences is an important
step in building support networks for your
loved one and in enabling non-judgmental and
supportive conversations about their mental
health.
A SINGLE STEP
LEADS TO THE
BIGGEST
CHANGE
9Information about Child protection and welfare
your loved one and St Patrick’s Mental Health Services, along with all
confidentiality healthcare providers, has a Child Protection and
Welfare Policy in place. This policy promotes the
Confidentiality is very important to people safety and wellbeing of children. It is important
who are receiving care and treatment. SPMHS that children have a secure and positive
can only give a supporter or a family member environment that promotes their wellbeing
information if the person who is receiving care and growth. It is our aim to join with parents
and treatment gives their consent. SPMHS is or guardians in promoting the best outcomes
bound by this agreement between the person for children.
receiving care and treatment and the mental
SPMHS has a clearly defined Child Protection
health professional.
Statement that is included in the SPMHS Charter.
If your loved one gives their consent, you can This Statement is also available on the SPMHS
speak to staff about their progress in hospital website, in the Service User Information Booklet
and be involved in some of their meetings with and on all wards.
their consultant and other staff. This is always
A summary of the charter is provided in the
decided on an individual basis as part of the care
next section of this booklet and you can request
and treatment plan. Your loved one also has the
a copy of the full charter from the Information
option of sharing key information about their
Centre, any staff member, or from the Clinical
care and treatment at SPMHS with you via Your
Governance Department.
Portal. This is an online, secure platform that can
be accessed on your computer, smartphone or
tablet. Information on how to register and use the
Charter of Service User
portal can be found on the SPMHS website. and Family Rights and
If the person you are caring for or supporting Responsibilities
indicates that they do not want any information
SPMHS has a Charter for those receiving care and
disclosed, SPMHS is legally bound to abide by
treatment and it includes a section for family
this. Any disclosure would be considered
members. This is summarised on the next page,
a confidentiality breach.
and a full copy of the charter is available in the
Information Centre, from any staff member, or
SPMHS does encourage friend and family from the Clinical Governance Department.
support as much as possible. However,
it cannot force this on any individual if they
You can contact the Clinical Governance
choose that they do not want to have family
Department by email or in writing at this
or carer involvement in their care and
address:
treatment. We know that this can be very
difficult, but education about the illness Clinical Governance Department,
and support groups may provide some St Patrick’s University Hospital.
help with this. James’s Street, Dublin 8.
10Summary of the As a relative or carer you have a
responsibility to:
SPMHS Charter • give accurate information to SPMHS
SPMHS are committed to delivering an effective • co-operate with investigation of any
mental healthcare service, in an environment complaint you make
that fosters mutual respect for the rights and
• consider and respect others and your
dignity of all.
surroundings
The SPMHS Charter of Service User and Family
• respect the confidentiality and privacy
Rights and Responsibilities helps SPMHS to
of others
achieve this goal.
• be responsible for belongings you keep
These rights are without regard to gender, culture,
in your possession
economic, educational, age, sexual orientation,
marital/family status, religious or ethnic • not to bring in, or arrange to be brought
background or source of payment for care. in, any items or substances that may be
considered harmful
As a family member / carer you have the right to:
• comply with staff direction in matters
• a safe environment of safety
• collaborate in the care of the person receiving
• not engage in criminal, violent or anti-
treatment with their consent
social behaviour
• visit the person receiving treatment in hospital
• abide by other rules made known to you.
with their consent
• be treated respectfully and considerately
• receive clear responses to queries you make
• make a complaint and know its outcome
• request to participate or refuse to participate
in teaching, clinical trials or research at any
time
• refuse to participate in teaching or research
at any time
• receive the following information:
- legal rights and entitlements
- names and qualifications of those
treating the person undertaking
treatment in SPMHS
- details of any treatments suggested
- notice of significant events (including
transfers) that involve your relative, and
plans regarding discharge
- pending discharge
- explanation of the costs of care.
Rights to information are dependent on your
relative or friend’s expressed wishes.
11Section Three
The inpatient or Homecare
journey
Post
discharge
Discharge supports
Inpatient care
Medication
12
Admission to hospitalWhen your loved one is admitted to Voluntary or involuntary
hospital, it can often be difficult to
admission
understand what will happen during
In most cases people admitted to hospital
their stay, particularly if it is their
recognise they need treatment and they are
first time as an inpatient. This section admitted on what is called a voluntary basis. This
provides a general summary of what means that they have the right to make decisions
you and your loved one can expect regarding their care and treatment including the
along the various stages of right to refuse or accept treatment, and to leave
the hospital prematurely if they wish to do so.
their journey.
However, there are also occasions when a person
There is no ‘one size fits all’ rule and just as is very unwell and does not have the capacity
everyone’s illness is different, so too is the (ie. ability, capability or fitness) to make these
treatment and their journey. However, we hope decisions. When this happens, they may be
that this overview will give you some general admitted on an involuntary basis.
information about how SPMHS delivers care
The law provides a mechanism to protect these
and treatment.
service users’ rights to access care and treatment
by means of an involuntary admission, but
strict procedures must be followed for this to
happen. This information booklet produced by
the Mental Health Commission provides more
detail about the Mental Health Act 2001 and the
circumstances when someone can be admitted
to hospital against their will.
Someone can only be admitted to hospital
involuntarily if they have been diagnosed with a
mental disorder. The definition of what a mental
disorder is in law is detailed on page 22 of the
information booklet produced by the Mental
Recovery Festival family fun day Health Commission.
Procedures for involuntary
admission
Before admission to hospital a doctor will
examine your loved one and if they think
that they meet the conditions for involuntary
admission, they will recommend that they
are admitted. Sometimes, in exceptional
circumstances, it may be necessary to have your
loved one accompanied to hospital by a specialist
ambulance service or the Gardaí. We know that
this can be very distressing for you and your loved
one, but these options are only used when it is
necessary for the safety of your loved one.
13A consultant psychiatrist in the hospital will If following that assessment, the treating then examine your loved one. If, following their consultant psychiatrist is satisfied that the person comprehensive assessment, the consultant agrees is suffering from a mental disorder, they can make that they meet the conditions for involuntary the person an involuntary patient, and they will admission, they will sign an admission order be afforded all of the protections of the mental which lasts for 21 days. The Admission order must health act, including independent review and be sent to the Mental Health Commission and review by an independently appointed mental it is them who assign a legal representative to health tribunal. your loved one and convene a Mental Health tribunal within 21 days of the order. The treating Stage One: consultant will review your loved one on a regular basis but will also do this formally in the seven days before the admission order ends. Admission to hospital If the consultant believes that your loved one Accompanying your loved one to hospital for still has a mental disorder, they will sign a an admission is difficult regardless of whether renewal order. This renewal order means that it is their first admission or if they have been their consultant psychiatrist believes that it is in admitted in the past. The first person you and their best interest to stay in hospital for another your loved one will meet will be a member of period of time, which cannot be longer than the reception team. They will direct you to the three months. This decision is reviewed by the Assessment Centre where you will be greeted by independently appointed mental health tribunal the Admissions Officer or the Clinical Nurse and either affirmed or revoked. Manager. Most service users who are detained under the Mental Health Act are admitted in to the Special Care Unit at SPUH. This is the intensive care unit where your loved one will have much higher levels of observation and more restrictive practices to ensure their safety and assist in their initial recovery. If your loved one does not meet the conditions outlined in the Mental Health Act 2001, the consultant psychiatrist will not sign the admission The Admissions Officer will complete all the order. This means that they are free to leave necessary admission forms with your loved one. hospital if they choose to do so, but it may be Following this, an admission assessment will be possible for them to stay in hospital as a carried out by an admitting doctor or a Team voluntary patient. Liaison Nurse (TLN). During their hospital admission your loved one The admission process and assessment procedure may decide that they want to leave the hospital. can take about two hours as it is important that If this happens they should always discuss this the staff have a comprehensive understanding of with a member of their care team. If a voluntarily symptoms to make an initial diagnosis. admitted service user expresses a wish to leave Your loved one will be asked to nominate a hospital and their treating team are of the family member, friend or relative with whom opinion that they are suffering from a mental hospital staff can speak to on an ongoing basis. disorder, they can be detained under the mental This nominated person can act as a spokesperson health act for a period not exceeding 24 hours for and inform other concerned family members or the purposes of assessment. friends of their progress. 14
When the admission process has been
completed, your loved one will be brought to
Your role at admission
their room or ward. A member of the nursing The admissions team may ask you, as a carer,
staff will then complete a risk assessment which family member, friend or supporter for additional
includes searching their belongings. This is done information about your loved one.
to make sure that there are no items which could
SPMHS staff will only ask you for this information
potentially cause harm either to themselves, other
if the person being admitted gives their consent.
service users, staff members or visitors.
This information is recorded in your loved one’s
Any items that are removed for safekeeping are medical chart.
logged on an inventory and will be returned to
The doctor who is admitting them may ask you
your loved one when they are being discharged
to provide some family history, or background
or later in their admission subject to risk
information, or both, about the person being
assessments.
admitted. This is recorded in the care plan. The
care plan is part of the medical record and is
reviewed weekly. People receiving care and
It is important to remember that the
treatment in hospital are entitled to receive a
admission and assessment process may
copy of their care plan.
be impacted by COVID-19 restrictions.
You should visit the Your Stay page on Your loved one will also be able to access this
the SPMHS website for up-to-date information on Your Portal. It is also possible for
information on the COVID-19 infection them to share access with you to their portal so
control measures in place. that you can view some or all of the information
in their record.
If, after discharge, your loved one requests
their clinical record, the hospital will seek your
written consent before sharing with them the
additional background information
you provided on admission.
Admission to Homecare
If your loved one is admitted to the Homecare
service, the admission process will be similar to
that detailed above, except they will not have a
physical assessment. Service users admitted to
Homecare also have a bed reserved for them
onsite. This is to ensure that if they need to
come into hospital for any reason, they can be
admitted without delay. The service also includes
arrangements with local pharmacies
for medication.
15Stage Two: You should direct ongoing or day-to day-queries
about your loved one’s care and treatment to a
member of the ward-based nursing staff.
Inpatient care
Supporting your loved
The first few days after being admitted provides
a period of rest, assessment and an opportunity one on Homecare
to settle in. During this time, the person in If your loved one is availing of the Homecare
hospital will meet the staff on the ward who
service, you can support them in a number of
will give them information about the routines
practical ways.
and practices on the ward such as mealtimes;
when the members of the treating team will be • Check in with them if they have appointments
available; and general activities. and help then to find a quiet private space
where they can engage with the members
Staff may initially place someone in a bay bed
of their treating team in private and without
which is located close to the nurses’ station and
disturbance.
not an individual room; this is so that the nurses
can observe and assess them. • Difficulties with technology can often cause
stress and worry. If they need support using
Every person receiving care and treatment has
technology to access appointments or
an Individual Care Plan (ICP) and their recovery
activities, then you can contact the Service
is managed through a multidisciplinary team
User IT Support (SUITS) Service on their
(MDT). The MDT is the team of mental health
professionals who will be looking after your loved behalf to request help.
one’s care and treatment. The SUITS service is available Monday to Friday
During their first few days in hospital, your loved from 9am to 5pm and you can phone them on
one will meet with their MDT, their key worker 01-249 3629 or contact them by email
and nursing staff on the ward. They may attend a suits@stpatsmail.com.
therapeutic programme or undertake one-to-one • Encourage and support them to engage with
therapy or assessments. the activities available to them. They will be
The team usually meets weekly to review their sent an email each day with information
care and recovery. A MDT generally consists of the about the activities available for the
following clinicians: following day.
• Consultant psychiatrist
• Registrar in psychiatry / Team Liaison Nurse Safety concerns
• Social worker
If you are concerned about the safety or wellbeing
• Occupational therapist
• Psychologist of your loved one, you should make contact with
• Pharmacist the ward to which your loved one is assigned. If
• Counsellor / Therapist you do not have this information, then you can
• Multidisciplinary nurse specialist contact the main hospital reception by phone on
• Ward based nursing staff 01 249 3200, day or night and staff will direct your
call and guide you to the most appropriate action.
The names of the members of the MDT for the
consultants on your loved one’s ward are clearly You can also contact the Support and Information
displayed on each ward. If your loved one has service by phone or email. This service is staffed by
any questions about any aspect of their care they experienced mental health nurses between 9am
should speak first to a member of the nursing and 5pm, Monday to Friday with an answering
staff, who will try to resolve any queries and call back facility outside of these hours.
or questions they may have.
16What is an Individual Your involvement in the care
Care Plan? plan and treatment
The MDT will work with your loved one to develop Sometimes, the person who is receiving care and
and implement an Individual Care Plan (ICP). This treatment will tell the hospital that they do not
information will be outlined in their care plan wish to have any information about any aspect of
document which is part of their clinical record their care and treatment discussed with family
and is reviewed weekly by their team. members or relatives. In these cases, SPMHS
Your loved one may request a copy of their ICP must respect the person’s right to privacy and
from the team. Each week your loved one will be confidentiality.
asked to complete an expectation form which This is a requirement under both medical ethics
forms part of their weekly review. Nursing staff and data protection laws. However, in most cases,
provide them with a copy of this form before their the person receiving care and treatment is happy
MDT meeting. to have information about their condition shared
with their carer or family members.
What is a key worker? Where suitable and appropriate to the individual’s
recovery and care plan, SPMHS will include family
A key worker is the health professional
members, supporters and relatives as active
responsible for making sure that your loved one
participants in their treatment.
and their MDT team work to their agreed ICP.
This may take the form of a meeting with the
Your loved one’s key worker can be any member
treating consultant or MDT responsible for the
of the MDT looking after their care and treatment.
care and treatment. This meeting may be with a
The key worker acts as a link between your loved
number of family members or with one individual
one and the other members of their MDT while
carer. This depends on the needs identified in
they are in hospital.
your loved one’s care plan. For example, on some
Your loved one will be assigned their key worker treatment programmes there are educational
following the first meeting with their MDT and components for family members or supporters.
they will arrange to meet with them within 72
As previously mentioned in this guide, if you are
hours of this team meeting to discuss their care
providing support to a loved one they may share
plan and recovery.
access to their online record through Your Portal.
Your loved one should meet with their key worker This will help to keep you informed during their
within 10 days of admission to hospital. If they treatment.
have not met their key worker by that time, then
they should ask a member of the nursing staff to
find out the name of their key worker and request
that they contact them.
They will also be assigned an associate key worker
to cover this important role when the key worker
is not on duty.
Your Portal is a secure, online platform that provides
service users with access anytime, anywhere to view
and document their own health-related information
17Remote access to care Advocacy for service users
and treatment in St Patrick’s Mental Health
If your loved one has been admitted to the Services
Homecare service, they will receive their care and
As a supporter or carer, you may wish to advocate
treatment remotely. This means that they will
for the person receiving care and treatment.
have access to their treating consultant, MDT and
The Irish Advocacy Network provides independent
therapeutic programmes via phone or video call.
advocacy in mental health services throughout
If you or your loved one needs help accessing Ireland and can be contacted by phone on
these appointments remotely, then you or your 01-872 8684 or by email:
loved one can contact the Service User IT Support
admin@irishadvocacynetwork.com
(SUITS) service. This service is available Monday
to Friday from 9am to 5pm, and you can contact All adults who are receiving care and treatment
them by phone on 01 249 3629 or by email in SPMHS can access an independent advocate
suits@stpatsmail.com. SUITS can also help with through the Irish Advocacy Network. It is a peer
registration to Your Portal. advocacy service. Peer advocates are people
who have personal experience of mental health
Questions you might difficulties and who have achieved a sufficient
level of recovery to complete an accredited
want to ask care staff training course in peer advocacy.
When someone is admitted to SPMHS for the first Once they are qualified they can complete a
time, you as a carer may have a feeling of being period working with an existing peer advocate
overwhelmed or ‘all at sea’. We understand this. before engaging with service users on their own.
Below are some of the questions you might want Their role is to give support and information to
to ask staff. people in hospital.
We suggest that you should put them to the ward Other advocacy agencies include the
manager, known as the Clinical Nurse Manager National Advocacy Service,
(CNM) of the ward to which your loved one has www.advocacy.ie,
been admitted; or to an appropriate member of telephone 0761 01 3000, and
your loved one’s MDT. Sage Advocacy
• What is their diagnosis and what does it www.sageadvocacy.ie,
mean both in the short and long term? telephone 1850 71 94 00.
• How long are they likely to be in hospital SPMHS encourage people to self-advocate, if they
or on Homecare? so choose and are able to do so. This is to ensure
• Will they have to take medication and, that their rights are upheld and that they have
if so, for how long? access to support and treatment that meets their
• Will the medication have side effects and, needs. They do this through the care planning
if so, what might they be? process, by listening to the views of service users
• What is a therapeutic programme? and ensuring that service users are included in
• Will they be put on a therapeutic programme all aspects of their care. Written comments and
and, if so, when might it start and how long feedback are also encouraged, as is speaking
will it last?
directly with the nurses on the ward or their MDT
• Will there be aftercare follow up after they
in the first instance. Comments, feedback and
have been discharged?
complaints are managed through the Clinical
• What involvement can we as family members
Governance Department.
or supporters have?
• What can we do to help and support?
18Therapeutic programmes Activities
SPMHS offers a wide range of therapeutic While your loved one is an inpatient, there is
programmes for those receiving care and a wide variety of activities they can avail of. It
treatment. This may be as an inpatient, on is possible that for the first few weeks of their
Homecare, or as a day patient after admission, they may not feel up to taking part
discharge. in any of these activities, and that is perfectly
Service users are referred to programmes by understandable. As they settle in and hopefully
their MDT that are appropriate to your loved start to feel a little better, they may begin to take
ones needs and as identified in their ICP. more interest in the activities available.
If your loved one is referred to a therapeutic If your loved one has been admitted to the
programme, a member of the programme Homecare service, they can access a range of
team will arrange to visit them to discuss the activities remotely. These are social, recreational
programme in more detail. A therapeutic and therapeutic programmes, which are recovery-
programme is a programme aimed at providing based.
information and education as well as developing The following information details the range of
skills for recovery from illness. activities that are available to your loved one while
Your loved one may need to answer questions they are an inpatient or on Homecare.
or complete an assessment to ensure that it is
the most appropriate programme to meet their Daily activities
needs and recovery.
Each day a range of activities and talks are
Once they have started a therapeutic programme, available for inpatients and those on Homecare.
they will be given all of the information about the An information sheet detailing all the activities
programme including a timetable. available that day is positioned outside the
lecture hall, on ward noticeboards and in the
Information Centre. These are also emailed to all
Additional information on programmes
inpatients and those on Homecare.
and how to access them is available from
any member of the MDT, from the Support Your loved one, if they are able, will be
and Information Service and the encouraged to attend activities such as morning
Information Centre. lectures, which are held daily at 9.45am. These
morning lectures are delivered by SPMHS staff
on a variety of topics that are connected to their
care and treatment. Staff do encourage service
users to take part in the various activities available
throughout the day and evening.
19Occupational therapy Evening and weekend
There are a wide range of occupational therapy activities
activities available to inpatients to support them
SPMHS provides a range of evening and weekend
to take part in the everyday activities that matter
recreational activities for service users.
to them. These include an art room, craft room,
computer room, pottery room, music room, Activities include but are not limited to bingo,
therapeutic garden and library. quizzes, movie nights, music sessions, karaoke,
singing and performances, Tai-Chi, art and
creative activities.
SPMHS also organises major events from time
to time which are available to both service users,
family members and the general public. Notices
for these activities are placed on all wards as part
of the daily information sheets that are emailed
to service users and are also available in the
Information Centre.
Therapeutic leave
As people recover and are feeling better, the MDT
may recommend ‘therapeutic leave’ for either a
day or over a weekend. You should check with
your loved one’s care team if therapeutic leave
is permitted under the current public health
Gym and exercise facilities restrictions.
Therapeutic leave provides your loved one with
in hospital an opportunity to go home, to see how they
A modern gym is located in the grounds of SPUH are progressing in their recovery, and to review
adjacent to the Temple Centre. There is also a progress when they return to hospital.
games room available in St Patrick’s, Lucan (St
Edmundsbury) as well as indoor and all-weather
Their bed in hospital remains available
gym equipment in the garden which is available
if they have any difficulties and they can
to all service users.
return at any time. This is an important
Exercise classes including pilates, yoga and part of recovery and is encouraged as
circuit training are also available. A walking part of the recovery journey.
group leave from the main reception every day
at 3.30pm and do a walk in the local area that
takes approximately 45 minutes.
20Stage Three: Stage Four:
Medication Discharge
Medication can play an important role in your The discharge process, strange as it might seem,
loved one’s recovery. It is important for you and begins at the point of admission and should be
your loved one to be informed about medicines an integral part of your loved one’s care plan.
and the choices available. Discharge involves a number of components.
The Choice and Medication website is available These include:
through the SPMHS website. It provides easy- • care and monitoring after discharge
to-understand information about medication • self-help techniques
and the side effects. This means you have this • information about relevant support groups.
information to hand and a better understanding
of the medication and side effects that the Admission to hospital is part of a person’s journey
person you are caring for or supporting is taking. of recovery. In some cases, that recovery may be
complete when they are being discharged.
The website address is:
www.choiceandmedication.org/spuh/ Others may need additional supports after
discharge, for example:
You may also wish to speak to a member of the
MDT looking after your loved one in hospital or • day programmes
on Homecare. In this context, here are some • aftercare
questions that might be on your mind about • follow-up therapy
medications. • individual appointments.
• What medication is to be used? At discharge, people are at various stages in their
recovery. It is important as a carer or supporter
• How often will the medication be reviewed? to remember that, sometimes, an inpatient stay
• How long will the medication have to be or Homecare can be only part of the journey and
taken for? ongoing help and support may be needed.
• Are there other medications that could be
used if this one doesn’t work?
You may wish to develop a plan to
• What will happen if they stop taking the support ongoing recovery, or if there is
medication? a relapse or other difficulties arise. This
• What happens if none of the medications will ensure that you are clear about,
works? and reflect, the wishes of the person
you are supporting.
If your loved one is on Homecare, they will
have their medication reviewed as regularly
as inpatient service users. The MDT will also
make arrangements with local pharmacies for
prescriptions to be sent and collected.
21Stage Five: Post discharge supports When your loved one is discharged from hospital or Homecare, they may return to attend a day services therapeutic programme, to undertake one-to-one therapy, or to attend an aftercare programme. When they are discharged they will be given a free-of-charge follow up appointment in a Dean Clinic which are in Dublin, Cork and Galway. Dean Clinic at St Patrick’s University Hospital SPMHS also provides a Support and Information Service by phone or email. This service is staffed by experienced mental health nurses between 9am and 5pm, Monday to Friday with an answering and call-back facility outside hours. This service provides information and support for service users, the general public, family, friends and healthcare professionals. You can contact the Support and Information Service by calling 01 249 3333, or if you would like to email your query to info@stpatsmail.com 22
Section Four
Some practical matters
23ATM / access to cash Children visiting hospital
There is currently no ATM service available in St Patrick’s University Hospital provides for
SPUH. However, a cash back facility is available at children to visit their parent or relative in hospital.
the hospital shop, which is located opposite the All children who are visiting a service user must
restaurant on the ground floor. be accompanied by a parent or guardian.
Opening times: SPUH has a dedicated visiting room for children,
Monday to Friday 8am to 8pm and called “The Wishing Well Room.”
Saturday and Sunday 9am to 5pm This room is situated along the corridor leading to
The nearest ATM machines are in Heuston Station the garden. Children must be accompanied by
and at the Bank of Ireland on James’s Street. Both an adult in the room at all times.
facilities are a five-minute walk from the Hospital. Access to the room can be requested from
the reception staff and is restricted to adults
Beauty therapist accompanied by children.
A beauty therapist visits SPUH every Thursday. If your loved one is resident on Dean Swift Ward
Details of the services provided are displayed or Special Care, a designated area where your
on notice boards or are available from the children can visit can be provided.
Information Centre. Appointments can be booked You should check the SPMHS website for the
at the main reception. This is a paid service and most up to date information about any visitor
payment should be given directly to the beauty restrictions that may be in place to limit the
therapist. spread of COVID-19.
Hairdressing service
A hairdressing service is available in SPUH on
Wednesdays. Appointments can be booked at
reception for the hairdresser and information
on prices and services is available from the
Information Centre. This is a paid service
and payment should be given directly to
the hairdresser.
24GP service
SPUH provides an onsite GP service
from Monday to Friday. If your loved one
needs to attend the GP a member of nursing
staff will make an appointment for them. There
is also an out of hours GP service provided for
medical emergencies.
Car parking
The hospital does not provide free car parking.
The hourly rate is currently €2.20 per hour.
A weekly ticket can be purchased in the hospital Information centre
shop and this costs €25.00. This ticket is valid
from first use for a period of seven days. Car SPMHS provides a free drop-in mental
parking rates are set at commercial rates and health information centre that is open to
these may change. current service users, family members,
supporters and the general public.
Hospital shop The Information Centre is open Monday
to Friday and is located opposite the main
In SPUH the Hospital shop is located directly hospital reception in SPUH.
across from the restaurant on the ground floor.
It provides information about mental health
This facility sells newspapers, drinks, cigarettes
issues including diagnoses, symptoms,
and a variety of other items.
medications and support services.
Opening times:
Monday to Friday 8am to 8pm Public transport
and Saturday, Sunday and Bank Holidays
8am to 5pm. St Patrick’s University Hospital is a few minutes’
walk from Heuston Station. The Luas Red Line
operates to the city centre, Busaras and Connolly
Station (Irish Rail). Dublin Bus also operate
services to the city centre.
25Restaurant IT support
There is a restaurant called ‘Ridgeways’ located The Service User IT Support (SUITS) service can
on the ground floor along the corridor from the help you or your loved one with any technical
reception area for staff, service users and their issues or information support you need to access
families. care and treatment.
They are available Monday to Friday from 9am to
5pm and you can phone them on 01 249 3629 or
by email suits@stpatsmail.com
Laundry
The hospital provides a paid-for laundry service
through an external contractor. Details of
collection times and costs are available on
each ward.
Ridgeways Restaurant
Phone communication
This facility is managed by an external contractor
and serves breakfasts, lunches and evening meals Mobile phones are permitted in the hospital
as well as snacks and refreshments. unless specifically disallowed in your loved ones
Opening times are limited due to COVID-19 own Individual Care Plan or when they are
public health guidelines and access to Ridgeways receiving care and treatment in the Special
is not currently available to visitors of SPMHS. Care Unit.
As restrictions are eased, revised access and Service users may be asked to turn off their
opening times may be introduced and these will mobile phone while attending programmes,
be advertised within the hospital. during mealtimes, during specific activities or in
one-to-one sessions.
Current opening hours are:
• Monday to Sunday 8am to 11.30am You or your loved one should not take
and 2pm to 6pm photographs or record other service users,
members of staff or visitors in order to
An outdoor coffee kiosk, The Well Bean, is situated
ensure their privacy is maintained.
in the middle garden at SPUH. This is open from
9.30am to 12.30pm and from 2pm to 4pm, seven If your loved one does not have a mobile phone
days a week. they can receive calls directly to the ward.
The Well Bean, St Patrick’s University Hospital
26Wi-Fi access Ward mealtimes
Wi-Fi is available throughout the hospital. Visitors are not allowed on the ward during
mealtimes and these are provided in SPUH at
Valuables the following times:
Delany, Kilroot, Stella, Grattan, Clara
SPMHS encourages people to only bring what
and Swift Main Wards:
they need when they are attending the hospital.
A safe is provided in each room to store valuables Monday to Sunday (including Public Holidays)
and nursing staff can also arrange for valuables to • Breakfast 8.30am
be stored on behalf of a service user. • Lunch 1pm
• Tea 5pm
Visiting times Vanessa Ward
Contact and visits from family and friends is an Monday to Friday (excluding Public Holidays)
important part of treatment and recovery. SPMHS • Breakfast 8.30am
encourages contact between service users and • Lunch 1pm
their family and friends but please remember • Tea 5pm
that your loved one may be attending therapeutic
Saturday, Sunday and Public Holidays
programmes and activities during the day and
may not always be available for visitors and they • Breakfast 8.30am
should make you aware of this. • Lunch 1pm
• Tea 4.45pm
A separate visitor room/area is provided on each
ward for visits. A member of nursing staff can Temple Centre
arrange access to this room if needed. Monday to Friday (excluding Public Holidays)
General visiting times in SPUH are: • Breakfast 8.30am
• 2pm to 4pm; and • Lunch 1pm
• 6pm to 8pm. • Tea 5pm
General visiting times in SPL are: Saturday, Sunday and Public Holidays
• 2pm to 5pm and • Breakfast 8.30am
• 6pm to 8.30pm and there is some • Lunch 1pm
flexibility around these times. • Tea 5.15pm
You should check the SPMHS website for the Swift Special Care Unit
most up to date information about any visitor Monday to Sunday
restrictions that may be in place to limit the
• Breakfast 8.30am
spread of COVID-19.
• Lunch 1.15pm
• Tea 5pm
St Patrick’s, Lucan (St Edmundsbury)
Monday to Sunday
• Breakfast 8.30am
• Lunch 1pm
• Tea service 5pm
27Section Five Supporting you 28
Usually, the person you are caring for Your own feelings
will accept that they need help and
Some carers feel that their loved one is letting
support, but it is important to know
them down. However, it is helpful to remember
that sometimes it can be difficult that the person you care for would rather be well
to maintain a positive relationship than in crisis. You might find it challenging that
between you and the person receiving suddenly all attention is focused on your loved
one.
care and treatment. Where possible,
it is useful to explain to the person You might think that nobody cares about you and
that you are being excluded. It is very important
that you are helping them because
to recognise such feelings as they are quite
you care about them. common. If you need support about issues like
this, think about attending a support group.
When they are well enough, you could consider
These groups are a great way to connect with
discussing your needs and feelings. Try to
people and find support from others who are
talk honestly with them about how you feel,
experiencing similar challenges and often know
particularly if there are times when you feel
how you feel.
especially tired or stressed. This can also help
your loved one to understand that you care
and are trying to do your best. How else can I look
Remember that it is natural to wish that the after myself?
person did not have a mental health difficulty
It is important to look after yourself as well
and, particularly, if you knew them before
as using other services to help you as a carer.
symptoms developed, to want them to be well
Remember:
again. This does not mean that you resent them.
• you are not responsible for your loved
The Information Centre opposite the main
one and their illness
hospital reception in SPUH is a great resource
and is open for anyone seeking information about • they are in good hands with a very
mental health issues including various diagnoses, experienced team
symptoms, medications and support services. • you should plan your time carefully to
The Social Work Department in SPMHS provides ensure you have breaks doing things you
advice and support to family members through enjoy.
casework with the service user. A Family
Connections Programme is provided by the
Department for family members and supporters
of service users with a diagnosis of Borderline
Personality Disorder.
Several external organisations provide
training and support for families. Details
of these supports can be found in the
Information Centre and in Section Six
of this booklet.
29Learn more about Stay in contact with your
the condition own supporters
Develop your understanding of the condition or Make sure you are in regular contact with your
conditions that the person you are caring for is own supporters to help get some of your worries
experiencing. It is often less stressful or worrying off your chest.
to be a carer for someone with a mental health
difficulty when you have an understanding of Coordinate visits
what they are facing.
Coordinate visits to the hospital with other carers
If they have a diagnosis, you might want to read
or relatives so that you can get time out.
about the condition. Remember to be careful
to get information from a reliable source - some
websites may not be accurate. The SPMHS Look after your health
Information Centre is an excellent resource and is
It is important to:
located opposite the reception desk in SPUH.
• try to get exercise
Keep up your own interests • get outdoors when you can
• eat a healthy varied diet.
As well as any organised activities like work
commitments, education or social groups, try to
make time for things you are interested in, for There are sayings that are very
example: relevant here:
• reading the newspapers “ If you don’t look after yourself, then
• book clubs you will not be able to look after
• arts and crafts groups anyone else”
• sports clubs.
“ Is ar scáth a cheile a mhaireann
na daoinne”
(proverb)
“ I’ll get by with a little help from
my friends”
(Lennon & McCartney)
While this can be difficult if you are very
concerned about your loved one, the chance to
relax, even briefly, can be helpful. You should not
feel guilty about this.
30Providing support during Be optimistic
mental health difficulty or Encourage the person who is ill to be hopeful
crisis about recovery.
Supporting your loved one while they are unwell
can sometimes be a challenge.
Accept help
A good place to find out more information is the Remember, as a caregiver, you cannot do
hospital Information Centre. The mental health everything; sometimes, you need to take a step
section on the SPMHS website is another very back and accept professional help.
useful resource, as is the Library in Your Portal.
You can also contact the Support and Information Understand behaviour
Service by phone or email. This service is staffed
Try to understand that some behaviours are not
by experienced mental health nurses between
personal and are often a feature of the illness
9am and 5pm, Monday to Friday with an
itself.
answering and call-back facility outside hours.
Helping children Avoid asking too
many questions
If someone with a mental health difficulty has
children, they should decide if they want to tell Try not to ask too many questions of the person
them, and what they should say. The Social Work you are supporting. Learn about the illness using
Department at SPMHS can provide support to the resources available to you in the hospital,
service users and their families on how to discuss such as the Information Centre, and the SPMHS
mental health with children. A range of resources website, www.stpatricks.ie.
for the person accessing treatment is available This means you will be able to ask relevant
through the Information Centre and the team questions as you will have a level of
social worker. understanding about the condition.
It is also important for you to know that you can
discuss any concerns you might have with the Daily life
multidisciplinary team and with the social worker
on that team in particular. The multidisciplinary Remember to talk about everyday things; just
team’s social worker will engage with you to because someone is not well doesn’t mean that
assess what supports would best suit your they should be excluded from what is happening
family’s needs. Then the social worker can provide outside of hospital and in daily life.
relevant information, advice and/or counselling,
and can help you to access potentially beneficial
services and resources in the community.
31You can also read
