Welcome to SPIRE, St Patrick’s Institutional Repository.
SPIRE is a digital space for research, academic and organisational information generated by staff across our services.
Established by Jonathan Swift in 1746, St Patrick’s Mental Health Services (SPMHS) is Ireland’s largest, independent, not-for-profit mental health service. In conjunction with our newly establish Academic Institute, SPIRE has been designed to store, catalogue, index, preserve, and share our academic outputs and aims to make published and unpublished work of our staff as widely available as possible. It includes the full text of journal articles, conference presentations, books and book chapters, technical reports, working papers, reviews and other scholarly contributions. Where material has already been published by external sources, it is made available subject to the open-access policies of the original publishers.
SPIRE aims to support and increase the impact of mental health research and ensure the voices of people who experience mental health difficulties, who participate in research, are heard and listened to. It is managed by the Academic Institute here in SPMHS.
You can learn more about our Academic Institute and our research activity here.
Recent Submissions
Item A Global Delphi-Based Expert Consensus on Relapse Prevention Strategies Following Successful Electroconvulsive Therapy for Major Depressive Disorder.(2026-03-11)Electroconvulsive therapy (ECT) is a highly effective treatment for depression, yet relapse rates up to 50% within a year are reported. Studies have examined ECT, pharmacological, and nonpharmacological relapse prevention strategies, and although current guidelines provide general recommendations, no consensus-based or operationalized guidance exists regarding optimal relapse prevention after successful ECT for major depressive disorder. The aims of this study were to identify relapse prevention strategies commonly implemented after ECT, to evaluate their perceived effectiveness among international ECT experts, and to establish consensus-based personalized clinical recommendations.Item Psychometric Evaluation of the FFOCI-SF and Other Clinical Outcome Measures in a Group Therapy for Overcontrol (Group Radical Openness).(7 Mar 2026)Group Radical Openness (GRO) is a group therapy program targeting costly and harmful overcontrol. This service review psychometrically evaluated GRO's outcome measures as part of the clinical team's ongoing deliberation about their suitability. Particular attention was given to the Five Factor Obsessive-Compulsive Inventory-Short Form (FFOCI-SF), the program's primary measure of overcontrol.Item Mental health nurses' knowledge of providing physical health care: analysing educational needs in an Irish independent mental health service.(2026-02-07)Background/aims: Many people living with serious mental illness experience physical health issues, making it important to adopt an integrated approach to care. Assessing the training needs of mental health nurses in providing physical health care can help to implement appropriate training in holistic care. This study aimed to understand mental health nurses' perceptions of knowledge and confidence in delivering physical health care to determine the type of training requirements they require personally and as a group. Methods: A mixed methods approach was used for the study. An anonymous survey with Likert-type questions was sent to all nurses in an Irish independent mental health service. Open-ended questions were thematically analysed. Ethical approval was received. Results: The largest perceived gaps in physical healthcare knowledge related to the delivery of intravenous fluids (64.8%), vascular skin changes (58.1%), interpretation of bloods (45.9%) and wound care (41.8%). Three themes were identified from the thematic analysis: value of interactive sessions, method and frequency of educational sessions, and mental health upskilling. Conclusions: This study found that there was a need for flexible and consistent training for mental health nurses to effectively provide physical health care for people in hospitals experiencing mental ill health. Implications for practice: This study highlights the need for consistent, flexible, and skills-based physical health training to strengthen mental health nurse competence in core areas such as wound care, diabetes management, intravenous therapy and interpretation of blood results. Strengthening these skills can enhance early recognition of physical deterioration, improve holistic care, and ultimately support safer outcomes for mental health service users. Further studies evaluating the effectiveness of educational modules relating to physical healthcare should be conducted, examining their effectiveness both in terms of nurse- and patient-related outcomes.Item Global trends in clozapine utilisation between 2014 and 2024: a longitudinal epidemiological study with data from 75 countries(2026-02-03)Background Clozapine underutilisation in treatment-resistant schizophrenia represents a global public health challenge. We aimed to investigate contemporary trends of clozapine utilisation internationally. Methods National estimates of clozapine utilisation were obtained for 75 countries through analysis of national prescribing databases and global pharmaceutical sales data from the IQVIA Multinational Integrated Data Analysis System. The annual national prevalence of clozapine utilisation was calculated between 2014 and 2024 via the number of defined daily doses (DDD) utilised per 1000 inhabitants per day (DDD/1000 inhabitants/day). Time trends in the annual prevalence of utilisation were tested using linear regression. Haematological monitoring stringency and the number of psychiatrists were explored as predictors of clozapine utilisation. Findings In 2024, the global average clozapine utilisation was estimated as 0.46 DDD/1000 inhabitants/day, being greatest in New Zealand (2.99 DDD/1000 inhabitants/day), and Finland (2.61 DDD/1000 inhabitants/day) and lowest in Singapore (0.0007 DDD/1000 inhabitants/day). Over the period analysed, worldwide clozapine use increased by 0.13 DDD/1000 inhabitants/day. In 45 (60.0%) countries clozapine utilisation increased significantly, in 19 (25.3%) use remained similar, but in 11 (14.7%) use decreased significantly. Higher clozapine utilisation was associated with a higher number of psychiatrists (B = 0.11 [95% CI 0.05, 0.17]), but was unrelated to haematological monitoring stringency (B = 0.007 [95% CI −0.02, 0.03]). Interpretation Whilst global utilisation appears increasing, substantial intercountry variation in clozapine use continues. The absence of an association between haematological monitoring stringency and rate of clozapine utilisation suggests the need for measures beyond monitoring relaxation within policy and practice to systematically increase use.Item Personal Recovery in Substance Use Disorder: A ‘Best Fit’ Framework Synthesis Systematic Review.(2026-02-03)Personal recovery is increasingly important in service delivery. While personal recovery has been examined in relation to several mental health issues, it has yet to be reviewed in recovery from substance use disorders. This review of qualitative studies, which followed PRISMA guidelines, used a ‘Best Fit’ framework synthesis. To organise studies, the a-priori, transdiagnostic CHIME framework was employed. 2885 papers were initially identified, with 3 added in updated searches; 13 papers were included for analysis. Findings show that CHIME captures many elements related to recovery from substance use. However, the original framework does not consider challenges associated with trauma, loss, and stigmatisation. Including a ‘Difficulties’ domain supports the use of the CHIME-D framework. Personal recovery from substance use is a complex and individual process. The CHIME-D framework emphasises the importance of professionals adopting a balanced approach to recovery, recognising both benefits and challenges.
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