By Etáin Quigley, Research Assistant, Change Team, ARCH

The elephant in the room trumpets from time to time and we all pay attention for a while. However, little has changed in terms of stigma and apprehension about mental health. We remain in an era where individuals are comforted and supported when ill generally but, more often than not, disassociated from and viewed with trepidation when suffering from a period of mental health upheaval.

Mental health is an umbrella term for many illnesses affecting a person’s mental wellbeing. Further, it has varying degrees of severity and symptom presentation. It can be a short term period of mental sensitivity and upset, or a lifelong illness which requires patient investment into their own well-being and long term contact with mental health services.


A functioning and carefully constructed patient self-management or collaborative-management system is key to securing better outcomes for patients and likely to result in a more effective reallocation of resources in the already struggling mental health care system. However, and reverting to the thought provoking blog ‘Self-management: Is Irish Healthcare even ready for it?’ written by my colleague, Patrick Slevin, on the 24th of November 2015, such a model must be explored with caution as the system must be ready and able to provide a workable and patient-centred model. Assumptions that such a model can be easily applied may result in patients being over responsibilised thus potentially jeopardises their well-being. Referring to another point raised by Patrick, non-adherence to medication is a key cause of relapse, crisis, and rehospitalisation. Rehospitalisation not only dramatically increases the cost of care for these patients but also causes problematic upheaval in terms of education and employment, and disrupts family life and relationships.

This is not a new problem, nor is it an unknown problem amongst practitioners in the field. Indeed, my own work as a mental health tribunal member repeatedly highlights this issue and yet little is being consistently done to truly address the problem of weak collaborative-management as it currently exists.

Patient empowerment, a recent buzz word in the area of health care, is key to success for people who suffer from mental health issues. Providing patients with the correct tools to take control of their own health, whilst being properly supported by community service health care professionals, can promote a workable collaborative-management regime particularly suited to the mental health care services.

Such a model will only work if patients are assisted when well and in a strong position to make clear decisions related to their future needs. Intervening at crisis stage only relieves the crisis. Is it not time to adopt a collaborative-management crisis prevention model that aims to prevent the onset of a crisis?

My aim in the future is to explore what connected health has to offer in terms of constructing a collaborative-management model aimed at reducing crisis intervention and hospitalisation, and promoting community led collaborative care. This model will reduce the burden on the already over stretched mental health system and assist patients with leading a more stable and sustainable life in the community.

Please feel free to contact me if you are interested in discussing my work further.

You can contact Etáin on or call 01 716 5410.

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