Introduction Despite the rapid advance of psychedelic science and possible translation of psychedelic therapy into the psychiatric clinic, very little is known about mental health service user attitudes. Objectives To explore mental health service user attitudes to psychedelics and psilocybin therapy. Methods A questionnaire capturing demographics, diagnoses, previous psychedelic and other drug use, and attitudes to psychedelics and psilocybin therapy was distributed to mental health service users. Results Ninety-nine participants completed the survey (52% female, mean age 42 years). The majority (72%) supported further research, with 59% supporting psilocybin as a medical treatment. A total of 27% previously used recreational psilocybin, with a male preponderance (p = 0.01). Younger age groups, those with previous psychedelic experience, and those with non-religious beliefs were more likely to have favourable attitudes towards psilocybin. A total of 55% of the total sample would accept as a treatment if doctor recommended, whereas 20% would not. Fewer people with depression/anxiety had used recreational psychedelics (p = 0.03) but were more likely to support government funded studies (p = 0.02). A minority (5%) of people with conditions (psychosis and bipolar disorder) that could be exacerbated by psilocybin thought it would be useful for them. One fifth of the total sample viewed psychedelics as addictive and unsafe even under medical supervision. Concerns included fear of adverse effects, lack of knowledge, insufficient research, illegality, and relapse if medications were discontinued. Conclusions The majority supported further research into psilocybin therapy. Younger people, those with previous recreational psychedelic experience, and those with non-religious beliefs were more likely to have favourable attitudes towards psilocybin therapy.

AimsPrescribing errors can lead to patient harm and are a patient safety issue. In 2019 the Acute Psychiatric Unit in Tallaght Hospital was identified by the Mental Health Commission of Ireland as non-compliant with regulation 23 of the Mental Health Act pertaining to the Ordering, Prescribing, Storing and Administration of Medication. Compliance with regulation 23 is a mandatory condition for the registration of the Unit as an Approved Centre to provide treatment for mental illness in Ireland. Regular auditing was performed to identify areas of non-compliance in prescribing practices and where identified to improve upon these practices per Mental Health Commission standards.MethodA cross sectional review of 14–18 medication Kardexes was completed monthly from August – December 2020. Kardexes were audited against 20 standards set by the Mental Health Commission. An electronic audit tool was used to collect data. Medical teams were informed of any incidences of non-compliance. Education sessions delivered by both medical staff and the ward pharmacist were provided to junior doctors and consultants regarding the Mental Health Commission regulations for prescribing. We developed information leaflets that were placed at the front of Kardex folders highlighting key areas where errors were regularly made. Monthly staff emails were sent reminding prescribers of the importance of adhering to guidelines and updating them on the most recent audit results.ResultImprovements were noted in all aspects of prescribing over the five-month period. Prescriptions of non-proprietary medication improved from 40% of Kardexes to 87% over the five-month period. Recording of prescriber medical registration number improved from 80% to 87% of Kardexes. Documentation of the dates of initiation and discontinuation of a medication improved from 40% to 67%. The use of appropriate patient identifiers on Kardexes improved from 93% to 100%.ConclusionTargeting staff across multiple domains including emails, information leaflets and education sessions resulted in consistent improvements in medication prescribing. The Mental Health Commission has since inspected the Acute Psychiatric Unit in Tallaght Hospital in 2020 and deemed it fully complaint with regulation 23 pertaining to medication prescribing.

AimsThe Mental Heath Commission (MHC) is an independent body in Ireland, set up in 2002, to promote, encourage and foster high standards and good practices in the delivery of mental health services and to protect the interests of patients who are involuntarily admitted. Guidelines on the rules governing the use of seclusion are published by the MHC. These guidelines must be followed and recorded in the patient's clinical file during each seclusion episode. A Seclusion Integrated Care Pathway (ICP) was devised in 2012 for use in the Approved Centre in Tallaght University Hospital. This ICP was developed in conjunction with the MHC guidelines to assist in the recording and monitoring of each seclusion episode. Since its introduction in 2012, this ICP has become an established tool used in the Approved Centre in Tallaght University Hospital.The aim of this audit was to assess adherence to MHC guidelines on the use of seclusion in the Approved Centre in Tallaght University Hospital 8 years after the introduction of an ICP and compare it to adherence prior to its introduction and immediately after its introduction.MethodThirteen rules governing the use of seclusion have been published by the MHC. These include the responsibility of registered medical practitioners (RMP), nursing staff and the levels of observations and frequency of reviews that must take place during each seclusion episode. Using the seclusion register we identified a total of 50 seclusion episodes between August 2019 and July 2020. A retrospective chart review was conducted to assess documentation of each seclusion episode.ResultThere was an overall improvement in adherence with MHC guidelines compared to adherence prior to the introduction of the ICP and immediately after its introduction. Areas of improvement included medical reviews, nursing reviews, informing patient of reasons for, likely duration of and circumstances that could end seclusion, and informing next of kin. The range of compliance levels across the thirteen MHC guidelines improved from 3–100% to 69–100%. Post intervention there was 100% compliance with five of the thirteen guidelines.ConclusionThe introduction of an ICP led to an overall improvement in compliance with MHC guidelines. The ICP has ensured that many of the rules governing seclusion are explicitly stated; however adjustments and revisions to the document and ongoing staff training are needed to ensure full adherence to MHC guidelines.