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Aim: To explore the barriers to accessing mental health services in the Republic of Ireland from the perspectives of young LGBT + people aged 14–25. Background: Significant mental health disparities exist between LGBT + young people and their cisgender and heterosexual peers, yet they do not have equitable access to mental health services. Limited research has explored barriers, which exist for LGBTI + young people in accessing services, particularly from their perspectives. Method: An anonymous online survey design, consisting of closed and open questions, was used. The study was advertised through local and national organisations and media. 1,064 LGBT + participants aged 14–25 opted to complete the survey. Results: Most participants reported several barriers to them accessing mental health services that were interlinked across three levels: individual; sociocultural; and mental health system. Conclusion: Cultural competency training for practitioners, which address issues and concerns pertinent to LGBT + young people, is key to addressing many of the barriers identified. Implications for Nursing Management: Nurse managers can use the findings to advocate for practice and organisational change within their services to ensure that care and support is responsive and sensitive to the particular needs of LGBT + young people.

This paper explores factors which contribute to happiness among lesbian, gay, bisexual, transgender and intersex (LGBTI) individuals as part of the largest study to date of mental health in the LGBTI community in the Republic of Ireland (LGBT Ireland study). This mixed methods study informed by minority stress theory, contained an online survey (n ¼2,264) which explored various aspects of mental health and distress, but also the extent and experience of happiness and concomitant factors. The survey included ratings of happiness and life satisfaction and an open-ended question on LGBTI related happiness. Quantitative findings showed a mean happiness rating of 6.58 out of 10 (11-point scale), which is lower than the general population in Ireland. Those identifying as gay men or lesbian women rated their happiness significantly higher than bisexual, transgender, or intersex participants. There was also an effect for age: teenage LGBTI participants had significantly lower ratings than other age groups. Happiness ratings very highly correlated with life-satisfaction (.88). A multiple linear regression showed happiness was predicted most significantly by self-esteem and being in a relationship. Qualitative findings emphasized the importance of selfacceptance and peer support for happiness. Findings are discussed using the minority stress perspective and cognitive dissonance theory.

Despite health policy and research increasingly advocating for recovery-enabling principles to be better integrated into mental health services, finding solutions to enhance the translation of recovery policy into practice remains a challenge. This study sought to understand whether a co-facilitated group education intervention for service users and family members reached beyond the intervention and impacted the everyday recovery promoting beliefs and practices of the practitioners involved and the wider organization. The study employed a qualitative design involving semi-structured interviews with a purposively selected sample of 28 participants (mental health nurses and other members of the multidisciplinary team) who were involved in delivering the intervention. Data were analysed using thematic analysis, with the assistance of NVivo. Participants reported that not only did involvement with the programmes help them reconnect with the contextual realities of service user and family members lived experience, but it enabled them to move beyond traditional power relationships and pathologizing discourses. Having engaged with and experienced the feasibility and positive impact of the co-facilitation process practitioners’ self-efficacy around partnership working and co-production was enhanced. In addition, those involved demonstrated a willingness to challenge paternalistic practices and advocate for the perspectives of service users and families to be further embedded within the organizational infrastructure and operational spaces. Providing mental health practitioners with real-life examples of partnership working and peer support in action within a co-facilitated psychoeducation context has potential to be a forum for promoting second-order change around recovery-oriented practice within mental health services.

Background: Research to support the added value of including Epilepsy Specialist Nurses as members of the multidisciplinary team is developing, yet little information exists on factors influencing the translation of these roles into practice. Aim: To describe the enabling and inhibiting factors to the implementation of the Epilepsy Nurse Specialist role in the Republic of Ireland. Methods: A qualitative design involving semi-structure interviews, observation and analysis of documents, such as portfolios was used. The sample included 12 epilepsy specialist nurses, 24 multidisciplinary team members, and 35 individuals with epilepsy and family members. Data were analysed using the Consolidation Framework for Implementation Research. Reporting rigor is demonstrated using the COREQ checklist (See Supplementary File 1). Results: While there was overwhelming support for the role, barriers and enablers were identified across all domains of the Consolidation Framework for Implementation Research. Enablers included national policies and guidelines, leadership from senior nursing and medical colleagues, climate of learning and mentorship, networking opportunities, infrastructural supports, and competence of ESNs. Barriers included the limited consideration of service expansion and the increasingly complex nature of clinical cases on workload capacity. Deficits in infrastructural supports, challenges in relation to role preparation, role implementation and role responsibility, including concerns around lone practitioner models and concerns that the role was a cost saving measure, also emerged as potential barriers to future sustainability. Conclusion: The Consolidation Framework for Implementation Research offers researchers a pragmatic typology for analysing interrelationships between enabling and inhibiting factors that impact implementation of advanced practice roles, across different evidence sources, disciplines and boundaries. Relevance to clinical practice: In order to s