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Mayor ��ɫ��Ƶ expert group set up to tackle homelessness and associated drug addiction.

CIRcUL is playing a pivotal role in an expert group set up by the Mayor ��ɫ��Ƶ, John Moran, to tackle homelessness and associated drug addiction.

The group, which is co-chaired by Cllr Sarah Beasley and Mayor Moran, is made up of officials from Limerick City and County Council’s Housing Support Services team, An Garda Síochána, the HSE, approved housing bodies, researchers from ��ɫ��Ƶ and others from the voluntary sector.

It was agreed that the group’s remit will specifically focus on tackling street homelessness and linked dynamics to drug use in Limerick city and county.

The group has been engaging in stakeholder mapping and data gathering, led by Dr Keyes, and is continuing to progress its work in supporting individuals and families.

A series of workshops held with stakeholders, including those with lived experiences of addiction and homelessness, has been held in recent weeks. The aim of these workshops was to generate fresh insights and innovative solutions that could inform future strategies, policies, and interventions to better address these social challenges in Limerick and further afield.

A questionnaire intended to be completed by people living with street homelessness on a voluntary basis has also been developed by the group in conjunction with UL. This questionnaire is unique and is believed to be the first of its kind to be completed in the country by persons who are directly affected by street homelessness.

Distribution of the questionnaire has recently begun in conjunction with Ana Liffey and St Vincent de Paul (SVP) and it, along with other actions being addressed by the group, will inform its final report.

It is envisaged that this data, being gathered by speaking with those who have lived experiences of homelessness and addiction directly, will eventually enable Limerick City and County Council and other bodies to adopt even more effective, person-centred policies to improve quality of life.

Mayor ��ɫ��Ƶ, John Moran, commented: “As Mayor, I welcome the continued progress of the cross-agency group we established to tackle the complex challenges of homelessness and addiction in Limerick. I want to thank Cllr Sarah Beasley, Dr Laura Keyes and officials from Limerick City and County Council for embracing this innovation to policy development in Limerick in an area where people forward thinking is so important.

“The work group will play an important role in producing specific practical policy actions, which can be prioritised over the course of the More for Limerick Mayoral Programme. It isn’t about a short-term fix, though. We want to take our time to understand root causes through data, listening to those who are experiencing homelessness and addiction, and to ensure our policy is formed by hearing those voices. But we remain focused and determined to find a better solution for Limerick.”

The task force remains dedicated to assisting individuals facing homelessness and addiction within the community.

It is anticipated that a further update on the working group will be issued upon the completion of the group’s work and the publication of its final report.

Community Access Support Teams (CAST) Pilot Project Limerick Garda Division and HSE Mid-West Co-Response.

This Project, led by Prof. Owen Doody, School of Nursing and Midwifery UL, examines how to design and implement a co-response crisis intervention model to improve outcomes for individuals experiencing mental health crises or situational trauma. It will investigate effectiveness of a multi-agency approach involving law enforcement and mental health professionals in providing rapid, integrated, and sustainable responses to such crises.  

The Community Access Support Team (CAST) pilot project is a groundbreaking initiative designed to improve responses to individuals in crisis, particularly those experiencing mental health challenges or situational trauma. Based in Limerick, this project brings together An Garda Síochána (police) and the Health Service Executive (HSE) to form a co-response team that combines the expertise of law enforcement and mental health professionals. The goal is to provide rapid, compassionate and effective support to people in crisis, reducing the need for arrests or emergency department visits and to ensure individuals get the care and support they need in a timely manner.

The CAST model involves three key components: specialised call handling, a co-response team that includes Gardaí and mental health professionals and a community support hub consisting of different support organisations who collaborate for follow-up care. By working together, these teams aim to address immediate crises, connect individuals with appropriate services and reduce repeat incidents. The project also includes evaluation and training to ensure its effectiveness and sustainability.

CAST aims to transform how mental health crises are managed, emphasising care, collaboration and recovery. The pilot project in Limerick will serve as a blueprint for nationwide implementation, offering a template for a more supportive approach to mental health and community safety in Ireland.

Supporting Disabled Parents

This project addresses an urgent need to enhance the quality of prevention and early intervention policy and practice for children and young people by focusing on the experiences of disabled parents and the professionals who support them.  The nexus of parenting and disability has tended to be parenting children with disabilities.  Indeed, “it has barely been taken account that a visually impaired child might one day become a parent” (Van Havermaet et al., 2021).  While it is clearly important and necessary to support disabled and non-disabled parents to parent their disabled child, there is also a separate and equally important need to focus on equitable support for disabled parents and their children.  Parenthood is described as the final frontier for disability rights (Kirshbaum & Olkin, 2002).   

In Ireland, parenting services and disability services have developed separately, with little dialogue, and no dedicated supports for disabled parents.   

Parenthood is an arena in which disabled people encounter prejudice, stigma, and systemic bias (Franklin et al., 2022; Lightfoot et al., 2017; Molden, 2014).  The experiences of Irish disabled parents, mirror those of their international counterparts, in that they experience ableist, negative and at times coercive attitudes from health and social care professionals (Flynn et al., 2023; Walsh-Gallagher et al., 2012; Lawler et al., 2015). Internationally – and in Ireland - disabled parents are disproportionately represented in care proceedings (Corbet & Coulter, 2024; Lightfoot & DeZelar, 2016), despite evidence that disabled parents can provide satisfactory care when appropriately supported (Spencer et al., 2024).   

For their part, professionals acknowledged their lack of ‘competence, knowledge and skill’ (Walsh-Gallagher et al., 2013).  There is a need to improve professionals’ understanding of disability and parenting with disability and enhance services for disabled parents (Albert & Powell, 2020).  And indeed, professionals appear to be interested in such training (Edwards et al., 2022).   

To address this need, this project will establish a professional Community of Practice to support professionals in health, social care, and child protection services, to improve their understanding of disability and parenting with a disability.  The project will raise awareness and share information and best practice amongst a diverse group of professionals.   

This project will be cross-disability, inter-disciplinary, and cross-sectoral, and aligns with international human rights standards, enhances inclusive service delivery, and sustains quality through evidence-based, co-produced approaches.  Given the gap between the aspirations of the UN CRPD and practice on the ground, the project will be underpinned by implementation science approaches.  The project will maintain integrity by involving disabled parents and disabled professionals at all stages in the design, roll out, and evaluation.  The project builds on a recent HRB funded conference Supporting Disabled Parents.  

Collaborative & Proactive Solutions

(CPS) is an evidence-based model of psychosocial treatment originated and developed by Dr. Ross Greene. Rather than focusing on kids’ concerning behaviours (and modifying them), CPS helps kids and caregivers solve the problems that are causing those behaviours. The problem-solving is collaborative (not unilateral) and proactive (not reactive). Research has shown that the model is effective not only at solving problems and improving behaviour but also at enhancing skills.

Virtual Wards 

CIRcUL is supporting the evaluation of the implementation of two Virtual Ward pilots - St Vincent’s University Hospital (SVUH), Dublin and University Hospital Limerick (UHL).

Virtual Wards support patients who would otherwise be in hospital to receive the acute care, monitoring, and treatment they need in their own home (Health Service Executive, 2024). It is a safe and efficient alternative to HSE in-patient care that is enabled by technology (HSE, 2024). Using advanced remote monitoring technology, patients in a virtual ward receive the same level of hospital care from the multidisciplinary team who can provide a range of tests and treatments in the patients’ home (HSE, 2024). This can enable low-risk patients to return home from hospital sooner, supported by 24/7 health professional monitoring assisted by technology which makes inpatient beds available for those who need them more. The HSE expect that virtual wards will have a positive impact on patient care, healthcare services and health professionals (HSE, 2024).

In the United Kingdom benefits identified are better patient outcomes and a reduced strain on hospitals and internationally virtual wards are recognised as a practical and economical choice to hospital-based care (Norman et al. 2023).

In Quarter 2 2024, the HSE’s successfully launched the virtual ward programme in two sites. The service is currently available and managed at St Vincent’s University Hospital (SVUH), Dublin and University Hospital Limerick (UHL). This exciting innovative HSE programme will support patients to receive care at home by expanding virtual services and leveraging digital technologies (HSE, 2024). 

Research Evidence into Policy, Programmes and Practice (REPPP)

Research Evidence into Policy, Programmes and Practice (REPPP) is a research collaboration between the School of Law at the ��ɫ��Ƶ and the Department of Justice.  Established in 2016, REPPP’s mission is to support the youth justice system in Ireland to make rational judgments regarding youth justice policy and practice that are informed by scientific evidence. It does this through significant and ongoing policy-oriented youth crime research. 

Several CIRcUL members are developing projects under this initiative:

Johnny Connolly, The Local Leadership Programme 

Jacqueline Dwane, The Relationship Study

Helen Fitzgerald, No Wrong Door: Supporting Young People with Complex Needs

Alphonce Omolo, Youth Justice Strategy 2021-2027 Research

Aisling Reidy, No Wrong Door: Exploring Service Delivery and Complexity through the Voices of Young People, Parents, and Frontline Practitioners
 

Swallow Perspectives, Advocacy and Research Collective -  SPARC

Professor Arlene McCurtin (UL School of Allied Health) is leading the SPARC project (Swallow Perspectives, Advocacy and Research Collective). SPARC is a solution-focused interdisciplinary, international network of clinicians and researchers focused on challenging clinical issues in the area of eating, drinking and swallowing to help improve clinical practice and policy-making. Impacts of SPARCs work on the intervention of thickened liquids, employed to reduce aspiration in people with swallowing disorders and beset by evidentiary, person centred and medical consequences, has led to a position statement from The Royal College of Speech & Language Therapists (2024) altering recommendations regarding this intervention, and a targeted grant call from the (National Institutes of Health Research) focused on de-implementation of the intervention (2024). 

HSE Community Integration - Leading with and for Inter and Multi-Professional Collaboration – a multi-stakeholder study

Dr Nuala Ryan (UL Kemmy Business School) is leading this collaboration with the HSE. Working together collaboratively in interprofessional and multi professional teams is a cornerstone of future healthcare practice. Each member of these teams can make a unique contribution to achieving a common goal and ultimately enhancing patient care and wellbeing.  Collaboration is the essence of both the Enhanced Community Care programme and the operation of the Community Healthcare Networks (CHNs) to ensure decisions are made closer to the point of care and are specific to population needs. CHN’s aim to improve integration with health and community support services, delivering on the Sláintecare vision to provide the right care, in the right place, at the right time. The formation of the CHNs has brought to the fore the need for collaborative leadership capability in teams consisting of different skills, experiences and career stages to ensure more of an enhanced coordinated effort than was traditionally the case. The creation of Community Healthcare Networks and the need to work collaboratively with discipline managers has therefore created a unique interprofessional, multi professional and general leadership context that merits investigation to ensure impactful delivery of integrated services for enhanced patient care and staff wellbeing. 

The overall research focus of the study is to undertake a review of the concepts, advantages, enablers, barriers, and opportunities for CHNs adopting a multi- stakeholder perspective.  It will identify a framework of factors that contribute to good practices in interprofessional and multi professional collaboration and from an individual, team, and network perspective.