1. (1) To recognise and understand the development of PTSD following childbirth and baby loss.

2. (2) To understand how Ehlers and Clark’s (2000) cognitive model of PTSD can be applied to post-partum PTSD.

3. (3) To be able to apply cognitive therapy for PTSD to patients with perinatal PTSD, including traumatic baby loss through miscarriage or birth.

4. (4) To discover common personal meanings associated with birth trauma and baby loss and the steps to update them.

There are high levels of nutritional and metabolic, cardiovascular, and respiratory tract diseases among people diagnosed with serious mental illness (SMI). Consequently, we developed a pragmatic, affordable nutritional and exercise intervention: Choices4Health. Due to the COVID-19 pandemic, we modified this intervention so it could be delivered online. The aim of this study was to explore the experience of participating in online Choices4Health, in a real-world clinical setting, from the perspectives of service users with SMI.

The study aim was addressed using thematic analysis. Service users who had attended online Choices4Health, received a SMI diagnosis (defined as a schizophrenia spectrum disorder or an affective disorder), and resided in a South Dublin catchment were invited to participate. Nine participants were purposefully sampled. Semi-structured interviews were conducted by telephone. Data analysis was guided by thematic analysis procedures.

Six themes were generated: Being ready and not overburdened (Engagement); Gaining knowledge and implementing it (Learning and doing); Viewing the intervention as appropriate and effective (Targeted impact); Being at home with others online (Belonging); Having a positive affective attitude towards the intervention (Feeling); and Perceiving problems with intervention delivery (Recommended change).

Findings suggest that online Choices4Health is, broadly speaking, acceptable from a service user perspective, but that further refinement is required to address specific issues participants identified. These relate to follow-up or programme extension, technology access, in-person contact preference, and participant inclusion criteria. Further research is required into online Choices4Health efficacy, innovations to reduce digital exclusion, and managing group dynamics in telehealth interventions.

Studies reported an initial decrease in the number of presentations and incidence of self-harm in young people during the pandemic. As the pandemic progressed young people may have experienced increased levels of distress, contributing to worsened mental health. There is a need for mental health services to evaluate the presentations of young people presenting to the Emergency Department (ED) so that services can meet the needs of young people.

To examine the mental health presentations of young people (aged 16-25) to the ED and how this may have changed since the start of the pandemic.

This study reviewed all 16–25-year-olds presenting to the Mater Misericordiae University Hospital (MMUH) who were triaged with a mental health issue in a 2 month period (September-October) over three years – 2019 (Period A), 2020 (Period B), 2021 (Period C). Approval for this service evaluation was granted by the Clinical Audit and Effectiveness Committee at the MMUH.

Of 232 presentations across all periods, there was no significant difference in the number of presentations in each study period - Period A (n=76), Period B (n=79) and Period C (n=77). In all three periods, most presentations occurred out of hours (A: 57.9% [n=44]; B: 74.7% [n=59]; C: 68.8% [n=53]) statistically significant (p=0.034) from before (A) to during the pandemic (B and C). Out of hours arrival by ambulance was most common in in Periods A and B (45.5% and 55.9%). Over all three periods discharge home was the most frequent outcome of assessment (A: 69.7% [n=53]; B: 70.9% [n=56]; C: 76.6% [n=59]). Overall, there was a decrease in self-harm presentations over the period (A: 47.4% [n=36]; B: 41.8% [n=33]; C: 40.3% [n=31]). The percentage of presentations with self-laceration increased during the pandemic (A: 33.3% [n=12]; B: 39.4% [n=13]; C: 48.4% [n=15]). There was a significant increase in attendees who were already taking psychotropic medications (p<0.001).

The findings suggest that the majority of 16–25-year-olds present out of hours and do not require admission. Although the number of presentations remained similar, the increase in out of hours presentations and arrivals by ambulance in Period B may reflect increased distress in the initial stages of the pandemic, and restricted access to services. The higher rates of medication prescribing suggests that these young people are already receiving health care, but that their needs are not being fully met. Mental health services should be designed to provide access to mental health care out of hours when young people are most likely to require them.

None Declared

Research has shown 30-40 % of people who have experienced traumatic injury are at risk of developing mental illness. Some injuries may be the result of mental ill-health, including self-inflicted injury. Furthermore, the development of psychopathology after injury appears to be a major determinant of long term disability. Early intervention can reduce symptom severity and prevent development of mental illness.

Ireland’s National Trauma System Implementation Programme, announced in April 2021, highlights the need for screening for mental disorders.

The Mater Misericordiae University Hospital (MMUH) is designated as one of two national Major Trauma Centres in Ireland. Its trauma service will expand with an expectation of an additional 450- 500 major trauma patients over the next three years.

The Consultation Liaison Psychiatry Service (CLP) currently provides expert mental health input to medical and surgical teams, in managing a range of patients with mental illnesses or psychological difficulties, including those with experience of major trauma.

To examine the current mental health service provision for trauma patients over a six-month period. We aimed to identify areas of need to inform future development of a psychiatry-led MDT service for trauma patients.

A review of all patients admitted on the MMUH trauma pathway between January 2021 and June 2021 was performed. The following data were recorded: demographics, mechanism of injury and information on referrals to the liaison psychiatry service.

There were 105 trauma cases over the six-month period; 46 females and 59 males. The mean age was 58.4 years (SD 22.16). Twelve individuals were recorded as ‘No Fixed Abode’ or living in homeless accommodation(11.4%).

In terms of mechanism of injury; 20 were assaulted of which 8 were stabbing/ knife injuries. There were 65 falls and 12 road traffic accidents. In 3 cases (2.8%), the mechanism of injury was self-inflicted. Twenty patients were admitted to critical care (19%).

Of the 105 trauma patients, 19 (18%) were referred to CLP service; 2 (10.5%) were seen in the outpatient setting, the rest as inpatients (89.5%). At least one repeat review was indicated in 10 of the 19 patients (52.6%).

Trauma patients have a high rate of comorbid mental illness. Nearly 1/5 are currently referred to the CLP service, which is likely an underestimation of the actual burden of mental health disorders and could be explained by the lack of dedicated services. The liaison psychiatry team provides valuable input into the multidisciplinary care of trauma patients and the demand for its services is likely to increase with the expansion under the Major Trauma Strategy for Ireland.

None Declared

Dementia - one of the most common diseases in old age - is often only diagnosed at a late stage. Therefore patients with dementia have often a 1.4 to 3.6 times greater risk of treatment as an inpatient. Consequently it is highly relevant within the caring system to identify and treat the onset of dementia at the earliest possible opportunity.

Part of a new treatment center, a psychiatric clinic in the Hanover area (Wahrendorff) has concentrated on treating patients with a mild or moderate form of Alzheimer’s disease as early as possible on an outpatient basis. The method of transcranial pulse stimulation (TPS®) is used. Acoustic pulses generated outside the body are introduced specifically into the brain regions requiring treatment. The aim being the release of growth factors and an improvement in cerebral blood flow, as a means to maintaining and promoting cognitive performance for as long as possible. The poster contribution shows reports from clinicians, patients and relatives, using TPS®. The development of cognitive performance in the course of treatment is also considered.

The data collection for the quantitative study design will take place at the clinic in the period from 06/2021 to 10/2022 (N planned = 60). Cognitive performance is recorded using the Montreal Cognitive Assessment (MoCA test) and the experience reports via interview.

Results of repeated measurement and analysis of the variance in terms of cognitive performance (MoCA test, baseline and follow-up measures) are presented. Field reports are considered and the suitability of TPS® as a method for treating the symptoms of dementia in Alzheimer’s disease is discussed in the form of a best-practice example.

Field reports are considered and the suitability of TPS® as a method for treating the symptoms of dementia in Alzheimer’s disease is discussed in the form of a best-practice example.

None Declared

Hospital employees are at risk of SARS-CoV-2 infection through transmission in 3 settings: (1) the community, (2) within the hospital from patient care, and (3) within the hospital from other employees. We evaluated probable sources of infection among hospital employees based on reported exposures before infection.

A structured survey was distributed to participants to evaluate presumed COVID-19 exposures (ie, close contacts with people with known or probable COVID-19) and mask usage. Participants were stratified into high, medium, low, and unknown risk categories based on exposure characteristics and personal protective equipment.

Tertiary-care hospital in Boston, Massachusetts.

Hospital employees with a positive SARS-CoV-2 PCR test result between March 2020 and January 2021. During this period, 573 employees tested positive, of whom 187 (31.5%) participated.

We did not detect a statistically significant difference in the proportion of employees who reported any exposure (ie, close contacts at any risk level) in the community compared with any exposure in the hospital, from either patients or employees. In total, 131 participants (70.0%) reported no known high-risk exposure (ie, unmasked close contacts) in any setting. Among those who could identify a high-risk exposure, employees were more likely to have had a high-risk exposure in the community than in both hospital settings combined (odds ratio, 1.89; P = .03).

Hospital employees experienced exposure risks in both community and hospital settings. Most employees were unable to identify high-risk exposures prior to infection. When respondents identified high-risk exposures, they were more likely to have occurred in the community.