The purpose of this paper is to consider some of the legal implications of adopting a harm minimisation approach in supporting people who self-injure within inpatient mental…
Abstract
Purpose
The purpose of this paper is to consider some of the legal implications of adopting a harm minimisation approach in supporting people who self-injure within inpatient mental health units. It is argued that a focus on risk and the increasing influence of the law and legal styles of thinking often associated with the allocation of blame have produced a more risk adverse clinical environment. As a result health professionals are more likely to err on the side of caution rather than engage in practices that although potentially therapeutic are not without their risks.
Design/methodology/approach
The analysis draws on the clinical, philosophical and legal literature to help understand how harm minimisation may support people who self-injure. It considers some of the complex medico-legal issues that arise in a clinical environment dominated by risk.
Findings
A focus on risk and accountability has produced an environment where the law and legal styles of thinking have come to influence practice. This is often associated with blame in the minds of the health professional. Given the legal obligation to prevent suicide, health professionals may take a conservative approach when working with people who self-injure. This makes the adoption of harm minimisation difficult.
Originality/value
This paper provides a legally informed analysis of some of the challenges associated with using harm minimisation techniques with people who self-injure. It adds to the literature regarding this area of clinical practice.
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Bríd D. Dunne, Katie Robinson and Judith Pettigrew
This paper aims to examine the relationship between psychiatry and occupational therapy in Ireland through a case study of the development of the occupational therapy department…
Abstract
Purpose
This paper aims to examine the relationship between psychiatry and occupational therapy in Ireland through a case study of the development of the occupational therapy department in St. Patrick’s Hospital, Dublin, from 1935 to 1969. Patronage by psychiatrists was an important factor in the professionalisation of occupational therapy internationally.
Design/methodology/approach
Documentary sources and oral history interviews were analysed to conduct an instrumental case study of occupational therapy at St. Patrick’s Hospital from 1935 to 1969.
Findings
The research identified key individuals associated with the development of occupational therapy at St. Patrick’s Hospital, including psychiatrist Norman Moore, occupational therapy worker Olga Gale, occupational therapist Margaret Sinclair, and social therapist Irene Violet Grey. Occupational therapy was considered by the hospital authorities to be “an important part in the treatment of all types of psychiatric illness” (Board Meeting Minutes, 1956). It aimed to develop patient’s self-esteem and facilitate social participation. To achieve these objectives, patients engaged in activities such as dances, arts and crafts, and social activities.
Originality/value
This study has highlighted the contributions of key individuals, identified the links between occupational therapy and psychiatry, and provided an insight into the development of the profession in Ireland prior to the establishment of occupational therapy education in 1963. Occupational therapy practice at St. Patrick’s Hospital from 1935 to 1969 was congruent with the prevailing philosophy of occupational therapy internationally, which involved treatment through activities to enhance participation in society.
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Liam O’Callaghan, David M. Doyle, Diarmuid Griffin and Muiread Murphy
Judith Pettigrew, Katie Robinson, Brid Dunne and Jennifer O' Mahoney
Major gaps exist in the documented history of occupational therapy in Ireland. The purpose of this paper is to contribute to filling these gaps by providing an overview of three…
Abstract
Purpose
Major gaps exist in the documented history of occupational therapy in Ireland. The purpose of this paper is to contribute to filling these gaps by providing an overview of three major transitions in Irish occupational therapy in the century preceding the opening of St. Joseph?s College of Occupational Therapy in 1963. Research on occupational therapy’s past is valuable not only for recording and commemorating key events and individuals but also for allowing reflection on and questioning of contemporary practice and assumptions.
Design/methodology/approach
This descriptive paper draws on multiple documentary sources to present an overview of the first 100 years of the use of occupation as therapy/occupational therapy in Ireland from 1863 to 1963.
Findings
Three major transitions in occupational therapy in Ireland are presented: from moral treatment and the use of occupation as therapy to medical patronage of occupational therapy, from medical patronage to the early/pre-professional era and finally from the pre-professional era to the era of professionally qualified occupational therapists. To illustrate these transitions, a small number of individuals and their contributions are discussed including Dr Eamon O’Sullivan, Dr Ada English, Donal Kelly, Olga Gale and Ann Beckett.
Originality/value
This paper charts the foundations upon which the currently thriving profession of occupational therapy are built. The Association of Occupational Therapists of Ireland recently celebrated their 50th anniversary (AOTI, 2015a), and in 2017, it is 100 years since occupational therapy was formalised in Clifton Springs, New York, USA. Occupational therapy is a relatively young profession, and great opportunities exist to research its history in Ireland to capture the memories and experiences of the pioneers who laid the foundation of the profession as well as to situate the development of the profession in the broader social, cultural and scientific contexts within which it developed.
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Rebecca Cahill and Judith Pettigrew
In the early to mid-twentieth century, psychiatrist-led occupational therapy departments emerged in Irish psychiatric hospitals. This marked a transition towards establishing…
Abstract
Purpose
In the early to mid-twentieth century, psychiatrist-led occupational therapy departments emerged in Irish psychiatric hospitals. This marked a transition towards establishing rehabilitative services in institutional settings. This paper aims to examine the development of occupational therapy in Grangegorman Mental Hospital and its auxiliary hospital, Portrane Mental Hospital from 1934-1954.
Design/methodology/approach
Historical documentary research methods were used to analyse primary source data from Grangegorman Committee Minutes, Inspector of Mental Hospital Reports, Boroughs of Mental Hospitals, Department of Foreign Affairs documents and newspaper archives. The archival data was analysed using both a chronological and thematic approach.
Findings
The main key event emerged in 1935 when four Grangegorman nursing staff were sent to Cardiff Mental Hospital to undergo a six month training course in occupational therapy. The following themes emerged – “establishing occupational therapy in Grangegorman and Portrane”; “the role of short-course trained nursing staff in providing occupational therapy services” and “therapeutic rationales vs hospital management rationales”.
Originality/value
This study throws light on the early practitioners of occupational therapy in Grangegorman and highlights the complexities of occupational therapy’s role origins in mid-twentieth century Ireland. In line with contemporaneous psychiatric hospitals, the occupational therapy activities promoted in Grangegorman were mainly handicraft or productivity based. The absence of patients’ voices means there are limitations to determining the therapeutic nature of this early occupational therapy service.
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Ross B. Emmett and Kenneth C. Wenzer
The position of these Irish agitators is illogical and untenable; the remedy they propose is no remedy at all – nevertheless they are talking about the tenure of land and the…
Abstract
The position of these Irish agitators is illogical and untenable; the remedy they propose is no remedy at all – nevertheless they are talking about the tenure of land and the right to land; and thus a question of worldwide importance is coming to the front.3
WorldCom has been in the headlines since 2002 because of the $11 billion fraud that it acknowledged at that time. In order to please Wall Street and investors, WorldCom's top…
Abstract
WorldCom has been in the headlines since 2002 because of the $11 billion fraud that it acknowledged at that time. In order to please Wall Street and investors, WorldCom's top executives inflated the firm's profits by misallocating expenses and making many false accounting entries. The reactions of managers within WorldCom varied dramatically. Vice President of Internal Audit Cynthia Cooper and internal auditors Gene Morse and Glyn Smith became suspicious of accounting entries, which had no supporting documentation. They decided to pursue their suspicions. Working on their own time for several months and often late at night, the team ultimately uncovered $3.8 billion in false entries. During the course of their investigation, the internal auditors presented their suspicious information to both the chief financial officer Scott Sullivan and to WorldCom external auditors at Arthur Andersen.1 Both Sullivan and the auditors at Arthur Andersen defended the entries and refused to provide additional information or to pursue the matter any further. The internal auditors at WorldCom found the fraudulent accounting entries four-quarters after they first began.