Professor Brendan Kelly

We have an ongoing programme of quantitative, qualitative and historical research into mental health law and human rights, both in Ireland and globally, especially India. Ongoing projects include analyses of involuntary psychiatric admission patterns in various Dublin hospitals (e.g. Curley et al. Exploring and explaining involuntary care: the relationship between psychiatric admission status, gender and other demographic and clinical variables. International Journal of Law and Psychiatry, in press); analyses of developments in international human rights law (e.g. Kelly BD. An end to psychiatric detention? Implications of the United Nations' Convention on the Rights of Persons with Disabilities. British Journal of Psychiatry 2014; 204: 174-5); various studies of last statements by prisoners on Death Row, Texas (e.g. Kelly BD, Foley SR. Love, spirituality and regret: thematic analysis of last statements from death row, Texas, 2006-11. Journal of the American Academy of Psychiatry and the Law 2013; 41: 540-50); historical studies of mental health law (Kelly BD. Criminal insanity in nineteenth-century Ireland, Europe and the United States: cases, contexts and controversies. International Journal of Law and Psychiatry 2009; 32: 362-8); and a range of other projects relating to the intersection between psychiatry and law (e.g. Kelly BD. Voting and mental illness: the silent constituency. Irish Journal of Psychological Medicine 2014; 31: 225-7). Recent books: Kelly BD. Dignity, Mental Health and Human Rights: Coercion and the Law (Routledge, 2015); Kelly BD. Mental Illness, Human Rights and the Law (RCPsych Publications, 2016).

Our work on happiness centres on analyses of data from the European Social Survey (www.europeansocialsurvey.org). Peer-reviewed publications to date include: Kelly BD, Doherty AM. Impact of recent economic problems on mental health in Ireland. International Psychiatry 2013; 10: 6-8; Doherty AM, Kelly BD. When Irish eyes are smiling: income and happiness in Ireland, 2003-2009. Irish Journal of Medical Science 2013; 182: 113-9; Doherty AM, Kelly BD. The social and psychological correlates of happiness in seventeen European countries: analysis of data from the European Social Survey. Irish Journal of Psychological Medicine 2010; 27: 130-4.

Background: While procedural and technical skills are integral to the practice of medicine, a large proportion of doctors' time is spent in cognitive behaviour. The literature suggests that most medical errors arise from errors of thinking, rather than technique, and that it is possible to reduce such error through acknowledgement of cognitive biases and deliberate implementation of cognitive strategies. This study aims to examine decision-making biases over the course of medical education and beyond formal training, bringing the existing research on clinical decision-making to bear on medical education, which has been neglected in the literature, and the Irish context. This is a collaborative project with Ms Kathryn Lambe (PhD student) and Dr David Hevey, Associate Prof, Research Methodology (Psychology), Trinity College Dublin. Research plan: We will formulate, pilot and validate a new measure with which to examine cognitive biases among healthcare professionals. The measure will be in questionnaire form, formulated with contributions from and reviewed by appropriate medical practitioners, and piloted among populations of interest for reliability and validity. In due course, we will assess decision-making biases among medical students in different years of study on a cross-sectional basis to descriptively compare thinking styles across the course of undergraduate medical training. In the future, we will also assess decision-making biases among practising physicians to describe thinking styles across years of experience and medical disciplines. Implications: The project will yield a new measure for use by us and other researchers, and provide a greater understanding of cognitive error and bias for medical educators and practitioners. It will provide a model intervention to inform the inclusion of cognitive skills in medical curricula. We will thus generate useful policy recommendations that fit theoretically and practically in the modern strategic context. Sample peer-reviewed paper: Lambe, K., O'Reilly, G., Kelly, B.D., Curristan, S., Dual-process cognitive interventions to enhance diagnostic reasoning: a systematic review, BMJ Quality & Safety, 2016 doi: 10.1136/bmjqs-2015-004417. [Epub ahead of print]

This project seeks to explore voting behaviour of people with mental health problems in inpatient and community mental health services. This will be studied in the context of voting behaviour of the local community where the hospital services are located and to the twenty-six counties in relation to the Irish General Election. People with mental health problems encounter stigma as a part of their illness. A social misperception of mental illness is perceived incompetence. A consequence of this can be discrimination where people with mental health problems can be excluded from social processes such as voting. The purpose of this study is to determine if people with mental health problems are registered to vote, actually vote, and what the relevant voting patterns are. We will also examine perceived barriers to voting, determine any information needs about voting, and explore attitudes to voting and social inclusion. This is a collaborative project with Dr Michael Nash, Asst Prof in Psychiatric Nursing, Trinity College Dublin. Sample peer-reviewed publication: Kelly BD. Voting and mental illness: the silent constituency. Irish Journal of Psychological Medicine 2014; 31: 225-7.

The history of psychiatry is both fascinating and under-researched. I collaborate with the Quinnipiac University (Connecticut, USA), National Forensic Psychiatry Service (Dundrum, Dublin), University of Limerick, Delaney Archive (Carlow) and St Brigid's Hospital (Ballinasloe) in a range of original studies of psychiatric archives from the 19th and 20th centuries. In 2011, I completed a PhD in History at the Department of History, University of Northampton: "Custody, Care and Criminality: Clinical Aspects of Forensic Psychiatric Institutionalisation in Late Nineteenth- and Early Twentieth-Century Ireland". In 2012, I was Visiting Professor at the Centre for Psychological Research, Quinnipiac University, Connecticut, USA, linked with their 'History of Madness' module. Our history of psychiatry research programme has resulted in 25 peer-reviewed publications, four invited book contributions, numerous non-peer-reviewed publications, and three single-author books: Kelly BD. Custody, Care and Criminality: Forensic Psychiatry and Law in 19th-Century Ireland (History Press Ireland, 2014); Kelly BD. Ada English: Patriot and Psychiatrist (Irish Academic Press, 2014); and Kelly BD. 'He Lost Himself Completely': Shell Shock and its Treatment at Dublin's Richmond War Hospital (1916-19) (Liffey Press, 2014). Multiple projects are ongoing and further publications are in progress.