Our recent history of conflict and the legacy of inequality and poverty means that in Northern Ireland, people with poor mental health often have more severe and disabling conditions than in neighbouring regions. Despite this we continue to spend less on mental health services than other regions (£157 per capita in NI, compared to £232 in England). The Mental Health Strategy has not received the necessary funding. The Funding Plan stated that in 2024/25 we needed £42 million; however, the funding available was around £5 million. With only a tiny proportion of the necessary funding, the Strategy has delivered some important goals. The Structures of the Regional Mental Health Service, incorporating the Community and Voluntary sector, are in place, and the Service Lead and Service User Consultant have been appointed. A Chief Psychological Officer is now in place to oversee the expansion of psychological therapies. Perinatal Mental Health teams are operating across the Region, and there is progress on delivering on the Regional Outcomes Framework. Many key actions have not progressed, staff shortages have curbed expansion of some services and there are many vacancies in key professional groups, including in psychology and psychiatry. Importantly we still do not have the Regional Crisis Intervention Service, which would have led to suicide prevention interventions in the Community and Voluntary sector, with appointments and intervention programmes immediately after a crisis.
Mental ill-health is related to trauma, social inequalities (including poverty), and childhood adversities. A high proportion of the population (6.1%) have Post-Traumatic Stress Disorder (PTSD) or complex PTSD and the rates have risen in the past twenty years (6.1% now, compared with 5.1% in 2005). The percentage with four or more Adverse Childhood Experiences (a critical threshold for increased risk) has also increased from 7.2% to 17.6% in the past 20 years. Mental ill-health costs our economy £3.4 billion annually, and people in NI are developing mental health difficulties at younger ages (particularly anxiety disorders). The impact of the conflict continues; recent research showed that the conflict impacted the mental health of around 30% of the population; a similar proportion reported a traumatic conflict–specific event, and almost half had witnessed conflict related violence.
Mental illness is preventable, and the causes must be addressed to meaningfully reduce the numbers who need mental health services. Northern Ireland’s Programme for Government is disappointing in this regard. There is no commitment to fully implementing the Mental Health Strategy. The elimination of child poverty, perhaps the most important action necessary for us to thrive as a population, is missing. Worryingly, there is no commitment to ensuring that every pupil in NI has access to the vital and cost-effective education in emotional regulation, coping skills, and mental health support promised in the Schools’ Emotional Health and Wellbeing Framework. The Violence Against Women and Girls Strategy is strong, but I remain concerned that the actions in schools, to address the root causes, harmful attitudes to women, are not in the implementation plan. There continues to be too little funding for the Preventing Harm Empowering Recovery Strategy, despite a very worrying rise in deaths related to alcohol.
In addition, the UK government has announced proposals to cut welfare for those disabled due to mental illness, and this will have a devastating impact. I am extremely concerned. Under the proposals, young people will be the hardest hit, and I am extremely worried about the reduction in payments to young people leaving care, who have significant trauma and very high risk of suicide. The draft Anti-Poverty Strategy is very much welcome. However, to make a meaningful impact, at a minimum it must include reform of the benefits system, and the additional payments for children aged 0-4 years and those receiving free school meals recommended by the Expert Working Group.
The broader context is disheartening, however, I feel confident that positive change is happening. Relationships that have developed across the mental health services sector over the last few years are creating a momentum for positive transformation. Many schools now recognise that wellbeing is the foundation of learning; they are modifying policies to support pupils’ needs and providing interventions for children to enable them to thrive. Community groups are supporting the vulnerable and the marginalised, and every day people are getting help from dedicated workers in health, the community, schools and the justice services, who are doing their bit to improve people’s lives. That alone is a great reason to stay hopeful. Our leaders also need to prioritise mental health and direct investment to reducing inequalities, transforming mental health services and improving the mental wellbeing of the whole population.
Link to original article: https://www.belfasttelegraph.co.uk/news/northern-ireland/mental-illness-is-preventable-and-the-causes-must-be-addressed/a1263791120.html