The recent headline that 80% of the Mental Health Strategy has been shelved was a huge disappointment to many. The reality is even bleaker.
As Mental Health Champion, I’ve been highlighting my concerns around the lack of funding for the Strategy for a long time. We are now in a very serious funding deficit, and the idea that transformation in mental health services could be delivered by 2031, without a very radical and significant increase in investment, is a complete fantasy.
The Deliverability Review for the Strategy makes for grim reading. Only a fraction of one action has been delivered, and most of the £5-6 million invested in the Strategy per annum (£12.3 million overall) has gone to perinatal services (almost £3 million), CAMHS with just over £4 million, and Early Intervention and Prevention (£2.2 million). The funding gaps are significant, with the integration of the Community and Voluntary sector accounting for the largest gap (£12.3 million). This comes on the back of years of under funding of mental health services generally, with the annual allocation for mental health services per head of population in NI remaining much lower than neighbouring regions (£212 per head, compared with £264 in England).
Many actions in the Strategy have commenced with working groups, plans and reviews, in preparation for the time when a budget for action on the ground might be available. However, the Strategy has received 16% of the funding needed to date and we are around a third of the way through the Strategy’s 10-year term. The Strategy’s funding plan shows that as the years progress, the investment needs to increase, because new services will be developed and rolled out on the ground. Whilst the £12.3 million invested represents 16% of that needed in years 1-3, it is actually only one percent of the total needed over 10 years. If this rate of funding continues then it is extremely unlikely that it will result in any change in the experience of service users.
The Programme for Government was, for me, the final nail in the coffin. Despite an apparent focus on transformation, the only reference to the Strategy was “continued implementation”. This represented a failure to acknowledge how little had been achieved, and worse, that the tiny steps and repeated reviews and plans was to continue for the remaining period of the Strategy.
Two actions have been identified as short-term priorities; Crisis Services and Workforce. Both are necessary to stabilise the system and are a foundation of transformation. Crisis services are particularly urgent given the introduction of “Right Care Right Person” in the PSNI and the importance of suicide prevention interventions on the ground. A focus on workforce is needed to address current vacancies and commence the 45% increase recommended by the Statutory Workforce review. However, the Deliverability Review is clear that these “priorities” will only be progressed if there is additional funding, and to date the Minister has stated that no additional money will be provided from the Health Budget.
The cycle of reviews and working groups, in the absence of delivery, is a waste of resources. In the five years I have been Mental Health Champion, I have seen plans go out of date, duplication of existing services, new programmes unable to recruit suitably qualified staff, and expansions in services creating vacancies and more pressure in other parts of the system. I have seen great services close their doors, and I have seen highly skilled practitioners who have trained in NI, who want to work here, delivering services in the private sector or in neighbouring regions.
This must be devastating for those who have worked hard to develop the plans and, of course, exacerbates the moral injury of those supporting people on the ground. Worst of all, it is yet another kick in the teeth to those who are ill and struggling, and who hoped that we would see delivery on the Mental Health Plan in New Decade New Approach. In the meantime, people with treatable conditions will suffer, their vital welfare payments will be cut, and the ripples will harm children and grandchildren.
The Mental Health Strategy is no longer feasible in its current form. My view is that there needs to be a more radical recalibration, with all possible resources pushed into the completion of the priority areas, particularly a responsive crisis service for people who are not eligible for statutory mental health services. There is also the need for a rescue package to address current needs, as part of the health re-set initiative, including funding for the Community and Voluntary sector. Together these actions would help to shift the dial and help many of those who are most in need. Inaction comes at a considerable cost and the Executive need to come together to agree a way forward.
Link to original article: https://www.irishnews.com/news/northern-ireland/people-are-suffering-while-this-tokenistic-mental-health-strategy-stalls-PYNNCGL7XZFKHK7H2IVMBBNHEQ/