In Northern Ireland, Poverty is both a cause and consequence of poor mental health. In addition, our suicide rates are at least double in the most deprived areas, compared with the least deprived area. Unfortunately, the Executive’s draft Anti-Poverty Strategy falls short of what is necessary to address this issue. It does not contain measurable outcomes or targets, nor does it include new funded actions to eradicate poverty, including support for people who are unable to enter employment. As Mental Health Champion, I wish to highlight the aspects of the Strategy which are relevant to mental health and encourage all those with an interest in poverty and mental health here to respond to the consultation.
Pillar One, Minimising the Risks of Poverty does not include poor mental health as a risk factor. The commitment to support people in relation to substance use is vague, and there is no reference to the existing Substance Strategy which has received only a fraction of the funding it needs. Pillar Two, Minimising Impacts of Poverty, states that “everyone will be supported in improving their mental and physical wellbeing”. I would argue that outcome needs to focus on mental health support for those who need it, and treatments for mental illness. This requires that the Mental Health Strategy is adequately funded so that services can meet the population’s needs. The recognition of the need to drive down health inequalities is very helpful, and one of the most effective ways to do this is increase the resources of the poorest and ensure that the welfare system provides an effective safety net. The Strategy needs additional targeted actions in both areas.
The education outcomes, “maximised opportunities” and “addressing socio-economic gaps” in attainment, needs to align with the full implementation of the recommendations in “A Fair Start” and the Independent Review of Education to address the structural aspects of the education system that contribute to poverty. The “family factors” outcome recognises the role of abuse and neglect but fails to target our high (and increasing) levels of Adverse Childhood Experiences through parenting support and effective early years services. The outcome on promoting the benefits of “a good family structure” may well increase the stigma experienced by lone parents and people leaving violent relationships, and, as such, is not in keeping with a trauma informed approach. Effective actions in this area would be improvements to relationships education and expanding mediation for families going through separation.
The outcomes referring to disadvantage and disability are again vague; they fail to acknowledge systemic discrimination and ableism. The Strategy should result in adequate protection and dignity for the disabled people who are unable to enter paid employment. The goal of minimising the costs of accessing education falls short of the Expert Review Committee’s recommendation of cost-free schools. There are missing actions on early years services, after school programmes and holiday activities. Debt is recognised as a contributor to poverty, and financial wellbeing is important, however I would have also liked to see policies targeting unethical lending practices, illegal moneylenders and actions to address our disproportionately high rates of problem gambling.
Importantly, the Strategy acknowledges that ethnicity is linked to socio-economic disadvantage. However proposed action in relation to this, “take steps to ensure that ethnicity does not increase a person’s risk of poverty”, is unclear. I also worry about the how the statement “we must work to ensure our society is equal and fair for all those who contribute to it”, may be interpreted by vulnerable people who are unable to access employment.
The Supporting People to Exit Poverty pillar fails to recognise the impact of the welfare system and the education system in maintaining poverty, and the need to increase payments to families in poverty. I had hoped that the Strategy would have included new policies to improve the resources and living circumstances of those who live in poverty, more explicit commitments with targets for “good jobs” across the region, and additional childcare programmes. The outcome “appropriate and effective” financial support to the socioeconomically disadvantaged (Pillar Two) appears to fall short of the welfare mitigations and payments that the Expert Panel recommended.
Poverty is one of the most prominent ways in which the legacy of the past continues to impact the mental health of the NI population. We need and deserve a robust Strategy to eradicate poverty, particularly child poverty. This needs to include funding and targets, as well as the Independent Commission and anti-poverty legislation recommended by the Expert Panel, and strong actions to address regional imbalance, and direct resources to those most in need. We must also implement the existing Strategies, including the mental health and substance strategies; and ensure that all our policies and Strategies embed a trauma informed approach, empowering our citizens to lead meaningful lives, characterised by dignity and hope.