I am honoured to have recently accepted a three-year extension as mental health champion for Northern Ireland, having served in the role for the past four years.
There have been many successes during this term, including the development of our first 10-year strategy to transform mental health services.
Much of my work has been dedicated to its implementation, including the review of the mental health workforce in statutory services and a plan for early intervention and prevention.
I’m particularly pleased with the design for the Regional Crisis Intervention Service, which includes effective suicide prevention interventions, responsive crisis services and alternatives to emergency departments.
These plans are necessary and with them comes the hope that the desperately needed improvements to services are coming.
However, the speed of change remains much too slow because there is insufficient funding to implement the strategy at the anticipated pace.
In 2023/24, only £5.1m of the necessary £24.38m was allocated, and it appears the allocation for 2024-2025 will be similar.
This equates to an eighth of the necessary investment for this year of the strategy.
In a positive move, the Department of Health recently just published the Mental Health Strategy Delivery Plan for 2024/2025.
This sets out the key goals for this year of the strategy and progress made on the previous year’s plan.
Progress is slow and much of the activity refers to reviews, plans and key appointments, rather than the much needed funding for the community and voluntary sector, and expansion of services and training places to address vacancies in psychology and psychiatry.
They note: “While progress is being made, ongoing delivery of the strategy continues to depend on the provision of additional and sustained funding.”
Our political parties have claimed that mental health is a priority, our executive claim that transformation and invest to save are their goals.
Yet the one plan we have for transformation of a vital and extremely cost-effective element of health care has not been supported. All the political parties are vocal in their support for the strategy; however, the minister for health is clear that he is unable to allocate funding from any other aspect of health.
The ministers from other departments state that they are unable to allocate any of their funds and state that the funding should come from within the health budget.
On the one hand, it is a Department of Health strategy, with actions for that department; however, the savings will be seen across others.
Poor mental health costs the economy £3.4 billion annually. The additional funding required for this year is £37m.
It will be a monumental failure if our Executive cannot find this money to address an issue that they consistently state to be a priority. It will require cross-party, and cross-departmental collaboration, courage and maturity to achieve a resolution.
At the minute, we are tasked with developing annual implementation plans which slowly bring forward preparatory work in the hope that adequate funding will be available in the future. My fear is that the strategy will become out of date and that it will need to be reviewed, and even more money will be needed to update the plans.
In the meantime, it feels like the situation on the ground has never been worse. Poor mental health affects one in five adults and one in eight young people.
The deaths from alcohol-specific causes have increased by 45% in 10 years, to 356 in 2022. The same year saw 127 drug related deaths and 203 suicides. GPs are inundated with people seeking mental health services, one in five (and a quarter of women) are in receipt of an antidepressant prescription, and psychological therapies are almost impossible to access.
The community and voluntary sector remain key providers of counselling, however funding pressures are leaving groups to fight for survival. Strategies are pointless if they are not funded, it is an insult to those who have given their time to develop the strategy and the plans within it, that it is not being delivered at the appropriate speed.
The current system in the absence of the reform promised within the strategy, does not fully support those needing to access it, and those tasked with supporting vulnerable people with dwindling resources.
When resources are limited, tough decisions need to be taken, and the government’s objectives need to be clearly communicated. In addition to the mental health strategy, our government must tackle inequalities, and prioritise early attachments and the needs of children as a matter of urgency.
These are the by far and away the most cost-effective ways of preventing illness and building the foundations for economic success.
As mental health champion, I will continue to do everything in my power to drive forward the strategy’s implementation and the mental health agenda generally, but those who hold the purse strings also need to play their part.