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LAST MODIFIED ON: 11/09/2020 - 13:23
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There is no current overall mental health strategy for any age. Calls have been made for a new 10-year strategy and ‘improving mental health’ is amongst the key indicators set out in the draft Programme of Government 2016-2021 (see Current debates and reforms). A research briefing by the Northern Ireland Assembly Research and Information Service provides an overview of policy since the last major review of mental health, the Bamford Review, was initiated in 2002. In March 2018 a Service Framework for Mental Health and Wellbeing 2018-2021 was published. This builds on the 2010 version but with a more streamlined approach and fewer standards, as well as including both experience and service indicators. The Framework provides the mechanism to audit the ‘You In Mind’ care pathway. The domains, standards and indicators for this Framework are all extrapolated from ‘You In Mind’ and this represents the key reference point for all staff implementing the Framework.
In 2019, Protect Life 2 2019-2024 was published, a long-term strategy for reducing suicides in Northern Ireland and the incidence of self-harm with action delivered across a range of Government departments, agencies, and sectors. The strategy encompasses:
- General population-based approaches to influence attitudes and behaviours
- Targeted interventions for the community as well as health and social care staff
- Crisis de-escalation and case management
- Postvention support for those bereaved or otherwise affected by suicide.
In May 2020, the Department of Health published a Mental Health Action Plan. The Action Plan contains 38 actions, including a commitment to produce a mental health strategy, which will include a comprehensive funding plan for mental health. There is also a plan on dealing with the response to the Covid-19 crisis.
The Finance Minister also announced a £250 million funding package in June 2020 which includes additional support for children and vulnerable people. £90 million of this has been allocated to health, including the Mental Health Action Plan.
The Children and Young People’s Emotional Health and Wellbeing in Education Framework has been developed collaboratively by the Department of Education (DE) in conjunction with the DoH, the Public Health Agency, the Health and Social Care Board and the Education Authority. The Wellbeing in Education Framework was shaped from emerging research and following on from a scoping report which was commissioned from the National Children’s Bureau to establish what level of support for emotional health and wellbeing is currently being provided for children and young people through schools and in youth services, and the issues they are facing.
The aforementioned Protect Life 2 2019-2024 has a strong emphasis on the mental health of young people. 72% of people who die by suicide in Northern Ireland had not been under the care of statutory mental health services in the 12 months prior to death. A focus is therefore required on promoting help-seeking; detection of risk in primary care; removing barriers to accessing suicide prevention services and mental health services where these are needed. Local surveys indicate that a quarter of 16 year olds have experienced serious personal, emotional, behavioural or mental health problems, with this figure increasing to over 40% for those from a disadvantaged background.
The strategy contains specific guidance for services for children and young people:
“It is important to retain a focus on children and young people in order to prevent future suicidality. A number of actions under Protect Life are targeted at younger age groups. These include suicide prevention training for teachers, youth workers and sports coaches; emotional resilience building and responding to critical incidents in schools (iMatter programme); the schools counselling service; the Facilitating Life and Resilience Education (FLARE) project; child-focussed bereavement support services; and developments within Child and Adolescent Mental Health Services.”
An online Harms White Paper was published in April 2019 and sets out a programme of action to tackle online safety and content or activity that harms individual users, particularly children with regards to internet safety and mental health.
Locally, an e-safety strategy is in development by the Safeguarding Board of Northern Ireland to ensure the safety of children and young people when using the internet and electronic media. This will contribute to suicide prevention through the encouragement of responsible use of digital and internet technology so that children and young people in particular have the skills to protect themselves from potential risks. An open consultation ran from March - April 2019 on the draft e-Safety Strategy and Three Year Action Plan for Northern Ireland 2019 – 2022.
The Department of Education issued two guidance documents to schools in 2016:
The Department of Education (DE) has funded an independent counselling service (ICSS) for post-primary aged pupils in grant-aided schools since 2007. Schools are grouped into areas and each school is allocated an agreed number of counselling sessions per week, based on pupil numbers. Pupils can self-refer to this free service or be referred by their school.
Independent Counselling Service for Schools: Handbook (ICSS) (DE, 2012)
Colleges and universities offer confidential advice and support through their students union and from a wide range of student services and other agencies.
The Self-Harm Intervention Programme (SHIP) is a short-term counselling service for those who engage in self-harming behaviour. The Public Health Agency has commissioned this service throughout all Health and Social Care Trusts within Northern Ireland. Individuals aged eighteen and above are referred to SHIP through a number of pathways which include; Accident and Emergency Departments, Primary Care Mental Health Teams, Home Treatment Crisis Response Teams and WellMind Hubs. Young people aged eleven to seventeen are referred to SHIP through the Child and Adolescent Mental Health Team (CAMHS). Those referred to the service receive a minimum of five counselling sessions. This one to one psychological intervention is tailored to individual needs which could include problem solving, psychodynamic and cognitive behavioural therapy. This also includes promoting positive coping skills / strategies.
ARTiculate Young People and Wellbeing Arts Programme.
This is a three-year partnership programme funded by the Arts Council of Northern Ireland and the Public Health Agency. It aims to improve the health and wellbeing (mainly mental health) of young people at risk across Northern Ireland.
The programme is delivered by artists and professional arts organisations working in partnership with youth and community organisations and Protect Life Implementation Groups within the Public Health Agency, which work across the five Health and Social Care Trusts in Northern Ireland.
The Change Your Mind anti-stigma campaign is funded by the charity Comic Relief and the Public Health Agency. The campaign is led by Inspire. The aim is to tackle mental health stigma in every part of life, including in schools, colleges and universities. Inspire has developed a toolkit for educational institutions to help them start their own projects.
‘Helping Others’ is part of the wider Change Your Mind campaign and aims to encourage people to talk to those who may have a mental health problem.