Meet Northern Ireland’s new Mental Health Champion

We have the highest suicide rate in the British Isles - more people have died from suicide since the signing of the Belfast Agreement in 1998 than in the 30 years of the conflict - , and according to a 2015 study undertaken by researchers at the University of Ulster, 30 per cent of the population here suffer from mental health problems.

Research has also found that the province has high levels of post traumatic stress disorder as a result of decades of violence, the latter being a serious condition that can produce complex psychological problems, sometimes leading to greater propensity to alcohol or drug addiction.

Prescription drug and alcohol misuse is also well-documented as growing problem in Northern Ireland, with the cost to the public purse standing at £900m according to a report published this week, with 200 hospital beds a day occupied by addicts.

Northern Ireland prescribes more of the anti-anxiety drug diazepam per capita than anywhere else in the UK, another indicator that the collective psyche is still haunted by the dark legacy of the Troubles.

Despite this bleak picture, mental health services are notoriously under-funded and under-staffed and the effects of Covid are only like to augment the situation, with the isolation of mass quarantine occasioned by lockdown combining to further undermine the nation’s mental wellbeing.

Despite having a 25 per cent higher rate of mental illness, we spend less on mental health services here than the rest of the UK. Between 2008-2014, the actual spend by our health trusts on mental health services has been 25 per cent less than planned, with year-on-year reductions. The portion of Northern Ireland’s health budget going into mental health has fallen progressively from 7.72 per cent in 2012-13 to just six per cent in 2016-17, a figure which cannot be deemed adequate.

Health Minister Robin Swann must be given credit for publishing his Mental Health Action Plan in May, with 38 actions including a commitment to develop a Mental Health Strategy, despite the manifold challenges of the pandemic and just last week he appointed the University of Ulster’s Professor Siobhan O’Neill as the interim Mental Health Champion - charged with being an advocate for change; someone who can rally to influence government policy to achieve a better deal for those battling mental illness.

Announcing her appointment the Health Minister claimed he had identified mental health as a priority; but under-funding suggests otherwise.

Professor of Mental Health Sciences at UU’s School of Psychology, Siobhan O’Neill, from Claudy in Co Londonderry, said she is “delighted” to be given what she sees as a very important job.

“I’m feeling the weight of expectation, but I’m also humbled, because it’s amazing to be asked to do this job on behalf of the people of Northern Ireland.

“I’m from the mountains. I live on a farm. I was brought up here. I’ve been at the School of Psychology for 20 years. I did a study in 2005 that identified the high rates of mental illness here, the relationship of this to the Troubles, and the high suicide rate.

“I suffered a relationship breakdown that left me really quite broken and I sought help for mental health problems myself. All of that really shaped my passion for this area. I want to make a difference and I know there is a lot that we can do to help people in distress because I have been there and I understand it. You can feel that there is no hope for you and that is just not true. Over 300 people in Northern Ireland take their own lives each year. It doesn’t have to be like this.”

Professor O’Neill’s aim is to link the Mental Health Action Plan and Mental Health Strategy with what the public want in terms of mental health services.

“We need to hear people’s voices and the opinions of service users - do they feel that mental health service provision is adequate and how can we improve it?

“I want to work across government departments; for education, overseeing the mental health plan for schools; in terms of justice, considering mental health in the context of the criminal justice system; with infrastructure, how do we improve that so that people are more connected, mindful of how can this improve mental wellbeing?

“We will be advising the Executive on what it can do to improve mental health services, especially in terms of addressing problems that have arisen as a result of the pandemic. We also want a review of crisis intervention services.”

Prof O’Neill acknowledges the gaps in service allocation, lengthy waiting times for talking therapies, people in suicidal crisis not receiving adequate care, over-stretched GPs prescribing medication too readily perhaps in the absence of ready access to things like cognitive behavioural therapy or immediately available psychiatric treatment.

“We need to improve mental health services and to get the message out there to people about where they can go for support, because there are also lots of charities and the community and voluntary sector who are doing amazing work.

“Spending on mental health is around half of what it should be compared to elsewhere in the UK. This under-investment has been going on for a long time and we are currently seeing the cumulative effect of that. The problem is that there is so much need across the health services. How to make best use of the services that are already out there?

“Part of my role is certainly to criticise government policy.”

During the pandemic we have seen lots of great things happening such as the Public Health Agency’s development of stress control classes online and managing stress is a big part of protecting mental health.

But the goal here is to produce a world-leading mental health service and there is a long way to go.

“We want people to know that we do care about what they are going though and we want service users to tell us what they would like to see change,” Prof O’Neill adds. “I want to hear what people have to say and make recommendations to government on the back of that.”

In terms of Northern Ireland’s particular vulnerability to mental illness, she explains that childhood adversity or trauma, poverty and inequality are major factors in the development of pathology.

“So the question is, how do we tackle inequality and poverty? In Northern Ireland, because of the Troubles, there were areas where investment and jobs were just not available, and people missed out. Then there was exposure to violence and trauma and we are only really starting to understand the impact of that because there has been a lot of silence and fear.

“But in our 2008 research at the University of Ulster it was socioeconomic deprivation that actually accounted for a higher incidence of mental illness than the legacy of the Troubles.

“Social welfare policies going forward are going to be very important and especially with the particular challenges presented by the pandemic. Welfare policies are critical, as are things like programmes to support vulnerable families and children.”

Prof O’Neill talks about the benefits of social prescribing, where people are encouraged to attend social activities like gardening or art classes in order to help manage depression and of a future where online courses and talking therapies will be more readily available.

“It’s not just about giving people a tablet or a few sessions with a therapist, it’s about helping them to create a purposeful and meaningful life. A lot of people are isolated and lonely.

“So it’s about helping them find connections, pursue hobbies, ambitions, take care of themselves, find time for leisure, discover a life worth living.”