Now is the time to plug the gap in mental health funding in Northern Ireland

The Mental Health Champion for Northern Ireland, Professor Siobhan O'Neill, calls for political representatives to put funding the Mental Health Strategy in full at the top of their agendas for the upcoming election and stresses that a piecemeal approach to mental health is unacceptable.

Poor mental health costs the NI economy £3.4 billion every year, The Mental Health Strategy is a smart investment, says Professor O'Neill. ​

The conversation has started, and now more than ever, we are talking about our mental health, and there is wide recognition of the considerable suffering experienced by those with mental health difficulties. We are also having important discussions about how our government should spend our money. It is important that we also put the two together, and consider the economic cost of poor mental health, not only to the person who is struggling, but to the whole of society.

A new report by London School of Economics and Political Science and the Mental Health Foundation has calculated the economic cost of poor mental health in Northern Ireland to be a staggering £3.4 billion annually. To put this in perspective, the amount is just under half of the overall Health budget (around £6.5 billion), and just over a quarter of the annual block grant that NI receives from the UK government (around £12 billion)1. In comparison, we allocate around £150 million annually to mental health in the Department of Health.

“As we approach the election, I am calling for the NI population to demand that our political parties plug the gap in funding for mental health; and fund the Mental Health Strategy in full so that we can reduce the terrible suffering caused by mental illness and the economic impact of mental illness across society,” champions Professor O’Neill.

Why is mental illness so expensive?

Mental ill health is surprisingly common, especially in NI, where it is estimated that 19% of the adult population, and one in eight children and young people have emotional difficulties.

The economic costs come from having reduced productivity in the workforce, and “intangible” costs caused by poor quality of life, exclusion and stigma, health and social care costs, and education costs. The figure can be described as an “conservative” under-estimate, because it did not include the costs of severe stress on workplace productivity, nor did it include the cost of addiction and substance use, or the physical health problems, which are more common among people with poor mental health. Almost a quarter (23%) of these costs are as a result of depression, 18% anxiety disorder and 17% bipolar disorder.

Professor Siobhan O’Neill

How do we reduce the costs of poor mental health?

Mental health is influenced by stress, pressure, and trauma; the environment within which a person lives; and the person’s ability to cope. The childhood years, and the relationship between infants and their caregivers are particularly important.

Many of the factors that influence mental health can be modified. There is mounting evidence that we can prevent mental illness and much of the associated distress and suffering by intervening at an early stage.

The Mental Health Foundation's review team also looked at the types of effective interventions to reduce these costs; and prevention and early intervention came out on top.

Based on the research evidence, their recommendations include universal programmes, especially those that identify and support infants and parents. They also recommend school programmes addressing bullying, physical activity, brief psychological interventions for adults at risk, workplace actions, reducing isolation in older people, reducing access to suicide methods and help for people at risk of suicide.

Why is the Mental Health Strategy so important?

Northern Ireland's 10-year Mental Health Strategy is a detailed plan from the Department of Health to address the high levels of mental illness here. Designed by professionals and experts by experience, it includes 35 actions across three themes.

Many people are already aware that the Strategy includes the creation of a single Regional Mental Health Service and the many necessary and urgent improvements to services that provide treatments for people with a mental illness.

However, less has been said about the actions in Theme 1 of the Mental Health Strategy, Early Intervention and Prevention. These actions reflect the key cost-effective, evidence-based measures identified in the Mental Health Foundation report. However, the Mental Health Champion is concerned that funding shortages may mean that this part of the Strategy gets left behind.

Accept nothing short of full implementation of the Mental Health Strategy

Our failure to prevent and address mental ill-health is costing us dearly, and the situation is getting worse, affirms Professor O'Neill.

The proportion of people with a potential mental health problem rose to 27% in the year of the pandemic. Parental mental illness is affecting the next generation, and if we do not act now, it may impact their outcomes.

Investing in mental health reduces the levels of suffering across our society and makes good economic sense. The Mental Health Strategy is a strong plan that incorporates many preventions and early intervention activities, saving us money in the medium and long term.

To implement all the actions fully, the Strategy requires £1.2 billion across ten years, representing a 34% increase in funding for this part of the Health budget. The funding uplift would align with the mental health spend per person in England, which is currently 31% higher than NI. A piecemeal approach to mental health is not acceptable, this Strategy must be implemented in full.