Stop pretending things are ok - fund mental health in line with need


If money was no problem we would get all the services we asked for but money seems to come first and it makes me angry”                              

                                                                                                                       Mental health service user

A noticeable recent phenomenon has been the number of people in public life stepping forward to talk about their mental health. We’ve seen a raft of celebrities, sports people, members of the British Royal family and others publicly talking about their own experiences of battling with poor mental health. This is undoubtedly a positive development, as it helps break the stigma associated with poor mental health and hopefully encourages more people struggling with their mental health to seek help.

Alongside this, there has been a steady drip feed of additional funding being announced for mental health, both here and in England.  Most recently in May 2018 the Department of Health announced an additional £5m to fund two pilot projects for primary care multi-disciplinary teams – to include mental health specialists -- in GP federations in deprived areas. A further £6.4m -- obtained through a £1billion confidence and supply deal between the DUP and the conservative UK government in June 2017 – has been allocated to mental health for 2018/19 for primary care talking hubs and psychological therapy services, suicide prevention and child and adolescent mental health services, amongst other areas. Again, without any question a welcome development.

Where the rubber meets the road

For somebody watching from afar who is taking a reading from these positive developments, it would appear that things overall are improving. But a closer look reveals a much different picture.

Figures obtained by PPR in July 2018 from the Department of Health under Freedom of Information show that the spending on mental health programmes hovers around just 5 per cent of the total departmental budget every year. This abysmally low amount has remained fairly constant over the past 10 years, with .1% point being the most it has ever risen by.  This puts Northern Ireland’s proportionate spend on mental health significantly below the global average, reported by the United Nations Special Rapporteur on the right to health to be around 7 per cent.

There are also concerns about how and where the money is spent. Section 28e of the Northern Ireland Act (as amended by the St. Andrews Agreement) places a duty on the Northern Ireland Executive to tackle poverty, social exclusion and patterns of deprivation on the basis of objective need. Coupled with the section 75 equality duty to ensure equality of opportunity, this effectively requires that resources be proportionately allocated to deprived areas with greater objective needs  – something that does not happen of its own accord. The proof of this is be found in the official statistics - rates of mental ill health in the most deprived areas are twice those for the least deprived areas , while rates of deaths by suicide are over three times those in the least deprived areas.  In fact, in some areas of Belfast the rates of suicide are a shocking 10 times higher than the overall rate.[1]

Traumatic experiences during the conflict in Northern Ireland have led to higher levels of specific mental health disorders and to poorer overall mental health than in England, Wales or Scotland . In fact, Northern Ireland has the highest rate of post traumatic stress disorder of 28 countries examined by the World Mental Health Survey Initiative. The higher levels of chronic and serious mental ill health also has a significant economic impact, with one study by the NI Association for Mental Health (now Inspire), found that the annual direct costs of medication and treatment associated with mental ill health in 2003 was in the region of £372million. The wider economic and social costs are enormous. The health charity Centre for Mental Health has estimated that £105 billion is the annual cost of mental ill health.

All of this clearly points to the need for our mental health services to receive significant investment, not the negligible 5% of the budget it currently receives.  Those with the power and resources to address this cannot continue to ignore the human and financial cost of what is a growing crisis. In the words of mental health and suicide awareness and prevention campaigner Phil McTaggart “ stop pretending things are ok – we need more funding, we need more resources”.

[1] Figures quoted by Professor Siobhan O’Neill University Ulster on BBC Talkback 2 August 2018