Raise the profile of mental health

Seamus Logan argues that Northern Ireland’s
mental health services urgently require ring-fenced funding.

As a student of mental health care 20 years
ago, I couldn’t understand why it was referred to as a “Cinderella
service”. But it makes sense that people’s attention will be more
easily captured by headlines involving life-threatening conditions
such as cancer or heart disease. Mental health problems rarely lead
to death.

Yet the World Health Organisation tells us
that depression will be one of the biggest health challenges for
the Western world in the 21st century. In Belfast, throughout the
troubles, suicide has been a major cause of premature death. Now,
in less troubled times, it is the single biggest cause of death
among our young males. Each year in Northern Ireland, there are
about 10,000 admissions to mental health hospital beds and 11,000
new referrals to psychiatrists. We spend about 10 per cent of our
health and personal social services allocation here directly on
mental health care, but it feels as if we get 0.1 per cent of the
public’s attention.

People in Northern Ireland, including our new
locally elected assembly, seem oblivious to the fact that the UK
government has identified mental health care as one of its top
priorities. It made it the subject of its first national service
framework and allocated a tidy sum to drive its implementation. Our
response? Well, not a lot at a political level yet, and certainly
nothing like the level of ring-fenced investment promised for
England.

Even some of our planners seem to think that
the entire integrated health and social services structure begins
and ends at the doors of a general hospital. Worse still, despite
the valuable and unique contribution to mental well-being that
approved social workers make, a forthcoming review of mental health
legislation, prompted by a similar process in England, may threaten
to remove their function, making the process more medical and less
social.

By April, the establishment of local health
and social care groups, our equivalent of primary care groups, will
be a reality. Can we depend on them to make mental health care a
priority as they begin to shoulder the responsibilities of
commissioning health and social care?

It is right that agencies such as the Eastern
Health and Social Services Board in Belfast try to address these
strategic planning issues by forging partnerships at all levels.
While my heart tells me we need this kind of leadership, my head
tells me that the only real answer is ring-fenced funding if we are
to provide the urgent help that mental health services need.

Seamus Logan is project manager for
the mental health strategy at Eastern Health and Social Services
Board.