This document discusses public mental health in Northern Ireland. It notes that mental health issues place a large burden on societies worldwide in terms of health and economic costs. Northern Ireland in particular has high levels of issues like poverty, domestic abuse, self-harm, and suicide that stem at least in part from its history of conflict. Several policy initiatives in Northern Ireland have aimed to improve mental health services, support for caregivers, and legislation to protect those with mental health issues or lack of capacity. The Programme for Government has included mental health outcomes and action plans focused on issues like parity with physical health, children's mental health, and reducing stigma. However, challenges remain regarding fully implementing family support programs, expanding therapy access, integrating crisis services,

1. NO HEALTH WITHOUT PUBLIC MENTAL HEALTH
POLICY & PRIORITIES – NORTH & SOUTH
Gerard Collins & Kate O’Flaherty
November 2017

2. What is public mental health?

3. Source – Well Scotland. Adapted from K. Tudor, ‘Mental Health Promotion:
Paradigms and Practice’, 1996

4. The Big Picture
• WHO – Major global concern, a main cause of the
burden of disease worldwide; largest single source of
economic burden (£1.6 trillion).
• Europe - 20% of the burden of disease; 27% of the
adult population.
• UK – Largest burden of disease (28%), costs up to
4.5% of GDP.
• NI – Greater mental health needs than England, costs
up to £2.0 billion?

5. NI – The need for action
• High levels of poverty & economic inactivity
• 29,100 incidents of domestic abuse
• High rates of self-harm & suicide
• The “Troubles” & PTSD
• Adverse childhood experiences; 40k children
affected by parental substance misuse
• Behaviour problems in children – 10%
• High rates of mental illness

7. GHQ respondents scoring 4 or higher 2014/15
No mental health
condition
79%
Diagnosed mental
health condition
20%
Undiagosed mental
health condition
1%

10. Bamford Review & Response
• Better services
• Support for carers
• Supporting people
• Better structures
• Health & wellbeing
• Psychological therapies
• Perinatal mental health
• Service Framework
• Recovery approach
• Crisis response
• Re-settlement
• Schools, workplaces
• Trauma
• Legislation
• Physical health

11. Mental Capacity Act (NI) 2016
 Decision-making framework in relation to acts that require
consent where person lacks capacity to consent
 100 enabling powers
 Safeguards to protect rights & interests of person who
lacks capacity
 Rights-based approach to strengthen personal autonomy
 Remove legislative discrimination against those with a
mental health problem
 Codifies common law defence of necessity into a
protection from liability for acts that otherwise would
require consent.

12. Programme for Government Outcomes
Long,
healthy
active lives
Safe
communities
Best start
in life
Care for
others &
help those
in need
A shared
society
A more
equal
society
More
people
working in
better jobs

13. PfG Action Plans
 Improve mental health
 Reduce preventable deaths
 Reduce health inequality
 Reduce poverty
 Reduce crime
 Improve self-efficacy
 Improve child development (pre-school)

14. Improve Mental Health

15. PfG actions on mental health & wellbeing
• Parity of esteem –
meeting physical health
needs
• Improving CAMHS &
ADHD provision
• Perinatal mental health
• Eating disorders
• Stigma
• Early years & infant
mental health
• Mental trauma service
• Psychological therapies
• Mental health &
wellbeing in education
• Looked after children
• Employment support
• Addiction services
• Suicide & self-harm
• Recovery colleges

16. Evidence base

17. Positive Mental Health Plan
 We enjoy long, healthy lives with
positive mental health throughout
 Promote positive mental health
for all; prevent mental health
problems

18. Best start Developing well
Living &
working
well
Ageing well
Awareness raising
Resilient
communities

19. Gaps & Scale
• Family Nurse
Partnership
• Psychological therapies
• Crisis services
• Assertive outreach
• Evaluation
• Primary care training
• Social prescribing
• Service integration
• Stigma
• Serious adverse
incident reporting