Mental health: the next steps

Photo by Aaron McCracken/Harrisons Health Minister Edwin Poots sets out the progress made on reforming mental health services and the next steps, including more emphasis on recovery, talking therapies hubs and designing services to meet the particular needs of young people.

Services for people with a mental illness have been transformed in recent years. The Bamford Review of mental health and learning disability was the catalyst for the reform and modernisation of these services, and Transforming Your Care will carry the Bamford vision forward into the future.

The Bamford vision is that people with a mental illness should be treated in the community, close to their families and friends, unless there is a clinical reason for not doing so. Inpatient hospital care should only be provided for acute cases or where someone needs to be detained for their own safety. Accordingly, the focus in the last number of years and for the future in terms of mental health service development is on early intervention and home treatment services. We are also moving people out of long-term hospital care into community-based settings.

At the heart of what we are doing is the Bamford Action Plan 2012-2015. This is a cross-cutting action plan, involving all government departments. It was developed with service users and their carers, and covers a range of issues that are important to people with a mental illness – health, education, housing, benefits, employment and leisure. Things that are important to us all.

We are placing a greater emphasis on mental health and well-being. We want to promote lifestyles that help people maintain good mental health. My department will continue to work closely with the Public Health Agency to tackle stigma and encourage people with a mental illness to talk about how they feel and to seek help.

We, in government, will continue to tackle stigma by ensuring that policies and services enable people with a mental illness to live full and purposeful lives in their communities. We will also continue to support our local mental health charities who work tirelessly to educate the public about mental health issues. My department currently provides almost £700,000 to these organisations annually.

We are also placing greater emphasis on recovery. It was once thought that a diagnosis of mental illness was a life sentence. We now know that people can and do recover from mental illness. Recovery-focused practice will allow individuals to take control and build socially inclusive, connected lives that are satisfying, fulfilling and enjoyable – even if they continue to experience symptoms related to mental ill-health.

The Health and Social Care Board, Public Health Agency and trusts are currently rolling out the Implementing Recovery through Organisational Change (ImROC) programme. ImROC is all about embedding recovery-focused practice throughout all mental health services in line with the Bamford vision.

One of the key developments in mental health service provision over the past four years has been the introduction of psychological therapies – or ‘talking therapies’ as they are commonly called. There is now considerable evidence demonstrating the effectiveness of these therapies in the treatment of particular mental illnesses. This means that we can now deliver better outcomes for people with a mental illness. Today some £6.5 million per year is spent on these services.

This year, we will be focusing on the setting up of primary care talking therapies hubs. These hubs will bring together GPs, the voluntary sector and specialist mental health services to provide a stepped psychological therapy service. The Health and Social Care Board is committed to incrementally build these hubs as a new way of working over the next three years.

We must not forget that many children and adolescents also suffer from mental illness. This may be due to a range of factors including their family environment, social deprivation, bullying or substance abuse. Early and effective intervention is essential if we want these young people to enjoy life, benefit from education, and grow up to lead purposeful lives as adults.

My department published a service model for child and adolescent mental health services (CAMHS) in July 2012 which promotes a more consistent, person-centred approach to mental health service delivery for our children and young people. Improvements to CAMHS will include an increased focus on early intervention, better multi-disciplinary working and better collaboration with the community and voluntary, education and youth justice sectors.

This will ensure that our children and young people have access to the full range of support they need no matter where they live in Northern Ireland. The Health and Social Care Board and health and social care trusts have commenced delivery of the CAMHS service model, and this will continue into this year, with a particular focus on the establishment of primary mental health teams and crisis resolution and home treatment services across the region.

Bamford provided the roadmap for the development of mental health services. We are still on that journey. We have made good progress to date. But we have still much further to go. This will require a collective understanding between those who use our services and those who provide them to ensure we have the right services in the right place at the right time.

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