Although it could be curtailed due to the absence of an Executive for the foreseeable future, the Department of Health has released its implementation plan for the Mental Health Strategy for this decade.
The plan outlines the 35 actions to be achieved over the next two years, in order to facilitate the implementation of the Mental Health Strategy, the stated aim of which is to “promote mental wellbeing, resilience and good mental health across society, provide the right support at the right time, and find new ways of working”.
The plan is accompanied by a funding plan, which outlines an implementation cost of £1.2 billion over the next 10 years. The source of this funding is not clear, especially as the health budget has already been critiqued by officials in the Department of Health as requiring a further £400 million “just to stand still”.
The latest draft health budget allocated £6 billion to health spending per annum. Given that the figure of £1.2 billion is for the 10 year period, “the funding for mental health will only account for 2 per cent of the overall health budget over the next 10 years.”
Mental health funding in Northern Ireland is 30 per cent less than that in England and Scotland, as a proportion of population, despite the prevalence of mental illness being 20 per cent higher in Northern Ireland than both of those estates.
Without the formation of an Executive in Northern Ireland, the Mental Health Strategy may not be able to be fully implemented, as acknowledged by the report itself.
“In light of the significant financial challenges across the health and social care system, it is not possible to fund this level of implementation from within the Department of Health’s existing resources”, the report states.
It continues: “A significant level of additional and sustained funding is therefore required in order to implement the strategic improvements outlined in the strategy and to address the challenges facing mental health services.”
The funding for mental health will only account for 2 per cent of the overall health budget over the next 10 years.
Actions currently in progress
The document, despite the funding gap, outlines the actions which are currently being undertaken to facilitate the implementation of the Mental Health Strategy for the decade.
One action is the creation of an action plan for promoting mental health through early intervention and prevention and increasing public awareness to reduce perceptions of stigma. The document further states that action is underway to create clear and regionally consistent urgent emergency and crisis services for children and young people that will work together with crisis services for adult mental health.
Additionally, plans are underway to create a Regional Mental Health Crisis Service that is fully integrated in mental health services and which will provide help and support for persons in mental health or suicidal crisis.
There are ambitions to enhance the role of existing services, including the provision of personality disorder services regionally through the formation of a Personality Disorder Managed Care Network, as well as enhancing the regional eating disorder service.
The document lists a further three development priorities, the first of which is a regional mental health service, operating across the five HSC Trusts, with regional professional leadership that is responsible for consistency in service delivery and development.
Secondly, there are ambitions to establish a comprehensive workforce review considering existing workforce need, training, and development of new workforce, such as allied health professions, therapists, and physician associates.
In addition, there is the immediate ambition of establishing a regional outcomes framework in collaboration with service users and professionals, to underpin and drive service development, and delivery.
Other actions for delivery
These proposed actions are based on the responses received in the consultations process when the Mental Health Strategy was in draft form. The aim is to maximise the use of digital resources which was driven forward and encouraged by the Covid-19 pandemic, according to the document.
The expansion of therapy hubs, which are resourced sustainably, to ensure Northern Ireland-wide coverage, with the hubs to be managed by primary care and linked with the wider work on establishing mental health as an integral part of the primary care multi-disciplinary team.
There are furthermore ambitions to introduce a dedicated student mental health resource across tertiary education through the delivery of existing mental health services.
The plan outlines ambitions to increase the funding for children and adolescent mental health services (CAMHS) to 10 per cent of adult mental health funding and improve the delivery of the stepped care model to ensure it meets the needs of young people, their families and their support networks.
Ensuring that the needs of infants are met in mental health services is a further ambition outlined in the document, in addition to meeting the needs of vulnerable children and young people when developing and improving CAMHS, putting in place a ‘no wrong door’ approach.
Given that there is no sitting Executive, in addition to the existing funding gap in the health budget, whether this strategy will be implemented remains an open question.