Recognising that one in five people in Northern Ireland will be affected by mental ill-health, Northern Ireland’s Chief Medical Officer, Michael McBride’s annual report focused on positive mental health, with an emphasis on children and young people.
In my 11th annual report I have emphasised the ways we are promoting the development of emotional health and wellbeing in children and young people, because positive mental health in childhood contributes to productive relationships and good health throughout life, writes McBride.
Good mental health builds resilience. If you are feeling more resilient you are better prepared to cope with life’s challenges. At other times you may require support to bounce back.
It is not uncommon for people to experience difficulties with their mental health at some point in their life. One in five of us will be affected and every one of us will have a friend, family member or colleague who has experienced a degree of mental ill-health. It is important therefore to emphasise that help is available in the first instance by speaking to your GP and that recovery is possible.
However, I remain concerned that stigma continues to be a barrier for people seeking help with mental health issues, and stigma can itself adversely affect someone’s mental health. We all need to tackle stigma to create a lasting, positive change in people’s attitudes towards mental health.
Supporting children, young people and families
Protecting and nurturing mental health in childhood contributes to wellbeing throughout life. Parents have a key role to play in building the skills necessary for strong emotional wellbeing in their children such as positive self-esteem and resilience.
GPs, midwives, health visitors, social workers and teachers also play a vital role in the emotional wellbeing of children and young people, through identification, intervention and referral to targeted support.
My report focuses on a number of initiatives that currently help families, children and young people address the challenges they face on a daily basis.
The Multiple Adverse Childhood Experiences: Breaking the Cycle Project
The MACE Project is supported by the European Union’s INTERREG VA Programme and managed by the Special EU Programmes Body. The Project has been awarded grant funding of up to €5 million, which includes match funding from both Departments of Health in Ireland.
The Project aims to transform the lives of vulnerable children and their families by identifying, intervening early and providing nurturing support within their homes and communities by delivering over 3,000 interventions to those aged 0-3 and 11-13 and their families over a four-year period.
The Family Nurse Partnership (FNP) programme is an early intervention programme for teenage mothers, which offers intensive and structured home visiting, delivered by specially trained ‘family nurses’. It is an intensive preventative programme for vulnerable, first time young parents and runs from early pregnancy until the child is two years of age.
FNP aims to introduce a new approach to nursing, working with parents to help them build up their own skills and resources to parent their child well. FNP significantly improves outcomes for young parents from disadvantaged communities who have experienced multiple adversities.
Perinatal mental health problems in mothers affect infant brain development and increase the risk of a child having a number of poor health, educational and social outcomes throughout their life. The cost of perinatal mental health problems in Northern Ireland is estimated to be around £250 million per year.
Currently, only the Belfast Trust has specialist perinatal mental health practitioners providing care. Where inpatient care is required, this is provided within existing general adult mental health facilities, as there is no specialist Mother and Baby Unit in Northern Ireland. The case for more investment and better provision of perinatal mental health services across Northern Ireland is becoming increasingly more evident.
The Health and Social Care Board have been improving services for parents with mental health issues and their children via the work of Think Family NI. This group aims to improve outcomes for children who have a family member with mental health issues by improving the interface between children, mental health and adults services across the statutory, voluntary and community sectors.
The Infant Mental Health Framework represents a commitment by the Public Health Agency, Health and Social Care Board and Trusts, as well as academic, research, voluntary and community organisations across Northern Ireland, to improve interventions from the ante-natal period through to children aged three years old. The promotion of positive infant mental health and wellbeing is a cornerstone of the framework.
“We all need to tackle stigma to create a lasting, positive change in people’s attitudes towards mental health.”
The aim of this framework is to ensure that all children have the best start in life by prioritising and supporting families during pregnancy and in the first three years of life. In particular the framework supports workforce and service development to ensure the optimum use of evidence informed interventions with families with children aged 0-3 where there are significant developmental risks for the child.
Roots of Empathy
Roots of Empathy is an evidence-based classroom programme that has been shown to reduce levels of aggression among school children, while also improving social and emotional competence and increasing empathy.
At the heart of the programme are a baby and parent from the local community, who visit the classroom on a monthly basis throughout the year. A trained instructor coaches students to observe the baby’s development and label the baby’s feelings. This ‘emotional literacy’ lays the foundations for more safe and caring classrooms.
The Department currently provides over £0.5 million per annum to support young carers through the Northern Ireland Regional Young Carers Service (NIRYCS). This service is delivered in partnership by Action for Children and Barnardo’s NI.
NIRYCS offers young carers a break from caring; a listening ear; information about illnesses; peer support groups; a safe environment to express concerns and worries; advocacy; advice; and signposting.
Given the importance of their role within the family context and the effect that this level of responsibility may have on their development and emotional well-being, it is vital to ensure that young carers receive the additional support they may require.
Young people are eligible if they are aged between eight and 18, have a substantial caring role for a member of their family, or whose health or development is affected due to their caring role.
In 2018, the UK Chief Medical Officers commissioned independent researchers at University College London to map published research on ‘screen time, social media, and children and young people’s mental health’.
The conclusion is that published scientific research is currently insufficient to support evidence based guidelines on screen time, but there is sufficient concern to warrant a precautionary approach and actions by schools, government and technology companies.
Barnardo’s NI has published a research report exploring parenting 0-3s in a digital context. ‘Connections: Parenting Infants in a Digital World’ provides insight into how digital technology may influence interactions between parents and infants at home.
The message from Barnardo’s NI focuses on supporting parents to understand the need for positive and consistent interactions to help develop their child’s emotional wellbeing and attachment.
You can access my report at https://www.health-ni.gov.uk/cmoannualreport2018/19