Debate contribution: Mental Health Provision in Northern Ireland

Debate contribution by Mr Mike Nesbitt on 30 September 2024.

MLA

Mr Mike Nesbitt

Party at the time

Ulster Unionist Party

Date

30 September 2024

Type

Debate contribution (made as a minister)

Business

Opposition Business

Heading

Mental Health Provision in Northern Ireland

Assembly identifier

Official Report component 4563541

Read the official Assembly record

Text

Madam Principal Deputy Speaker, thank you very much. Thank you, too, to the movers of the motion and the amendment. Mr McGrath, the mover of the motion, began by reminding us that we have lost more of our fellow citizens to suicide than we did during the course of what we euphemistically call our Troubles. I remember making that point a few years ago on a live debate on BBC Radio Ulster, and the host reacted as if he had been given an electric shock. We are talking about a very well-researched journalist. The point about that is that there is a lot more that we have to do in raising awareness, and to the extent to which this debate raises awareness of suicide and poor mental health, so much the better. Mr Carroll asked whether the Protect Life 2 strategy was ambitious enough. That took me back to a meeting that Órlaithí Flynn chaired with the all-party group in Derry/Londonderry at, I think, the Magee campus of Ulster University when Protect Life 2 had just been published. We were debating the policy and the idea that the target was to reduce the number of suicides by 10%. We thought, "Gosh, that's not very ambitious". To be fair to officials, that is internationally based by, I think, the World Health Organization. It is a practical, achievable target, but we all agreed that it was not a target to be celebrated if we achieved it. None of us wants to go to one of the families that continue to lose loved ones through suicide and say, "Haven't we done well by reducing the rate by 10%?", because, for them, the loss is 100%. So, crudely, one suicide is one too many. I believe, because the experts have told me, that every suicide is preventable right up to the moment when it takes place. As is often said, suicide tends to be a permanent solution to what is often a very temporary problem, emotion, feeling or set of circumstances.

Yes.

I thank the Member for his intervention. I am on record many, many, many times saying that, if you take a map of Northern Ireland and put on that map the hotspots of the Troubles measured by shootings, bombings and murders and then superimpose a contemporaneous map of mental health issues — completed and attempted suicides, drug and alcohol abuse etc — you will have a match. I mean somewhere like north Belfast, to pick one area, so, yes, the Member's point is well made. The Protect Life 2 strategy was launched on World Suicide Prevention Day, 10 September, back in 2019, and it has now been extended to 2027. At least £12 million is spent annually on suicide prevention in Northern Ireland, and the strategy is also supported by activities in the mental health strategy. Of course, when the strategy was first published, it envisaged much greater investment and Executive-wide buy-in than has actually been the case. I have to say that, when it comes to those who supported the Budget, the irony klaxon has not been silent during this debate. Mrs Dodds referred to the mental health champion expressing her disappointment at the allocation, and I really welcome the fact that Professor Siobhán O'Neill made those comments and made them so explicitly and so publicly, because having a mental health champion — an independent assessor — was my idea. The fact that she can make those remarks proves that she is an independent assessor. Indeed, more recently, I appointed an independent autism reviewer, and Members will recall her remarks from last week. Again, that shows that, in Ema Cubitt, we have an independent person at work, and I really welcome that. The strategy on suicide prevention has 10 objectives that I hope will achieve better outcomes. The first has great significance to today's motion. It seeks to:

"Ensure a collaborative, co-ordinated cross departmental approach to suicide prevention."

The leader of the Opposition and Members will be aware of the Executive working group on mental well-being, resilience and suicide prevention, which Mr Middleton wanted me to refer to. The group plays an important role in ensuring that all Executive Ministers are informed of and involved in the governance of the Protect Life 2 strategy. The group was established in recognition of the fact that suicide is a societal issue and that it cannot be solved by the Department of Health alone but requires efforts across all sections of society. It requires each Executive Department to recognise and step up to the fact that it has a critical role to play. It is widely acknowledged that many factors can impact on suicide — for example, financial difficulties, poor employment or a lack of housing opportunities — and the Executive group affords important opportunities for Ministers to hear at first hand from stakeholders about the impact of suicide and about exactly what is needed to improve outcomes and to prevent suicide and self-harm. The group also provides a forum for Ministers to hear about some of the great work being done in our communities, and I think that working in the communities is the key to better outcomes. I have agreed that the group should be reformed, and we could usefully discuss having a wider remit to focus not just on mental well-being and suicide prevention but on the wider public health aspect. Some Members mentioned my commitment to tackling public health, including by tackling health inequalities, and I believe that that broader focus will help to address the wider social determinants that are linked with poor mental and physical health. On that basis, I affirm that I am a fan of Professor Michael Marmot, a man who talks about not just the causes of ill health but the causes of the causes. For example, we know that smoking causes cancer, but what causes people to smoke in the first place? That, I think, is how we unlock better outcomes for people.

The advantage of the wider group that I am talking about would be that the societal determinants of mental health are the same as those for physical health outcomes, including individuals' experiences in early years, education, housing, employment opportunities, the physical environment and exposure to pollutants, and access to a healthy diet. It is essential to address those social determinants in order to improve the physical and mental health outcomes of our population. The group will also ensure that there is greater synchronicity across strategies, given the close linkages between mental health, physical health, substance abuse and suicide prevention. While suicide prevention is not explicitly mentioned in the draft Programme for Government, I always welcome the opportunity to work with other Departments in that area. Much excellent work is already being taken forward with other Departments, and I will take the opportunity to highlight some of it. For example, the Department for Communities has rolled out a mental health first aid pilot scheme across the Department. DFC has also ensured that suicide prevention training is mandatory for all front-line staff, and it has a six-point plan for managing suicide and self-harm declarations that are received from claimants, whether that is in person, in a phone call, in writing or via electronic media. The Department of Justice supports suicide prevention efforts through the PSNI's contribution to the multi-agency triage team. The PSNI has also developed an online mental health lesson plan for police officers. That is aimed at increasing awareness of mental health as a significant public health issue in Northern Ireland and preparing officers to deal with the sometimes challenging incidents that they encounter where no crime has been committed but an individual is experiencing a mental health or emotional crisis. The PSNI already trains all student officers in suicide prevention rather than in just suicide awareness. Some Members will be aware that the Chief Constable, Jon Boutcher, intends to introduce a policy called "Right care, right person" (RCRP) in recognition of the fact that police officers are not fully trained to deal with all mental health issues. I look forward to working with the PSNI to determine the best way to roll out the "Right care, right person" policy.

I absolutely will give way to the Member.

I thank the Member for the intervention. I am in favour of Departments offering suicide prevention training. I pause at the idea of making it compulsory for every member of front-line staff, however, given that that person may have had experience in their family or community circles. I think, Principal Deputy Speaker, that the Member is sympathetic to that. I pay tribute to the Member, because, through chairing the all-party group on suicide prevention, her work on understanding and promotion is absolutely exemplary not just on this issue but on cross-party and cross-community cooperation. I commend the Member for that. I go back to Protect Life 2, which contains a number of programmes designed to prevent suicide. They include Towards Zero Suicide, the multi-agency triage team collaboration between Health and Social Care (HSC) and the police; resilience building; counselling provision; the self-harm intervention programme; the "Flourish" church suicide prevention initiative; and Lifeline, to name but a few. We have undertaken extensive research and engagement to better shape the future of suicide prevention service delivery here. A review of Protect Life 2 has just been completed and is now available on the departmental website. That review has highlighted the need for a more focused and measurable action plan. To achieve that, work is well under way on revising the action plan in line with that report and to develop a new three-year delivery plan. That will set out the detail of how we will deliver actions and the targets that we wish to achieve. The action plan highlighted a new strategic action area around a whole-of-government-and-society approach. As I bring my remarks towards a close, I want to talk about the need for a societal approach. Mrs Dodds asked me to comment on prescribing rates. They are shocking, and that is a sign — a symptom, perhaps — of the fact that, to some extent, we over-medicalise how we approach mental ill health. Pills and medication have their place, but so do societal interventions. For example, a community psychiatric nurse sitting in somebody's kitchen, offering the human touch and saying, "Let's go on this journey together. I'll walk with you. I know how to get you to a better place", is important. I have also felt that, for a long time, societal interventions, empowering communities to understand the members of that community, to spot when they are not as they should be and to know how to intervene are important. Órlaithí Flynn mentioned Christmas trees. I am a member of the Ards suicide awareness group, which I helped to set up a few years ago, and, last Christmas, we put a tree in Tesco on the Castlebawn Road in Newtownards. On the table, there were a lot of blank cards, and I sat one afternoon and watched individuals and families lift one of the cards, write a note on it and put it on the tree. There was a shockingly high number of people. For them, the importance of that simple gesture was exponential. It was out of kilter. It reminded me of the scale of the problem and the fact that, if we can tackle it as a community, we have a chance. It seems to me that, if we really want to make a difference, there are three things that we need to do. First, we need to raise awareness, and, once again, I thank Members for using the debate to raise awareness. Secondly, we need agreement on how to cure the problem or, at least, how to address it and take a bite out of it. Thirdly, we need to devise a policy with a fully funded and resourced action plan that gives meaning to our determination to cure or tackle the problem. If we can do all three things, we will achieve better outcomes, and, if we achieve better outcomes, we will offer hope. Hope, for me, is success.

2,029 words. Text as published by the Northern Ireland Assembly.

Assessment

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Assessed 21 October 2026 at 11:10 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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