22 Feb 2005

Key Note Speech by Nigel Williams, Northern Ireland Commissioner for Children and Young People at the HOPE Conference on Self Harm and Suicide at the Park Avenue Hotel, Belfast.

I have visited many parts of Northern Ireland over the last 16 months since my appointment as Commissioner for Children and Young People. I have been to schools, youth groups, churches, and many conferences. I have met homeless young people, young people in care, and young people in custody. But in terms of sheer impact, one visit stands out from the others.

It was a cold February night last year. Accompanied by the local youth worker Stephen, I drove around a small part of North and West Belfast. As we went up a street in a matter of fact way he said “The young man in that house took his own life a few weeks ago; the girl in that house has been self harming and tried to drug overdose; the boy in that house died last week a few weeks after his friend had taken his own life…” and so it went on. We came to the end of the street and there against a wall were pictures of those who had taken their own lives, with candles, flowers and cards close by.

I found it hard to keep back the tears. It seemed such a waste – so heartbreaking that young people should feel so desperate that there was no other way out. Even with the best efforts of friends, family, youth workers and all kinds of professionals these young people slipped through the net.

I decided that night that we had to think again about how we approached young people’s mental health needs. I knew there was lots of activity among professionals, reviews and plans were underway both at a regional and local level. I was concerned though about whether in all this planning, all this reviewing, we were really hearing the voice of those most affected – the children and young people at risk.

And so the idea for today was born. Today is about all of us, those who are younger, and those who are older, working together to see what we can do to improve the mental health of young people in Northern Ireland.

I doubt if anyone here thinks that the current situation is acceptable.

  • How can it be right if hard pressed frontline staff spend days trying to secure a bed in hospital for a suicidal young man, whose parents can’t cope, and is under threat from the paramilitaries because he owes drug money?
  • How can it be right that a number of mental health beds for adolescents have been closed for some months because of serious staffing problems?
  • How can it be right that we have so few local sources of help for teenage girls with eating disorders whose physical and mental health is so fragile?
  • How can it be right for a GP to be told that consultant psychiatrists don’t have time to see young people with serious mental health problems – they can only deal with emergencies?
  • How can it be right that a high school principal is so concerned for the welfare of his pupils that he has to go and beg local businesses to help fund the provision of a trained counsellor?
  • How can it be right that the future of some ground breaking projects working in the field of prevention with young people will stop because the Executive Programme Children’s Fund is to end?

I do not think it is overstating matters to say that the Child and Adolescent Mental Health Services in Northern Ireland are in crisis.

Our in patient service is creaking at the seams, although there are promises of extra provision. There are great examples of prevention work and of primary care both in schools and in the community but they are too few, and their funding is too short term and fragile.

I have to ask - “How have the Department of Health and the government let things get so bad?”

This is a matter of fundamental human rights. Our government along with nearly all other governments around the world, have made specific promises to the children and young people living in this country through the UN Convention on the Rights of the Child.

The Government have promised in Article 6 to ensure that young people have the right to the maximum extent possible to survive and develop. They have promised in Article 12 that they will listen to the views of children and young people. And they have promised in Article 24 that children “have the right to the best health possible and to facilities for the treatment of illnesses and rehabilitation of health”

These promises to our children are being broken right, left and centre in Northern Ireland in the field of mental health.

But you know, it need not be like this! Things can change and that’s what we need to focus on today. Many of the problems are well documented, but what are the solutions?

Before I took this job I headed up a small international charity. I had to travel to Washington frequently, and on an early visit I discovered the Lincoln Memorial at the other end of the Mall from the Congress Building.

I love the Lincoln Memorial not just because it is a haven of quiet in a frantic city, but also because that is where Martin Luther King delivered one of his most famous speeches, “I have a dream”. On a number of occasions I have sat on the steps in front of the Lincoln Memorial and read that speech.

Well, I too have a dream for the children and young people of Northern Ireland.

I have a dream that you will not be stressed out by the academic pressures of school and the need to perform.

I have a dream that the hoods in our society who control whole neighbourhoods with intimidation, threats and punishments will leave young people alone and that the drugs trade they largely control will be eradicated.

I have a dream that anyone who is bullied will be immediately supported in their school or youth group, that bullying will not be tolerated, and no young person will feel desperate and alone because of other’s threats.

I dream of a Northern Ireland where we have a fully integrated Child and Adolescent Mental Health service.

I dream of a day when we have a clear strategy for child and adolescent mental health that includes promotion, prevention, community care and acute care.

A day when there is no rivalry between professionals in the community and those who provide acute psychiatric care; a day when we have the highest ratio in the UK of professional psychiatrists to young patients rather than one of the lowest.

I dream of a Northern Ireland where every school has some counselling provision whether provided by an outside agency or a trained staff member; where every child has someone to turn to when the going gets tough; where funding for such services is mainstreamed, guaranteed, and sufficient.

I dream of a place where no child, save for the most exceptional circumstances, has to leave Northern Ireland to get the professional help they need.

Is this an idle dream? Why should it be?

In the autumn of the year 2000 the Scottish Executive commissioned a needs assessment of the mental health of Scotland’s children and young people. The report, published in 2003, made 10 recommendations. It has led directly to a process involving all the professionals at a community and acute level, and young people themselves that has now produced a “Framework for Promotion, Prevention and Care”.

The crucial point about the Scottish Experience is that they are integrating all their work – their promotion and prevention strategies with their community and acute services. They are bringing in all the other agencies through the children services planning process. They are recognising the importance of the workforce dealing with child and adolescent mental health – such a crucial issue in Northern Ireland that is largely contributing to our crisis – and they are tackling underprovision.

No one in Scotland would claim they have got the problem licked, but I do believe they are heading in the right direction.

We have a number of elements of this work already happening here. Work on a mental health promotion strategy is underway. We have some excellent children services planning teams in place. We have the major review of learning disability and mental health headed by Professor Bamford, which I believe will push for the kind of integrated provision we need.

And we also have a Health Minister in Angela Smith whom I believe is seized of the issues and wants to see things change and improve.

So let us not get stressed about our situation. We already have enough stress, and it would be ironic in the extreme if today’s event contributed to it!

But let us be realistic, and let us send a clear message to the Government about what we need; a clear message to the paramilitaries in our communities to get off the backs of our young people; a clear message to those who want to harm or abuse children and young people; a clear message to everyone involved in this issue that we must work together for the sake of all.

Thank you for coming today – I am sure you will feel it is worthwhile when the day is over. I hope professionals will go back to their workplaces energised to tackle these issues with new vigour, and that all the young people here will feel a new sense of HOPE that they can bring change and make things better.

Thank you.