Thank you for inviting me to address today’s seminar and while this issue of mental health and resilience is timely it is with sadness that I speak to you today.
In NICCY I have a panel of 42 young people who help me to do my job. Just over 2 weeks ago one of my youth panel died – apparently death by suicide. He was a lively, charming, handsome 15-year old who would have been the last person we would ever have thought would have taken this action. After the immediate shock of the news I asked myself was there something that NICCY could have done or was there signs we did not pick up on?
These same questions face each and every person, each and every organization confronted with such tragedy. They unfortunately can never be answered.
Then there are the challenges that come afterwards- Help for those left behind…consequences…coping skills – issues that need to be addressed.
You only have to lift any daily newspaper or listen to the news to get a sense of the huge amount of good work going on, across Northern Ireland by the voluntary, community and statutory organizations - these organisations are the people who are working with children and young people every day - to promote positive mental health, and prevent our young people harming themselves or, even worse like Vyishnu ending their lives. Representatives of some of those organisations are in the room today and they deserve our acclaim and thanks.
But this work is not receiving sufficient support from Government. The way the current service is provided lacks direction, strategy and without the proper funding the service is left fragmented.
While there is good practice in some areas of Northern Ireland – each community and individual child has differing needs; and unfortunately at this time these needs are not being met.
NICCY Response to the Problem:
As Northern Ireland Commissioner for Children and Young People my job is described simply as:
Promoting and safeguarding the rights and best interests of children and young people to help them challenge and change the world in which they live. But most importantly- to give children and young people in Northern Ireland a voice.
And that’s all children and young people up to 18 in Northern Ireland. Except in 2 special circumstances of children and young people who have been in care or who are disabled and that’s to the age of 21
When my office was first established, my predecessor, Nigel Williams, commissioned Queens University to research the ‘state of children’s rights in Northern Ireland’. This research highlighted that more than 20% of children and young people in Northern Ireland suffer from mental health problems.
The research found that children here experience higher levels of abuse and suicide than those in the rest of the UK and the problem of substance abuse is continuing to grow.
Despite this fact, support and therapy services are unable to provide an efficient and coherent service for all those who need to access it. One professional who was interviewed during this research summed up the current service provision saying;
“Some of the most vulnerable young people in our society, children who have been exposed to indescribable levels of trauma and abuse, are having clinical decisions made based on resource availability rather than need.
The report said that only approximately 20% of children and young people with significant mental health problems or disorders receive specialist mental health services. That means 80% of children and young people in desperate need of mental health services cannot access them).
Many are going unrecognised. For those children who are referred it is estimated that between 60 and 70% donot receive appropriate early intervention. These figures should shame Government into action now.
In February, 2005, NICCY hosted a conference which highlighted the issue of self harm and suicide and also displayed best practice in the area of prevention.
This was followed by a NICCY campaign entitled “Message to the Minister” whereby young people were invited to place messages on the NICCY website to be relayed to the Minister for Health, detailing views on how self harm and suicide could be dealt with. In February, 2006, a report of the findings was delivered to Minister Shaun Woodward – and the message from young people was clear – too many problems, not enough solutions!
At the time the minister asked if there was one thing he could do for you people what would it be and they said counselling in schools. Here we are almost 18 months later and we are still talking about it.
Since I came into post at the start of the year the serious mental health difficulties experienced by our young people have been brought into very sharp focus by the high number of suicides of young people in areas across the North such as in Lurgan, Derry and North Belfast; where a recent spate of youth suicide has both shocked and saddened the local community.
My office has supported many young people under 18 years who have been inappropriately placed on adult psychiatric wards.
Now I ask you to put yourself in the position of a 15 year old girl, already frightened and anxious, unsure of what is happening to her as a result of her mental distress.
Now then, imagine they are placed on a ward with adults, who are mentally ill and finding life difficult already, how would this make you feel? Would it make you feel like you are a person who is valued and in a system that cared for you that was going to make sure you were safe and protected? - I think we all know the answer to that question.
We also have many young people receiving treatment outside the jurisdiction as we do not have enough inpatient beds to meet the current demand. As a parent I can just imagine the stress, worry and heart ache of having to stand by and watch as your child is sent miles away to a strange place and at a time when they most need family support. And can you imagine, again, what the child or the young person feels like being isolated from their loved ones, at the most vulnerable time in their young lives?
With this in mind NICCY is developing a policy paper on mental health. This paper will set out what we see as the priorities for the mental health of children and young people and will make recommendations and will challenge the Assembly, to urgently improve the way services are provided.
That is why seminars such as this are important. Whether it is a policy paper from NICCY, or recommendations to Government from yourselves, we all need to hear about positive action on mental health.
And, it is clear from the work of Professor Ken Fox and others that physical activity can play a vital role. Exercise, sport, and physical fitness activities – these all play important roles in positive mental health.
In Northern Ireland there are literally hundreds of children and young people already engaging in activities both inside and outside school. There needs to be more.
One example of an excellent scheme was talked about on Monday on BBC Radio Ulster. Families and young girls were interviewed about girls and ladies football training. All the children sounded happy and engaged by this. One even said that in years to come the Northern Irish Women’s Football team would do better than the men!
Training and coaching schemes like this provide obvious benefits in terms of fitness. The obvious benefits to mental health are, put simply, the feel good factor of taking part and the camaraderie of being in a team.
One of my NICCY colleagues used to coach at a local swimming club, and he tells me that of the 150 plus children and young people who were in that club almost all emerged after each session full of chat, gossip and the banter that can only come after a good workout. Professor Fox can no doubt tell us about the positive chemicals released to the brain by physical exercise – my colleague just said the children were happier after the exercise than before.
In NICCY we are conscious that Play is a Serious Matter – it is one of our current priorities. We have told Government that more needs to be done on the issue; play is important to children and young people’s social, physical and emotional development. Play should also be fun!
Unfortunately we live in a risk adverse society, where rules and fears of legal action constrain what we as adults allow children to undertake. School trips now have to have a dozen forms filled out beforehand to take children across a stream – as well as ropes, helmets, safety clothing and three helpers. Unfortunately I’m not exaggerating that much.
If we believe – as I know you all do – that physical activity, exercise and sport can have a positive impact on mental health we must allow children and young people to have a say in how that can undertake such activity.
They may tell us many different ways that they want to get more exercise. From disco dance classes, through to women’s football, walking challenges to skateboarding – who knows what they may come up with. It is up to us in this room not to see the problems such activities may bring, but to say “How can we make this happen?”
We at NICCY have been talking to those children.
We are currently undertaking a major piece of research into children’s rights in Northern Ireland, in which we have spoken face to face with over 2000 young people as well as parents and professionals. We will be using the findings of this research in the development of our policy on mental health.
Changes Needed to Child and Adolescent Mental Health Services – CAMHS
The Bamford review of mental health and learning disability reported last year. It made a series of important recommendations on improving mental health services. While certain recommendations have been carried forward and implemented, such as the ‘suicide prevention strategy’, the majority of recommendations have been left unattended. There is still no specific or, set time frame allocated to implement the recommendations that are so urgently needed to fill the gaps in CAMHS in Northern Ireland. We seen yesterday at a suicide awareness event in the Long Gallery at Stormont the Ministers for Health and Education talking about what needs to be done but not giving strong commitment to doing it. The excuse often being the cost to implement but what question to all Ministers is how much is it costing you not to implement? How do you put a price on a young life all parents would say that life is priceless.
I believe that from the outset the recommendations of Bamford should have been implemented in line with the ten year strategy for children and young people, unfortunately this has not been the case. The action plan to implement this strategy for 2007-08 set its own targets for developing services for those children and young people experiencing mental ill health. The targets set in this action plan do not reflect the seriousness of the current situation. For example:
Provide a crisis intervention service for Child and Adolescent Mental Health by 2008
Self harm support services in place in all Health and Social Care Trusts by March 2009
If the Government is serious about addressing the high levels of suicide and self harm they would have set interim targets outlining the various services and supports that would be needed for young people who harm themselves and a series of implementation dates for all Trust areas, as opposed to a vague implementation date of March 2009.
I will fully support any policy, strategy or legislation which seeks to promote the social inclusion of children and young people with mental health difficulties. However, what Northern Ireland does not need is another review or strategy or task force. What we need is the Bamford review implemented in its entirety.
Today, your seminar focuses on how physical activity can help with many aspects of mental health. Today must not just be preaching to the converted. If there is a challenge I would like to leave you with it is: Join up Government!
Health, Education, Local Government – these and many more need to work together on how they can encourage and support children and young people find more opportunities for physical activity, more opportunities for sport, more opportunities to play – and most importantly more opportunities to be themselves.
I’ll be listening to what children and young people tell me on this – will you? Will Government?