Tackling mental and physical health in Derry & Strabane

Joe Thompson, coordinator of the Crisis Intervention Service.
Joe Thompson, coordinator of the Crisis Intervention Service.

They say that ‘your health is your wealth’ and there is no truer saying when it comes to leading a happy, fulfilling life. Improved wellbeing is the primary objective of the Strategic Growth Plan for Derry and Strabane, and this feeds into every outcome of the strategy from the economy to education.

Statistics published in the recently launched Statement of Progress for the Strategic Growth Plan – or Community Plan – for Derry and Strabane, reveal a clear picture of health inequalities in the region. According to an annual report issued by the Department of Health in 2019, 29 of 44 health outcomes were worse in Derry and Strabane than the rest of NI. It also showed that 14 inequality gaps had widened.

Professor Siobhan O'Neill

Professor Siobhan O'Neill

The figures indicate earlier deaths, more prescriptions for mood and anxiety, more self-harming, respiratory disease and admissions associated with drugs and alcohol. But while the scale of the challenges ahead in addressing these issues are undoubtedly significant and complicated by a wide range of inter-dependent factors, they are not insurmountable, and work has already begun to narrow the gap between Derry and Strabane and the rest of NI.

Interventions

There have been lots of interventions over the past two years to address this long-term issue. Council, in partnership with the Public Health Agency, the Western Health and Social Care Trust and local community organisations, are already delivering a series of projects and programmes aimed at creating the conditions to support improved health and encourage healthier lifestyle choices.

Already making a difference on the ground, schemes such as the Macmillan Move More Programme, the Everybody Active Programme, and the GP Referral Scheme are changing lives by raising awareness and altering attitudes about health and fitness.

Council has also seen increased usage of its leisure facilities, with growing demand for classes and lessons for all ages. The Public Health Agency has been focusing on improving wellbeing with initiatives such as the Positive Aging Month programme helping older people lead more independent, engaged and socially connected lives, while the cross-border Co-Sync project on health literacy, is tasked with strengthening capacity for improving health and wellbeing in participating communities.

Mental Health

As well as focusing on physical health, mental health has emerged as an area of major concern that has historically been neglected. The impact of social deprivation on mental health, is further exacerbated here by the fact that we are a society emerging from conflict and trauma.

Professor of Mental Health Sciences at Ulster University, Siobhan O’Neill, has extensively researched this area over the last 20 years, studying suicidal behaviour in N. Ireland. She believes a top down approach to mental health is urgently needed.

As part of her work, Prof. O’Neill has been involved in the steering committee associated with the innovative pilot Crisis Intervention Service, established in Derry in January 2019 – a unique non-medical support service for those who find themselves unable to cope and in urgent need of intervention. She hopes that, based on the evaluation of the service and the number of people who have accessed support in the past year, a funded long-term service will now emerge for the city.

“We know that N. Ireland has relatively high rates of mental health problems,” she explains. “Most of the studies suggest that rates of mental illness are about 25% higher here than in similar regions in the UK or Ireland for example. Because we’ve had such a history of conflict and trauma there’s data there showing that people whose families or themselves have been exposed to that trauma of the Troubles are more likely to go on to develop mental health problems.

“In the NW there are a number of contributing factors. It’s a deprived area, it’s an urban area and we know that in urban areas with high deprivation you always find high levels of mental health problems.

“We know that the Crisis Intervention Service is already having an impact because we see people using it every week or being brought to the Crisis Service by other services out there in the community who are working when it isn’t open. For those accessing the service, they are receiving an intervention and compassionate engagement and surely that’s going to make a difference.”

Prevention

According to Prof O’Neill, early intervention is crucial with much more information and support being made available through a range of channels.

“For the next ten years in N. Ireland what we really need is an effective mental health strategy, that is a top down approach were we can identify the gaps in the current services and put in place a plan to address those gaps. The gaps in my view include prevention services and services in schools so that when children and young people are starting to show signs of mental health problems and being at risk then we can get in there early. Because we know that the escalation into mental illness can be prevented if we intervene early.

“There’s so much we can do, particularly in the early years of primary school and at a family and community level to prevent mental illnesses from developing. Then we have trauma related mental illnesses, they need trauma-focused therapies, the type of therapies that are going to work and to address more complex mental illnesses.

“We need the updated Suicide Prevention Strategy to be implemented as soon as possible. Again these strategic approaches will drive change and help deliver the services we know will work, but we need that to be directed and properly funded.”

Crisis Service

Joe Thompson is coordinator of the Crisis Intervention Service, which is being delivered by support organisation Extern. The pilot service currently runs from 8pm on Thursday evening through to 8am on Sunday morning, providing vital assistance to the emergency services at the busiest times. Its future however is uncertain, with funding in place until March, when an evaluation of the service will decide its long-term sustainability.

As more people access their support, Joe is convinced of its value and hopes to see it extended to a seven day a week provision. “Anecdotally everyone knows there’s a high level of demand for a crisis intervention service,” he insists. “From our perspective certainly numbers are increasing but we would put that down to raised awareness of the programme.

“We’ve had consistent usage since the outset and a lot of this can be attributed to partnership working with Foyle Search and Rescue and the PSNI. But we are aware numbers are growing and we’re consistently helping people every weekend. I think without a doubt a service like this on a permanent basis would offer a lot of hope to this city, a lot of hope to the people who find themselves regularly in distress. And it would be a good thing for Derry to lead the way in the delivery of this type of service.

“If someone needs to go and see a medical professional then that’s who they need to see – we’re not here to replace any existing service, we’re just here to complement the services that are already there. But the sad reality is that if someone presents to A&E in emotional distress they could be waiting for five hours to see someone and they may get five minutes speaking with a medical professional. What we can offer is the opposite of that – you can be talking to a trained professional in five minutes and if you need five hours to talk to someone, then we’ll give you five hours.

“Undoubtedly there is an obvious need here - the people of the city deserve this service and we would like to be here to provide it for many years to come.”

You can find out more about the programmes and projects like the Crisis Intervention Service that are already making a difference locally within the full Statement of Progress which is now available to view online at www.growderrystrabane.com