Publications: Science Omega Review UK Issue 2

A modern day mentality: reducing the stigma of mental illness

Man standing in shadows
Being mentally or emotionally healthy is much more than being free of depression, anxiety, or other psychological issues. Stress can come from many different directions, whether we are at work, unemployed or still at school. 
Kathleen Lynch
Minister of State Kathleen Lynch TD describes the commitment of Ireland’s Department of Health to reducing the stigma and improving services for those with mental illness...

As Minister of State at the Department of Health with responsibility for mental health, my main priorities are to improve access to modern mental health services in the community, reduce the stigma of mental illness and ensure the availability of early and appropriate intervention.

Mental health is an area that had long been neglected in Ireland, but with the publication in 2006 of the strategy for mental health policy, A Vision for Change, many very welcome changes began to take place in the way our services were being delivered. It proposed a new model of service delivery that would be patient-centred, flexible, community-based and with an emphasis firmly on recovery.

Implementation of the strategy has been somewhat slower than originally expected. It has been delayed by a number of factors, including the changed economic context, constraints in public spending and the public service moratorium on recruitment. Nonetheless, a great deal of progress has been made with the accelerated closure of old psychiatric hospitals and their replacement with new bespoke facilities, better suited to modern mental healthcare.

A very welcome development is the establishment of the National Service Users Executive and the involvement of service users in all aspects of mental health policy, service planning and delivery. The executive provides an opportunity for all service users to have their voice heard and respected and to be represented and involved in the decision-making process.

'Major challenges'


One of the major challenges facing us is the stigma that is often associated with mental health and suicide. Since the launch of our national stigma reduction campaign, See Change, in 2010 and the development of the See Change – Make A Ripple campaign in 2011, I believe that we are gradually seeing a change in the way people talk about their mental health. People, including those in the public arena, are beginning to be more open about their mental health and are willing, when necessary, to seek help. This is indeed a very welcome development as it normalises mental health problems and brings home to us that mental health problems, like any physical illness, are treatable and that recovery is possible.

Of course, I am acutely aware that the current financial situation is having a major impact on the population’s mental health and wellbeing. Good mental health isn’t just the absence of mental health problems. Being mentally or emotionally healthy is much more than being free of depression, anxiety, or other psychological issues. Stress can come from many different directions, whether we are at work, unemployed or still at school. Our mental health is very precious and it is important that we learn to value and protect it from an early age. It is important, now more than ever, that we continue our efforts and focus not only on reducing the risk factors associated with suicide but on strengthening people’s resilience and preventing vulnerability to suicide.

'Treatment and care'


Over the last few years, I have worked with my colleagues in government to develop a modern mental health service in the community. In order to achieve this, the government has provided an additional €70m to enhance our community mental health teams in both adult and children’s mental health services; to advance activities in the area of suicide prevention, to initiate the provision of psychological and counselling services in primary care, specifically for people with mental health problems; and to facilitate the relocation of mental health service users from institutional care to more independent living arrangements in their communities. In addition, clinical care programmes for the treatment and care of patients with eating disorders, early intervention in psychosis and the management of self harm presentations to emergency departments are being progressed by the Health Service Executive. Core to the overall plans will be the principles of recovery, individualised care delivered in partnership with voluntary agencies and based on early intervention and evidence-based practice.

One of my major concerns is the increasing number of deaths by suicide. Suicide is a tragedy that we are constantly working to prevent and also working to give more support to the families affected. Dealing with the current high levels of suicide and deliberate self-harm is a priority for me and for the government. Suicide is such a final solution to a particular problem and, unfortunately, there is not a community in Ireland that has not been affected. Reach Out, our National Strategy for Action on Suicide Prevention, makes a number of recommendations in relation to fast-track referrals to community-based mental health services, effective response to deliberate self-harm, training, stigma reduction, etc. Since the launch of Reach Out and the establishment of the National Office for Suicide Prevention (NOSP), there has been a significant amount of cross-sectoral working that has resulted in considerable advances in suicide prevention.

Suicide prevention


In the aftermath of a suicide it is vital that supports are available to both families and communities. The NOSP has developed a range of initiatives to support people who are suicidal and also supporting their families, friends and peers in recognising and responding appropriately to signs of emotional distress and suicidal thoughts. Earlier this year, I was delighted to launch the guidance on mental health and suicide prevention for post-primary schools, which aims to adopt a comprehensive whole school approach to mental health and wellbeing.

Priority suicide prevention initiatives identified for this year include: the further development of existing National Mental Health Awareness campaigns to promote help seeking, increased training for GPs and practice staff, building the capacity of communities to respond to suicide, implementation of the clinical care programme for self-harm. This will include the funding of nursing posts within hospital emergency departments, training of acute hospital staff on suicide and self-harm intervention and the development of the Suicide Crisis Assessment Nurse (SCAN) model, which allows for crisis interventions at primary care and continued investment in voluntary agencies providing frontline services.

The NOSP is reviewing its current activities to make the most of available resources, including looking at best practice internationally to inform evidence-based policy decisions. This will result in a revised strategic approach for 2013 and will inform the final phase of Reach Out, our National Strategy for Action on Suicide Prevention, which runs until 2014.

Finally, notwithstanding the difficulties that lie ahead, my commitment to the continued development of our mental health services is unwavering and I will continue working to improve the lives of those with mental health problems.


Kathleen Lynch TD
Minister of State
Department of Health, Ireland

www.dohc.ie



[This article was originally published on 10th June 2013 as part of Science Omega Review UK 02]


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