Another Strategy

You may have read statements recently from a number of  elected representatives  relating to the Stormont Draft Mental Health Strategy 2021-2031, now out for consultation.  Whilst movement on the issue  is to be welcomed,  from an initial review of the proposed strategy this would appear to be a highly sophisticated framework dependant on  funds,  the will of an unsophisticated ‘government’  and the implementation of past policies to effectively address  key areas of the draft strategy. 

These include:

·         New ways of working 

·         Promoting wellbeing and resilience through prevention and early intervention

·         Providing the right support at the right time

 

I know this is going to sound cynical, but anything that comes from Stormont in my opinion should come with a warning label telling the public that it should be viewed with caution and may not  do exactly what it says on the tin. Yet, even in my well warranted cynicism I do try to be cautiously optimistic.

 

As a society, we are increasingly more aware of the impact of poor mental  health and mental illness, something that has become more prevalent since the planet was hit by the Covid pandemic. But predating Covid, the fact that more people died through suicide in the twenty years following the signing of the Good Friday Agreement than over the course of the troubles made people sit up and notice. Here in the N. Ireland we have higher levels of mental illness than England , higher levels of anti-depressant use and in a survey (young life & times) 26% of 16 year olds had serious personal emotional or mental health problems, and shockingly the figure increased to 43%  for those from ‘not well off backgrounds’. These are only some examples and they predate Covid.

 

The scourge of poor mental health and addiction has hit this city hard, and if you cast your mind back a couple of years there was a high profile campaign for a detox centre for the city, yet despite the overwhelming public support for this, a local detox facility was not established.  There is a crisis intervention service that has provided a much needed lifeline for many, allowing people to receive immediate support so interventions can be implemented. Yet even this service is piecemeal in comparison to what is needed. That’s not a reflection on those who operate  the service, the fact that this service was not properly funded and resourced from the outset is a scandal.

 

Sadly the deaths through addiction and mental illness continue, most recently in the city a young mother of three lost her fight with addiction. Louise White’s daughter bravely spoke about her mother and the lack of a detox service,  and sadly this young family have lost other family members before to addiction & suicide. It’s welcome that the strategy makes provision for a needs led approach to dual diagnosis in that instead of expecting a person to fit into a service the service should fit around the individual. Something which may have benefitted someone like Louise White whose daughter said that her mother felt uncomfortable and hated going to the hospital and never got the right support. Louise’s family have launched a petition calling for detox facilities and I would call on everyone to sign it. 

There are many factors which can impact negatively on someone’s mental wellbeing, these  risk factors are generally not individual factors but a culmination of different elements. The new strategy does propose to address these factors, but how it will achieve this is another matter.

 

Section 35 of the draft document looks at cultural, environmental and social and economic  factors.  The section further highlights the long term impact that poverty and disadvantage can have on mental illness.   In addition to this, it highlights the need to;  implement existing policies designed to address deprivation, poverty and social cohesion issues and the other detriments to mental health.  And here’s where my scepticism lies, if older strategies continue to gather dust on abandoned shelves then why would this time be any different?  An example of dust gathering being, when Stormont fell the Protect Life 2 Strategy sat on the shelf as many lives were lost to suicide.

 

As I mentioned near the start of this article, the ongoing pandemic has brought a number of issues to the fore. These include the growing poverty and mental health crises.  The need for  financial intervention  to address the welfare reform deficit and issues stemming from the pandemic has become more apparent through a number of government  and community led schemes.  These initiatives have been a lifeline for many families but in reality act as a short-term solution to a long-term manmade epidemic, poverty.  Equally, intervention is urgently required to begin to address the growing mental health crisis at a grassroots level . This through lobbying, utilising skills and resources, awareness raising , community education, upskilling and capacity building.  The strategy does talk about increased involvement from the community and voluntary sector but this needs to go further than the current structures and local council community planning.

 

An example of addressing  health issues effectively at a grassroots level would be the  Portuguese drug model .  Addressing the drug crisis the Portuguese people faced didn’t involve  reliance on government  it was spearheaded by ordinary people , from their homes. These were ordinary people with lived experience  through which they recognised the need  for immediate help and intervention.  In addition, a key focus of the model was to address the criminalisation of people who were being imprisoned without consideration being given to the factors impacting on them including inadequate support systems. 

 

A similar situation was raised locally a number of years ago by local Magistrate Barney McElholm, Mr. McElholm who actually went as far as to accuse the Department of Health at Stormont of misspending public funds and criticised the lack of funding for mental health services. This stemmed from an incident with a young lady with a diagnosis of personality disorder. The NI Personality Disorder Strategy was published in 2010, yet by the time of this incident in 2019 few of it’s recommendations had been implemented by health ministers here.  And you wonder why I’m cynical?

 

From experience of the frontline I have witnessed first-hand the impact that poverty continues to have not just on the economy but on mental wellbeing and addiction.  Obviously poverty is not the only factor but it is playing a significant part in the increase of people with poor mental health and addiction problems.  With this the case we must question why a ‘government’ would choose not to  directly and adequately provide for those in need especially at this time. The evidence that our physical and mental health impact on each other by cause and effect is there, it just seems that those in power  haven’t seemed to grasp this.

 

At the beginning of welfare reform there was a lot of emphasis on cost saving, but at what cost is the question?  Adequate financial  provision whether through earnings,  taxation or  benefits ensures a healthy economy, less pressure on existing health services and additional resources. 

 

In contrast, growing poverty places  undue pressure on current services, the NHS, the economy and existing resources .  Therefore the system in place is illogical and arguably an attack on the most vulnerable in society by those whose only experience of  limited finances and benefits would be a subsidised canteen and a generous expenses account.

 

The mental health strategy further looks at preparing those working in mental health services, however, surprisingly, it does not look at problems people face in the workerplace.  In figures  presented by the Centre for Mental Health in 2017 staff turnover due to mental health illness cost the UK economy 
£3.1 billion and sickness absence cost £10.6 billion.  From experience employers can play a part in declining mental health both  through act and omission.  The long-term effects of this and the failure to provide legal support through the legal aid budget for those suffering as a consequence of unscrupulous employers and seeking redress needs to addressed . 

 

The current Tribunal system is a minefield and in need of overhaul to ensure a fair and attainable system otherwise some employers will continue to opt in and out of organisational policies at their discretion with no regard for; consequences , equity of arms, human rights or workers rights.  I have experienced this recently with an organisation that prides itself on being established to address social inequality and disadvantage in early 1900s. Sadly it would seem that they too  have lost all sight of their foundation and no longer do what they claim on the tin and they're not alone in this. 

 

 

In closing, if implemented in full and with the inclusion of additional elements the mental health strategy could have a positive impact. I hope that my cynicism is proved unwarranted.  There is too much at stake, namely human life.  The foundations for the next generation are here and can be achieve if the strategy is implemented.  Therefore it is important that we all contribute to this consultation which ends on 26 March 2021. There is sufficient research into the causes of poor mental health, the challenge now is ensuring that the appropriate steps are taken to build resilience in communities and protect life too.. 

 

 

 

 

 

 

 

 

Who Cares?

It’s been a while but hey it’s hard to keep a Derry woman down.  In this piece I will cover a number of topics with a specific focus on the Social Care Sector.

It would be strange given the current situation not to acknowledge the impact of the Covid 19 pandemic. From the outset of this, as someone with absolutely no faith in central ‘government’ I did question the local measures implemented and whether or not they formed part of a wider agenda.  In particular, measures which continue to erode our fundamental freedoms.  I believe I can be forgiven for this considering the hullaballoo around Brexit negotiations prior to this and the need to deal the growing number of elephants in the Stormont chamber, the biggest of which was our troubled past.  A past which continues to hide behind its own mask and the skirt of the mothership, Westminster.

I have read a lot of commentary recently around Covid, some I agreed with and some I didn’t.  From reading this I could gauge a real sense of frustration on both sides of the debate. Frustration stemming primarily from a lack of substantive information and the failure of ‘government’ to provide adequately, coupled with contradictory information and guidance.  Guidance which at one point permitted people to meet their loved ones in a bar but not at home and, kept children in school were in vast numbers they were deemed safe providing they did not partake in PE.  All totally questionable

In addition to the above issues there is a huge question around the accuracy of data which suggests that the majority of recent deaths have been Covid related.  Having been badly affected by the virus I know first-hand of the need to follow guidance no matter how frustrating and contradictory.  I can only hope that those fine folks in Stormont are taking guidance strictly from health experts and not Edwin Poots who you’ll recall gave rise to the notion of a ‘Fenian flu’.  Seriously though, a proper Covid strategy from the outset may have helped us curb the spread of the virus and the need to dip in and out of lockdown which has caused so much hardship and uncertainty.  Whatever your position on the virus, the wearing of masks and restrictions it is important that we don’t get too bogged down and end up polarised which would serve no purpose.

The ‘all in this together’ cheer we’ve heard during this time is now more than ever visible in the community where solidarity and a spirit of generosity has been to the fore of growing efforts to provide for the most vulnerable in our communities.  I believe that through this there is now a greater understanding of the growing poverty crisis and the treatment of workers including healthcare heroes, many of whom are among the growing numbers of working poor.

 

The NHS that is now more than ever the focus of protection and gratitude was for a long time a victim of privatisation by stealth.  The effects of this are visible in the current state of the NHS which is in urgent need of radical overhaul to ensure adequate service provision for all going forward. 

 

 

The NHS is not the only service in need of additional support, the social care sector needs to be included in this.  In many instances care workers are underpaid, undervalued and their contribution until now has gone unnoticed. The pandemic has changed this bringing the work that carers do crashing into the public eye.  This includes the conditions they work in.  Thankfully from experience there are companies that treat their staff well and know their worth, sadly there are others that don’t.

In my years as a community activist I supported a number of people with employment issues stemming from poor practice and unscrupulous social care employers.  During this time I witnessed a lot of horrendous practice and care workers up against a system which remains stacked against them.  These cases included discrimination, humiliating and degrading treatment, sectarian threats, a refusal to make reasonable adjustments and in the case of one organisation, the deliberate scapegoating of care workers for the actions of others.

What many might not know is that every health & social care worker here is required by law to register with the Northern Ireland Social Care Council. NISCC as it is known, is the regulator for the social care workforce and sets standards of conduct & practice for the workforce. Working alongside NISCC is the Regulation & Quality Improvement Authority – The RQIA. The RQIA regulates the health & social care sector in the North.

If a social care worker breaches the standards of conduct & practice they can be sanctioned by NISCC, this can result in them being suspended or banned from working in the sector. And I would say rightly so, if someone is not suitable to work in the sector then the appropriate action can be taken. Anyone found to have breached the standards will have the details of their infraction published on the NISCC website.

NISCC also publishes standards for employers and here’s where it gets interesting.  One of the care workers I supported in the past wrote to NISCC to raise concerns that their former employer had breached the NISCC Employers Standards. Despite publishing the standards NISCC replied that ‘we believe the concerns you raised may be best placed with your employer to conclude through the grievance process and for consideration by the RQIA.’  

And also, ‘While the Council have responsibility to publish the standards and keep them under review, the RQIA have responsibility for enforcement of Department of Health Standards and will consider compliance with the Standards for Employers, as part of their registration and inspection process.’

So if workers can be sanctioned by the regulator for breaches of their standards one could righty assume that any employer found to have breached the Employers Standards would face sanction by the regulatory bodies if they were found to have mistreated a care worker. After all it is outlined in the care standards published by Stormont that Employers must adhere to the standards.

However, in freedom of Information requests to NISCC and the RQIA a number of contradictions came to light as you will read below: 

NISCC 

1.   When asked how many Social Care Employers have faced investigation & or sanction for breaches of Employers standards since 2015?

Response; ’While action may have been taken against individual managers, this would not extend to employers as this falls under the remit of the RQIA.’

2.   When asked ‘What action has been taken against employers who have been found to have breached employers’ standards since 2015?

Response; ‘NISCC may have taken action against individual managers, but not against employers per se, as the RQIA has the enforcement powers re the Employers Standards.’

RQIA 

1.   ‘How many complaints and or concerns have been registered with RQIA about Employers breaching NISCC Employers Standards since 2015?’

Response; ‘I should explain that Social Care Employers under NISCC Regulations are not required legally to comply with The NISCC/RQIA Employer Standards and therefore RQIA do not regulate this matter.’

So if NISCC doesn’t enforce the Employers standards, and RQIA doesn’t enforce the standards, the question is who does? Ultimately, who cares for the carers?  Maybe one of our underworked and overpaid public servants would care to enlighten us.

This lack of support for care workers needs be addressed by all with an interest in worker’s rights including the trade union movement. The work our carers do is invaluable as is their contribution to wider society.  This was so eloquently captured in a tribute from John Hume Junior to the staff at the Owen Mor Care Home following the passing of his father: 

 ‘If he were here, he would urge us to look at those young carers and the incredible and heroic daily work they do as a model for future leadership - their ethos of deep respect, a respect for everyone regardless of where they come from or stage of life. - These are the foundation stones that are critical to all communities.’

This past year has been a very challenging time for everyone, but like you I am mindful of the care workers who supported many people in their end stages of life and who held the hands of people when their families could not be there because of the restrictions. And, for many care workers, this has, is and will continue to be their role when covid-19 becomes a memory. As a society we clapped for carers, but more is needed to reflect the value of the work that care staff carry out, often in challenging circumstances. The question needs to be asked, who cares, and we should respond, we do!

It’s time for change.

 

 

 

 

 

Less than £100 for a life.

Foyle Search and Rescue staff pictured searching
the river bank under the Foyle Bridge 

Since it's inception in July 1993 Foyle Search & Rescue has been an invaluable resource for the people of Derry City. In the years from 1993 to 2012 the Charity has stopped over 2200 potential suicides, rescued over 278 people directly from the water & recovered 112 bodies.

Not only do they have regular patrols Foyle Search & Rescue respond in emergencies 24 hours a day 365 days a year. The service they provide to this city cannot be measured, from intervening when people are in distress, entering the river to search for people, assisting families in searches for loved ones, sadly helping recover the remains of those lost or helping people in the aftermath through counselling services.

They also maintain the City’s lifebelts, promote water safety & suicide awareness by giving talks to schools & youth groups and facilitate a support group for people who have been bereaved by suicide.

So the question has to be asked why this group which has done so much for the city would be denied funding from the DUP/SF Slush fund, officially known as the Social investment fund.

Foyle Search and Rescue in conjunction with HURT (a Derry charity that helps people who have suffered as a result of drug & alcohol abuse) had applied for funding to create a counselling facility for people found in distress around the River Foyle.

Foyle Search and Rescue has expressed disappointment at failing to secure the £220,000 needed for the project. If you consider that they have prevented over 2200 attempted suicides and rescued 278 people from the River Foyle it works out at less than £100 for each life saved, which in the grand scheme of things is a small price to pay.

It could be argued that there are other counselling facilities in the city who could benefit from the funding and I am not in any way taking away from the excellent work other groups carry out, however a core difference for me is that not only do Foyle Search & Rescue deal with people in distress and in situations where their lives are in immediate risk, but they also deal with people who have not completed suicide and the families of those who are still reeling from the aftermath.

Less than a year ago Belfast DUP MP Nigel Dodds stated in Westminster that death by suicide in Northern Ireland has increased by 100 per cent in less than 15 years.

This figure came mere months after it was stated by DUP Health Minister Edwin Poots that people who are unemployed are at an increased risk of suicide. Mr Poots said studies indicated that a 1% increase in unemployment was met with a corresponding 0.79% increase in suicide.

Now consider that figure in the following context that Derry is the unemployment blackspot of the North. Figures released in October 2013 show 6,098 were unemployed – 4,172 male and 1,926 female, 8.6 per cent of the population are unemployed. Derry City Council also has the highest level of child poverty in all 26 council areas of Northern Ireland at 35%, within this, the figures for the wards of Brandywell, Creggan South and Creggan Central soar to 61%, 63% and 59%.

In light of this there seems to be a lack of joined up thinking, a level of unparalleled ineptitude or a decision to fund pet projects in areas that will curry favour at election time for the two parties behind the Social Investment Fund namely the DUP & Sinn Fein. Both the SDLP & UUP have described the Social Investment Fund as nothing more than a slush fund.

The former leader of the UUP Tom Elliot claimed 'Grants from the funds are disbursed by the Office of the First and Deputy First Minister (OFMDFM) which is controlled by the DUP and Sinn Fein. I suspect that money will go into projects in Sinn Fein and DUP constituencies or areas which they favour,”.

Initial Steering Groups were established for the nine Social Investment Zones. The fund is being delivered in partnership with communities across nine social investment zones. Each zone has a steering group with up to 14 members from the business, political, statutory and voluntary and community sectors. The steering groups developed plans for each social investment zone. They will manage the plans.

The members of theSteering group responsible for the Derry Area include: 

Members of the Derry Steering Group

What should be noted is that two out of the four members of the voluntary/community sector. Noel McCartney & Charles Lamberton are leading Derry Sinn Fein members. And whilst I'm sure Mr McCartney & Mr Lamberton would argue their independence separate from their political affiliation, I myself would consider the steering group to be weighted favourably in Sinn Fein's favour.

One other person on the steering group who also merits a mention is Darren Kirby of the Outer North Neighbourhood Partnership. Mr Kirby once infamously told residents in the area of a contentious planned development that they had been excluded from discussions because they didn't agree with the people who had the plans, although his major claim to fame was that he met the Department for Social Development over them providing information under Freedom of Information legislation to members of the public.

Let's just say I'm not filled with optimism, and sadly this seems to have been confirmed by one of the initial announcements of a decision made by the 'Steering group'.

£4.5 million will be used to build new sports pitches.

£3.3 million will go to delivering community employment projects for young people, the long-term unemployed and those in low wage jobs.

This disparity begs the questions:

Why is more being spent on sports pitches than on delivering employment & training opportunities? And if these pitches are to be sustained how will they be paid for? Will a fee be charged to children already in poverty? If they are to be free how will they be sustained?

When you consider the figures that spell out the level of child poverty in the city, you have to marvel at the decision made. Statistics published by Barnardos show that a child is at greatest risk of poverty if they live in a family where no one works, however a substantial and growing number of poor children are living in families where at least one a parent is in paid employment. In 2011, nearly two thirds of poor children were living in families where someone was in work. So why invest more in pitches than employment?

People are stuck in a vicious cycle which unless addressed properly may end up with more people needing the services of Foyle Search & Rescue among others. The only sure winners out of the Social Investment Fund have been the consultants who to date have received nearly £400,000, nearly double what Foyle Search & Rescue had requested. I wonder how many of those consultants patrol the river Foyle on a cold winters night?