The announcement on 27 April 2020, by the Minister for Health Robin Swann of the creation of a new post of Mental Health Champion, is fairly inexplicable in terms of timing. Any development that brings increased focus and priority to mental health is positive. However, the prioritisation of this appointment, with its projected ‘price tag’ of between £300K to £500K seems misguided and a misdirection of previous public resources. With much of the detail still to be provided in relation to its powers, reporting, accountability as well as the recruitment and appointment process, it is not possible to make an informed assessment of what its potential contribution might be in this radically changed context.

There is a myriad of issues which a mental health champion, equipped with the necessary powers and resources could have a significant impact on. For example, the need for independent scrutiny and regulation of both community and in-patient mental health services was recently highlighted by the Detail investigative news website. Shockingly, neither community nor in-patient mental health services fall under the remit of Regulation and Quality Improvement Authority (RQIA), meaning that these services have less legal oversight and scrutiny than any other jurisdiction in the UK. That is just one amongst a large number of issues that a Mental Health Champion should be empowered to address.

Our society already has Mental Health Champions - in all of the 123GP activists who have campaigned tirelessly for years for better mental health services, alongside the thousands of others fighting for better mental health and suicide prevention services. Listening to their ideas to ensure timely and effective access to services - and urgently implementing these - should be the first port of call for the Minister during this period.

Mental health responses to Covid

Research into mental health responses by governments elsewhere, who are further down the line with COVID, show that public mental health interventions must be formally integrated into public health preparedness and emergency response planning.

A piece by Angus Lambkin, a UN expert on humanitarian planning and coordination for complex emergencies for The Detail highlights the importance of prioritising mental health services as a critical support sector within the overall response planning. Among the priorities he cites is the need for defunded and therefore dormant counselling and therapy capacity to be remobilised.

Looking to China, where the first outbreak of Covid occurred in December 2019, a whole raft of measures designed to address the mental health impacts been systematically rolled out.

These have included:

• Publication of free electronic books on CV-19 that deal with mental health
• Guidelines for public psychological self-help and counselling during CV-19
• Online psychological services
• Free 24/7 services
• Online self-help psychological intervention systems – online Cognitive Behavioural Therapy (CBT)
• Artificial Intelligence programmes – intervention for psychological crisis during epidemic.

As with China, a number of US states have moved to introduce Freephone mental health hotlines during Covid.

Closer to home we’ve seen both Public Health England and the Scottish Executive announce additional funding and new initiatives to respond the mental health needs arising from Covid. The investment of almost £4.8 million by the Scottish Executive to increase capacity of their telephone and digital mental health services is something that needs to be urgently addressed by the Department of Health, with reports of Trusts being unable to facilitate appropriate and much needed mental health interventions.

Acutely aware of the pre-Covid situation in relation to mental health services, activists are determined to keep campaigning for increased resources and funding for mental health to respond to Covid.

A Covid Mental Health Response Plan is urgently needed

While currently unable to physically mobilise, mental health activists continue to meet together online, to monitor impacts and developments and to organise. Acutely aware of the pre-Covid situation in relation to mental health services, activists are determined to keep campaigning for increased resources and funding for mental health to respond to Covid.

Keen to build the capacity of grassroots groups and organisations to support people in psychological distress due to Covid, one of the first initiatives undertaken by #123GP was to partner with Psychologists for Social Change to deliver WHO Psychological First Aid training to over 50 individuals.

Activists have also come up with a multi-staged response plan they want to see implemented by the Department of Health and the Public Health Agency, which should include the following initiatives:

• Make information readily available on the resources and services that can be accessed online. For example, the inclusion of the Trusts’ Z cards on the NI Direct Covid website is something that could very easily be done.
• Create a centralised referral point through a telephone hotline for anyone needing emotional/psychosocial support arising from Covid.
• Roll out an online programme of training in mental health and suicide prevention within communities across the north.
• Plan now for a significantly increased resourcing of mental health and suicide prevention services, both in statutory and community and voluntary services.

Conclusion

Before the pandemic there was a widespread consensus on the scale of the mental health crisis in this society and the need for urgent investment in both mental health and suicide prevention. There is no question but that the pandemic and the aftermath will have massive psychosocial impacts across the entire population, with vulnerable groups being disproportionately affected.

The Department for Health must urgently provide accessible mental health support for all those struggling as a result of Covid, with resources targeted towards those most at risk populations. We also need a properly resourced, scaled up mental health and suicide prevention response plan that can respond effectively to the trauma caused by Covid. The consequences for generations to come of not being equipped to respond to these new traumas, layered as they will be upon significant levels of unaddressed conflict related trauma, are simply too grave to sit by and watch unfold.

** The Minister for Health released a Mental Health Action plan with a budget of £2.8m for 2020 which includes a ‘Covid-19 Mental Health Response Plan’ on 19th May. We welcome the publication of a Covid-19 response and will publish our analysis on No-one Left Behind shortly.

Mental Health and Suicide Prevention Resources

‘Mental health emergency - if you’re in crisis or despair’ - NI Direct

Zero Suicide Alliance Training

Free online stress control classes for workers and clients

How to mind your head during the lockdown

NI Helplines Network

Urgent Help and Further Supports for longer term psychological work