123GP campaigners have responded to the publication of the Mental Health strategy with the following statement.
For more than four years now, as families bereaved by suicide and/ or seeking mental health care, we have campaigned tirelessly for the right to timely and easy access to counselling for all who need it.
Sadly, too many people continue to end up in emotional crisis and too many are losing their lives to suicide. All too often, we hear of the failure of services to provide the right support at the right time.
Increasingly, people who can afford to pay can access counselling privately, while those who can’t afford to pay, often the most marginalised and most in need, cannot access it at all, or are stuck on lengthy waiting lists.
We are also alarmed at the exponential and unchecked rise in the prescribing rates for antidepressants, an issue we brought to public attention earlier this year.
Our proposals for improving services are set out in the Consensus on Counselling statement, which has secured the support of all the main political parties (bar the UUP), the Assembly’s Health Committee, the All-Party Group on Mental Health and a wide cross-section of civic society.
The Mental Health strategy, with its focus on early intervention and prevention, provides a unique opportunity to end the counselling postcode lottery and to put in place a properly funded counselling service in line with need.
While the strategy covers a number of themes and contains over 30 actions, these comments are confined to those provisions related to counselling.
Expansion of the Primary Care Talking Therapy Hubs
We are pleased to see that the Strategy sets out plans to expand the Hubs to cover all geographic areas and to resource them sustainably. The postcode lottery nature of provision has been repeatedly highlighted by our campaign.
The Strategy proposes a widening of the existing talking therapy hubs, to become mental health hubs, encompassing a wide range of different interventions. Any such plans must guarantee timely and easy access to counselling for all who need it.
Funding for the Hubs
The funding plan that accompanies the Strategy outlines a funding requirement of £2.9 million per annum, representing an increase of £1 million per annum. It also states that an immediate additional £504K is needed for staffing.
The funding plan does not provide sufficient data against which to assess these figures. However, campaigners have data, obtained via Freedom of Information, that shows many people wait up to 5 months for a first counselling appointment, that some people cannot access the service at all, and that there is a de facto cap of 6 sessions.
In light of this data, it would appear that the proposed increase in funding will not be adequate to provide timely and easy access to counselling to all who need it, of sufficient quality and duration and with a waiting time of no longer than 28 days.
We are calling on the Minister to provide an immediate injection of £504,000 as identified in the funding plan, to enable the Hubs to tackle waiting lists.
A realistic funding plan should then be drawn up, based on detailed analysis of level of need, utilising Trust data on the operation of the Hubs. This analysis should be published in the interests of transparency.
GP practice-based Counselling Service
The Mental Health Consultation Summary of Responses noted that ‘one of the most consistently raised points regarding community mental health provision was the availability of counselling in GP practices. It went on to note ‘many responses highlighted the inconsistency in provision across Northern Ireland, the long waiting lists, and the benefits of easier and quick access to such therapy’.
It is inexplicable as to why there is no mention of GP practice-based counselling in the Mental Health strategy.
In 2020/21 the Health and Social Care Board provided funding of £2.3million to GP practices to provide this in-house counselling service, more than is currently being invested per annum in the Talking Therapy Hubs.
123GP have highlighted the postcode lottery nature of provision with only two thirds of GP practices providing this service. The Consensus on Counselling calls for all delivery options to be resourced, including GP practice-based counselling. It is a service that, where currently provided, is meeting the needs of both patients and GPs.
For whatever reason, the NILES GP practice-based counselling has been written out of the Strategy. This is extremely concerning, not least because there is no transparency or public accountability for this service and the allocation of public monies.
We are calling on the Minister to explain the reason for this and to urgently clarify plans for the future of this service.
Community-based counselling providers
The Consensus on Counselling called for the role of local community-based providers in providing timely and accessible counselling to be fully recognised and resourced.
We welcome the recognition accorded to expertise of the community and voluntary sector and the need to significantly increase funding for the sector.
However, without greater detail around plans to integrate this sector into mental health service delivery, including the development of a protocol and funding plans, it is not possible for us to comment in greater depth at this point.
In conclusion, there is a need for greater clarity and more detailed information to enable us, along with our coalition of supporters, to fully assess the potential of the proposals set out in the Mental Health Strategy, alongside the Funding Plan, to deliver on the Consensus on Counselling.
We are committed to continuing our campaign for timely and easy access to counselling, as we know how urgently it is needed.
In the words of one person who shared their story with us:
“timely access to counselling would mean that those vulnerable individuals would be able to access services in a timely manner rather than having to suffer in silence”.
Sara Boyce works as an organiser with the #123GP mental health rights campaign. She has worked with PPR since 2016, both as an organiser and also as a policy worker across a range of campaigns supported by PPR. Prior to joining PPR Sara worked on both sides of the Irish border with a range of community and human rights organisations, including with Traveller groups and children and young people’s organisations.
She also worked for over a decade from the mid 1980s to the late 1990s as a Speech and Language Therapist, before undertaking a Masters in Equality Studies in UCD in 2006. Sara is passionate about promoting the power of poetry and other forms of creativity in challenging oppression and inequality at all levels.
‘Poetry is the lifeblood of rebellion, revolution and raising consciousness.’ (Alice Walker)