Speech at Please talk.org 3rd annual please talk forum

Good Morning, thank you for the very kind invitation to address you at this extremely important conference; I am delighted to be here. Thank you for your attendance. Today by your presence you are making a commitment to yourself, to your peers, to your colleges and to tackling the issue of mental health. You are saying that you are available, willing to engage, to listen and to support.

I want to at the outset to thank the previous speakers for their very positive words of introduction. I would like to thank the organising committee and in particular Derek Chambers for his invitation to speak. I would also like to pay tribute to Dr. Stephanie o Keeffe, Director of the national office for suicide prevention on her appointment and wish her well in this challenging role. She brings a wealth of experience, as a former head of the crisis pregnancy agency. I want to acknowledge the presence of Susan Kenny from the NOSP who will speak later.

“If mental health becomes more of an everyday issue that matters to us all then the stigma attached to getting help can be reduced. While Irish society will continue to experience considerable change and face new challenges ahead, a mentally healthier Irish society will be much better able to cope.” (Mental Health in Ireland:Awareness and Attitudes, 2007)
 

That is the task that faces us all, to make mental health a priority, erode the stigma and to be able with confidence to speak about mental health. I did and so many more have. It is important to talk, it’s not a slogan a mantra it’s a fact. Talking sharing is good.

Today will I’m certain be very informative and educational. The workshops or breakout sessions will be an opportunity to engage. Indeed active engagement is critical, as collectively and individually we all learn not just from each other but from shared experiences and especially from talking. Today’s conference “Please Talk” is one where we continue to explore further the issues of mental health. Indeed

There is an onus on us all as legislators, public health professionals, student leaders, mental health professionals to try to understand the causes, reasons which send people into dark despair. Those of us who have experienced the death of a family member, friend from suicide or those of us who know a survivor understand the devastation, the tragedy on a family, circle of friends and a community. Those who attempt self-harm are seeking help, sending out a cry for help in many cases. Each of us know many who make the journey to recovery, glad of a second chance, often assisted by you in your role and by a community who care.

On entering public life and before that as a teacher I have been struck by the make-up of society, how we are all different yet the same, how different personalities connect, deal with issues and how our lives are touched by each other. We all come with our own personal story to tell and each of us brings gifts and talents. That is the beauty of life and of each other. I hope in your roles as student welfare officers that you recognise that each student who emails, chats on line, posts a comment on a message board, walks in to your office is a person and is a gift and are reaching out to you for help and support.
It is appropriate that we meet at this juncture in summer 2012, the Olympics are on, GAA championship is reaching its critical stage, repeat exam preparations are underway, Leaving cert results are imminent, and students (parents) are looking at options from colleges, courses to study, to types of accommodation, is there money available? In each of these situations there is a huge sense of pressure, tension levels are increasing. Choices to be made, results to be attained. Success or failure in the minds of many will be the judgement. Which is the case but not necessarily a full evaluation.
 

The Irish independent editorial of 12th July 2012 stated “Suicide remains the great unmentionable in Irish life… The biggest obstacle to reducing the number of deaths from suicide is the taboo most of us still have about discussing our mental health €¦” that is why today is important. Recent CSO figures report indicates an increase of 7% in the number of suicides. 525 suicides were registered in 2011, compared with 490 in 2010. The figures also revealed a rise in male suicides, which accounted for 84% of all suicide deaths in 2011. These are people, a son daughter, a brother sister a friend or class mate. Each is a person and that is why in our third level institution we must view each student as a person, someone who counts, and someone who matters.
 

Reach Out, the national strategy for action on suicide prevention, sets out a series of specific actions and calls for a multi-sectoral approach to the prevention of suicidal behaviour in order to foster co-operation between health, education, community, voluntary and private sector agencies. Up to 20 voluntary organisations are part funded by the HSE to provide excellent support services, including telephone and web based helplines. The National Office for Suicide Prevention, NOSP, has implemented most of the Reach Out recommendations in a four way strategy of delivering a general population approach to mental health promotion and suicide prevention, using targeted programmes for people at high risk of suicide, delivering services to individuals who have engaged in deliberate self-harm and providing support to families and communities bereaved by suicide. A wide range of awareness and training programmes is also available, including safeTALK and ASIST, which train participants to become more alert to the possibility of suicide in their communities. The NOSP has also piloted a system of suicide crisis assessment nurses working with emergency departments and GPs which will be rolled out nationally this year
 

It is imperative that in our Third level institutions a mental health strategy for students is developed. It is one aspect of college life to have the best facilities and a wide choice of courses but I sincerely believe that our places of higher education must attach a significant emphasis on the health and well-being of its students. In compiling its strategy NUI Galway found “There is robust evidence that mental health is a crucial element of overall health and well-being and that a University-wide commitment to promoting mental health will produce a wide range of benefits.” How correct it is because there is a strong correlation between well-being, be it physically, mentally, or emotionally to academic success and student retention.

Vision for Change
The publication of a Vision for Change in 2006 heralded a new beginning, the blueprint for the development of a modern Irish mental health service. Much has changed economically since 2006. The economic reality poses challenges to the delivery of not just a vision for change but for the wider general health system and specifically in the way we can improve services in specific areas.

This Government is committed to reform how our mental health services are delivered. This means moving away from the old hospital-based model, where treatment was episodic, reactive and fragmented and carried out, at times, in hospitals that were not fit for purpose, to a community-based patient-centred and recovery orientated service where the need for hospital admission is reduced. Mental health is a priority for this Government. A special allocation of €35m for mental health was announced in Budget 2012 in line with the commitments contained in Programme for Government. Funding from this special allocation will be used primarily to strengthen Community Mental Health Teams in both Adult and Children’s mental health services.
 

I want to pay tribute to Minister Kathleen Lynch for her stewardship and her commitment.
Reform health system

The Government has published legislation to give effect to changes in the governance of the HSE. This involves radical reform of the health service generally which will see the introduction of Universal Health Insurance (UHI). Significantly the new system of governance will involve seven Directorates, including a separate Directorate for Mental Health which will have full responsibility and accountability in that area. This is a significant step forward for mental health and finally puts it on a par with all other healthcare services.

Reform of the health service will take time, it cannot happen overnight. I am confident that a new model of health care will be delivered upon by this government. Personality issues, vested interest must be left to one side. Those who write and commentate on health matters should focus on the delivery of change and on the outcomes of the Government’s policies. If your role is student centred then the health system must be patient centred.
 

Raising Awareness
Mental Health is about every day events. In practical terms it’s about many different things: the type of accommodation; the people we live with; settling into college; coping with living away from home; balancing budgets, selecting wrong course; class attendance, study; alcohol and drugs; relationships, sexuality. Ordinary to many, but extraordinary to some. That’s why the person we encounter in our offices, student welfare, OR constituency office must be at the centre of our mental health approach. Care, planning and recovery are important elements of an approach we must take with those we meet and encounter.

Undoubtedly each of you play a critical role in supporting students in your colleges, you have adopted good practices, put in place structures and campaigned for resources. That is all admirable but for you to succeed you need to “let your light shine”, each one of you must publicise your availability, tell the campus of the support and help available. It is important and critical that both staff and students know where to go, can seek support and help in a confidential, friendly environment. Early intervention is better. Equally you must work to enhance understanding of mental health issues among students, and staff. In essence everything you do in this area is about the student and is “student centred”
Reach Out, Ireland’s suicide prevention strategy challenges each third level institution to place a strong emphasis on promoting mental health within higher education the following objective from Department of Health and Children 2005 is clear:

“To promote positive mental health, develop counselling and support services and put standard crisis response protocols in place in all third level education settings, and to establish mental health issues as part of the appropriate third level curricula. “(Department of Health and Children 2005)

Relationship with alcohol
The abuse of alcohol and other drugs, but particularly that of alcohol, has contributed to a wide range of health, social and behavioural problems across a wide spectrum of Irish society. Every village, town, city and county of Ireland and in your case college has been impacted by the negative effects of alcohol and drug misuse. There is absolutely no doubt that the misuse of alcohol and drugs is one of the biggest challenges facing society today, not just from a health perspective, but from an economic and social perspective too.

This year the committee of which I chair published a report on alcohol and drug misuse.
We found that alcohol misuse is associated with early school leaving. However, alcohol misuse can also have negative consequences for those who remain in the education system. For instance research finds that alcohol has negative effects on the learning and memory of adolescents.45 A recent study found that access to alcohol negatively impacted college students €Ÿ test scores.46
In addition, alcohol is sometimes used by young people who are anxious or depressed and therefore inhibits the young person’s development of proper coping strategies.
The effect of alcohol misuse on students therefore is wide-ranging.
Quite clearly our relationship with alcohol has to change and you have a role to play here. We must promote an alternative to binge drinking, to the drinking to be senseless approach and to be out late at all times.

Earlier this year I came out as a gay man. At 45, you can legitimately ask why now? Why not earlier? Why bother at all? My story is no different to many, filled with fear, denial acceptance and living life. The one thing that when I talked to friends, attended counselling, I found acceptance, non judgment and inner peace. My journey is no different to so many who began with unease, fear and moved thanks to support to being at peace and knowing that the journey isn’t as hazardous as one imagines.
Supporting LGBT Lives: A Study of the Mental Health and Well-being of Lesbian, Gay, Bisexual and Transgender People (Mayock et al, 2009) is the most significant and comprehensive study of LGBT people and their lives in Ireland to date, and it has a special emphasis on young people. The online survey gathered data from 1,110 lesbian, gay, bisexual and transgender (LGBT) people,and face-to-face interviews were carried out with 40 people.

The study was commissioned by BeLonG To Youth Services and GLENRisks to LGBT People’s Mental Health

• 27% had self-harmed and 85% of these did so more than once
• 40% of females and 20% of males had self-harmed
• 18% had attempted suicide and 85% saw their first attempt as related in some way to their LGBT identity
• 24% of females and 15% of males attempted suicide at least once
• over a third of those aged 25 years and under had thought seriously about ending their lives within the past year.

The report clearly demonstrates that it is social and structural factors that account for elevated mental health risks among the Irish LGBT population. The research also shows that being LGBT per se is not indicative of or correlated with mental health problems, and finds that the greater the support, inclusion and equality for LGBT people, the lesser the minority stress.

The Problem
One of the biggest challenges faced in the Western World today is the challenge of improving youth mental health and preventing youth suicide. This challenge is acutely felt in Ireland where we have experienced so much sudden and dramatic social change in recent years, from the boom years of the Celtic Tiger to the current recession. I encounter it on a daily weekly basis as people’s lives have been turned upside down, you in your roles as education welfare offices experience the same issues.
The best information available on youth mental health in Ireland reports that at any given time around one in five young people (teenagers) are experiencing a mental health problem (e.g. Martin and Carr 2004, Lynch et al 2006, Sullivan et al 2004).50% of mental disorders are onset by age 14 and furthermore, 75% of disorders are onset by age 24.

Addressing the problem

Young people in Ireland are early adapters, they have embraced the digital revolution and they know how to:

• Get information online
• Communicate with each other online
• Get services and supports (or whatever they want) online.

Research shows us that when it comes to getting help about mental health and well-being, that young people will turn to the Internet above all other sources. Inspire has developed services to improve the mental health and well being of young people so that they are supported to feel safe, healthy and resilient. Their services are safe, professional, evaluated and governed by clinical guidelines.
 

I want to compliment Reachout.com on developing a number of services and programmes and on forming important partnerships to make sure young people are reached throughout Ireland. Indeed a key partnership in this has been the unique 3-way collaboration between Inspire, the HSE National Office for Suicide Prevention and the students who founded PleaseTalk.
 

PleaseTalk is both a service and a campaign €“ and it adopts a simple, but effective, approach in both regards. The service, through the PleaseTalk website, details all of the supports available in each participating campus for any student who needs support. The campaign promotes the message that “talking is a sign of strength, not weakness”.

With PleaseTalk highlighting support on campus, and ReachOut.com signposting the support available in the wider community, help for students is available across Ireland to get through tough times. Many people who take their own lives and the vast majority of people who self-harm do not engage with health or support services. Yet, every thought of suicide and every act of self-harm occur as I said earlier in the context of families, social networks and communities, campuses throughout Ireland.

Therefore, the only opportunity to effectively prevent suicide and improve mental health at a population level is by providing low threshold, easy access services in everyday settings, including online. The provision of these services online makes sense from a user’s perspective, from a cost perspective and, because we can scale and scale quickly, to reach and support thousands of people every day.

We must remove the stigma associated with mental health; it is as I have said an everyday event, part of life. Collectively the please talk message to encourage students to use services and supports must be taken up, solutions to problem can be found. Services and supports exist.

It’s in your hands