Northern Ireland Assembly Flax Flower Logo



Inquiry into the Prevention of Suicide and Self-Harm

10 January 2008

Members present for all or part of the proceedings:

Mrs Michelle O’Neill (Deputy Chairperson)
Mr Alex Easton
Mrs Carmel Hanna
Mr John McCallister
Ms Carál Ní Chuilín
Ms Sue Ramsey


Mr Bobby Cosgrove ) Families Forum
Ms Ann McGarrigle )
Ms Maureen Young )
Mrs Jean Carson ) West Belfast Suicide Awareness and Support
Mr Michael Doherty )
Mr Vincent Donaldson )
Mr Robert Doyle )
Mr Séamus McCabe ) PIPS
Mr Gerard McCartan )
Mr Phillip McTaggart )
Ms Jo Murphy )
Ms Roberta Coates ) RAYS
Ms Phyllis McDoal )
Ms Marie Osbourne ) West Belfast Parent and Youth Support Group

The Deputy Chairperson:

We turn to an evidence session with two sets of representatives of local community and family groups. Those will be formal evidence sessions as part of the Committee’s inquiry into the prevention of suicide and self-harm. I refer members to a number of submissions from the local groups, which are contained in members’ packs. I invite the first group of witnesses to the table.

From the outset of the inquiry, the Committee was keen to engage directly with stakeholders such as you, who are carrying out the work on the ground. We wanted to ensure that you had an opportunity to talk to the Committee, and I welcome you. I understand that you have broken into two groups, and that each group will deal with different issues. Mary Creaney, who helped the Committee to organise today’s event, cannot attend, but we are grateful to her for the work that she has done to bring people together. We are pleased that she has been able to arrange for Robert Doyle to be here. You are very welcome Robert, thank you for coming.

I have a list of the names of witnesses, but it might be better for witnesses to introduce themselves and give their presentation. Members may then ask questions.

Mr Michael Doherty (West Belfast Suicide Awareness and Support Group):

We want to raise a number of issues today. The first concerns the evaluation of the current suicide strategy. As members will be aware, the strategy was 12 months old in September 2007. It is now January 2008, and no adequate evaluation of the strategy has been carried out. A lot of money has been spent on it, and perhaps another £3 million will be spent this year, but we want an adequate evaluation that considers whether the actions that were planned for the first year have taken place and, if so, what the outcomes have been. We must learn from those outcomes in advance of moving into the second year of the strategy.

Secondly, we want to discuss funding. I will talk about funding from a community perspective, and Roberta Coates will talk specifically about the funding of the RAYS project. When the strategy was first launched, people lauded it and the additional money that came with it. However, funding has been totally inadequate, as well as the manner in which it has been handled. The next funds will be made available in April 2008, but nothing seems to have been learned from previous funding scenarios. Attempting to deal with issues of suicide prevention and intervention in a short-term manner is totally inadequate. Particularly in the community sector, funding must be for a three-year period. Last year, for example, we heard in July that funding had been granted for services that had been up and running in our areas since the previous April.

Groups had to lucky enough to be able to borrow money to continue providing services such as counselling. Last year, our funding was due to end at the end of the financial year in March. We were told in March that it was not known whether any funding would be available, but we still were receiving people who had attempted to take their own lives — or family members of people who had taken their own lives — who were referred to us for counselling. Decisions had to be made about whether to tell our clients in the middle of counselling sessions that we did not know whether we had the money to sustain our services. Groups on the ground took the decision to continue with those services. However, we are in the same position this year — the funding that we have been allocated is inadequate, and we do not know what funding we have beyond March 2008.

We will be in exactly same position at the end of March as we were last year, and we will have to decide whether to tell people — who are living in tragic circumstances — that we do not know whether we can continue to provide our services.

Ms Roberta Coates (RAYS):

I am the co-ordinator of RAYS crisis centre on the Woodvale Road. Under the suicide strategy, our priority has been to ensure that prevention, intervention and postvention support and signposting services exist in our area. We have been funded by the Renewing Communities fund over the past 16 months. That funding was for an 18-month project and concludes in March.

We are in a precarious position because we do not have our own management committee — we are non-constituted — and the project was set up under a service-level agreement. As our funding will finish in March, and there is no sign of any further funding from the Renewing Communities fund, can the Department confirm — as soon as possible — whether the Renewing Communities fund will receive money after March 2008 so that organisations such as RAYS can look to the future with some degree of hope?

An absence of funding would mean an end to our services as we have no means of sustainability. We are totally dependent on the Forum for Action on Substance Abuse (FASA), which houses us at the moment, and it is not feasible for it to support us after March 2008 with its current level of funding. If money is not going to be available through the Renewing Communities fund, I ask for a commitment that money will be available to RAYS through the SSIB. We have not received SSIB funding in the past and realise that doing so will have an impact on similar services because the same money will have to be divided among more recipients. We are weeks away from closure and realise that we are in a particularly difficult situation.

Ms Phyllis McDoal (RAYS):

I am a member of RAYS and a member of a bereaved family. If the services of RAYS are taken away in March, who will give me the help and support that I get from RAYS, which I would be lost without? I need to know who will help me — and others like me — if that money is not going to be available.

Mr Phillip McTaggart (PIPS):

I work with the PIPS project. I constantly hear about £3 million that is being invested in suicide prevention. However, the real figure for the money that goes to work on the ground is only £1·3 million.

Michael Doherty is right about the services that we provided when there was no funding for them. We took the decision to pay for those services with money that the community and others raised for us. However, when we tried to recoup that, we were told that no money was available, and so it was lost.

We had a heavy fight amongst ourselves to decide who got what money, and a lot of us had to cut our counselling hours and our art therapies to ensure that we all benefited. That is the reason that I say that when the funding reaches us it amounts to just over £1 million.

There is another funding issue that I do not understand — I might be a bit thick about it — and I hope that someone will explain it to me. We have three co-ordinators in Belfast: one in the north, one in the west, and one in the Shankill. We do not know whether funding will be available to carry those co-ordinator posts through to next year. It would make sense if we knew, before devising programmes of work, that we will have co-ordinators who will implement the programmes.

There are a total of eight co-ordinators, a number of whom were already employed as suicide co-ordinators in the Department of Health. Perhaps I am not picking up correctly on what has happened, but I would like to know the reason that those co-ordinators are now being paid with money from the Protect Life policy. Where did their salary go, given that they were already working on suicide prevention in the first place? It seems to me that they have jumped from one job to another and are now taking money from the Protect Life policy funding.

Where is the money that those co-ordinators were being paid in their previous jobs? Why did they have to move jobs? How did they get the co-ordinator jobs in the first place, when they would have had to have been advertised? If the funding that we received was additional money, where has the money gone that was previously being used to pay those co-ordinators? I cannot work out that out, and I cannot work out how those co-ordinators were slipped into those positions.

We have three people from the community occupying co-ordinators’ positions, yet other people are also doing Department-based co-ordinator jobs. I cannot give an accurate account of who they all are. Is the Department just looking after itself — is that the way it is? I think that it is a case that it is jobs for the boys. Is that true? I am not criticising them because they do good work, but that needs to be examined seriously.

The Deputy Chairperson:

Does anybody else want to speak before we take more questions?

Mr Vincent Donaldson (West Belfast Suicide Awareness and Support Group):

I support what my colleagues have said. We would like the Committee to recommend that funding is examined seriously and that it is provided as a three-to-five-year package, rather than annually. Also, beyond what is happening in the communities, the relevant structures in the Health Service do not know whether they will retain funding after March. That is ludicrous. People are in suicidal crisis. The people who are trying to hold their finger in a dyke are those who are under the most pressure.

We want to see real recommendations from the Committee saying that funding should be granted on a three-to-five-year basis. That would allow us to plan for what needs to happen, and it would also benefit the structures in the Health Service. That is what we are looking for.

Mr M Doherty:

I know that the Committee has heard a lot about funding, but I want to point out that the majority of work being done by community groups is on a voluntary basis — it is not funded. I am talking about people who work 24/7 and who will respond when they get a call on their mobile phone at 2.00 am or 3.00 am. Those people are not looking for any funding for that work.

We are asking for the back-up services that are needed in the community. For example, in north and west Belfast we ran a pilot helpline under the strategy, and the Minister went ahead and tendered for a new regional helpline in the absence of a proper evaluation. I know that the helpline does good work, but concerns about it have been raised constantly.

Through the SSIB and other avenues, we have raised the point that once the regional helpline is up and running and being used, as was the case in north and west Belfast, the expectation will be that after a call is made, a back-up service will be available. It will not. There are not enough resources to cope with what is already happening in north and west Belfast. I do not believe that such resources are available in the rest of the Six Counties, in areas such as Fermanagh. If I were someone from a rural area talking to a person on the regional helpline, my expectation would be that, as a result of my phone call, the person at the other end of the line would get help for me or my family the next day. However, those services do not exist. A strategy must be adopted to ensure that adequate services will be set up. Let us not build up people’s expectations.

Mr V Donaldson:

In support of what Mr Doherty is saying, we must consider the work that is not being funded. The existence of a strategy gives the community the impression that services are in place. Services are not in place. When people’s expectations are raised in that way, and they go looking for a service that does not exist, you are dealing in death.

Crisis-intervention teams provide voluntary services — they are not paid, yet they work all hours of the night. The helpline is ready to go regional, yet, as Mr Doherty says, if people who are in a dark place when they lift the phone are told that the help and resources that they need are not available, again, you are dealing in death. The services must be stepped and properly evaluated in order to determine what is available and what back-ups are in place.

Ms Marie Osbourne (West Belfast Parent and Youth Support Group):

I want to reiterate what Mr Donaldson is saying about the crisis-intervention teams. In some cases, they are needed to bring people to the Mater Hospital. The people who those teams bring to that hospital are badly treated by front-line medical staff. Something must be done about that. I am from the suicide awareness and support group, Zest. My group has taken part in training with front-line medical staff in the Royal Group of Hospitals. Training must be provided, not only to doctors, but to receptionists, nurses and so on. The way that people are treated in the Mater Hospital is abominable.

Mr McTaggart:

We try to work in partnership with the different Departments. We believe that we can learn from them. However, they need to know that they can learn from us. We are on the ground, working with families. It is right that we bring people to hospital. We have come up against medical staff who have not been friendly towards individuals. However, in my experience, all the doctors and nurses have been good.

The problem has always been that when a person is in dire need of help and support, the facility is not available — a bed or the doctor who must treat that person is not available. It is left to the person’s family to take him or her home. That is unfair on the family. We are constantly being told and encouraged to get in touch with the Department of Health because it will help us out in any way that it can. However, in September 2007, we asked the Department to consider a proposal for a newbuild development of two houses. Since that proposal was sent, we have not heard a word about it.

I have absolutely no doubt that each of our groups saves the Health Service a lot of money. We are saving lives. If the Department, the Health Committee and other agencies work in partnership with us, we will save many more lives and a lot more money. It is about working in partnership, yet it sometimes feels as though that does not happen.

The Deputy Chairperson:

The Committee is conducting the inquiry because it agrees with all your points. It is hoped that at the end of the process, the Committee will be able to tell the Department how the situation stands and how the strategy is being rolled out. It wants there to be a better system. Consistency is needed. All your groups provide brilliant services. Even from the Department’s perspective, your contribution is immeasurable. However, constantly having to go through a raft of funding applications is taking away from the resources that you provide.

What Phyllis does is an example of the good work that can be done for people, and through such efforts, we can see what can be achieved and where we would be if such activities were not carried out.

We will now open the meeting for members to ask questions.

Mr V Donaldson:

I would like to make a couple of small points before we go on. I recommend to members that they try to access all the relevant services that are listed in the Yellow Pages. Have any members ever tried to do that? They should try it and see what they find.

Over a year ago, we asked that a simple A-Z be compiled of the available services that deal with suicide — be that people in suicidal crisis, or people needing counselling — and the answer was no. That was because no one knew whether those services would still be there after March, and therefore money could not be put into devising that list. That is one example of why a three to five-year package is needed.

Ms S Ramsey:

Thank you for your presentation. I commend you all, because I am aware of the good work that you and others do. I agree wholeheartedly with Phillip that a holistic approach is required. The work that you and your colleagues do every day probably saves the Health Service millions of pounds. You should not lose sight of the fact that you are doing very positive, good work.

With regard to the inquiry, the Committee wants to reach the point at which it can make recommendations to the Minister and the Department. We also want any strategy that is proposed to get the agreement of the Assembly. If that happens, a contract will exist between the Committee and the Department, and we can hold it to the agreement and tell it that it needs to do A, B, C, D and E.

I will try and tease out some information from you, and if you cannot provide it today, you can forward it to the Committee at a later date.

In human terms, what resources are currently lost due to your organisations’ having to use someone to access funding? If you get money for A, B and C, you must have to use someone’s time, energy and effort to access funding. As Phillip said, even though £1·3 million is available on the ground, the actual amount is probably less than that given that half of an employee’s time is spent trying to access funding. We must try to humanise the process and see what happens.

How many projects involved with Renewing Communities will be affected come April 2008? The Committee should write to the Department for Social Development and ask where it stands with Renewing Communities. It is now January, and some groups do not know whether they will still exist in March. Is there any indication that where projects have been funded through Renewing Communities the SSIB will pick them up?

Mr V Donaldson:

It is a waiting game. The people who organise strategy money say that they do not know what happens under Renewing Communities. If the money that is available under that scheme is recurring we will not have to worry about it. If it does not recur, we will have to go back to the drawing board, and everyone will have to tighten their belts again to try and make sure that funding is available for another co-ordinator.

Mr McTaggart:

We could not do that again. We already had to tighten our belts last year as regards counselling, therapies and the programmes of work that we were already doing. We had to do that only with regard to our work in north and west Belfast. Let us throw west Belfast into the mix. All the co-ordinators’ posts are essential for the work that is involved in suicide prevention. On top of those posts, we would not be able to operate without administrative support. That applies to all the groups. Therefore, we need to take account of three co-ordinators’ posts and three administrative posts before we look at programmes of work. We will have people in post but no programmes of work.

Ms S Ramsey:

Does that mean that, when you get the resources, less money is available?

Mr McTaggart:

Yes. We depend on people in the community raising funds for us.

Ms S Ramsey:

I just want to tease out that issue, so that we get all the information.

Ms Osbourne:

Can I just say that the groups first received money in October 2006? It came from the strategy money, and it was for north and west Belfast — the Shankill was not included. The only certainty about that funding was that the three co-ordinators’ posts would be safe until March 2008. Therefore, everybody here is in the same boat; we only know that we have money until March 2008.

Ms S Ramsey:

Therefore, it is now January, and from what you have said, nobody in the Department’s senior management knows at this stage whether Renewing Communities or SSIB will continue the projects?

Ms Coates:

No. We do not know.

Mr McTaggart:

Nobody is telling us. They say that they do not know.

Mr McCallister:

Does that mean that all the co-ordinators are on notice?

Ms Coates:

Yes. We must put them on notice.

Mr M Doherty:

I am conscious that another delegation of witnesses is due to speak, but bad as the situation that we are describing sounds, we are hearing mainly from people in urban areas. The situation in rural areas is worse. We hear that there are three co-ordinators: one each for the Shankill, west Belfast and north Belfast. In the rural areas, as Phillip McTaggart mentioned earlier, the co-ordinators, by and large, are people who are already employed by trusts or boards. In rural areas, the majority of the money that has been given to suicide prevention projects is not reaching the communities.

Mr McTaggart:

I am not hammering anyone or suggesting that anyone should lose a job, but I am concerned about that situation. I have talked to people in rural areas who did not even know that positions were available. For instance, I would be delighted if people who are working on the ground here took up those posts, because that is what I imagined would happen. The backup support could then come from those individuals who are employed by the trusts. It should not be the other way around; trust employees should not jump ship into the Protect Life strategy and access that money.

Ms S Ramsey:

It is a question of accountability, and that is what the Committee is here to ensure. I take on board your point; nobody is saying that the co-ordinators are not the right people for the job. Is the money, therefore, not additional funding?

Mr V Donaldson:


Ms S Ramsey:

That is something that we could examine.

Mr M Doherty:

Accountability cuts both ways; it applies to us also. Every penny of the Protect Life money must be accounted for. Every ha’penny that we as community groups get should be monitored and evaluated. The schemes must be run according to best practice. Ultimately, if we do not deliver, we should not get money. All that we are asking for is an opportunity, and not just to get money.

I do not want to hear, on 30 March 2008, that Lenadoon counselling project has a particular amount of money for the next 12 months. We deliver counselling for whatever money our project gets. Not one ha’penny goes into administration. We deliver counselling for half the price that people pay anywhere else. I signed a service-level agreement, which says that over the next 12 months we will deliver 2,000 counselling sessions — or whatever number — to people who are referred to us because they are suicidal or are at risk of suicide. That includes their families. Every single ha’penny goes directly to that service.

I do not know whether I can offer the service beyond April this year, despite the fact that we fill in monitoring and evaluation sheets every month that list what we delivered for the money that we got. If we are delivering the services that we are being asked to — cost effectively and in accordance with best practice — we cannot keep going back every six or nine months to ask for money again.

Ms S Ramsey:

I have just one more quick question, and I am conscious that other Members want to ask questions. I take on board Michael’s point. We have all been members of groups that have been asked to jump through hoops to receive money — that is fair enough. In a presentation that we received this morning, the evaluation was brought to our attention, so, to be fair, the professionals are also raising the issue. We have agreed to write to the Minister to find out where that matter stands.

I was interested to hear about the healthcare professionals. On reading one of the documents that the Committee received, it struck me that although GPs are being asked to sign up to the applied suicide intervention skills training (ASIST), organisations have concerns about surgery managers, receptionists and triage nurses. We should take that on board.

Finally, I would like to hear more information about the project that you are still waiting to hear word about.

Ms Ní Chuilín:

We walked through the A&E department of the Mater Hospital this morning to see what it is like. We asked about ASIST being made available for everybody who might be involved, and we will pursue that matter. Anyone who is experiencing mental-health problems is in a distressed state. Their family may not be with them, but by the time that they hear about it and look for them, the person’s distress might have increased. When a person reaches the A&E department, the last thing that they need is to be met by a cheeky receptionist. Therefore, we will highlight that issue.

We all wanted to carry out this inquiry because we all live in areas that are affected by suicide and because we know what the problems are. The budgets will be for three years, because, up until last year, there was no locally devolved Assembly. The Budget is set from 2008-11, and, if organisations do not get money for three years, that raises an equality issue.

Sue is right; she has already mentioned that you need to let us know about any outstanding queries and correspondence that you have with the Departments before you appear in front of the Health Committee. We all live in the communities, and we all have offices around the corner from you. That is what we are here for, and it is a problem if you cannot get access to us. If you have any outstanding matters, concerning either your building or anybody else’s money, you should bring them to us and we will raise them formally through this Committee.

There is a huge urban/rural divide. We have heard evidence from the Niamh Louise Foundation. That divide is apparent in healthcare across the board — people in country areas cannot even find dentists. The stigma that is attached to mental-health issues, particularly suicide, is 10-fold in those areas.

However, we will be asking about the process that was used to employ people in those areas, because it has been mentioned in the public arena that the employment and recruitment procedures elsewhere were not applied as robustly as they were for the three posts in Belfast. If it is the case that those people are employed through the Protect Life strategy, we will also be asking whether that is value for money and a fair use of resources.

We will most definitely be asking about evaluation. If every aspect of this strategy is to be evaluated, for example, phone-line services and so on, the common-sense approach would be to evaluate any programmes before putting them out to tender or releasing more money. If your funding was held up due to evaluation issues, you could have looked at an interim arrangement. However, that is not the case. No evaluation has even been instructed. If it were any other service that had been contracted out, evaluation would have been part of it.

Mr V Donaldson:

They get monitoring forms on a monthly basis, so it can be evaluated as it goes along.

Ms Ní Chuilín:

If there is a framework for evaluation, such as your monitoring returns, you need to know that. However, at the minute, there is no framework. Therefore, if funding were withdrawn rather than secured or extended at the end of the cycle, you would need to know the reason. If you did not have the chance to address that through a monitoring and evaluation process, equality concerns then become an issue. To be frank, this whole issue should have been subject to an equality impact assessment from the start. Healthcare should be based on need, rather than matters that are politically opportunistic. Anyway, that is our beef. It is important to bring any issues to the attention of the Committee, because this is the first statutory inquiry in which it has been involved.

Funding is a major issue, and we have heard about others. If there are other issues that relate to the inquiry, such as problems with the building or being unable to find out about funding, bring them to the Committee’s attention. I know that Roberta Coates is here, but I will be honest: it was me who asked whether Renewing Communities initiative money would be directed towards the services that we are talking about. We are dealing with a health issue. Suicide and mental health is a social, cultural and economic issue: social development work should come from the Department for Social Development, and health-related work should originate in the Department of Health. I understand the reason that the money was with DSD in the first place, and if work on aspects that Department’s remit is to continue, so be it. The draft Budget should be amended to provide an increase to cover the needs that you have raised with the Committee, rather than people having to tighten their belts and effectively squeeze each other, which you do not wish to do.

Finally, we are concerned about the impact that the draft Budget will have on mental-health issues; for example, it has not been made a sufficient priority, and many Members have said as much in the Chamber. I realise that the consultation process ended on 4 January, but I would like to have seen some results. I hope that you provided an input to the process, because it is important that it is not only politicians who are involved, because it will look as though we are being politically astute or manipulative, rather than responding to the needs of the people.

Mr M Doherty:

Three or four groups responded to the consultation.

Ms Ní Chuilín:

I am delighted to hear that.

Mr McTaggart:

We set out to raise funding for the building, but we then heard that the Minister had said on radio that if we had sent him a proposal, he would have looked on it favourably. We sent a proposal that very day. In fact, three proposals were sent to various Departments — that is neither here nor there.

Ms S Ramsey:

That is the reason that he has not looked at the proposal.

Mr McTaggart:

We had an idea for a respite centre. I am not concerned about whether it would be a PIPS project or a west Belfast project; we just wanted something in Belfast that would provide a halfway house for people. The majority of people who have issues simply need to talk to someone. In some cases, they need to be kept safe and to feel safe, and that burden needs to be removed from the family for 24 or 48 hours.

There are respite centres in England, and many of them are run without any medical staff. Such centres make sense. If money were put into the provision of a respite centre, it would save the Health Service an absolute fortune in the long term. It does not make sense to totally ignore such things. We have said it many times, and we have put it in proposals, but they have been totally ignored. A bit of money may need to be spent, but, in the long term, money will be saved because we are doing the work. We are willing to do that work. We are asking only for services and facilities.

Ms Ní Chuilín:

We are all based locally, so you should tell us about those things, because we will raise the issue as part of the inquiry. We should agree to send the proposal to Michael McGimpsey, or the Department, or both. If the proposal was sent in September and you have had to wait for the outcome of the inquiry, that is a problem.

Mr McTaggart:

We never received a reply

Ms Ní Chuilín:

That means that there is an issue that must be addressed.

Mrs Hanna:

Good afternoon. I have met you all before on previous occasions. I acknowledge what you have said about evaluation and accountability, and we are aware that we must be accountable for the money. However, we also want to be appreciated when we do good work, and we want to know that the outcomes can be measured. Therefore, if something works, we can repeat it, and, if not, we can try something else.

I want to ask a few practical questions about the helpline and the people who man — or woman — it. I presume that, quite often, callers may be in a distressed state. Is a team available late in the evening and at weekends that can react immediately, by getting someone to hospital or by giving some advice? You said that there is no backup. What do you consider the most essential backup?

Mr McTaggart:

One of the pilot schemes that was set up under the Protect Life strategy was a helpline for north and west Belfast. That was established, and the Minister launched it. Contact Youth Counselling Services and Opportunity Youth won the contract to deliver that service. However, some 15 months later, no evaluation of that helpline scheme has been carried out.

The West Belfast Suicide Awareness and Support Group has two mobile telephones, which members — mainly members of bereaved families — carry at all times. The number is publicly advertised. That helpline is not publicly funded. The two phones that they carry are manned by bereaved family members and volunteers. I am sure that PIPS and RAYS are in the same position. However, the pilot scheme — the helpline that is publicly funded — has been up and running, but has not been evaluated. I am not suggesting that that helpline does a bad job. It has good elements, but it also has weaknesses.

The Minister has now tendered for a new regional helpline. Had an evaluation of the pilot scheme been carried out, weaknesses might have been discovered and corrected. A helpline is needed most after 9.00 pm and at weekends. When I asked the question at SSIB four months ago, I was shocked to discover that that helpline operates only one line after 9.00 pm. I could be on the end of that helpline for two hours and no one else would be able to get through during that time.

Mrs Hanna asked about backup services. I am a local service provider with our counselling project; so are members of most of these groups. We are finding that, after taking a call, the helpline will ring us and refer a client to us for help. We already have waiting lists; we are snowed under.

Mrs Hanna:

Are they being referred for counselling?

Mr McTaggart:

It is for counselling and other services.

Mrs Hanna:

I am trying to build up a picture of your circumstances. I wonder whether a record is kept of calls to the helpline. The Committee needs to find out about measurement of outcomes: if there is none, it is difficult to know how the helpline is performing.

How well do you liaise with professional staff? We were given presentations by Mary Black from the Northern and West Belfast Health Action Zone, and from Dr Maria O’Kane. They reported that a joint approach is working for the community. I believe professionals and volunteers are working together.

All of you, as volunteers, have been trained in counselling. The professionals also have roles to play, depending on the severity of the patient’s state and whether he or she has to be admitted to hospital. How well does the relationship between professionals and volunteers work?

Ms J Murphy:

Good partnership working is the key to our area of work. In our organisation, PIPS, good partnerships make it work. That should be reinforced at departmental level.

Ms Hanna:

That must be formalised.

Ms J Murphy:

We, on the ground, know that. We have boundaries, and we bring the key players with us.

Mr McTaggart:

There are barriers to be broken down, not only in suicide prevention, but between volunteers and professionals too.

The only reason I am involved in this work is because I lost a son. Like other family members, I do not want that to happen to anyone else. We should not tell doctors and others what to do. However, believe it or not, because we come from the community, we can sometimes see better ways of doing things. We might say: why not try this?

Mrs Hanna:

The professionals have acknowledged that.

Mr McTaggart:

Sometimes, they have letters after their names, and so on. However, a lot of negative attitudes have been broken down. We are now working much better with professional services.

The Deputy Chairperson:

Volunteers and professionals complement one another.

Mr McTaggart:

Exactly. I do not mean to knock the professionals. We are getting better at working together. There was, and there may still be, some barriers to be broken down in that respect.

Mrs Hanna:

The pilot scheme is working and is being evaluated, but there is no funding. However, the Committee wants to see you all working together to get people better. That is the bottom line for us all. We want to see, perhaps a year down the road, young people and others ceasing to self-harm and fit in well with their families. We must be able to measure that and to continue with what is working well.

Ms S Ramsey:

The point that needs to be made is that the helpline is funded by the Department. If it were funded through community infrastructure, and was not evaluated, it would be crucified. There cannot be double standards.

Mrs Hanna:

I was just trying to find out how it works. I appreciate what has been said. I was referring to a different issue.

Ms Osbourne:

I do not know how the helpline monitors and evaluates its calls. By chance, I recently met someone who works on the helpline. She told me that she was unaware that we operated a 24/7 helpline, although that is stated on all of our documentation. She said that a young person called from Belfast City Cemetery, and they did not know what to do with him. She went on to say that had they known that we operate a 24/7 helpline, they would have transferred him to us.

Mrs Hanna:

That is a problem.

Ms Osbourne:

They simply wanted to hand him over to us.

Mr V Donaldson:

We are in favour of a 24-hour helpline, but it has to be properly managed. If it is not, death will be the result. I am part of the crisis intervention team. At weekends, I am sometimes out at 3.00 am and 4.00 am, trying to keep young people safe and get them to where they need to be. I do not want to have to do that, but I am aware that nothing else is available.

If the 24/7 helpline is properly managed, I will not have to do what I have been doing. There could then be a crisis team that goes out to talk to those people. Sometimes, all they need is someone to talk to, and sometimes someone has to stay with them until a doctor or counsellor becomes available the next morning. As I have said, if the helpline is properly managed, there should be no problem. The problem that we had with it was that there were a lot of faults during the pilot period, and, all of a sudden, before it has been evaluated, it is being expanded.

Mrs Hanna:

That is helpful. It gives us a fuller picture of what goes on.

The Deputy Chairperson:

It is a point well made. Schemes should not be tendered for if they have not been properly evaluated in the first place.

I am conscious of time, and we have yet to hear from the second set of witnesses. A number of points have been raised, including the evaluation of the pilot helpline; funding; the appointments process; the application for the respite centre; the ASIST training; and the role of DSD and the Renewing Communities fund. The Committee will raise those points with the Department and with the Minister.

Ms S Ramsey:

There is also a point to be addressed regarding the A-Z directory.

Ms Ní Chuilín:

Let us know if there are any other issues that you think of when you leave.

The Chairperson:

I thank the first set of witnesses, and I welcome the next group. Thank you for waiting. Would you like to introduce yourselves?

Mr Séamus McCabe (PIPS):

I am chairperson of the PIPS project in Newry and Mourne. I am here to represent the rural community.

Mr Gerard McCartan (PIPS):

I represent the PIPS project in Belfast.

Ms Maureen Young (Families Forum):

I represent the areas covered by the Northern Health and Social Services Board.

Mr Robert Doyle (West Belfast Suicide Awareness Group):

I represent the Northern Ireland Association for Mental Health, Northern Ireland Children’s Enterprise and the West Belfast Suicide Awareness and Support Group.

Mr Bobby Cosgrove (Families Forum):

I represent the south-east Belfast Families Bereaved by Suicide group.

Ms Ann McGarrigle (Families Forum):

I represent the north-west region, from Omagh to Limavady, of Families Bereaved by Suicide. Our meetings are held in the headquarters of Foyle Search and Rescue.

Mr McCartan:

I will talk mainly about the availability of beds for children and adolescents. After I lost my son to suicide, the major independent review of his death made many recommendations. Therefore, I speak as someone who has experienced the healthcare system with a child who was mentally ill, self-harming, and was unable to get any help. We had to fight to try to get help. I could not believe that, at that time, there were only 12 beds for children and adolescents in the whole of the North of Ireland. We could not get my son any of those beds, and he was admitted to an adult ward, where he continued to harm himself.

When the suicide strategy was announced, Shaun Woodward said that a new unit would be up and running within 12 weeks. I challenged him to tell me where he would get the necessary staff. That unit never materialised. Unfortunately, the unit at Knockbracken Healthcare Park was destroyed by fire. We have heard that another unit will be built at Forster Green Hospital in 2009, but I remain sceptical.

Carál, you said that you visited the Mater Hospital today. I do not know whether you visited the psychiatric unit but, unfortunately, it is a very scary place for a child. Children from north and west Belfast are being admitted to what for them is a terrible place.

Jo Murphy, my wife, Carol, and I are involved in a project to oversee the implementation of the recommendations that were made after the death of my son. A few moments ago, I was talking to someone outside who told me that four beds will be partitioned off in the Dorothy Gardner and Donard adult wards at Knockbracken — two for boys and two for girls. We have been told that the funding has been approved, and that the go-ahead is forthcoming. Next week, I will visit Knockbracken to see exactly how that has been done.

The criteria state that there should be 28 beds for children and adolescents in 2008. There is some confusion but, as far as I am aware, there are only six. Under the Freedom of Information Act 2000, ‘The Irish News’ discovered that, over a period of five years, some 500 kids were admitted to adult wards. However, given that £5 million was spent sending kids to England, Wales and the Republic of Ireland, the money is available for extra beds. The situation simply does not make sense.

Daily, we hear about a simple problem that would cost nothing to rectify. When someone is discharged after admission to a psychiatric ward, he or she must wait for a letter detailing an appointment to be posted to them. Sometimes, the letter does not arrive, and people cannot understand why the hospital does not simply give them an appointment card, because a confirmed appointment is a lifeline to people who are being treated, and to their carers. I see a definite increase in that problem.

Mr Cosgrove:

When the suicide strategy was first introduced in March 2006, the lack of adolescent beds was raised at the first meeting in the Culloden Hotel. At that time, there were four beds for kids. The pressure from families that was applied through the Suicide Strategy Implementation Body led to the number being increased to, at one time, 14. The number has now decreased again, and the total lack of facilities for 16- to 18-year-olds in the Health Service is scandalous.

When we first received the SSIB strategy, it informed us that when an individual takes his or her own life, it costs the Government £1·2 million. When we asked how that was possible, we were told that the figure was arrived at by calculating lost income based on age and various other factors. My group deals solely with families, and trying to help them. We do not take phone calls, etc. However, considering the work that Phillip McTaggart and others in this room have done, and the number of lives that they have saved, they have saved the Government, according to their own figures, one hell of a lot of money.

When we first started, we received £1·9 million for the first six months, which has still not been accounted for. We have accounted for the funding that we received. However, people in the statutory bodies have not accounted for what they did with their share of quite substantial sums of money. Dr Brian Gaffney, chief executive of the Health Promotion Agency, received quite a substantial sum of that money to run mental-health GP training, and so forth. As families, we repeatedly ask questions. In fact, Dr Gaffney walked out of a meeting in Derry one night because of the questions that he was asked. Nevertheless, they were realistic questions. I asked him to account for what happens. For example, if he takes £350,000 for GP training, and he only spends £100,000 on that training — which is probably closer to the sum that has been spent on training the number of GPs that we have been told about — no one has told us what happens to the other £250,000.

There is an ongoing television campaign that focuses on the issue of mental health. The Dublin Government’s mental-health logo appears at the bottom of the advertisement. That has nothing to do with suicide awareness, yet Suicide Awareness is paying for the advertisement. That is coming out of our budget. Those are the types of issues that we, as families, feel strongly about. We believe that those matters need to be examined to see whether we are getting value for money. In this game, £3·1 million is not a lot of money. If we save three lives — PIPS and Suicide Awareness have probably saved between three to five times that number of lives — we have saved the Government £12 million pounds. Therefore, we are entitled to answers.

Mr Doyle:

My contribution is more of a personal perspective on dealing with people — I am not a great man for facts and figures. Yesterday, I looked at the strategy document, ‘Protect Life: A Shared Vision’, and read about the action to be taken and the three targeted approaches. I also looked at the section on children and young people. I echo the first group of witnesses when I cite the importance of an evaluation of whether the targets have been met — and how and why they have or have not been met — and what can be done, using the resources of community, voluntary and statutory organisations, if they have not been met.

I want to mention schools, and I would like the Committee to consider the development of an emotional literacy programme, or healthy living programme, or whatever you would like to call it. That programme should be something that does not carry a stigma and that children will be comfortable to learn about, regardless of their age. It should be practical and capable of being evaluated. It should also be standardised and have protocols for teachers and staff on the ground.

I have spoken to many teachers who have asked about the signs that they should look out for and what do they do if they see those signs. They want to know whom they should contact. They do not know the answers to those questions. As a result, they are not engaging with individuals with whom they have a close enough relationship to talk about suicide, self-harm or mental distress. Action must be taken to address that situation. Committee members, if they examine the issue, can decide for themselves the action that should be taken.

In respect of front-line Health Service staff, many of the young people with whom I come into contact through my work in mental health have been taken to hospital, and end up discouraged from going back because of negative reactions that they have received there. On the other hand, there are some individuals who have had positive experiences and would be willing to go back for further help. The people who have been involved in many of the negative cases that I have seen are fearful of the rigmarole around initial assessment, questioning and waiting around. We need, as has already been said, a centre of which everyone in the community, and other organisations, is aware. That should be a centre that specialises in dealing with children, can think outside the box, and can think beyond the medical approach, assessment, detainment if need be, or medication.

The young people with whom I come into contact who have been through that system will continue to go through it. They are grand for a while, but things deteriorate; they go back into the system and, before long, their situation resembles that which adults must deal with — they are in the same situation as before, or worse. We must take that into consideration, try to catch them early, and attempt to introduce positive coping strategies. That point may emerge after evaluation, but I am not sure whether it has been implemented in all schools.

I am aware that all schools have pastoral-care systems and contracts with organisations such as Opportunity Youth and Contact Youth, but are those services effective for everyone who engages with them? We must find out.

Creative therapies such as art or music therapy have been mentioned. Is it possible to conduct research to find out whether such therapies are effective or beneficial? The work that is done on the ground involves such therapies, and the feedback that I have received from children and young adults is that, having felt crap when they came in, those therapies really worked and helped them to bring out their problems and work through them. Obviously, more is required and no one solution can offer a magic cure for everything. However, society, Government and the relevant agencies must work in conjunction with one another and start to think outside the box. They must ensure that they have a joint aim, they know how that aim will be achieved, and, if it is not achieved, that they know how, why, and what must be done at the next stage.

Mr McCabe:

As I said earlier, I represent PIPS in Newry and Mourne, which covers a population of more than 90,000 people from Crossmaglen to Banbridge, and from Armagh to Kilkeel.

PIPS stands for the Public Initiative for the Prevention of Suicide and Self-Harm, and we have experienced several issues relating to self-harm because the resources to deal with that problem are non-existent. Although members of the Committee may not have heard of us because we are from a rural area, PIPS in Newry and Mourne was established in 2003 and constituted and registered in 2004 — shortly after PIPS in Belfast.

In our attempts to access self-harm resources, it has been difficult even to get information, and we have had to go through various voluntary groups such as Zest, which has outreach counsellors. In rural areas, getting information and accessing the available resources are major concerns. It is almost impossible to get our hands on anything.

I will touch on several points that have already been covered by Michael Doherty and Phillip McTaggart, and I will speak about rural areas and the problems we have with — here we go again — funding. I am sure that Committee members love to hear that word. However, it is a big issue, and it cannot be overlooked.

The first group of witnesses represent inner-city areas. PIPS in Newry and Mourne, as I said, was constituted in 2004, and we have a major problem. This time last year, we made a request for a co-ordinator. We cover a population of 90,000 — PIPS Belfast covers a similar population, but has three co-ordinators in place. To date, we have only just received confirmation that we will receive funding for a one-year non-recurrent post that must be shared between ourselves and the Niamh Louise Foundation.

According to the southern area action plan, which members may check on the Internet, and as Phillip McTaggart said earlier, everything is trust led. PIPS in Newry and Mourne has been established for more than four years, and has done much of the groundwork. Our experience is that many jobs are being restructured — people are taking on different jobs — and the funding is coming out of the same pot.

This time last year, we applied for the post that I mentioned, and we were told that not enough money was available. We are now told that, because the end of the financial year is approaching, last year’s money is now available for non-recurrent posts. Therefore, we will be funded for one shared, non-recurrent post for one year.

The action plan also stated that a co-ordinator post would be created. That position has been claimed by the trust — the Southern Health and Social Services Board now has a member from the trust who has filled that post. The two non-recurrent community-development posts for PIPS in Newry and Mourne and the Niamh Louise Foundation must correspond with the trust at every opportunity. That is totally inadequate. We have been doing all the groundwork, and the wheel is now being reinvented.

There was a cluster of suicides in the Kilkeel area last year. Eleven suicides occurred within a three-mile radius among a group of young people aged between 18 and their early 20s. At the request of the community, we did not attract any attention to those suicides. The Committee will be aware of the media frenzy in the aftermath of the suicides of three young people in the Tandragee area. Eleven young people took their own lives in Kilkeel. We put a number of projects in place and did all the groundwork. We contacted all the people in the Department who needed to be contacted, and they arrived at a later stage. They came back at the postvention stage, but we were there for the prevention and intervention stages, and we are still there for the postvention stage. We did all the groundwork, but feel that we are just being pushed aside to let the trusts and all the other statutory groups take control of everything yet again.

It is very unfair, and, as Michelle O’Neill said earlier, the voluntary groups need consistency. We cannot achieve consistency with a one-year, non-recurrent post. That post must be offered on a three-to-five-year basis, otherwise people will not come on board.

Like Phillip, I became involved in this work because of a personal tragedy — I too lost a son. However, I am here, and I work with a passion. That passion can last for only so long, because people tire themselves out, and run out of breath. The people from the trusts are bringing a different agenda. At the end of a nine-to-five day, they can go home, watch Coronation Street and go to bed, or whatever. On the other hand, we in the families sector do not have those options. If a bereaved family member makes a phone call or other form of contact, we have to be there for them. We feel that none of those considerations are being taken on board, and that the view is that the community and voluntary groups can be left to do the work, because they do not have to be paid and they will do the work anyway.

Ms Ann McGarrigle (Families Forum):

I am from the north west, and, as part of the suicide strategy, Zest was one of the teams that received some money for a pilot self-harm and suicide young people’s mentoring project. If I had been talking to you a few months ago, I would have told you that I was seriously concerned, because the group could not get up and running owing to all of the protocol and data that had to be attended to. Every time the group was ready to go, something else would crop up. I am very pleased to say, however, that the group is up and running, and will eventually be able to provide some evaluation figures.

We are different: we are part city, part country; we work in places such as Limavady and Dungiven. Like Bobby Cosgrove’s group, our wee support group does not do any intervention; we offer support. I am a member of the Western Health and Social Care Trust’s suicide strategy implementation group, comprising seven people from statutory bodies, five from the community and voluntary sectors, and two bereaved parents — I represent the city and Limavady, and Brian Rogers represents Omagh and Fermanagh. We cover a massive area, but we seem to be able to bring town and country together.

Most bereaved people want help and support. They want to talk to others, to meet and help one another to fix things. Rural areas are different: there are more elderly people, who might come along to one conference and never be seen again. It is enough for them to know that there is a number that they can call to get support. Counselling is on offer in the west, and it is working. In the Omagh area, counselling is provided by the Tara Centre, which is an excellent venue, providing various therapies. In Derry, Cruse Bereavement Care is paid for its counselling service. The funding for those counselling services came from money provided by the Western Health and Social Care Trust.

The last time I came before the Committee, I told members about a spate of suicides among young people in one specific area. Through money that was made available by the Western Health and Social Care Trust, a plan involving youth clubs and a mental-health team will provide a clinic where young people can mix. That funding will also provide for a music programme in conjunction with the Nerve Centre and the Verbal Arts Centre, which will help to build self-esteem.

I also work in the further education sector, and we provide a lot of pastoral care. Although each college does that differently, they work alongside one another. Education has a role to play in pastoral care. Ms Young will back me up when I say that nothing is definite. At the same time, though, wherever something happens, we have applied for small amounts of money to deal with people who have displayed poor mental health, or some other incident, in that area, and we have been given it.

It is hard to keep bereaved families together. Young people will not mix with older people. Two or three families visit us from over the border in Donegal. We are fortunate in that we have the services of Foyle Search and Rescue Service. It provides intervention through the great work that it does on the River Foyle, and it also allows us to use its premises. ASIST is also delivered to all the taxi drivers in the area. Those measures work. However, suicide figures have not been quashed; there is still much work to be done. Between Halloween and Christmas, there was a spate of suicides, although, as I was told at a support group meeting on Monday night, there were not so many during Christmas. In fact, there were not that many attempted suicides. Therefore, we wait in anticipation to hear how effective Zest’s work is.

With regard to the music sessions, the co-ordinator that Mr McTaggart and others mentioned also works with us. Tomorrow, I will meet with Barry McGale, who was our suicide awareness co-ordinator. He has now been appointed as an intervention officer for families, and he carries out similar work to that which is being done on the ground by the groups in Belfast. Dermot Lynch is doing that work in the Omagh and Fermanagh area. Such matters have, therefore, been covered.

We are also involved in training with the Churches, and that strategy has been a big initiative in rural areas. Events have also been held in the City Hotel in Derry. All that work adds up to our being involved in events. For example, on 16 February we are holding a hope and healing conference in Fermanagh. That has been funded with money from the suicide strategy. In 2007, the same conference was held in Derry. I can, therefore, report that events are being held, and a lot of work is ongoing. I asked the support group whether there was anything that it wanted to be introduced. It asked whether it would be able to hold a residential. That is not for the Committee to decide; it is for us to decide tomorrow. However, those are measures that seem to help and support people in getting them over the second and third stages of recovery, and we deal with people of all ages.

It must be remembered that if the regional helpline is introduced, people of all ages will have to be dealt with and work on it. Someone from a remote farmyard could need immediate help, so he or she must be able to speak to someone else of an appropriate age group. Indeed, yesterday I heard that someone in Magherafelt had phoned the north and west Belfast helpline.

Ms Young:

As Ms McGarrigle has said, the Northern Health and Social Services Board area stretches from Newtownabbey to Coleraine. Therefore, it has a wide geographical spread. The suicide co-ordinator who has been appointed there is doing a great job — she has hit the ground running and has introduced many initiatives. Her work has meant that a directory is available of the various organisations that are involved in suicide prevention. Again, the same issues apply — money must be guaranteed for the continuation of jobs and appointments.

Mr Doyle and Ms McGarrigle also referred to education. The Committee needs to be aware that child-protection issues put teachers in a delicate position. Often, when a child indicates that something is wrong, we cannot ask questions — the matter must immediately be passed on to designated personnel in the school. In many ways, teachers’ hands are therefore tied. As professionals, we often feel that we would like a little more scope to deal with situations. The pastoral system that is up and running in many schools is patchy and varies between schools. The action that is taken by a school depends on its principal and policies.

Given that I am involved with the Families Forum and in teaching, I sometimes wonder whether teachers realise fully what they are being asked to do. Much emphasis has been put on education. If one were to talk to teachers, 99·9% of them would say that they already have enough to do. They say that they are willing to help, but that they are unable to take full responsibility for it.

Ethnic issues also arise for the Northern Board. Last year in Cookstown, a spate of tragic incidents occurred that involved people from eastern Europe. Language difficulties meant that unfortunately, it became too late to intervene. More resources and availability of help must be concentrated on that area, and that is perhaps even more important as we approach a slight economic recession. I heard a story about St Vincent de Paul having to provide heating oil for a Cookstown family at Christmas. Many issues and problems can arise from that type of situation.

Bobby Cosgrove mentioned GP training. That has been offered by the Northern Board and the Western Board, and we understand that it has been taken up fairly well. However, we would like to know the numbers of GPs that have availed themselves of the training that has been carried out so far.

I realise that time is an issue, so that is all that I want to say.

The Deputy Chairperson:

Thank you all for your contributions. A lot of your points were also made by the previous group, and we certainly take those points on board. Maureen, you are right to point out that there is disparity in the uptake of ASIST across the area. Some areas might be stronger than others in that respect, and in some hospitals the front-line staff might have taken up the training more than others.

Issuing a patient with an appointment card when they leave hospital is a simple suggestion, and we can recommend that in our conclusions. The emotional literacy programme in schools is an excellent idea, and it is also something that we must consider. So far as people who live in rural areas are concerned, the representative from the Niamh Louise Foundation told us that that organisation was formed because her family felt that it had nowhere to turn. From speaking to the witnesses, I know that you are a great help to each other. Has the fact that you have reconstituted yourselves as Family Voices made a difference to how you are heard in the SSIB?

Mr McCabe:

Family Voices is the result of a lot of families getting together from across the Province, and it allows us the opportunity to share information. It meets on a regular basis.

Ms McGarrigle:

We met just before Christmas, and we will meet again on Saturday 19 January. We are trying to include all suicide-prevention groups, and we have appealed to all of those groups to be part of Family Voices. It is difficult and tiring for bereaved people to talk about their story, but we need to know the issues and act on those as a collective bunch. The group will meet prior to the hope and healing conference, and we are hopeful that that will allow people who might come to our meeting only once to raise issues that they have with the coroner or A&E units.

The Deputy Chairperson:

When Mary Creaney attended a previous Committee meeting, she said that she felt that families’ voices were not being heard. I wonder whether the organisation has helped to strengthen those voices.

Ms McGarrigle:

We are still trying hard. We have not given up, which is the main thing.

Mr McCabe:

One of the major concerns for the southern area is the fact that, because it is a rural area, it does not have the same voice. I do not think that there are any representatives here from a rural area.

The Deputy Chairperson:

I am from the mid-Ulster area.

Ms S Ramsey:

I used to live in a rural area, then 70,000 houses were built.

Mr Cosgrove:

In early October 2007, the Committee sent an email asking people to respond to its inquiry into suicide. Did you get many responses to that, and have those responses been collated?

The Deputy Chairperson:

Yes. We received roughly 65 responses, and we are meeting people and trying to put all the evidence together. All the evidence will be published in the report: we make sure that all contributions are recognised in the Committee’s recommendations.

Mr McCabe:

The main issue is the reason that the trusts take ownership of everything. We are doing a lot of groundwork, and when the action plan was released, there was no word at all about voluntary groups taking ownership of anything — the trusts were taking the lead and giving wee bits and pieces to the voluntary groups to keep them happy. We have received £2,000 from the strategy to date, but having said that, there has now been an offer of a post. We have not received much from the Department.

The Deputy Chairperson:

It is concerning that someone was working in a post that was paid for by the trust at one stage but is now being funded from elsewhere.

Mr McCabe:

We have a co-ordinator who was employed in November, but obviously, funding for that could end in March. The probability is that the post will be recurrent. That post was made available for them, despite the fact that we submitted an application form for it this time last year. Our application was not looked at until later in the year, and even then we were given another recurrent post for a year and told that that was all that was available.

The Deputy Chairperson:

That point was well made.

Ms Ní Chuilín:

Presentations were made to the Committee this morning by Mary Black and Maria O’Kane, who are consultant psychiatrists. Mary Black told the Committee that there will be a conference on 6 February to examine good practice across Belfast and to set future priorities for the action plan. Are you aware of that conference?

The Deputy Chairperson:

The groups that are here now deal with areas beyond Belfast.

Ms Ní Chuilín:

Ann, if your group is meeting next Saturday, that conference should be discussed then. It is important that we hear from families and groups who have not only been bereaved through suicide, but who have to live with the consequences of self-harm. It would be worthwhile to find out what the main issues are. That conference will examine good practice, which should include the recruitment and retention of staff, evaluations of phone lines, the disparity in funding between urban and rural areas, and the issues that Robert spoke of, such as self-esteem, confidence building and —

Mr Doyle:

Personal skills development.

Ms Ní Chuilín:

— personal skills development in schools. I know that money was invested in such services after three young people took their lives, but was that a one-off, short-term solution? We will ask what each Department is doing to ensure that the strategy is implemented.

Mr McCabe:

That is one of our points. In the case that you mentioned, the Department intervened only in the aftermath of that tragedy when a media frenzy was going on. That tragedy happened in Kilkeel, and when we needed the Department to intervene, it still did not get involved until a later date. Therefore, it perhaps takes such a media frenzy to catch the Department’s attention.

Ms Ní Chuilín:

That is a problem. Michael McGimpsey met Internet providers and media representatives, and our parties have also met with media representatives. The Samaritans published guidelines on how to report instances of suicide. However, there are big lessons for us to learn. The difficulty is that, although we have a responsibility and do not want to sensationalise incidents, we want to use any means possible to raise awareness. Therefore, a balance must be found.

We are happy to include in our report instances of people behaving sensitively but not feeling that they are getting the Department’s support. There are big disparities, in some instances due to bigger populations, and the resources do not meet needs. It is important for you, Gerard, to talk about your views on the recommendations in the report, which were a result of the treatment that Danny received, and the subsequent treatment of your family.

Mr McCartan:

People are still going through what we did two and a half years ago.

Ms Ní Chuilín:


Mr McCartan:

When Danny was in Knockbracken, his records did not go to the Mater Hospital as they should have. When the Belfast Health and Social Care Trust was established, it stated that such an occurrence would not happen again. However, someone rang us today who is in Windsor House and is waiting for an appointment in the Mater Hospital because their records have not arrived. That person is in limbo — they have no psychiatrist and no community psychiatric nurse (CPN) because their records are in Windsor House instead of the Mater Hospital. Therefore, the same thing is still happening.

The Secretary of State gave £400,000 to the Children and Young Peoples’ Funding Package for Sure Start. Half of that has been spent, meaning that £200,000 is still available. However, organisations are having trouble finding staff. Why is that?

An excellent woman called Dawn Rees is involved in the project, and she has worked with the Department, helping to pull all the co-ordinators together in England. She seems to know what she is talking about, and I think it would benefit the Committee to meet with her.

Ms Ní Chuilín:

Please bring to us any information or lessons that can be learnt, because some of the recommendations are that no other family should have to go through what yours did. We do not want to single out any families. I imagine that there will be resolution when you feel that no other family will have to go through what you went through.

However, there is a statutory obligation and a duty of care to look after children, and it is a problem if they are still consistently being put into adult wards. Given that child protection issues are involved, it would be worth the Committee’s asking how many children are put on adult wards. I have spoken to hospital staff who literally watch children 24/7 by sitting beside their beds. That is not good for the child or young person, the staff, or the family. It is also not good for the service, because it means that people will lose confidence in it.

Mr McCartan:

That is the reason that a respite centre is an excellent idea. That would get the young person out of the damaging environment, the family would get a break, and the young person would be safe and looked after.

An organisation charity called Winston’s Wish has been established in England. That is a community-based charity for bereaved children that has excellent programmes for young people until they see representatives of the statutory agencies.

Ms Ní Chuilín:

Obviously, respite for the entire family, and certainly for the children and young people, is needed.

The Deputy Chairperson:

It is disappointing for you to have to say today that lessons have not been learnt, because people are still ringing you with the same problems in 2008. Carál is right when she says that many lessons are still to be learnt.

Ms S Ramsey:

Thank you for the presentation. I have a couple of comments to make, and I will then ask one or two questions.

First, you should not be downbeat, because the Committee has raised with the Minister some of the issues that you highlighted in your previous presentation. I will give you a couple of examples.

You raised the issue of young people in further and higher education, and we pushed the Minister on that, and, in fairness, he was going to talk to the Minister for Employment and Learning to get his Department involved in the ministerial task force. Therefore, suggestions and recommendations that come from organisations such as yours allow us to do that.

I remind you all that this Committee is independent, and that no one will be pulling our strings when we write our report. We are not answerable to anyone except the Assembly and the people who vote for us, so we can make as many radical recommendations as we choose. We could ask the Department now for an update on the recommendations from the inquiry, and even a time frame for when they will be implemented in full. When the findings of previous investigations were produced, everyone and their granny said that they would learn lessons from them and implement certain recommendations. However, I feel that some lessons have not been learnt. Therefore, using our scrutiny role, we can probably get an update without having to wait until we write our report.

To give you some information about what will happen and to reiterate my point about not being downbeat, any issues that you raise with the Committee will be taken on board by the parties and others in civic society who are working on a bill of rights. As you are aware, that will mean that certain provisions will be set out in legislation. For my sins, I am working on the children and young people’s section of that, and the provision of child and adolescent psychiatric beds is one of the main areas of health and education that we are considering. Indeed, Sinn Féin has been fighting for the availability of more beds for a long time.

The Departments have a moral and legal duty to ensure that services are provided where they are needed. Through the bill of rights, we are pushing to have that provision included in legislation to which the Departments cannot legally or morally fail to adhere. We are able to do that in large part because of the evidence of groups such as yours. Although the Committee may be able to make a difference, the bill of rights will also have a role to play.

Lessons must be learnt. Bobby, it struck me that you said that when a family is bereaved through suicide, there is no joined-up approach by the PSNI, the coroner and social services. I raised that point this morning when I met people representing the health action zones. That issue will be taken on board, because the last thing that a parent wants to do when struggling to come to terms with the death of a loved one is deal with all those separate agencies. If simple issues such as that are addressed, a big difference will be made to individuals and families.

It is unfortunate that you have become the experts and are in the position of being able to bring the solutions to us. It is up to the Committee to include those in the inquiry’s report and to push the Executive to encourage all the Departments to take a holistic, joined-up approach. The Department of Health, Social Services and Public Safety, the Department of Education, the Department for Social Development, the Department of Culture, Arts and Leisure and the Department of Finance and Personnel should all adopt such an approach.

Thank you again for coming back today and giving us a great deal of information and knowledge.

Mr McCallister:

I have a couple of comments to make. I am aware of PIPS in Newry and Mourne, because I come from Rathfriland and am a member for the South Down constituency. I am aware of the good work that you do, and I am more than happy to meet with you there sometime.

Several years ago, before I became involved in politics, I worked on strategies in Banbridge and Craigavon. I agree with your comments about funding a post for a year. To employ anyone for a year ends up being almost pointless, because everyone has bills to pay, so once in post, the individual starts to look for another job. If the individual leaves before the year is over, the appointment has been a waste of time, and employers end up running around chasing their tails.

The previous presentation also made it clear that funding mechanisms must be established to secure streams of funding for probably at least three years, and perhaps for as long as five years.

Hearing about your experiences has made this an interesting afternoon. I am grateful to you for sharing them with us, as, I am sure, are all the Committee members. It is important that all the work in which we are involved is evaluated properly. It would be great if we could consider our final Committee report as a true representation of our vision of what should happen.

As Sue rightly mentioned, no one pulls the strings here: the Committee will stand over its decisions. It would be nice to see a report that challenges the Health Department and, as was mentioned earlier, other Departments that have an interest in the issue. If they disagree with any aspects of the Committee’s report, they should state the reasons and be asked to suggest better alternatives. The Departments must be held to account, and we must check their progress on the implementation of any part of the report for which they are responsible.

Too often, a nice report is compiled that simply collects dust on a shelf somewhere; it does not become a living, working, breathing report with measures that are being implemented on the ground. All Assembly Members, not only Committee members, should be encouraged to listen to groups from their constituency to hear what is happening on their patch. That is more of a comment than a question. I wish you well in your work.

Mr Easton:

Most of my points have been raised already. However, one point that I picked up in our session with the other groups — and perhaps more so from listening to your contribution — is that there seems to be a lack of a joined-up approach from Departments, boards and so on. They seem to give you a small amount of funding and talk to you a little, but when matters reach a certain level, they do not want to take them any further — they do not seem to want to listen.

Do you agree that any inquiry that this Committee conducts, or any measure that the Minister puts in place, will be pointless unless Departments and boards get to the bottom of this matter with the local community groups and the families who face the issues daily or weekly? Do you agree that it is vital not only that we put that point across in our work, but that the Minister takes it on board, too? No approach can work unless we have your and the families’ input.

Mr McCabe:

I agree. The strategy is a bottom-up strategy, and it was put in place as a result of lobbying that bereaved families carried out. As you said, when work reaches a certain level, the Department takes ownership of it, and we are cut off. The community groups take the work as far as they can, and the Department then takes over. That is the way it is. I do not know how the system works in the inner city, but I know that that is how it works in rural areas.

Mrs Hanna:

Hello again. I know that it is hard for you to come back because you feel that you have been there; it has happened to you. You can see some of the solutions, and it is frustrating when there does not seem to be any change.

As each of you spoke, I made a few notes. Séamus, from listening to you, the main point that emerged was the poor relationship with the trust, which Alex mentioned. You are like the poor relation. It is somewhat like the situation with carers; similar to them, you are the people who have the practical experience, and no approach can work unless a real and meaningful partnership exists. Both sets of people must be involved: you, the people with the experience who know what happens in the community and who can see the solutions; and the professionals, who also have their role to play. However, a genuine partnership must be established.

Gerard, you talked before about the lack of beds, and a respite centre has been discussed. Some people perhaps need an acute bed to get them through the first 24 hours. The whole focus now — and this was apparent even from talking to Dr Maria O’Kane this morning — is on keeping people out of hospital if possible. However, people still need hospital treatment if they are in the acute phase. Medical professionals are now talking much more about counselling and talking therapies, in which, again, so many of our first group of witnesses are very much involved. It seems crazy that your idea about an appointment card cannot be introduced. That seems like one of the simple things that certainly should be happening.

Professor McClelland from the Bamford Review group has made it clear that there are no easy answers to mental-health problems and self-harm and suicide issues: there is no magic solution. He talks a great deal about the need for new ways of working together and for a better and different kind of training. Raising awareness among everyone is important, especially among staff, teachers and parents.

Robert, a very good presentation was held in the Long Gallery on the Bamford Review. Again, the economic argument for prevention and early intervention was made, and some good schools’ programmes were mentioned. Introducing coping strategies and raising self-esteem were discussed at that presentation. People who are trained in the matter must come into the schools to deliver those programmes. Many of those training programmes already exist, but we must make sure that they are actually delivered.

Mr Doyle:

Those are the sorts of programmes that I deliver daily, because it is the adults who I work with who need them. We are developing the courses carefully and taking our time. We are developing similar programmes with the Northern Ireland Children’s Enterprise (NICE) so that they are appropriate for our target audience.

Mrs Hanna:

NICE had very good programmes. Its members gave a presentation with Dr Graham McDonald, who was here today, and they have written a book on the issue. Their work is excellent, and they were interesting to listen to.

Not all the answers can be found, and perhaps they never will. However, we must try different things that will help some people. Some of the issues relate to self-esteem and people feeling as though they have a meaningful role in life. Some people will search for ever for reasons, but they get no answers. We do not have the answers.

However, we will listen to you and to the professionals, and, as John said, we will try to develop a vision of a better way in which to deal with the problem and get the resources to deal with it. It was good to hear from Ann about some of the good things that are happening.

Ms McGarrigle:

I am glad to have been able to do that.

Mrs Hanna:

There are some good things amidst it all. Everybody gets frustrated —

Ms McGarrigle:

We say that west is best.

Mrs Hanna:

Your work is good, and it gives us all a lift sometimes to hear that some good things are happening. I hope that Bobby, and others like him, hang in there and keep going. Thank you.

The Deputy Chairperson:

Thank you all for coming along. Your contributions are vital in order that the Committee can create a robust document, which it will present to the Department at the end of its inquiry.

You made several points, and, if I have missed anything, you can tell me before you leave. You mentioned a specialist respite centre for children and adolescents and the lack of adolescent beds in general. There is a need to recognise the rural aspect of access of funding and services, and that one must realise that size does not fit all. There must be a collective approach; this is a cross-departmental issue, not one for the Department of Health, Social Services and Public Safety or the Department of Education. Given that this is a social issue, Departments must work together. You also mentioned the uptake of GP training and taking note of the change in our population, with the increase in migrant worker population. That is something of which we must be mindful when taking a strategy forward.

The television campaign was discussed, including the fact that suicide was not mentioned in the advertisements. Sue mentioned that we must be proactive in promoting the positive aspects of the work that the families and groups do to help people. The appointment card is another issue. Have I missed anything?

Mr McCabe:


Ms McGarrigle:

Please mention the directory again. I talk about this all the time, but I want to know whether there is any possible way that a directory could be created that people in every area could use.

Ms S Ramsey:

That should come with a health warning, depending on funding.

Ms Ní Chuilín:

Michelle, could you also mention the lessons that were learnt from Gerard McCartan’s story.

The Deputy Chairperson:

Yes. I have that.

Mr Cosgrove:

On behalf of the families, I thank the Committee for inviting us, for listening to us and for taking on board what we have been saying.

Briefly, I will tell you how far we have moved on. Nineteen years ago, my son took his own life. I had absolutely no one to turn to. I went everywhere. I just wanted answers to simple questions to make sure that I was not going insane. No support was available to me. Twelve years ago, Ann’s son did the same thing. Again, there was no support. Over the past five years, the families have made massive changes. It is the families who have made those changes.

We do not come at the issue from a professional background; the only hidden agendas that we have are lying in graves. That is where we are coming from. With our hearts and souls, we want to help people through what we went through and to try to make life easier for them. We see the horrors that are happening, and we believe that we can make an impact.

As far as I know, our offer to speak at GP training courses in the future has been accepted. We have been fighting for that with different trusts for 18 months or two years. That is at least a small development.

Thank you very much for listening to us.

The Deputy Chairperson:

Thank you.