To ask the Minister of Health to detail (i) the community-based mental health crisis intervention services that are currently commissioned by his Department in each Health and Social Care Trust; and (ii) whether any assessment has been made of geographical gaps in provision.

i) Mental health services in Northern Ireland are delivered in line with the Stepped Care Model outlined within the You in Mind Care Pathway.

It is important to note that the term ‘mental health crisis’ can encompass a broad range of circumstances, including acute deterioration in mental wellbeing, significant psychological distress, suicidal thoughts, self-harm, or other situations where an individual requires an urgent response. Not all crises are attributable to mental illness, and support may therefore be provided through a range of statutory, community and voluntary sector services depending on individual need.

Community-based mental health crisis intervention and support services currently commissioned across Northern Ireland include:

Lifeline, Northern Ireland's regional crisis response helpline, which is available 24 hours a day, 7 days a week for individuals experiencing distress, despair or suicidal crisis. Where appropriate, Lifeline also provides short-term counselling support.

Mental Health Practitioners (MHPs) in General Practice, commissioned as part of the Multidisciplinary Team (MDT) Programme. These practitioners provide assessment, intervention and support for individuals presenting with a range of mental health difficulties, including anxiety, low mood and psychological distress. MHPs are currently available in 12 of the 17 GP Federation areas. Rollout to South Belfast, East Belfast, Mid-Ulster, Antrim and Ballymena, and Lisburn Federations remains subject to available resources.

PHA commissions a range of community-based Step 2 talking therapy and counselling services including:

The Self-Harm Intervention Programme (SHIP), which is available to people aged 11 years and older across all five Health and Social Care Trust areas. Referrals can be made following crisis presentations where a mental health practitioner considers an individual's needs and level of risk appropriate for the service. SHIP provides evidence-based psychological interventions aimed at reducing the likelihood of repeated self-harm and suicide.

Counselling services for people experiencing distress in the Belfast and South Eastern HSCT areas as listed at Annex 1.

In addition to the above, Health and Social Care Trusts provide a range of community mental health services operating at Steps 1 and 2 of the care pathway, including primary care, psychological support and community mental health interventions. Further support is also delivered through community and voluntary sector organisations funded through a variety of commissioning and grant arrangements.

(ii) Actions 12 and 27 within the Mental Health Strategy relate to the development of mental health crisis services. Prior to commencing future-state work on regional mental health crisis provision, Departmental officials and the Public Health Agency undertook a regional mapping exercise of statutory and community-based mental health crisis services. This work identified variation in the availability and distribution of community mental health and emotional wellbeing services across Northern Ireland, including differences in provision at Steps 1 and 2 of the care pathway. It also highlighted areas of underinvestment and inconsistency in service availability across the region.

The mapping exercise has informed ongoing work to develop a regional business case for a Community Crisis Service. The proposed model aims to provide timely, short-term support for individuals experiencing a mental health crisis who do not meet the threshold for secondary care mental health services. The model is being developed in line with evidence-based best practice and seeks to address regional variation and improve equity of access.

Any future commissioning decisions will be informed by assessed need, the findings of the regional mapping exercise and the availability of funding.

Annex 1:

The Public Health Agency fund a number of Step 2 talking therapies for individuals in crisis or distress in Belfast and South Eastern Health and Social Care Trust areas as in the Table below. This pattern of provision reflects historical funding and commissioning arrangements.