Armed with evidence of success in reducing risk of self-harm and suicide, East Belfast Community Counselling Centre calls for increased funding of mental health services in the community.
New analysis by Pro Bono Economics shows that:
- East Belfast Community Counselling Centre reduces the assessed risk of suicide by 51% and of self-harm by 40% amongst Belfast residents seeking its help
- Belfast women are 50% more likely than men to seek help for their mental health difficulties
- Therapy for each EBCCC client costs approximately £283. This is about a third of the average cost of one episode of self-harm, which is £809, while the economic cost of one suicide is £1.45million
Lord Gus O’Donnell, Chair of Pro Bono Economics, says: “As a matter of urgency, to ensure that mental health in Northern Ireland gets the funding it deserves, we need more robust data and stronger evidence to demonstrate the effectiveness of mental health programmes. Without that funding, we will be having the same conversation a year from now and ten years from now.”
Roberta Richmond, Chief Executive, East Belfast Community Counselling Centre, says:
“Research has shown that traumas and tensions linked to the conflict in Northern Ireland have resulted in poor mental health in our community. This affects not only those people who directly experienced the region’s dark times, but also their children and their children’s children… More money is needed if we are to reduce Northern Ireland's suicide rate by 10% over the next five years, as per the target set by the Department of Health, and more broadly improve the mental health of our population.”
Mental health interventions, such as one-to-one counselling sessions from mental health professionals, can reduce the risk of suicide by 51% and self-harm by 40%.1 This is a key finding of an independent analysis, conducted by charity Pro Bono Economics, of East Belfast Community Counselling Centre’s (EBCCC) work. EBCCC is a small charity located on the peace lines* in Northern Ireland, which delivers an average of 142 counselling and life-coaching sessions each week.
But the analysis also suggests that much more needs to be done to reduce the high rate of suicide, particularly among men in Northern Ireland.
EBCCC approached Pro Bono Economics for help in understanding the effectiveness of its work, potentially to be used as part of a future ‘business case’ to secure funding. Its aim was to continue to engage successfully with the community and to do more outreach work, particularly among men.
Pro Bono Economics’ analysis found that of the 1,143 residents who received counselling from EBCCC in 2018 (61% were women vs 39% men), women are 50% more likely than men to seek help for their mental health difficulties.1 Yet compared to women, men are 3.5 times more likely to take their own life: in 2018, 25 men per 100,000 population took their own life vs 8 women per 100,000 population2. Figures show that 72% of the people who die by suicide in Northern Ireland are not even known to the region’s mental health services4,5.
The analysis also shows that counselling therapy for each EBCCC client costs approximately £283. This is just 35% of the average cost of one episode of self-harm, which is £8097, while the economic cost of one life lost to suicide is £1.45million8. In 2018 there were 305 suicides in Northern Ireland with an associated cost of £442million, and 13,911 acts of self-harm, resulting in visits to A&E at a cost of £11.25 million.6
Protect Life 2, the suicide prevention strategy published by the Department of Health, aims to reduce Northern Ireland's suicide rate by 10% in the next five years. Additional funding of £1.35 million for suicide prevention in Northern Ireland was announced in September 2019, bringing the region’s total funding of suicide prevention in this financial year to just over £9 million.9 Based on these findings, the Pro Bono Economics analysis suggests that this total may not go far enough to meet this target.
Based in East Belfast, EBCCC works to improve mental health, and minimise the suicide rate among its residents. The charity uses professional mental health counsellors, working as volunteers, to provide vitally needed counselling services to members of the community, who are often people with complex mental-health needs. Before the service was established, apart from counselling offered by local churches, there were no dedicated mental health services in East Belfast.
Roberta Richmond, Chief Executive, East Belfast Community Counselling Centre, commented.
“Research has shown that traumas and tensions linked to the conflict in Northern Ireland have resulted in poor mental health among the community. This affects not only those people who directly experienced the region’s dark times, but also their children and their children’s children. Even in today’s Belfast, there are high levels of deprivation, crime, and prescription-drug dependency. These factors, together with family discord, have resulted in increasing levels of mental ill health amongst the city’s residents.
“Even though EBCCC worked with a record number of residents in 2018, demand for our services always outstrips capacity. We see everyone who asks for help, but people can wait three months to be seen by a counsellor. More money is needed if we are to reduce Northern Ireland's suicide rate by 10% over the next five years, as per the target set by the Department of Health, and more broadly improve the mental health of our population.
The findings of Pro Bono Economics’ analysis make clear to current and future grant-funders just how much difference our work is making to the lives of vulnerable people. In normal circumstances high-quality economic advice and consultancy would not be financially feasible for a small charity like EBCCC.”
Lord Gus O’Donnell, Chair of Pro Bono Economics, commented.
“It is the duty of good government to address pressing social issues, such as those encountered by EBCCC on a daily basis, but far too little has been done in Northern Ireland in recent years. The work of EBCCC shows what can be achieved for the people most in need, but, inevitably, much more could be done to improve the mental health and wellbeing of all communities. I would urge policymakers in Westminster and Belfast to reflect on EBCCC’s work. As a matter of urgency, we need more robust data and stronger evidence to demonstrate the effectiveness of mental health programmes to ensure that mental health in Northern Ireland gets the funding it deserves. Without that funding, we will be having the same conversation a year from now and 10 years from now. I hope that the work undertaken by Pro Bono Economics, and its volunteer economist Danielle Wiggins-Conlon, goes some way to strengthening EBCCC’s future funding and to furthering the important work it does in East Belfast."
Pro Bono Economics matches professional economists, working as volunteers or on a voluntary basis, with charities and social enterprises that want to understand and improve their impact and value. The charity was co-founded in 2009 by Andy Haldane (Chief Economist at the Bank of England), and is chaired by Lord Gus O’Donnell (former Cabinet Secretary under three Prime Ministers).
For this East Belfast project, EBCCC was matched by Pro Bono Economics with Danielle Wiggins-Conlon, an economist working for the Northern Ireland Civil Service. The project was designed to produce an analysis and understanding of the charity’s mental health interventions, and to provide EBCCC with insights on how best to collect data, all with the aim of making an evidence-based economic case for this work. Danielle spent a number of months advising EBCCC and devising metrics to define and measure the benefits generated by the work of the Centre.
Pro Bono Economics analysed the mental health scores (known as CORE scores*) of the 1,143 residents before and after their sessions at EBCCC. The analysis found that many of the centre’s clients experienced a reliable improvement in their mental health1:
- Over half (53%) of EBCCC’s therapists observed a reliable improvement in their clients’ symptoms across all four of the centre’s projects;
- Crucially, the risk of suicide was reduced by half (51%) and the risk of self-harm by 40%;
- In addition, clients reported improvements in: day-to-day functioning (56%); wellbeing (59%); coping strategies (75%); and family relationships (81%).
- Ends –
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NOTES TO EDITORS
* The peace lines or peace walls are a series of separation barriers in Northern Ireland that separate predominantly Republican and Nationalist Catholic neighbourhoods from predominantly Loyalist and Unionist Protestant neighbourhoods. They have been built at urban interface areas in Belfast, Derry, Portadown and elsewhere.
** About CORE
CORE is a self-rated questionnaire, consisting of 34 5-point rating scales questions, which measures psychological problems and distress of patients pre- and post-therapy according to four dimensions:
- Subjective well-being
- Life functioning
Statistics on suicide in Northern Ireland vs UK
High levels of deprivation and intergenerational problems resulting from the Troubles mean that Northern Ireland is the UK region with the highest suicide rate. This is especially evident in Belfast. In the UK in 2018 there were 11.2 suicides per 100,000 population (6,507 in total)3. The comparable figures for Northern Ireland in 2018 were more than 50% higher in 2018, 25 men per 100,000 population took their own life vs 8 women per 100,000 (307 in total)2. Men in Northern Ireland are 3.5 times more likely to die from suicide than women.
Northern Ireland also has high rates of self-harm. Over 2017/18, acts of self-harm and ideas of self-harm or suicide accounted for 13,911 visits to A&E. During 2017/18, an average of 25 presentations to emergency departments involving self-harm were recorded per day4. Among the 18 Assembly Areas of Northern Ireland, Belfast East has one of the highest self-harm admission rates for both men and women.
About Pro Bono Economics:
Pro Bono Economics helps charities and social enterprises understand and improve the impact and value of their work, matching professional economists who want to use their skills to volunteer with charities. Set up in 2009, Pro Bono Economics has helped over 400 charities large and small, covering a wide range of issues including mental health, education, employment and complex needs.
Pro Bono Economics is supported by high-profile economists, including Andy Haldane (Bank of England), Sir Dave Ramsden (Bank of England), and Clare Lombardelli (HM Treasury) as Trustees, and Diane Coyle (University of Cambridge), Kate Barker, Lord Jim O’Neill, Robert Peston, Martin Wolf and Lord Adair Turner as patrons. Lord Gus O’Donnell has been Chair of the Board of Trustees since September 2016.
- Measuring the impact of the East Belfast Community Counselling, Pro Bono Economics, October 2019, data on file.
- Suicide statistics and strategy in Northern Ireland, Northern Ireland Statistics and Research Agency, 6th November 2019, https://www.nisra.gov.uk/publications/suicide-statistics
- Suicides in the UK: 2018 registrations, Office for National Statistics, 3rd September 2019, https://www.nisra.gov.uk/publications/suicide-statistics
- Appleby L, Shaw J, Amos T, McDonnell R, Harris C, McCann K, et al. Suicide within 12 months of contact with mental health services: national clinical survey. BMJ. 1999;318:1235.
- Hamdi E, Price S, Qassem T, Amin Y, Jones D. Suicides not in contact with mental health
- Lancet Psychiatry 2017; 4: 759–67 Published Online September 7, 2017 http://dx.doi.org/10.1016/ S2215-0366(17)30367-X
- Mental health promotion and mental illness prevention: The economic case. Knapp, M. McDaid, D. Parsonage, M. (editors) April, 2011). https://www.gov.uk/government/publications/mental-health-promotion-and-mental-illness-prevention-the-economic-case
- Protect Life 2’ Suicide Prevention Strategy, Department of Health Northern Ireland, 10th September 2019 https://www.health-ni.gov.uk/news/suicide-prevention-strategy-protect-li...