Executive Summary

Why we did this review

Major transformation of mental health services in Northern Ireland are being proposed. In May 2020, the Department of Health (NI) published a Mental Health Action Plan as part of a strategic commitment to improve the mental health of the population in Northern Ireland. The plan included a commitment to develop and produce a new mental health strategy and a comprehensive funding plan for mental health.

In June 2021, a new Mental Health Strategy (2021-2031) was published by the Department of Health (NI) setting the strategic direction of mental health services in Northern Ireland for the next decade.

Statistics are vital to support policy decisions and service delivery and must be viewed as a key component in measuring the effectiveness of any Government strategy or policy. Good quality data and statistics are the foundation blocks, enabling an in-depth understanding of what works, where improvements are needed and how services are impacting people’s lives. With mental health high up on the political agenda in Northern Ireland – we want our review to be relevant, well-timed and add to the positive momentum.

Whilst this review has been conducted during the COVID-19 pandemic, it is not intended to provide specific guidance on statistics directly related to the effects of the pandemic. Its purpose is to share strengths and weaknesses of the wider landscape of mental health statistics in Northern Ireland, with a key question in mind – are current statistics meeting the needs of users? Our findings and recommendations should be considered and used to enhance the implementation of the new Mental Health Strategy.

What we found

Statistics serve the public good when they enable a range of statistics users to answer key important questions on a particular topic. Mental health statistics in Northern Ireland are currently not fully serving this vision. Based on our conversations with statistic users, and our own observations and desk research, whilst the publication of a new Mental Health Strategy is a very positive development, there are significant issues hindering the development of statistics which need to be addressed.

• There is a scarcity of robust mental health data in Northern Ireland. This has hindered the development of official statistics, meaning that there are significant and fundamental data gaps. For example, statistics cannot tell us how many people are accessing mental health services in Northern Ireland and whether their needs are being met. This means it is also difficult to evaluate the delivery of mental health services and understand the outcomes for individuals.
• A lack of official statistics means that statistic users are turning to other data to answer questions that they have. Academic research studies are filling some of the gaps, with a wealth of valuable information being published by the research community.
• There is no accurate regional picture of mental health in Northern Ireland. Mental health data are currently collected in silos by each of the five Health and Social Care Trusts (HSCT). Data definitions are inconsistent and a fragmented IT infrastructure has led to poor data comparability. Different localised IT systems are implemented both within and across the Health and Social Care Trusts, making standardised data collection a challenge.
• There is no single point of access to official statistics on mental health. Users find it difficult to locate official statistics and data across a dispersed landscape of information. Unpublished data are requested on an adhoc basis, but this process can be slow and inconsistent. Access to mental health data for secondary analysis purposes is not easy and the absence of a legal gateway in Northern Ireland prohibits researcher’s ability to fully explore and answer their research questions.

These issues affect a wide range of individuals and organisations, who are not having their analytical needs fully met. These include: the general public, patients, carers, policy makers, public health bodies, professional bodies and commissioners, regulatory bodies, academics and researchers, charities and third sector bodies.

Statistics users have a strong vision of what mental health statistics should be delivering. While there is currently a large gap between this vision and what currently exists, statistics producers do share many of the concerns raised by users. The COVID-19 pandemic has impacted both resourcing and prioritisation, yet despite this, there is strong appetite in Northern Ireland to make improvements.

There are positive developments to highlight here – for example, the implementation of a new digital integrated patient record across health and social care in Northern Ireland through the Encompass programme. The new IT solution will improve efficiency by replacing current disparate IT systems across the Health and Social Trusts and allow greater standardisation. Robust data collection methods are the foundations on which good statistics are built upon and produced – this is a huge step forward towards improving statistics on mental health in Northern Ireland.

Our recommendations

Improving mental health statistics in the short to medium-term: our recommendations

To improve the public value of mental health statistics in Northern Ireland, we have seven recommendations to support short to medium-term improvements.

• To support user understanding, the Information Analysis Directorate (IAD) in the Department of Health (NI) should seek to provide more insightful commentary for existing mental health publications to explain key statistical messages.
• Statisticians from the Department of Health (NI) and clinicians must be involved in the development stages of the Encompass programme. Their involvement will maximise the benefits of a change in data recording of this scale and ensure that the data collected will be fit for statistical purposes.
• Prior to full implementation of Encompass, the Department of Health (NI) in liaison with the Health and Social Care Board (HSCB) and the five Health and Social Care Trusts (HSCT) must collaborate together to establish a minimum dataset to collect mental health information across all settings.
• Quality information for existing mental health statistics should be reviewed by the Information Analysis Directorate at the Department of Health (NI) in order to ensure that it is clear, relevant and meets the needs of a broad range of users.
• The Department of Health (NI), in liaison with the Health and Social Care Board (HSCB), should periodically review Freedom of Information and other data requests and consider whether to include the information in future routine data publications.
• The Information Analysis Directorate (IAD) in the Department of Health (NI), in collaboration with users of mental health statistics, should review, innovate and improve accessibility to mental health data. Relevant signposting and navigation between different sources of information should be clear, joined-up and easy to understand.
• As part of their longer-term plans to improve mental health statistics, the Information Analysis Directorate (IAD) in the Department of Health (NI) should harness technological advancements to disseminate information to a wide range of users, considering accessibility needs. For example, they should consider developing an online dashboard and a single central data hub for mental health information in Northern Ireland.

Longer-term transformation of mental health statistics: our recommendations

We welcome the ambitions set out in the Department of Health (NI)’s Mental Health Strategy (2021-2031) specifically those under ‘Theme 3: New ways of working’. We have identified three strategic actions required to support and deliver the long-term transformation in mental health statistics to support this:

• The Department of Health (NI), as part of the ‘New Ways of Working’ theme in the Mental Health Strategy 2021-2031, should use and build upon our findings in this report to augment and improve the availability of official data on mental health.
• Statisticians, analysts and clinical experts who lead the provision of mental health services must be involved in the development of standardised data collection methods and mental health outcome indicators, as highlighted in the Mental Health Strategy 2021-2031.
• Data and statistics need to be recognised as a valuable public asset. Given the extent of changes needed to improve mental health statistics in NI, the Department of Health (NI) should consider whether a separate data strategy is required to support and deliver the ambitions set out in the Mental Health Strategy 2021-2031.

We will continue to work with a range of organisations to make the case for improvements to mental health statistics. We hope to the raise the profile of the issues highlighted in this report and advocate for the importance of data and statistics at a time of major transformation of mental health services in Northern Ireland.