A Card before You Leave: Participation and Mental Health in Northern Ireland

Abstract

Due to a recent and dramatic rise in suicide and self-harm rates, mental health services have received a high level of attention in the politics of Northern Ireland, resulting in the implementation of numerous policies and the publication of many public reviews on the subject. Critically, these policies have also emphasized and required the participation of mental health service users in decision making about service design, implementation, and monitoring. This paper analyzes the experience of a group of mental health service users in north and west Belfast, the Public Initiative for the Prevention of Suicide-Greater Shankill Bereaved Families Rights Group supported by the Particpation and the Practice of Rights Project, as they campaigned for policy change using a human rights-based approach. It considers, first, the group's use of a participatory, "bottom-up" approach to set human rights indicators and benchmarks defined by group members themselves as an example of meaningful participation from an affected group. The paper then looks specifically at one of the group's issues--follow-up care--and reveals how the group was able to bring about policy change on this issue across Northern Ireland. Finally, it discusses how the group's experience in this campaign has revealed problems with the way that the government currently engages with mental health service users in Northern Ireland. The article closes by identifying key next steps to be taken as the focus of the campaign shifts to ensuring that active, free, and meaningful participation takes place in accordance with international human rights standards.