What we know
What information do we have about the Eastern Board area?
What is the result of this on our health locally?
Policies
What is happening in the Eastern Board area?

Good mental health is an important element of overall health and well being. Definitions of mental health are difficult and many have been suggested. The Health Education Board for Scotland, in the document "Mental Health Promotion: A Strategic Statement" highlights the suggestion from McDonald and O'Hare (1996) that it may be better to move from trying to get a definition to agreeing the parameters of good mental health, such as:

	Ensuring that our basic needs are met; this incorporates both a range of social and psychological conditions such as adequate food and shelter, as well as higher needs such as affectionate relationships and membership of a group (derived from Maslow 1968).
	Nurturing the development of skills such as the ability to manage change, recognise and communicate our feelings as well as cope with stress in our environment.
	Acknowledge that feelings and beliefs such as feeling worthy, understanding and acceptance that psychological or emotional problems can and do occur in ourselves and others; in addition, good mental health involves feeling positive about self and others.

Everyone has mental health needs, not just those with a diagnosis of mental illness.

Mental health promotion works at three levels:

	Strengthening individuals - or increasing emotional resilience, through interventions to promote self-esteem, life and coping skills.
	Strengthening communities - this involves increasing social inclusion and participation, improving neighbourhood environments, developing work to support mental health in health and social services, schools, workplaces and the community.
	Reducing structural barriers to mental health - through reducing discrimination and inequalities and providing access to education, employment, housing services and support.

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The Health and Social Well Being Survey shows that people in Northern Ireland are at greater risk of mental ill health than people in England and Scotland.

	12% of people aged 16 and over had experienced a great deal of worry or stress - this was more likely in women and the middle-aged groups.
	21% of people over 16 showed signs of possible mental illness by scoring highly on the GHQ12 (17% of men and 24% of women)..
	40% of people over 16 expressed a lack of social support from family and friends and 14% experience a "severe lack" of support.

It is estimated that at any one point in time as many as 1 in 6 people have been diagnosed with a condition such as depression or anxiety. Between 10% and 20% of teenagers will suffer from depression at some time.

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Many factors affect mental and emotional health. Factors which affect people in Northern Ireland more than anywhere else in the UK include poverty and community conflict.

Northern Ireland has higher levels of deprivation than Britain and Europe. A major cause of poverty and deprivation is unemployment and the proportion of males in long-term unemployment is higher in N Ireland (29.5%) than in Britain (17.6%).

The Eastern Health and Social Services Board has within its area the most deprived electoral wards within Northern Ireland. Those living in these deprived communities are at particular risk of ill effects on their mental and emotional well being and this is also linked to increased risk of physical ill health.

Community conflict is also an important risk factor. The impact of the conflict was set out in the report "Living with the Trauma of the Troubles." Residential segregation, population movement and displacement, the stigmatisation of certain neighbourhoods, bereavement and traumatisation all have negative effects on mental health.

There is a clear link between poor mental health and living in a neighbourhood that is both economically disadvantaged and has experienced greater exposure to conflict.

Physical factors are also linked to poor mental health. Chronic medical conditions and physical and sensory disability can lead to depression, anxiety, isolation and substance misuse. Carers can also be affected by their responsibilities so that their own health may suffer. Carers can feel isolated, unsupported and alone.

The mental well being of children and young people can be affected if they suffer the breakdown of close personal relationships and do not have emotional support. There is evidence that among young people, boys have less emotional support than girls. Greater personal isolation during teenage years may make boys and young men more vulnerable to mental health problems. Rates of suicide among young men in particular cause concern within the Eastern Board area.

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