Transcript Healthy Minds - New Resources from CRSI Cork

CRSI’s 7th Annual Joint Conference with UCC
“Lives less known”
Healthy Minds – Traveller Suicide & Mental Health Project.
Funded under the THU – HSE – South
HSE South,
Old Library Building,
St. Mary’s Road,
Cork,
Phone John: 087 7590050/Helen: 087 7592464
Email: [email protected]
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HSE –South Traveller Health Unit
• Task Force Report on the Traveller Community 1995
• Traveller Health Units (THU) were established in
response
• Local and Regional Level – to promote collaboration and
partnership – Cork/Kerry
• THU works in partnership with local Traveller
organisations
• Using a community development approach and
recognising the importance of the social determinants of
health
• 2010 All Ireland Traveller Health Study (Our Geels)
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Traveller Health Unit
• Employment of Travellers as Community Health
Workers
• Traveller Led Community Development
organisations – 5 in Cork/Kerry
• Interagency work on Health and Accommodation
• Health Impact Assessments (HIA) on
development of Halting sites
• Joint work with other departments in the HSE
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Culturally Appropriate Service
Provision
• AITHS 2010 showed that Discrimination is key barrier to
improvement of the health status of the Traveller
community
• THU recognises the importance of promoting Traveller
culture
• Commitment to an inclusive approach
• Recognition that all cultures have different social
positions
• A system of data collection to map all ethnic groups
• Contact: Deirdre O’Reilly – THU Co-ordinator – 087
9919792
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Healthy Minds
Traveller Suicide & Mental Health Project
• In a country with already high suicide rates - fifth highest
in Europe for youth suicide according to the National
Office for Suicide, four times more men take their own
life that our nearest neighbours in the UK. The Public
Health Agency (PHA) noted in their research ‘that
Travellers experience worse mental health and a higher
rate of suicide than the settled community (ROI data
only)’1. The All Ireland Traveller health Study reported
that the suicide rate in male Travellers is a statistically
significant 6.6 times higher than in the general
population
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Healthy Minds
Traveller Suicide & Mental Health Project
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Mental Health Status of Travellers in Ireland
All Ireland Traveller Health Study 2010 gives us the most
up to date information about the mental health status of
Travellers in Ireland
The study explored:
How many Travellers there are in Ireland and how old
they are
How is Traveller’s health
What affects Travellers health
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Healthy Minds
Traveller Suicide & Mental Health Project
Mental Health Status of Travellers in Ireland
Key findings of the study include:
 Participation rate of 80% - as a result of extensive
contribution of Travellers, Traveller organisations and
networks
 Traveller population 40,129 on IOI
 Average family size is 4
 Age profile:
42% of Travellers under 15 years compared to 21% of
wider population
63% of Travellers under 25 years compared to 35% of
wider population
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Healthy Minds
Traveller Suicide & Mental Health Project
Mental health status of Travellers in Ireland
 3% of Travellers are aged 65 years and over compared
with 13% of wider population
 Life expectancy – Traveller men can expect to live to 62
years;15 years less than a settled Irish man (no
improvements in the health of Traveller men since 1987)
– Traveller women can expect to live to 70 years;12
years less than a settled Irish woman
 Suicide – 6 times higher the rate of the wider population
and accounts for 11% of Traveller deaths
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Healthy Minds
Traveller Suicide & Mental Health Project
Mental health status of Travellers in Ireland
• Causes of death - compared to the wider population
Travellers have a higher rate of death from lung & chest
diseases and heart diseases and strokes
• Mental health – 2 in every 5 (40%) adult Travellers say
their mental health was never good in the past 30 days;
1 in 4 (25%) of Travellers strongly disagree that “most
people can be trusted”
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Healthy Minds
Traveller Suicide & Mental Health Project
Mental health status of Travellers in Ireland
• Education – only 6% of male Travellers and 5% of
female Travellers have completed their leaving cert
• Employment – only 5% of male Travellers and 4% of
female Travellers have jobs
• Lifestyle – 66.3% of Travellers said illicit drug use is a
problem in the community; 31% said that price is a factor
which prevents them to eat healthily; overall 15% higher
rate of smoking compared to wider population
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Healthy Minds
Traveller Suicide & Mental Health Project
Mental health status of Travellers in Ireland
 Discrimination – many Travellers said discrimination
affects how they live their lives; 60% in schools, 50% in
work, 60% housing, 40% getting healthcare
 Health services – most commonly used services
included: GP, Community Welfare Officer, Dental
Services, Public Health Nurse – barriers to using health
services included: waiting, shame/ embarrassment, lack
of information.
 Religion, identity and culture were ranked as very
important by nearly 90% of those who participated
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Healthy Minds
Traveller Suicide & Mental Health Project
Mental health status of Travellers in Ireland
• Travellers are particularly affected by poor mental health
and suicide
• The suicide rate is much higher than the general
population
• Traveller men are 7 times more likely to die by suicide
than a settled Irish man
• Traveller women are 5 times more likely to die by suicide
than a settled Irish woman
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Healthy Minds
Traveller Suicide & Mental Health Project
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Mental health status of Travellers in Ireland
Mainly Traveller men take their lives by suicide
Suicide is a growing phenomenon within the Traveller
community
There is a stigma in Ireland around suicide and this
relates to Travellers also
Travellers are a “high risk” group to suicide as they fare
poorly on every indicator used to measure socioeconomic status, health, accommodation, education and
employment
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Healthy Minds
Traveller Suicide & Mental Health Project
• At a local level, due to concern after a significant number
of suicides in the Traveller community in Cork city &
county, the Traveller health unit (HSE South), in
partnership with Traveller organizations, identified the
need to establish a mental health project to respond to
the needs and concerns of the Traveller community. In
May 2010, Healthy Minds was established to offer
support and information to members of the Traveller
community.
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Healthy Minds
Traveller Suicide & Mental Health Project
• The Traveller Health Unit has funded the “Healthy Minds”
project since 2010. The project has been managed and
supported by Cork North Community Department Dept..
and a multidisciplinary steering group membership includes
TVG and CTWN, THU Coordinator, Harbour Counselling,
Cork North Community work department and HSE Mental
Health services. Project employs : Project Coordinator
fulltime and part time TCHW
• The project was initially funded as a three year pilot
covering specific geographic areas of Cork City. An
evaluation process has been established to: document and
analyse the work and make recommendations for future
work to address the mental health needs of Traveller
community
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Healthy Minds
Traveller Suicide & Mental Health Project.
What the Healthy Minds project is providing :
• To work with existing services in Cork city to ensure that
the services delivered to Travellers will be appropriate to
their needs & culture.
• To work closely with the Traveller community so that we
are aware of the needs of Travellers and to ensure that
their needs regarding mental health support will be meet.
• To provide information & support to members of the
Traveller community to ensure a greater awareness of
how to access existing services will evolve.
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Healthy Minds
Traveller Suicide & Mental Health project.
• To offer training to Travellers which will enable participants
to provide peer support within their own community.
• To provide information & support regarding suicide, mental
health, positive well being & bereavement through suicide.
• To work closely with the HSE to highlight issues such as
lack of services or ‘blockage’ within the system that may
inhibit Travellers entering into services and how best to
address the problems.
• To link with HSE services in addressing these issues in
partnership.
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Healthy Minds
How do we link
• Link in with mental health services thru Cork
North Mental Health
• Link through the mapping of services – joint
work
• Can come and talk to workers- on our work and
the best way to link in
• Offer Cultural awareness training
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Healthy Minds
Traveller Suicide & Mental Health project.
• We also offer a one to one confidential service offering
support, advice, referrals and information to
individuals, family members and other services.
• If an individual needs we can contact other services
and key workers on behalf of individuals .i.e. social
workers, probation/prison/GP’s, mental health services
etc.
• To ensure that mental health information is available
to Travellers as part of broader health checks. That
information is widely available within the community
i.e. annual fairs, markets place, soccer tournaments
and other events where Travellers meet and socialize.
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Healthy Minds
Traveller Suicide & Mental Health project.
• On-going site visit and community groups visit to build up
a working relationship with members of the Traveller
community.
• Make visit to both Prison and Hospital to offer support
and information.
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Healthy Minds
Traveller Suicide & Mental Health Project
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Some of the Issues presenting to the Traveller Healthy Minds
project are:
Addictions
People entering/exiting HSE Mental Health Services
Suicide ideation.
Impact of suicide on family/community.
Depression, anxiety and PTSD.
Homelessness
Sexuality
Abusive relationship/ Domestic violence
Impact of feuding
Sexual abuse/ impact of residing in industrial schools.
People entering/exiting prison services
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Healthy Minds
Traveller Suicide & Mental Health Project
Brief summary of activities of project
• Outreach and one to one work –It is estimated that the
project has engaged with over 500 Travellers. At least 78
Travellers have accessed the one to one supports (41 male 37
female) up to 2013. This does not include additional support to
family members on an ongoing basis. This support has covered a
wide range of issues- bereavement, addiction, unemployment,
sexuality, low self esteem and anxiety, trauma, accommodation/
homelessness, domestic violence, conflict etc. This work
includes advocacy and ongoing referrals to a range of services,.
A significant amount of advocacy has taken place with a wide
range of service
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Healthy Minds
Traveller Suicide & Mental Health Project
Survey
• “HM” Completed a survey amongst Travellers in Cork
regarding their experience of mental health and mental
health services. 77 surveys were completes 34 men and
43 women. The survey showed evidence of very positive
feedback on work of project.
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Healthy Minds
Traveller Suicide & Mental Health Project
Engagement with agencies
• Wide engagement with voluntary and statutory services
providers; to raise awareness and facilitate referrals.
New initiatives in development :intersectoral
collaboration between CAMHs (Child and Adolescent
Mental Health Services), HM, Cois Ceim/SHEP: Social
Health Education Project to support to family bereaved
by suicide.
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Healthy Minds
Traveller Suicide & Mental Health Project
A brief description of some of the work provided:
John Walsh: Traveller Mental Health Co-ordinator.
• I offer one to one support, in this I provide information on
services, an assessment that ensures that the
individuals are referred to appropriate services.
• Offer ongoing support whilst entering and exiting
services.
• I provide advocacy work, provide information, support
and act as link person when an individual is linked with
social work department, mental health services,
prison/probation etc.
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Healthy Minds
Traveller Suicide & Mental Health Project
• Develop links with services and make recommendation
on best practices on how to engage with members of the
Traveller community.
• To link in with other services/organisations to develop
policy/guidelines on how to address the mental health
needs of the Traveller community.
• To organise or provide workshops on mental health
issues to members of the Traveller community.
• To ensure that the learning from our work in Cork is
shared with Traveller organisation national, in turn to
better the response of the mental health needs of the
Traveller community in Ireland.
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Healthy Minds
Traveller Suicide & Mental Health Project
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Helen O’Sullivan- Community Health Worker
I have delivered a number of workshops such as, Being
well, Peer support training, “Let someone know "and
SafeTALK training.
I hope to receive training in “Mind your Head”. This training
will enable me and Caroline Bernard from TVG to present
mental health awareness training to young people.
I am a Safe Talker Trainer –have delivered same to settled
and Traveller Community
Going forward I would like to see some of the women in the
groups become SafeTALK trainers.
I worked on a CD project with TVG and also acted and did
the voice over in a short animation last year on mental
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health.
Healthy Minds
Traveller Suicide & Mental Health Project
Group Work
•This includes specific group work in relation to positive
health and well being, information on mental health,
facilitated discussions on issues and concerns, healthy
eating activities and development of posters and materials
promoting positive mental health. Aprox 50 Travellers
have engaged with group activities undertaken by project.
Also through the “Let someone know project” work carried
out with young women group issues identified included: –
body image, pressure of appearance, post natal
depression and bullying, group designed posters around
these themes.
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Healthy Minds
Traveller Suicide & Mental Health Project
• Some of the Traveller groups the project has engaged
with: Meelagh Traveller women’s group. Farranree
women’s group, Blackpool women’s group, Spring lane
women’s group, Spring lane men’s group, Fairhill men’s
group, Mahon women’s group St Anthony’s Park
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Healthy Minds
Traveller Suicide & Mental Health Project
• I attend the Health Meetings in TVG. This allows everyone
to give an update of the work their doing. I find it useful as it
ensures there is no duplication of anyone's work.
• Recently I have asked to shadow some of the Community
Health Care workers in TVG so I can meet with their groups
that I may not have met before and let them know more
about Healthy Minds.
• Groups I have worked with are the Faranree women’s
group, the Springlane young girls group, the Meelagh
young girls group and the Togher women’s group.
• This year I hope to work with a young girls group in both
Meelagh and Springlane again.
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HSE South, Old Library Building, St. Mary’s Road, Cork.
Phone: John: 087 7590050 or Helen: 087 7592464 or
Eleanor: 087 6599485
Email: [email protected].
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Cork Travellers’ Women’s
Network
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Our key work is in the areas of
• Cork Traveller Women’s Network is a community development
organisation run by Traveller women and working for the rights of
Traveller’s across Cork City.
• Community development & promotion of leadership for Traveller
women
• Promote Traveller Health – responding to findings of All Ireland
Traveller Health Study
• Advocacy around issued affecting Travellers particularly health and
accommodation
• Supporting local Traveller Women’s groups
• Promotion of Traveller Culture
• Promoting more equitable access to services for Travellers
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Our team:
• Voluntary management committee &
project volunteers
• Project Co-ordinator
• Outreach development workers (2)
• Development worker Meelagh project
• Project administrator
• (All staff are part time)
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Cork Travellers’ Women’s Network
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CTWN are led by the Traveller community who we engage with through
our management & through their active participation in our projects.
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The community define the issues and prioritise our work - collective
decision making & accountability
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We deliver service directly and in partnership with key agencies.
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Also support key initiatives of the Traveller Health Unit – Healthy Minds
Project, Traveller Foster care Initiative, Traveller Cultural Awareness
Training Initiative, and others
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We also advocate for social change and more equitable service
provision
• Funded by the HSE
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Traveller Visibility Group
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Background Information about the
Traveller Visibility Group (TVG)
• “The TVG is a Traveller-led Cork based
organisation, which works within the
philosophy and ethos of the National
Community Development Programme.
The TVG brings together Travellers and
settled people in solidarity, to facilitate
community development work within the
Travelling Community”.
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Background information on TVG
• The Traveller Visibility Group recognises Travellers as a
nomadic ethnic group with its own distinct culture and
lifestyle.
• We were formed in 1992 by a group of Traveller women
concerned with the issues facing Travellers in Cork.
• The absence at that time of any community development
work to facilitate Travellers in identifying and addressing
these issues was one of concern.
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Background information on TVG
• Our work is based on the findings of research we
commissioned in 1993, which was carried out by the Social
Policy and Research Unit of University College Cork. This
research was published and entitled:
“Making Travellers Visible, an account of the lived
experience of Travellers in Cork; an examination of the
services and unmet needs in Cork”.
• Our catchment area is Cork City and the suburban areas near
the city
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Mission Statement of the Traveller Visibility Group
To work with Travellers in Cork towards achieving real
change and improvement in their lives
• Principles of the TVG
• Anti-racist and anti-sexist work practices be implemented in
all programmes
• Participation, partnership and empowerment – the core
elements of community development
• Starting from where the Travellers are at and passing on skills
• Seeing the value of working through a development process
with people being as important as completing the task
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Aims of the TVG:
• Continue to promote Travellers as a nomadic ethnic group, with its
own distinctive culture and lifestyles.
• Continue to promote Traveller self-determination and empowerment
(enabling Travellers to make decisions and work in a collective way
to bring about real change in their lives).
• Continue to work for real change and improvement in Travellers’
lives including the areas of education, accommodation, health, and
employment / work and rights.
• To challenge discrimination and racism against Travellers.
• Continue to ensure the inclusion of Traveller issues and resource
the real participation of Travellers in policy decisions and practices
that affect their lives.
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Aims of TVG
• Develop a suitable, well-resourced Travellers’ Centre
and Crèche.
• Develop the TVG's management, administrative and
staff structures and procedures.
• Promote mutual understanding, acceptance and support
between Travellers and others in Irish Society
• Develop network links locally, regionally and nationally.
• Carry out research on the circumstances of Travellers in
Cork and contribute to national research, which will
inform the TVG's work
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The Team TVG consists of:
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Voluntary Broad of management
Project coordinator
Administration
Community Employment Workers
Goras Community Crèche
Drugs and Alcohol Project
Health Development Team
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Community Health programme
TVG health team consists of:
• Health Coordinator
• 3 Community Development Workers
(2 job share and 1 full time)
• 4 part-time Traveller Community Health
Workers
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Community Health Programme
Community Development workers:
• support established groups in the Traveller community
which consist of both men and women
• They provide workshops, training and activities for the
groups on an on-going basis to address their needs. This
can include the following; wood work, computing and IT
skills, committee skills, employment, workshops on
health related topics, Driver Theory sessions, cooking
etc.
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Community Health Programme.
• They also provide one to one support to
families to help address individual needs.
• They furthermore support families at Estate
Management meetings, attend subcommittees locally and regionally to
represent the TVG and the needs of the
Traveller Community. Their working role brief
is also health focused.
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Community Health Programme.
Traveller Community Health Workers are:
• from the Traveller Community and they peer support their
community to access health services.
• They are a link for services also to the community.
• They are based across the city with 2 on the North side covering St
Anthony’s Park, Springlane, Farranree/ Fairhill, The Glen, Blackpool
and Mayfield areas, and 2 on the South side covering the Straight
Rd, Meelagh, Mahon, Douglas, Hazelwood Grove, Ballincollig.
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Community Health Programme.
• They are trained in a number of health promotion areas so
they can deliver training to their community around health
related needs. These include, walking group’s facilitation,
cook it and being well programmes, sexual health, child safety
and child protection.
• They provide one to one outreach support to the community
and help individuals to access services, as well as providing
information to services about the Traveller Community.
• They also represent the TVG and the Traveller Community at
local and regional committees.
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Drugs & Alcohol Programme
• TVG Drugs projects consists of a full time Drugs
and Alcohol Support Worker and a part time CE
worker who supports the project.
• The support Worker works in conjunction with
the Local Drugs Task Force and works with
people in the Traveller Community specifically
around the issue of Drugs and Alcohol. She
provides 1 to 1 support, some group work and
also information sessions to community
services.
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Drugs and Alcohol Programme
• Ongoing support to Traveller families who
experiencing difficulties with drugs and alcohol
misused
• Build up referral cases to mainstream services.
• Provide the community with access information
on these issues
• Build up a bank of data and resource material
for the centre library
• Continue to work with the existing clients
• Build a strong subcommittee to support the
community drugs programme
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TVG Community Crèche
• The crèche team consist of Crèche Manager, Team Leader and 4
childcare assistant all who are all women from the Traveller
community support through community employment scheme
• We continued to developed and support training opportunities for
Travellers as childcare workers.
• We access equality /diversity training and Traveller culture
Awareness training for all crèche staff.
• We are opened from 9:30am to 5pm Monday to Thursday and
9:30am to 1pm Friday.
• We continue to prioritise majority of childcare places to Traveller
community we also offer a number of limited places available to the
wider community.
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Traveller Cultural Awareness Training
Initiative (TCAT)
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TCAT
• Community led training in Traveller culture and issues affecting
the community
• Aims to support culturally competent service provision and
challenge stereotypes
• Traveller women completed Training for Trainers course and
deliver bespoke sessions to key agencies
• Since late 2012, TCAT has delivered training to a wide range of
services e.g. social workers, foster care workers, speech and
language therapists etc, Gardai, council Traveller
accommodation unit, Probation, Schools etc
• Co-ordinated by Traveller orgs (incl. VTWN & TVG) supported
by the THU and HSE Health Promotion
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An overview of issues affecting the
Traveller community
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Overview
• Background to Traveller culture and
identity in Ireland
• Public Policy towards Travellers
• A snapshot of Traveller health
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Background to Travellers in
Ireland
Travellers are:
“… a small indigenous minority group that has been
part of Irish society for centuries. They have a value
system, language, customs and traditions, which make
them an identifiable group both to themselves and to
others. Their distinctive lifestyle and culture, based on a
nomadic tradition, sets them apart from the general
population.” (AITHS 2010)
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Background to Travellers in Ireland.
• 29,000 – 36,000 Travellers in ROI, 1% of
population
• 600 Traveller families in Cork city
• Travellers fare poorly on every indicator used to
measure socio-economic status: health,
accommodation, education and employment
• Travellers experience high levels of racism and
discrimination
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Background to Travellers in Ireland.
• “[Traveller] experience of low social status and exclusion,
which can prevent them from participating in society as
equals is often aggravated by hostility and misconceptions
of people towards them” (Helleiner 2000, AITHS
2010:9)
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Myths and Realities
• Travellers are not settled people pushed
off their lands during various land
clearances in the past few hundred years
• References to a group identified as similar
to present day Travellers as far back as 5th
Century BC
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Myths & Realities:
• Travellers have their own culture – key
features are: nomadism, family, the
importance of extended family, economic
activity and faith
• One cannot become a Traveller; one has
to be born into the Traveller community
• Travellers have their own language; Cant,
Gammon
• Settled Travellers versus Travellers
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Public policy towards Travellers
Assimilation Phase (1963-1983): Report of the
Commission on Itinerancy
“Travellers (Itinerants) are social misfits and deviants”
• Led by priests, social workers and teachers
• Settled people know what is best for Travellers
• Travellers should be helped conform to “normal”
way of life!
• No recognition of Travellers culture and identity or
discrimination experienced by them
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Public policy towards Travellers
Intercultural Phase (1990 – present): Report of the
Task Force on the Traveller Community (1995)
• First official report to address Traveller issues from a
human rights perspective
• Recognises the role of Traveller organisations to
participate in decision-making processes that impact
on the Traveller community
• Traveller Accommodation Act, Traveller Health
Strategy, Education Strategy
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Public policy towards Travellers
2000 Equal Status Act
• Makes discrimination illegal and names 9 legal equality
grounds (including membership of the Traveller Community)
under which a complaint of discrimination can be made
2002 Trespass Act
• Trespass on public or private land a criminal offence
• Punishable by jail sentence, fine or confiscation of property
• Travellers living on roadside are criminalised
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A snap shot of the community.
• 4 out of 10 Traveller under 15 years (compared with 2 out of 10
wider population); 6 out of 10 under 25 (compared with 3 out of 10
wider population
• Only 3% of Travellers are aged 65 years and over (compared with
13% of wider population)
• Life expectancy – Traveller men can expect to live to 62 years;15
years less than a settled Irish man (no improvements in the health of
Traveller men since 1987) – Traveller women can expect to live to
70 years;12 years less than a settled Irish woman
• Infant mortality - A Traveller baby born in Ireland is 3.6 times more
likely to die than that of a settled Irish family
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A snap shot of the community.
• Health services
• most commonly used services included: GP,
Community Welfare Officer, Dental Services,
Public Health Nurse – barriers to using health
services included: waiting, shame/
embarrassment, lack of information.
• Health Information
• 82.7% of Travellers interviewed said they got
their health information/advice from Traveller
community health workers and the Traveller
organisations
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Equality?
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On going challenges
• No ethic identifier, no consistent way of
identifying Travellers within all state services, no
real true picture of Travellers take-up of services
• Huge gap in data analysis
• Lack of real cooperation between services on a
more effective deliver of services to the
community
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On going challenges
• Lack of Traveller specific accommodation ,crisis
in private rented sector
• Uncertainty in community voluntary sector,
funding cuts . A rode back on Traveller
infrastructure .i.e.
• Traveller education has experienced a
disproportionate cut in the last numbers of years
and this has led to dismantling of direct
education supports to the community .
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Thank you for Listening:
• We now open the floor to any questions
you may have.
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