Healthy Minds

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CRSIs 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. Marys Road,
• Cork,
• Phone John 087 7590050/Helen 087 7592464
• Email John.walsh2_at_hse.ie

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(No Transcript)
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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 OReilly 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

• 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 Travellers 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 years15 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 years12 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

• 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 socio-economic 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 MindsTraveller 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 MindsTraveller 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 MindsHow 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 MindsTraveller 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/GPs, 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 MindsTraveller 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 MindsTraveller Suicide Mental Health
Project

• 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 MindsTraveller 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 MindsTraveller 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 MindsTraveller 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 MindsTraveller 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 MindsTraveller 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 MindsTraveller Suicide Mental Health
Project

• Helen OSullivan- 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 health. 

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Healthy MindsTraveller 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 MindsTraveller Suicide Mental Health
Project

• Some of the Traveller groups the project has
  engaged with Meelagh Traveller womens group.
  Farranree womens group, Blackpool womens group,
  Spring lane womens group, Spring lane mens
  group, Fairhill mens group, Mahon womens group
  St Anthonys Park

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Healthy MindsTraveller 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
  womens group, the Springlane young girls group,
  the Meelagh young girls group and the Togher
  womens 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. Marys Road,
Cork. Phone John 087 7590050 or Helen 087
7592464 or Eleanor 087 6599485 Email
john.walsh2_at_hse.ie.
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Cork Travellers Womens Network
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Our key work is in the areas of

• Cork Traveller Womens Network is a community
  development organisation run by Traveller women
  and working for the rights of Travellers 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 Womens 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 Womens Network

• CTWN are led by the Traveller community who we
  engage with through our management through
  their active participation in our projects.
• The community define the issues and prioritise
  our work - collective decision making
  accountability
• We deliver service directly and in partnership
  with key agencies.
• Also support key initiatives of the Traveller
  Health Unit Healthy Minds Project, Traveller
  Foster care Initiative, Traveller Cultural
  Awareness Training Initiative, and others
• 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
GroupTo 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

• 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 sub-committees
  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 Anthonys 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 groups 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 930am to 5pm Monday to
  Thursday and 930am 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

57
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
  20109)

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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

63
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

64
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 years15 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 years12 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

66
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

67
Equality?
68
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

69
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.