Pavee Point Traveller & Roma Centre highlighted today the urgent need for a whole of government approach to tackle racism and discrimination and build culturally appropriate services to address the Traveller mental health crisis that has been compounded by COVID-19. Pavee Point was speaking to the Oireachtas Sub Committee on Mental Health established to examine the impacts of COVID-19 on mental health.
Traveller Mental Health Worker Geraldine McDonnell told the committee about the impact of COVID-19 on Traveller mental health explaining how it had increased stress in a variety of areas and added to the Traveller mental health crisis.
Disproportionate Impact of COVID-19
“From the outset it is important to acknowledge that while COVID-19 has had, a huge impact on people globally, it has disproportionately impacted on marginalised and minority communities, including Travellers and Roma. We know that Travellers (and Roma) who get COVID-19 have higher risks of ending up in hospital, going to ICU and death compared to the general population,” she explained.
Irish Travellers experience well-documented health inequalities, severe overcrowding and lack of access to the most basic facilities.
Traveller Mental Health Crisis
“As a community, we have been identified as ‘High-Risk’ group in relation to suicide and poor mental health,’ (including frequent mental distress). We know that Travellers experience a 6 times higher suicide rate, accounting for approximately 11% of all Traveller deaths. That means 1 in every 10 Travellers die by suicide. This is unacceptable for any community, let alone my community” said Ms. McDonnell.
Stress and Fear of COVID-19
“As mental health workers in Pavee Point we have seen how COVID-19 has impacted our community and the stress it has caused. Could you, imagine the stress of living on a site? without any water? Toilets? Worrying about trying to socially distance yourself and not spreading the virus to your family? Or spreading it to our grandparents or older Traveller neighbours – most of whom are already medically vulnerable?
Home Schooling Barriers
“Added to this is the additional burden of trying to make sure our children continue with their education while often not having a formal education ourselves-lacking computer, literacy and digital skills. Most sites don’t have WIFI or the necessary internet connection. It’s hard to get space for our children to do their school work and work quietly in a crowded trailer or house.
Lack of Green Spaces
“During the lockdowns it was particularly hard for us. Most sites or group housing schemes no longer have green spaces or any recreational amenities. We’re increasingly forced to live in large ghettos on the outskirts of towns and near motorways. Where can our children safely play or where can we go for a walk when often there’s no public lighting or safe paths to walk on during the depths of winter? This, all adds to our mental stress.”
Online Hate Speech
Ms. Mc Donnell also spoke about high levels of anti-Traveller hate speech during the pandemic. “We have seen a lot of hate speech and anti-Traveller racism published on social media platforms. Imagine how all this makes us feel? You’re made feel you’re not welcome in Ireland; that you’re a second class citizen and the country would be better off without us. This affects our health and especially our mental health.”
Struggling to Cope
Ms. McDonnell also outlined how people were struggling to cope.
“We’ve seen that in order to deal with this stress, some Travellers (similar to the general population) have turned to risky behaviours including drugs and alcohol which has made the situation worse. We have witnessed the alarming numbers of Travellers self-harming and unfortunately, Traveller suicides during this time. We personally know of 2 Traveller suicide death in the past week alone.”
Tele-Mental Health Not Suitable
Similar to the general population, many Travellers did not have access to mental health services during this pandemic. Instead, tele-mental health services were deployed to bridge the gap. Pavee Point understands this approach will be mainstreamed in line with Sláintecare moving into the future. However, this approach is not suitable for the majority of Travellers given well-documented levels of low literacy among Travellers, lack of access to suitable technology and lack of privacy when living in overcrowded accommodation.
COVID-19 Legacy of Collaboration
The Oireachtas Committee heard that since the beginning of the pandemic, Traveller organisations and Traveller Primary Health Care Projects worked across the country to protect Travellers health, including mental health.
“We have seen really goodwill, support and collaboration from colleagues in the HSE and other government departments, in working with us to ensure that Traveller health concerns relating to COVID-19 are addressed in an accessible and culturally sensitive manner,” explained Ms. McDonnell.
“We are hopeful that this will become a legacy of COVID-19 as we move into the future.”
“However, what the pandemic has taught us is that we need government leadership and a long-term plan- one that is focused, strategic and resourced if we are serious about having better outcomes and protecting Travellers health.”
Pavee Point reiterated its approach to the Committee explaining how we use a community development and a holistic approach to health. Our aim is to keep Travellers well through preventative work and promoting positive mental health.
Pavee Point is committed to working with mental health services to ensure access for Travellers and that the services are culturally appropriate and intercultural.
Pavee Point made a some key recommendations to the Oireachtas Committee –
1. Urgent publication and implementation of the National Traveller Health Action Plan with no further delay.
We welcome the commitment in the Programme for Government to implement the long-awaited National Traveller Health Action Plan. Travellers and Traveller organisations participated in consultations in 2018 and three years on we’re waiting for the publication and implementation of the Plan.
We call on the Minister for Health to prioritise Traveller health within the Department and immediately publish and implement of the National Traveller Health Action Plan, including establishing a clear consultative structure to drive its implementation and monitoring; and ensure all actions in the Plan have clear targets, indicators, outcomes, timeframes and budget lines and that Traveller organisations are involved in these processes. We also need to make sure that Travellers are included in all wider health policies and services being developed.
2. Resources allocated to Traveller mental health MUST be spent on Traveller mental health work
With the exception of the appointment of nine HSE Mental Health Service Coordinator’s for Travellers and Dormant Accounts funding, there is no dedicated budget for Traveller mental health. Since the coordinator posts were funded in 2015 (recruited in 2017/18), one CHO post has never been filled at an approximate loss of €250-000- €300,000, along with the loss of resources and support for Traveller mental health.
We believe this is unacceptable, particularly given the current Traveller mental health crisis, disproportionate rates of suicide and poor mental health amongst Travellers and the absence of a dedicated budget to address this. Further, while we acknowledge the Dormant Accounts Funding from the Department of Health, it is imperative that funding is mainstreamed and that ongoing Traveller mental health work receives sustainable and ringfenced funding to respond to Traveller mental health inequalities particularly in the post COVID-19 context.
3. Ensure Traveller mental health is prioritised within the Department of Health and HSE
Traveller health structures, at both national and regional levels often lack high-level representation from the Department of Health or the HSE and as result, Traveller mental health remains marginalised. We recommend representation of HSE Mental Health Heads of Service on national and regional Traveller health structures given the documented mental health crisis our community is living with.
Traveller organisation representation on mental health implementation and monitoring structures at national and local levels (e.g.) Sharing the Vision, Local CFLs, etc. must also be prioritised. Following our presentation to the Oireachtas Committee on the Future of Mental Health Care in 2018 the Committee recommended the development of a Traveller and Roma Mental Health Action Plan and we welcome this commitment in the Programme for Government
4. Implementation of ethnic equality monitoring across all health data collection systems, including mental health.
Travellers, Roma and other minority ethnic groups are invisible in mental health policy and service provision because we aren’t being counted in official data as the State is not capturing information on ethnicity, despite being government policy. We recommend the implementation of ethnic equality monitoring, including use a standardised ethnic identifier (consistent with national census and inclusive of Roma) across all routine data administrative systems in mental health services, including the National Self-Harm Registry Ireland to monitor equality of access, participation and outcomes to suicide prevention and mental health services for Travellers, Roma and other priority groups. It is essential that the application of an ethnic identifier take place within a human rights framework.
According to the All Ireland Traveller Health Study (2010), suicide for Traveller women is 5 times higher than the general population; with 6 out of 10 (62.7%) Traveller women disclosing that their mental health was not good enough for one or more days in the last 30 days; this was compared to 1 in 5 (19.9%) women in the general population.
 https://www.hse.ie/eng/services/publications/serviceplans/service-plan-2017/operational-plans-2017/mental-health-operation-plans- 2017.pdf