The Royal College of Psychiatrists in Northern Ireland is calling on political parties to make mental health a priority ahead of the 2027 Assembly election. Published today, the College’s Manifesto 2027, 'Stabilise Services Strengthen Staffing' sets out three key priorities to address the nation’s mental health emergency: addressing workforce shortages, improving access to care and introducing minimum unit pricing to reduce alcohol-related harm.
Mental illness is widely recognised as one of the four leading causes of ill-health and disability in Northern Ireland, alongside cardiovascular disease, respiratory disease and cancer. However, access to mental health services remains inconsistent. The College is calling for mental health to be treated equally to physical health, ensuring that everyone in Northern Ireland can access high-quality care, regardless of where they live.
The College is urging all political parties to embed mental health across their policy programmes and commit to building a sustainable, high-quality mental health system that meets the needs of everyone in Northern Ireland.
The manifesto highlights growing demand for mental health services across Northern Ireland, with the number of people waiting for an initial mental health appointment rising from around 13,500 in March 2019 to 17,500 in December 2023, an increase of almost 30%.
With persistent workforce shortages and years of chronic underinvestment in training, Northern Ireland's mental health services are at breaking point. The College is calling for urgent action to strengthen a strained workforce, tackle inequalities and ensure access to care is not determined by postcode. Around 32% of senior psychiatrist posts are currently vacant across Northern Ireland, placing the workforce under severe pressure and impacting patients, families and communities.
Despite having the highest level of mental ill health of any UK nation, Northern Ireland spends significantly less on mental health services than other parts of the UK and the Republic of Ireland. Spending is around £212 per person, compared with £264 in England, despite demand being approximately 25% higher.
Earlier this year, the College published a membership survey that highlighted the severe impact of workforce shortages and soaring workloads. It revealed that 72% of psychiatrists are considering leaving their current role amid burnout and a lack of support, while almost one in five (17%) are considering quitting within the next year.
Against this backdrop, the manifesto highlights that Northern Ireland has not seen an increase in psychiatry training places since 2007, despite critically high vacancy rates among consultant psychiatrists and specialty doctors. To help meet growing demand and secure the future sustainability of services, the College is calling for a significant expansion of psychiatry training places and investment in the mental health workforce.
The publication also calls for evidence-based action to tackle health inequalities. The College supports the introduction of minimum unit pricing for alcohol, noting that Northern Ireland has the highest rate of alcohol-specific deaths in the UK. With alcohol-specific deaths having risen significantly over the past decade, the policy could play an important role in reducing alcohol-related harm and preventing mental ill health and addiction. RCPsych in NI says investment in both prevention and treatment is essential to improve population mental health, reduce pressure on services and cut the wider economic and social costs of mental illness, which are estimated at £3.4 billion a year in Northern Ireland.
Dr Richard Wilson, Chair of the Royal College of Psychiatrists in Northern Ireland, said:
“Mental health services across Northern Ireland are under immense pressure. Demand continues to rise, waiting lists remain unacceptably long and workforce shortages are placing increasing strain on staff, patients and their families.
“To deliver safe, compassionate care, we need sustained investment in our psychiatry workforce. Addressing vacancies requires significant investment in training and a renewed focus on retention. Without this investment, we’ll continue to fall further behind in our ability to provide timely, high-quality mental health care.
"Ahead of the 2027 Assembly election, we’re calling for urgent and decisive action to address these longstanding challenges before it’s too late. The College stands ready to work with all political parties to ensure mental health is at the heart of policymaking. Our ambition is to see a stable, equitable and resilient mental health service that delivers the care patients and their families deserve."
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