The Card Before You Leave

Local campaigning leads to improved service for those at risk

The Card Before You Leave scheme was initially recommended in 2005 as part of an independent review into the death of a young man called Danny McCartan.

In April 2006, frustrated by a lack of prevention and intervention from the health services, local support groups in North and West Belfast began to discuss what could be done to tackle the growing problem of suicide and self-harm in their areas. The Card Before You Leave system was a clear priority. They felt it would be a lifeline – that all those who were discharged from hospital with serious mental health and self harm problems would receive an appointment card before they left, thus maintaining their link with the services.

These local support groups took part in a development programme run by Atlantic grantee, the Participation and the Practice of Rights Project (PPR). PPR works to support communities and groups in North Belfast in using a human rights based approach to tackling inequalities and deprivation. Following the programme, the groups named themselves PIPS/Greater Shankill Bereaved Families (PIPS/GSBF) Rights Group.

Over the last four years, the PIPS/GSBF Rights Group has campaigned tirelessly for the Card Before You Leave system. In April 2007, they secured the endorsement of international human rights and medical experts for their work and the Card Before You Leave scheme.

The group presented and supplied a written submission to the NI Executive’s Health Committee as part of their Inquiry into Suicide/Self-Harm. They enlisted support from other organisations and ultimately secured a recommendation for the Card Before You Leave scheme in the Inquiry’s report. At one point, the groups were told by the Belfast Trust, the Trust responsible for the delivery of mental health services in their areas, that differing IT systems across the various Health Trusts could not be changed to introduce such an appointment system.

Finally in June 2008, the group secured a meeting with the Health Minister, Michael McGimpsey, who agreed to implement the Card Before You Leave system. However, the groups still had to lobby to be included in the Card Before You Leave Implementation Board.

Last year, the group held an event to extract learning from their long and difficult journey while trying to make one small service change, supported by statistical evidence, international experts and service users. ‘From Pillar to Post: Linking Meaningful Participation to Improved Service Delivery’. As well as sharing their experiences, the group used the event to continue to apply pressure to the Department of Health to deliver on its commitment to introduce the Card Before You Leave system. The initial deadline for implementation was April 2009.

In January 2010, some ten months later than originally promised, the Health Minister Michael McGimpsey finally launched the Card Before You Leave scheme.

View Pillar to Post event at www.youtube.com/profile?user=PPRProject#p/i/4/5SqTi4-Agss

Pictured at the launch of the Card Before You Leave Scheme are (from left) Health Minister Michael McGimpsey; Director of Adult Services (Mental health) South Eastern Trust, Desi Bannon; Belfast Mental Health Rights Group member Gerard McCartan; and PPR Project Community Development Worker Stephanie Green.