This weekend, after more than three years of stalemate, Northern Ireland’s politicians returned to Stormont. Just days after the UK and Irish governments published a plan for the region under the title New Decade, New Approach, the executive resumed on Saturday, with the DUP’s Arlene Foster and Sinn Féin’s Michelle O’Neill appointed first minister and deputy first minister respectively.

The result should have been a start to a new year and new decade filled with optimism. But instead, Stormont is reopening in the midst of a public health crisis. In barely the first week of 2020, the Northern Irish community has been rocked by the news of several people who have taken their own lives. The youngest was just 11 years old.

Some 5,000 people have died by suicide in Northern Ireland in the 20 years since the Good Friday Agreement was signed, marking an end to three decades of violent sectarian conflict. Since the ceasefire, the rate of suicide has doubled, thanks to a perfect storm culmination of inter-generational trauma, an increase in drug addiction – both prescription and illegal – local services affected by austerity measures and a lack of closure and support for those affected by continued paramilitary violence. The total number of deaths now eclipses the number who died in The Troubles by almost 2,000. The growing crisis has recently led to calls from activists and politicians to declare a public health emergency in the province, with Deputy Leader of the SDLP Nichola Mallon calling for a dedicated Junior Minister dedicated to mental health and addiction.

“These past few weeks have been harrowing,” says Mallon. “I attended a vigil on Sunday night in North Belfast, and in the nine years that I’ve been an elected representative I’ve never felt fear and desperation in the community like I am feeling right now. People are terrified.”

If the same number of people were dying on the roads, she notes, “there would have been a concerted effort to coordinate and escalate a government response. We need to ask ourselves why we’re not doing more. The community is crying out for action. We need to give our young people hope.”

While young people, particularly young men, are struggling with their mental health in general, those in Northern Ireland are especially at risk. A variety of factors have combined in the north to create a perfect storm, leading to a wave of deaths.

The unique position of these young people as members of the “Ceasefire Baby” generation, a term coined by the late journalist Lyra McKee, plays a huge part. Recently published research by professor Siobhan O’Neill at the University of Ulster revealed Northern Ireland’s young people are suffering from extremely high levels of intergenerational trauma. Comparing the region to 30 other post-conflict societies, O’Neill’s research illustrated how the ripples of The Troubles continue to cause long-term problems and exacerbate risk factors leading to mental ill-health and suicide.

It’s perhaps unsurprising, then, that working class communities which bore the brunt of The Troubles and experienced high level violence and social disruption, are the same communities now being devastated by suicide. “Tragically, since I have been elected I have seen far too many suicides in my community,” says Gerry Carroll, People Before Profit MLA for West Belfast. The most deprived constituency in the UK, the area was a flashpoint for violence during years of conflict.

“Quite a high proportion of issues that we deal with in my constituency office has mental health attached to it. So whilst initially, somebody may be in contact about housing or benefits, there is very often a mental health aspect related to it. It’s so widespread that every week we are hearing of another tragedy after someone dies by suicide.”

The generation suffering mental ill-health in the greatest numbers today also grew up during the years of austerity, Carroll notes. “Research has consistently pointed to deprivation and poverty as key risk factors for mental ill-health. The persistence, therefore, of deeply embedded inequality in places like West Belfast has for sure intensified psychological suffering of people hard hit by cuts to public sector jobs and services.”

Carroll is right that austerity has affected mental health services, with 120,000 people on waiting lists and waiting times for mental health care 24 times longer than they are in England and Wales combined. Exacerbating the already dire situation is an addiction crisis in the region. Huge numbers of young people in Northern Ireland, many of them homeless and suffering from anxiety and PTSD, are turning to heroin and the powerful anti-anxiety medication Pregabalin (or “bud”) to cope. Anti-anxiety drug dependency, five times higher in Northern Ireland than anywhere else in the UK, has been directly tied to the suicide crisis.

“It’s obvious we’re at a tipping point,” says Stephen Donnan Dalzell, a Belfast-based mental health counsellor and activist. “Within the last three days I have personally lost someone, and read probably four or five more stories of people dying by suicide. I wouldn't even use the words epidemic or crisis as we have become so immune to those descriptors, I would say that we are in the middle of a mental health disaster.”

Struggling with a lack of public funding and without a functioning government, activists and charity workers like Stephen have borne the brunt of the situation for over three years. Jay Buntin is the 18-year-old co-founder of Pure Mental, an organisation set up to address the lack of mental health education in Northern Irish schools. This is despite the fact that half of all mental health issues arise by age 14, and 45,000 children in the north have been diagnosed with a mental health issue.

“Suicide is an epidemic facing NI,” says Jay. “It’s an issue that needed to be addressed decades ago, and as a result, emergency action needs to be taken to start saving these lives. We have passed the point of short term plans and fixes - we need urgent, long term solutions.”

The organisation – which aims to increase mental health awareness in schools and put pressure on Stormont to make mental health a priority – staged a protest in Belfast’s city centre last week, attended by 70 young people. Jay and Matthew also invited every NI MP and MLA to the event – but just two (Mike Nesbitt and Robbie Butler, both of the UUP) turned up. It was testament to the feeling among many young people in Northern Ireland that their government and politicians are letting them down.

“Northern Ireland has some great politicians who are dedicated to tackling the mental health epidemic. But for real improvement we need serious reforms, we need an action plan and we need legislation,” says Jay. “With Stormont collapsed, none of that has been possible. Politicians have been putting party bickering and ideological differences before the well-being of their constituents.”

The action plan charities, activists and politicians are calling for would mean the official designation of the mental health crisis as a public health emergency for the region. With that in place the newly appointed executive could co-ordinate an emergency response to the situation – diverting funds, for instance, to make sure local services are able to help vulnerable people currently stuck on waiting lists. The recognition of the current situation as an emergency would also, crucially, mean that attention and publicity would be focused on the suicide crisis. On top of opening up a crucial dialogue around mental health in the region, this would also result in more pressure and accountability addressed at politicians to tackle the crisis.

The situation is dire, but there is, at last, some cautious optimism. On Saturday the UUP’s Robin Swann was named Health Minister, and made quick work of contacting striking nurses in the province. But some are still sceptical of progress, noting that a three year political backlog could result in the suicide crisis could get lost in the deluge of legislation now finally coming before the Executive. For those currently struggling, a new Executive is little comfort.

“I want to urge people that they’re not alone,” said Nichola Mallon, reiterating calls for a public health emergency regardless of the changes at Stormont. “I want to make a plea not just an MLA but as a citizen and as a mummy, to all political parties.

“The time for talking and issuing press releases is over. We have to do something. People are dying.”