More to be done to improve community mental health services

(Title Image: Esquire)

The Motion (Amended/Final Version)

The Senedd:

  • Notes the thematic review of Community Mental Health Teams (pdf) and further notes the increasing number of referrals to community mental health teams across Wales.
  • Recognises the need to ensure parity between physical and mental health services.
  • Calls on the Welsh Government to continue to increase spending on mental health in real terms each year until the end of the Assembly term; ensuring arrangements are in place to respond to mental health crisis in all emergency departments; ensuring community mental health teams liaise with welfare rights services to protect vulnerable people against DWP assessments and decision making processes that can make mental health conditions worse.

A lot of common ground

Darren Millar AM (Con, Clwyd West) said there was often common ground around the Senedd chamber when it came to mental health. While there’ve been a number of debates on hospital-based and primary care services, there’s been little focus on community mental health.

A recent review (linked above) found a number of serious issues including inconsistent and variable services, problems with referrals and difficulties people have accessing community teams during a mental health crisis.

“Now, we talk a lot about the need for parity between mental and physical health services, and I think it’s absolutely right that we should have equality between those two services, to make sure that we are measuring performance against similar suites of targets. But it’s clear that here in Wales there are too many people at the moment waiting for far too long for access to talking therapies.”
– Darren Millar AM

Helen Mary Jones AM (Plaid, Mid & West Wales) said AMs would probably agree that there were serious problems with waiting time targets; people with a serious mental health problem need help immediately. There was a strong case for mental health teams to be co-located in accident & emergency departments; A&E doctors often don’t have the skills to treat people presenting with serious mental health problems or are potentially suicidal.

“Only three health boards in Wales provide crisis teams for 12 hours a day, seven days a week. In Powys, no services are available on weekends or after 5pm on weekdays….I have to raise the issue of the lack of beds for young people with high-risk mental health problems. There are only three specialist in-patient units in Wales, with 51 places. Since December, Welsh patients have been removed from Regis Healthcare in Ebbw Vale because of concerns about their safety. As a result, this leaves only 27 beds elsewhere.”
– Mohammad Asghar AM (Con, South Wales East)

Services are cumbersome and difficult to navigate

David Rees AM (Lab, Aberavon) raised the complexity and inconsistency in some services, which he said were often cumbersome and difficult to navigate. The report also raised a number of issues regarding the safety of care for some of Wales’ most vulnerable people. Less than half of the families of patients were involved in discussions on whether community support should be withdrawn and less than a third were told who to contact in the event of a crisis.

“….when I first came to this Chamber…. my colleague Jonathan Morgan sat where Nick Ramsay sits, and in the ballot for Measures at that time, he was lucky enough to win the ballot for the Mental health Measure. The Government took that Measure on themselves, and it was subsequently introduced. One of the things that Measure was trying to achieve was an end to the postcode lottery….Some 10 years later, sadly, that postcode lottery, according to the report, clearly does still exist in mental health.”
– Andrew RT Davies AM (Con, South Wales Central)

Additional support promised

While Health Minister, Vaughan Gething (Lab, Cardiff S. & Penarth) didn’t agree with everything said during the debate, it was at least thoughtful and genuine. He promised additional support:

“I can confirm that supporting community mental health teams will be a priority area in our ‘Together for Mental Health’ delivery plan….the delivery plan will also take forward the recommendations from the recent review of care and treatment planning by the NHS delivery unit. To support these improvements, we’ll target additional investment over the next financial year. That will include funding to increase the range of and access to psychological therapies, and that will build on the additional £5.5 million made available in the year just ended.”
– Health Minister, Vaughan Gething

He accepted that community mental health teams were under increased pressure due to a general increase in referrals, which in some ways was a positive as it means mental health was being taken more seriously and is better understood in society. Mental health spending will continue to be ring-fenced and £679million will be spent in total on mental health in 2019-20.

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