More than just a new hospital is needed

The Mental Health Commissioner did not mince words in his latest annual report on the state of mental health in Malta, particularly when it comes to Mount Carmel hospital. The report acknowledged that improvements have been made in some areas but overall it still paints a bleak picture of the sector.

Commissioner John Cachia said the patients at Mount Carmel Hospital seem to be better kept, with the vast majority saying they felt they were being treated with respect and dignity and that staff were kind and caring.

But the same cannot be said for the actual building. Safety is still an issue in some wards, the report states, and investment in safety measures is sorely needed.

Apart from the safety aspect, some are in dire need of improvement in the physical environment.

The report also highlighted the fact that the smoking area in one of the wards also doubles up as a lounge and television room, with nonsmokers exposed to continual second hand smoke. Apart from the discrimination suffered by non-smokers, this point also reveals that smoking is being allowed inside the hospital, which would normally be illegal.

The Mental Health report states that there is discrimination between patients, with a system where care is very dependent on which ward or in which facility one happens

Editor’s pick

to be, and urges the standardisation of care.

Now the health ministry had taken stock of the safety situation at Mount Carmel and recently started repairs and modernisation works at the hospital – even if these works proved controversial, at least in some sections of the media.

And Health Minister Chris Fearne had revealed with this newspaper that a 150-bed acute mental health hospital was in the pipeline, besides a massive renovation project at Mount Carmel, which cannot be closed down.

But investing in infrastructure, while vital, is not enough.

The Mental Health report states that staff in the sector are doing a pretty good job but there needs to be increased investment in continued professional education so that they can offer the best possible care that is more sensitive to patient needs.

It also calls for the strengthening of patient and responsible carer empowerment, mainly through more information about their rights and forms of seeking redress. Only half of patients said that their care process had been explained to them, with an even smaller number saying they had been informed about alternate forms of treatment or medication.

The report also points out that while basic medical care is being provided, this is not being complemented by other interventions and activities which help the patient maintain or regain any lost skills. In fact, the level of organised patient activity especially during the weekend is extremely low.

The report calls for the mainstreaming of mental disorders within the health sector, adding that the mainstay of care must be community-based.

It notes that sustainable employment prospects for persons with mental disorders remain poor, and also calls for more specialised programmes for young people, including one for individuals who recur to self-harm.

Other issues are related to mental health promotion and prevention where, the report says, there are serious gaps.

So while investment in infrastructure is very badly needed, especially at Mount Carmel Hospital, there also needs to be a holistic effort in policy and programmes.

The Mental Health Commissioner, in fact, has called for a revised mental health policy, strategy and action plan reflecting the principles of the Mental Health Act and the recent trends in holistic approaches to mental health and well-being.

This, along with the urgent improvement of conditions at mental health institutions, should be among the government’s priorities.