COLUMNIST

ON May Day this year an interim report on the Independent Review of the Mental Health Act was published by the UK Government.

The review aims to make recommendations on improving legislation and practice around the outdated Mental Health Act, and specifically to understand the reasons for rising rates of detention under the Act, among other things.

Hafal, as a charity led by people with a mental illness and their carers, has been very vocal in the review process.

Our clients are mainly people with serious mental illnesses such as schizophrenia and bipolar disorder – those most likely to be subject to the Mental Health Act.

We welcomed many of the interim report’s findings, although we want to see even more engagement with service users and carers in Wales, and much more recognition of the Welsh devolved situation.

For Hafal members, the rise in detentions under the Mental Health Act has been of particular concern.

The rise has come during an age of austerity when many local authorities have replaced specialist community mental health services with generic services.

It’s easy to understand why local councils with squeezed budgets have axed specialist services – including some provided by Hafal – with generic care and “wrap-around” services. They are under pressure to cut costs and cater for the many. But the result is that a number of problems are stored up for the future.

People with a mental illness are needlessly ending up in hospital, their lives put on hold, and financially we end up paying far more for the required services and support. Everybody loses.

This becomes especially apparent in the case of young people, where early intervention and the provision of specialist community services can prevent a lifetime engaged in mental health services, and the loss of an education and future career.

The problem for local authorities, of course, is that the scale of cuts to their budgets means they must make very difficult decisions which are ultimately based on short-term outcomes.

Additionally, generic “wrap-around” services can at first appear like a good idea for the majority. They meet a number of people’s requirements, even though they don’t cater as effectively for those with more complex needs.

Our experience is that generic services can be a very poor idea for those who are the most vulnerable, such as those with a serious mental illness who have very particular and acute needs.

In an age of austerity, prioritisation is difficult, and effective service delivery is a challenge. Everyone can recognise the unprecedented pressure which is being placed on local councils.

What we call for is courage: courage to push back against the loud voices of the many to hear the voices of the vulnerable, and courage to look to the longer-term instead of satisfying shorter-term goals.

As a charity led by service users and carers, Hafal will continue to advocate strongly at both local and national level for people with a serious mental illness and their carers, and to argue vehemently for a better deal from local authorities.

Providing effective specialist mental health services in the community is one of the key ways to reducing detentions under the Mental Health Act, and we call on the Independent Review to recognise and respond to this challenge.

■ Alun Thomas, chief executive at Welsh mental health charity Hafal