Encouraging progress on mental health

Laura Havens is the new policy officer at mental health charity Hafal

THE year 2020 is certainly an exciting time to be joining Hafal, Wales’ leading charity for people with serious mental illness and their carers.

While politics in Wales and the UK at large remains far from predictable, at Hafal we’re encouraged by recent progress in Wales such as the Mental Health Measure (2010).

This piece of mental health legislation enshrines an individual’s right to advocacy, access to services and treatment planning.

Although we’re proud of the measure, it’s not enough.

We therefore warmly welcome the Welsh Government’s full acceptance of five of the seven recommendations recently made by the Petitions Committee report regarding changes urgently needed to improve adult mental health services in Wales.

The five points accepted by the Government are:

1. Ensuring mental health services in Wales are based on a human rights approach

2. More clarity on what a “mental health crisis” is, and a clear pathway for individuals to access crisis support;

3. Supporting healthcare professionals in being able to offer more proactive support for those experiencing a crisis;

4. Considering alternate forms of crisis support such as the crisis sanctuary model seen elsewhere in the UK;

5. A review of waiting times targets in primary and secondary mental health care. Currently there is a major discrepancy between the two.

Arguably, for mental health services in Wales to be truly grounded in a human rights approach, there should be a clear nationwide structure for how local mental health services can achieve this.

The Welsh Government’s 2012 Together for Mental Health plan goes some way in providing this road map, but steps such as a full review of the Mental Health Act and its use in Wales are also needed.

At present the target waiting time for access to psychological therapies in secondary mental health services is 26 weeks. This is too long to leave an individual struggling with mental ill health.

While those accessing services from primary care have a target wait of 28 days, so those already open to secondary services must wait almost seven times longer. We ask why this inequality exists and why it appears to disadvantage those most in need of treatment.

Rapid access to a specialist service when you need it should form part of the human rights approach for service provision, and is something Welsh Government and local health boards should prioritise.

Waiting times for secondary care should be agreed nationally to ensure equality of access. Similarly, the definition of “what constitutes a mental health crisis” should be agreed at a national level, or else access to crisis support could vary across regions of Wales with different definitions of “crisis”.

With devolution and our relatively smaller size, Wales is ideally positioned to assess and adapt the best of other nations’ services to create our own unique model that functions well for Wales.

We should therefore see this as an exciting opportunity to create a crisis support service that works for the people it serves, and not a service sometimes run as an afterthought or “overflow” for the rest of mental health and emergency services.

In this response, the Welsh Government agreed in principal only to improving access to psychological therapies, pointing to local health boards investigating their own gaps in service, and upcoming plans for a formal psychological therapy infrastructure to strengthen governance.

Although we would have liked to see a clear commitment from the Welsh Government on this, we hope local health boards will make this a priority in 2020.

At Hafal we want to see real-life, measurable improvement in mental health services, and being a service-user led charity we base our work on the feedback of those who have experienced mental health services in Wales firsthand. Knowing the value of lived experience, we would like to ask the Welsh government how they intend to measure the impact of these recommendations. Outcomes should be measured at both local health board level as well as nationwide to ensure equal access for everyone across Wales.

At Hafal we are keen to work with the Welsh Government to ensure the recommendations are translated into real-life outcomes and improvement in the lives of people in Wales.

Awareness of mental health in Wales has massively increased over recent years, allowing us to make sure the experiences and opinions of those who use mental health services are heard. Today, there is no excuse not to listen, no excuse not to act.