Petition number: P-05-0764

Petition title: Better mental health services for adults

We call on the National Assembly for Wales to urge the Welsh Government to improve the treatment of adults in mental health services with particular focus on improving services in the community such as CMHT, inpatient, A&E and ambulance services.

Too often the mental health services have failed adults. It is appalling to think that everyday thousands of adults are being turned away when begging for help. To be admitted to hospital and quickly reviewed by a psychiatrist and being told 'just distract yourself you'll be fine' and sent home.

I understand that there have been major cuts to these services over the last few year, but frankly it is unacceptable. There should not be a price on someone's mental health. Mental health should have the same level of care as physical health.

Why is there more support in place for children suffering from mental health? Children have support in place following hospital admissions but there’s nothing for adults. There may be promises that they will receive support from certain services but they quickly fall through. I am disgusted by the horror stories I have heard from people in the system. I have witnessed first hand the lack of care provided for adults suffering from ill mental health. This needs to change and it needs to change fast. I will no longer sit back and watch this happen.

I want to see huge changes in the way adult patients are treated and supported. All services should liaise with each other to provide the best care possible. At the moment communication is lacking between services leaving the patient without support. If emergency services are needed then there needs to be some follow up support in place for when they return home. Most services work within the hours of 9am and 5pm but mental health doesn't go away at 5pm we need more accessible after hours support. I want to see more care from staff too, they may have the training required for their position but empathy and respect is nowhere to be found. It’s time to change.                                                                                   



Policy background

Mental Health (Wales) Measure 2010

The Mental Health (Wales) Measure 2010 has aimed to secure earlier, easier access to services for people with mental health problems, and help to prevent the development of more serious symptoms. This has included:

§    establishing local primary mental health support services (LPMHSS) to improve access to mental health services within primary care settings;

§    strengthening care and treatment planning for people with mental health problems in secondary care;

§    providing adult patients with easier access back into care/treatment when they have been discharged from secondary mental health services;    

§    extending the categories of patients entitled to independent mental health advocacy.

The Measure also placed a duty on Welsh Ministers to review the operation of the Measure. The Duty to review final report was published in December 2015. The report made recommendations for amending the legislation and the way it is implemented including:

§    extending the categories of health professionals able to undertake LPMHSS assessments and become care coordinators; 

§    amending Part 3 of the Measure to allow a person of any age, or a person they specify, to request a reassessment of their mental health;

§    placing reporting requirements on health boards around patient satisfaction, outcomes, and improving awareness and understanding of services under the Measure, particularly amongst patients and GPs;

§    a working group should consider improving the form and content of care and treatment planning. It should also look at strengthening the guidance on competence to undertake care coordination and on the interface between primary and secondary care.

The Measure was also subject to post-legislative scrutiny by the Fourth Assembly’s Health and Social Care Committee (2014/15).

In his response to the Petitions Committee (dated 11 June 2017), the Cabinet Secretary for Health, Well-being and Sport highlighted a reduction in waiting times for mental health assessment and treatment.

with the introduction of the Mental Health (Wales) Measure 2010 we set targets that 80% of people should have a mental health assessment by a local primary mental health support service (LPMHSS) within 28 days of a referral. (…). In December 2016, more than 85% of people were seen for an assessment within 28 days, compared to just over 60% in December 2013. In addition, 77% of therapeutic interventions were started within 28 days following an assessment last December, compared to around 63% in December 2013.

Together for Mental Health

The Mental Health Measure underpins the Welsh Government’s 10 year strategy to improve mental health and well-being, Together for Mental Health (published in 2012). A delivery plan for 2016-2019, the second of three, was published in October 2016. The delivery plan identifies a number of priority areas, including the following re. access to, and quality of, services:

Priority area 3 – Services meet the needs of the diverse population of Wales.

Priority area 4 – People with mental health problems, their families and carers are treated with dignity and respect.

Priority area 8 – People with a mental health problem have access to appropriate and timely services. A number of goals in this area are relevant to the issues highlighted in the petition including:

§    that mental well-being is given equal priority with physical well-being in the development and delivery of services;

§    that public services and third sector work together to provide an integrated approach;

§    that there are robust links between primary care and mental health services;

§    timely and appropriate services for people who require a secure mental health setting.

Implementation of the delivery plan is to be assured through Partnership Boards at national and local levels, with progress reported publicly through annual reports produced by the Welsh Government, and local health boards/NHS Trusts’ Integrated Medium Term Plans (IMTPs).

Crisis care

The mental health charity Mind Cymru reports that there is inequality of access to mental health crisis care across Wales, with care options and hours of availability varying significantly.

The multi-agency Mental health crisis care concordat (agreed between the Welsh Government and police, NHS, local government, and voluntary sector partners) aims to improve the care and support for people experiencing, or at risk of, mental health crisis, and minimise the use of inappropriate placements (such as in police custody). The Together for Mental Health delivery plan requires all partners to ensure they are adhering to the principles of the Concordat by March 2017. (Additionally, the Policing and Crime Act 2017 amends the Mental Health Act 1983 to prohibit the use of police cells as a place of safety for people under 18 years and places new restrictions on their use for adults).



Mental Health Act 1983

The arrangements for the compulsory detention/treatment of patients with mental health problems are set out in the Mental Health Act 1983. The Mental Health Act 1983 code of practice for Wales (revised 2016) provides more information on relevant professionals’ responsibilities under the Act, and the rights of patients and their carers. This includes the right to aftercare services following discharge from hospital for example. The Mind Cymru website provides further advice on people’s rights under the Mental Health Act.

The Cabinet Secretary’s response highlighted that mental health spending in Wales is ring-fenced, and that more is spent on mental health services than any other NHS service area.

We have increased spending each year since the ring-fence was introduced, including £22 million over the last two years which includes more than £3 million a year for psychological therapies for adults. We have announced an additional £20 million this year, taking the total mental health budget for Wales to £629m, compared to £510 million in 2010-11.