Today the Welsh Government launched its new Mental Health Strategy “Together for Mental Health” and an initial three-year Delivery Plan.
Here we analyse what’s in the Strategy and Plan – and what it could mean for mental health services in Wales.
What’s in the Strategy and Plan?
Here’s a summary:
· The Strategy sets out the Welsh Government’s vision for 21st century mental health services and is the first mental health and wellbeing strategy for Wales covering people of all ages. The Strategy reinforces the legal framework put in place by the Mental Health Measure and its accompanying Regulations and Codes of Practice.
· The Delivery Plan sets out a three-year programme of improvement, cranking up the progress required for service delivery.
The Strategy and Plan address the following key audiences:
1. People receiving secondary mental health services. About 80% of resources for mental health go towards providing services for people who have serious illnesses such as schizophrenia and bipolar disorder and are receiving secondary services. The Strategy reinforces parts 2, 3 and 4 of the Measure which cover holistic care and treatment planning, re-accessing services and advocacy for these patients. Specifically the Strategy underpins the Measure by placing an emphasis on these two things:
· A holistic approach to care and treatment planning: the Strategy explicitly sets out expectations for each of the eight life areas which are: accommodation; education and training; finance and money; medical and other forms of treatment including psychological interventions; parenting or caring relationships; personal care and physical wellbeing; social, cultural or spiritual; and work and occupation. It supports the Measure in ensuring that a holistic approach is taken when identifying services for people with a serious mental illness by promoting care plans which identify goals in all areas of life. This places a duty on a broad range of organisations within the community to provide services to patients – from housing agencies to education providers to employment services. The Strategy and Plan stress the need for a cross-Government commitment to all sectors working together to promote mental health and wellbeing.
· An emphasis on recovery from mental illness. In the past patients have been let down by unambitious services which often maintained them as opposed to supporting them to make progress. The Strategy re-focuses services on supporting patients to recover their mental health.
2. People engaging with primary care services. The Strategy reinforces Part 1 of the Measure by aiming to improve the experience of people who go to their GP surgery for help with issues such as anxiety and depression. The Strategy emphasises that patients’ needs should be identified quickly and that they should either get help at the surgery or be swiftly referred to specialist services.
3. Everyone in Wales. Finally the Strategy strives to get people in Wales to be smart about their own wellbeing – and smart about how to respond when others get unwell.
Other key issues
These are some key points to bear in mind about the new Strategy and Plan:-
i. Note that no new money has been announced for mental health services with this Strategy. So its success depends on a better use of funding – and on focusing resources from non-mental health departments such as housing and education on people with a mental illness.
However the Strategy does reinforce the Welsh Government’s commitment to ring-fencing for mental health services in the NHS so that if any efficiency savings are made in the provision of services, or where there is a withdrawal of services, all savings are to be reinvested in mental health.
ii. The Strategy is the first mental health and wellbeing strategy covering people of all ages and it aims for a seamless transition between youth, adult and older-age services. The Strategy aims to ensure that transfers between services are based on need and not on “artificial age boundaries”.
iii. The Strategy and Plan are fairly limited in what they say about carers and families of people with a mental illness although they underline carers’ rights to a needs assessment, and the requirement for local Carers’ Information and Consultation Strategies under the Carers Strategy (Wales) Measure.
iv. There is an emphasis on providing training to Care Coordinators who will be writing the new Care and Treatment Plans with patients, which are prescribed by the Mental Health (Wales) Measure. The Plan says that training on care and treatment planning using the prescribed materials produced by Lincoln University should be delivered to all Care Co-ordinators by the end of 2013.
v. The Strategy and Plan recognise the need to ensure that there are appropriate and timely interventions for people in custody – Public Health Wales is to complete an all-Wales mental health needs assessment by April 2013 and the Welsh Government is to publish policy implementation guidance for prison mental health services by April 2013. Meanwhile Local Health Boards are asked to develop a care pathway for those who need to receive care and secure provision away from their local area by 2013.
vi. The Strategy and Plan also aim to improve in-patient environments in mental health services, ensuring care is appropriately balanced between inpatient and community services. Local Authorities, Local Health Boards and Third Sector agencies are to develop joint local strategies to reduce delays in transfers of care, and rates of admission to mental health beds including repeat admissions within 28 days, by April 2014.
vii. The Strategy identifies timely access to a range of evidence-based psychological interventions as a service delivery priority (underlining Welsh Government Policy Implementation Guidance issued earlier this year) and says that other evidence-based psychosocial, occupational and non-verbal and creative psychological therapies such as art and music therapy should be available where clinically indicated.
viii. The Delivery Plan demands more detailed plans from a variety of departments setting out how they will undertake their duty to provide services to patients. For example, Local Health Board and Local Authority staff are to develop plans for joint working and developments on housing and associated services incorporating mental health and Welsh regional library partnerships are to develop literacy action plans. This underpins the aim of the Strategy to engage of a number of departments in the delivery of services to people with a serious mental illness.
ix. The Welsh Government will establish and lead a new National Partnership Board to coordinate delivery of the Strategy across Wales which will bring together Welsh Government, statutory, Third and independent sectors, service users and carers.
What are patients saying?
Bill Walden-Jones, Chief Executive of patient and carer-led charity Hafal, said: “In the next few days we’ll be reading the Strategy closely and gauging reaction from patients and carers – which is what really matters. Our first reaction is that the Strategy is welcome and it can now be said that Wales has both a good quality legislative framework for mental health and a good quality policy for moving mental health services forward. But the jury remains out about whether we are now actually going to deliver good quality mental health services in Wales.
“I will say that the Welsh Government has to mean what it says about ring-fencing. If Local Health Boards were to play fast and loose with the accounting of ring-fencing then this Strategy and Delivery Plan won’t be delivered. The Welsh Government needs to watch this like a hawk!”
Want to know more?
In the next few weeks we will be issuing a more detailed analysis for:-
· Planners/commissioners/providers so they can see what is expected from them
· Patients and carers who can see exactly what they are entitled to.
In the meantime…
· To read the Strategy and Delivery Plan, click here.
· To keep up to date with the latest mental health news visit www.mentalhealthwales.net.