Thursday, 12 June 2014

Mental Health (Wales) Measure – how is it measuring up?

Late on Tuesday afternoon this week I tuned in to the live debate on Improving mental health and wellbeing in the Welsh Assembly’s debating chamber in the Senedd. (You can watch archive video of the debate here 2hr 52min in or read the plenary notes here, at 16.21). In the debate, Assembly Minister Janet Finch-Saunders commented:

Today’s debate on mental health looks at an issue that can affect any member of our society, from the very wealthy to those living in poverty, male or female, young or old. Our mental health is not static and it certainly does not discriminate. Those who have been well all of their lives can suddenly find that a turn of events or a change in circumstances can affect their own mental health wellbeing. It can show itself in a variety of manners, from depression or mild anxiety to post-traumatic stress disorder and/or severe psychotic problems. Minister, I have to say that probably one of the hardest jobs for me as an Assembly Member has been when someone has presented and I find them, quite literally, crying out for help, for support, and yet feeling, you know, that nothing can be done.

Health & Social Services Minister Mark Drakeford introduced the motion, which proposed that the National Assembly for Wales notes Welsh Government action to improve mental health and wellbeing in Wales. He said:

Here in Wales……. change is happening, and it is making a significant and positive difference for those whose lives are affected by mental health problems. The basis for all this is, of course, the Mental Health (Wales) Measure 2010, the Assembly’s groundbreaking legislation.

The Mental Health Measure, which became law in 2010, introduced legislation around mental health for people in Wales which is quite different to that in the rest of the UK. We highlighted 10 interesting facts about the Mental Health Measure in October 2012 and provided further information, including videos, on our website here.

But is it working?

That question is being asked both formally and informally in Powys (and all around Wales) right now. People who have been in contact with services, those close to them, and those providing the services, are being surveyed, are meeting in focus groups, and sometimes contacting politicians such as Assembly Minister Kirsty Williams to represent their views in the Senedd debates (including this one, see 17.09 in, for an update on Brecon).

We thought we would write about elements of this review process on the blog over the coming months to highlight some of the issues that are coming to the fore.

Earlier this year, in April, the Welsh Government published the findings of a review of progress made so far against the aims of the Measure as part of an early Scoping Study carried out by Opinion Research Services (conducting Research to support the Duty to review the Mental Health (Wales) Measure 2010). With regard to Care and Treatment Plans (for people receiving secondary mental health services such as seeing a psychiatrist or community psychiatric nurse) the report highlighted that: Many consultees argued that the Measure persists with a medical model of care which in practice is neither recovery nor outcome focused and which takes little account of the social care needs of service users. To make the recovery process work as embodied in the Measure, there is a need to take positive risks with service users by allowing them to lead the process. However, this requires a complete change of culture.

The Royal College of Psychiatrists had already conducted an independent review looking at the impact of the Measure from the psychiatrists’ point of view, publishing the results of their findings in late 2013. 48.5% of respondents (out of 121 – a 20% response rate for the survey overall) said they noticed a negative change in the care given to patients since the Measure was implemented. They pointed out issues including: increased workload but reduced patient care, potential risks of patients slipping through the net, early discharge of patients, and concerns regarding legal implications of increased bureaucracy.

My colleague Freda Lacey has recently been involved in some local focus group sessions in Newtown and Brecon where people have looked at their experience of changes in provision of mental health services since the Measure became law. This research is again being carried out by Opinion Research Services with Freda’s support and a short report on the focus groups will be available soon.

In the meantime, have you been in contact with mental health services? Perhaps you have attended a GP surgery and tried to access counselling via your Local Primary Mental Health Support Services (LPMHSS)? Or you may have been referred to see a Community Psychiatric Nurse who works as part of a Community Mental Health Team? Do you understand what the Measure means to you, and have you any feedback about the way it’s working? Let us know what you think by commenting below.

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