“Together for Mental Health” Q & A with Sian Richards

Mental Health Wales recently interviewed Sian Richards on a range of issues in the Government’s new mental health Strategy, “Together for Mental Health.”

Topics covered in the interview with Sian, the Welsh Government’s Mental Health and Vulnerable Group’s Strategy Lead, included: service user input, young people, carers, accountability, and how the Strategy will improve the lives of the most vulnerable people affected by serious mental illness in Wales.

Here’s what Sian said…

What were the main concerns raised by service users during the consultation period on “Together for Mental Health” and how will the Strategy help ensure these issues are addressed?

As you would expect we heard many varied views in the 17 meetings held across Wales, when people openly shared their experiences – both good and bad. Similarly we read many different issues in the range of written responses we received, nearly 300 in total.  The most common themes included: the need for service providers to create a culture and have attitudes that inspire hope and aspiration; for stigma and discrimination to be tackled in both the workforce and in the general public; and for services to address physical health as well as mental health needs.

The need for safe and secure housing was also raised time and again. This re-enforced that “Together for Mental Health” cannot just be a Strategy for health and social care services but one that the wider public sector and indeed all other sectors have to buy into.

We have ensured that all these concerns have become priority actions in the Delivery Plan.

How will “Together for Mental Health” improve the lives of the most vulnerable people affected by serious mental illness in Wales?

The service priorities in the Strategy reinforce that people should receive the right services, at the right time and in the right place, and the outcomes set high standards.  In addition, a number of the new features of this Strategy should bring improvements to people with serious mental illness.

The cross-Governmental approach means that tackling mental illness will be a priority for all Government departments not only the NHS and Social Services. It also reflects the requirements set by the Mental Health (Wales) Measure.  This means that, for example, all secondary care users will have a care co-ordinator and, wherever possible, will be partners in developing Care and Treatment Plans that reflect the life areas where they have needs.

The fact that the Strategy covers all ages means that services will be based on need, not on age boundaries, and that transitions between services, such as Children and Adolescent services (CAMHS) to adult services or adults to older age, will be better managed.

The Strategy strongly supports ‘Time to Change Wales’ which means a concerted effort to tackle the stigma and discrimination faced by people with mental illness.  The work that we are doing with Third Sector partners’ including Hafal, to develop outcomes from a service user lens means that we will be focusing on what is really important to service users. The Strategy covers mental wellbeing for everyone as well as mental illness and we will ensure that people with serious mental illness are targeted in general health promotion initiatives.

We have excellent mental health legislation in Wales however service provision across Wales is patchy. How will the Strategy help bridge this implementation gap so that users’ Care and Treatment Plans are fully maximised?

“Together for Mental Health” looks to ensure early intervention and equity of provision across Wales based on individual need.  Ensuring that all secondary care users have Care and Treatment Plans is now a statutory duty on Local Health Boards and Local Authorities.  Service users and their carers should be full partners co-producing these plans wherever possible. Embedding these requirements into the Strategy and its Delivery Plan helps to reinforce this.  The cross-Government approach will ensure that partner agencies address issues such as housing needs. 

How will the Strategy hold managers to account if mental health services for the most vulnerable people are not improved and delivered to deadline(s) over the next decade?

A Strategy cannot hold managers to account – organisations do that.  The Delivery Plan sets out clearly what will be expected, by whom and when. Implementation will be overseen by the new National Partnership Board and statutory organisations will be held to account through performance management arrangements with Welsh Government.

How will delivery of the new Strategy/Delivery Plan be performance-managed centrally, and what will happen if some areas do not deliver?

Local Health Boards will be asked to submit annual reports to the new National Partnership Board on the delivery of the Strategy in their areas.  As outlined above, performance management of statutory bodies will be through existing Welsh Government mechanisms.

The current economic climate is very harsh. What does the Strategy say about ring-fencing money for mental health services and protecting existing resources?

“Together for Mental Health” reaffirms the commitment made by the Minister for Health and Social Services to the mental health ring-fence, ensuring that mental health funding is protected in these challenging financial times.  It sets out clear expectations that Local Health Boards’ expenditure on mental health services must be open and transparent and signals a review of the effectiveness of the ring-fence.  Spending on mental health remains the largest single area of the health budget.

What issues did young people raise during the consultation period and how will the Strategy help the most vulnerable young people with serious mental illness in Wales?

Specific consultation events took place involving 80 young people with experience of mental health services, and with youth groups.  The common themes they raised were the importance of having positive supporting relationships with professionals based on trust, having the right support at the right time, wanting choice about the services they receive and confidentiality, and the need to have good transition between CAMHS and adult services.

CAMHS services are a key priority area in the Strategy and a number of key actions are included in the Delivery Plan, focussing on early years support, rapid interventions and that transition is managed more effectively.

What input did you have from carers? How will the Strategy help them, and their expertise, be recognised?

Carers were, of course, invited to the consultation events and we had some very strong input from those who attended.  Ensuring that carers were aware of their rights was the main issue raised.  We have fed this back to colleagues within Social Care leading on this area for Welsh Government and they will ensure that this is reflected in their review of the Carers Strategy.  The Strategy reinforces this issue and that Local Health Boards and Local Authorities are required to develop local Carers’ Information and Consultation Strategies this month.

How will “Together for Mental Health” help improve primary mental health services in Wales?

The Strategy has at its heart an appreciation, and understanding, of the need for people to have their mental health needs assessed as soon as possible. Having more interventions available at a primary care level will make services more accessible and help reduce stigma. Part 1 of the Measure sees the creation of Local Primary Mental Health Support Services (LPMHSS) from 1st October. These will significantly enhance the support available to people as close to their homes as possible, ensuring that skills, support and information are available in primary care to meet people’s mental health needs. LPMHSS will provide advice and evidence based short-term interventions, as well as working closely with partners to signpost people to the most appropriate services for their needs. 

On a scale of 1-10, what state do you think mental health services will be in Wales in 2022 (one being poor, 10 being outstanding)?

We must of course aim for services to score 10.  We owe this to the people we serve.

The next edition of the Mental Health Wales journal, a “Together for Mental Health Special” is due out in November.

For more information on “Together for Mental Health” please click here.

To view a video of the “Together for Mental Health” launch please click here.