8. Welsh Conservatives Debate: Community Mental Health Teams

Part of the debate – in the Senedd at 5:40 pm on 3 April 2019.

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Photo of David Rees David Rees Labour 5:40, 3 April 2019

Llywydd, I'd like to officially thank the Tories for bringing this motion forward. I agree with Darren Millar's view, and I acknowledge it. It's in the spirit of working to ensure we get the right services for some of the most vulnerable people that this debate has been put forward, and that's crucial.

Last month, I chaired the cross-party group on mental health in which the report was discussed. The following day, actually, following that meeting, I raised it in the business statement with the Trefnydd, where I sought a statement from the health Minister as to how he would respond to the report, and I was informed that perhaps by the end of the week I would get a response, and I welcome the opportunity to ask the same question again today and see if we can now actually get a response from the Welsh Government to that report, because we haven't had it yet.

Now, it's essential that people with mental health needs as well as their carers and their families—we haven't mentioned their carers and their families yet—get the best care and support possible, and it's concerning that the report by HIW and CIW that was published actually shows there are inconsistencies in care across Wales, and stresses that there's a need for vast improvement in the community health teams in order to ensure people experiencing mental health needs and their families receive the best care and support.

We are increasingly moving to a world where care back in the community is the main aim, and, if we are to achieve that, we must ensure that people do feel safe and in control when they go back into their own environment. We cannot afford to not address the key findings in this report. And the foreword says it all, really. The Member for South Wales East, Oscar, actually stated the issues about inconsistency, availability of treatment, care provided in the community—said it all, and, in fact, if you read the report, we hear the words 'variable' and 'inconsistent' so many times, and it is important that Welsh Government, health boards and local authorities need to carefully consider and examine all areas highlighted in the report and act on the recommendations so that people living with mental health illness will receive equitable care wherever they live in Wales. 

People described the service as cumbersome and difficult to navigate. They referred to a lack of understanding of different referral criteria, which meant that referrals, especially from GPs, were submitting the wrong information, leading to delays in accessing assessments and support, and, more worryingly, there were concerns expressed over access to services for people experiencing mental health crises, which Darren Millar highlighted in his opening points and in his motion. Half the people didn't actually know who to contact out of hours, and that's frightening—to think that, if someone has a mental health illness, families and carers don't know who to access to help that person. We have to address that. 

There were several questions raised in the report over the delivery of safe and effective care. Please read those words: safe and effective care for these vulnerable people. And it's already been highlighted about the lack of data, but also the involvement of family members or carers in producing the actual care plans for those individuals. The report highlighted that almost half of family members or carers weren’t involved in the discussions leading to the decisions for the community health team support to be discontinued. So, they were being discharged with over half of the family members not actually being involved in those discussions. A third said that they weren't provided with information—. Sorry. Less than a third said that they were provided with information of who to contact. That is not acceptable. If you're caring for a person with a mental health illness and you're putting them back in the community, because you're discharging them, without support, the least you can do is to ensure their family members and their carers are informed as to what action to take if a crisis arises. We need to address that if we really respect the individuals who are facing those challenges. We often in this Chamber—. Darren said—you're quite right—we often in the Chamber highlight the vulnerability of these individuals and the actions we as an Assembly should be taking to protect them, and this report is saying we're not doing that. We should, therefore, request that our Government ensure that they respond to all the recommendations in this report to ensure that those people are able to depend upon the services available via the community mental health teams and all other teams to provide the care they would expect—the care I would expect if it was me or my family.

In concluding their findings, the CIW and HIW noted:

'There is still significant improvement required across Community Mental Health services to be in a position to meet the vision set out in Together for Mental Health'.

I look forward to that coming to fruition. Minister, I do know that one of the big issues is about resource. We've been talking about talking therapies—it's about resource. Sometimes, we haven't got the resources to do that. I accept that, but we need to start developing those resources. We haven't got enough, so let's get them in place, let's do the training, let's get people to be able to deliver those services. We have to be in a position, as a nation, to support people with mental health illness to ensure that, as a community, they're not left vulnerable in their own homes.