Mind Cymru responds to Wales Assembly publication of key documents on adult mental health services in Wales

On 10 October 2005 the Wales Assembly Government will mark World Mental
Health Day by publishing four key documents:

* Under Pressure - report of the Risk and Quality Review of NHS Mental
Health Services (Feb 2005)
* Report on Medium Secure Services, prepared by Health Inspectorate Wales
* Revised National Service Framework for adult mental health services
* Wales Assembly Action Plan for Mental Health for further development of
mental health services

Additionally the Audit Commission in Wales will publish:
* Adult Mental Health Services in Wales: A Baseline Review of Service
Provision, Wales Audit Office

Mind Cymru welcomes the publication of these key documents, and hope that
their contents and recommendations will be influential in raising the
profile of mental health service provision in Wales on the Assembly's
agenda. However, we have reservations about the context in which they are
published, this being that there has been very little evidence of effective
progress on implementation of the NSFi standards since publication of the
NSF in 2002, as demonstrated by the findings of the Audit Commission report.
The state of mental health service provision in Wales is still woefully
inadequate, as endorsed by the Pre-Legislative Scrutiny Committee reportii
on the draft Mental Health Bill.

Despite pockets of good practice and innovation, there is still no
consistent level of service provision across Wales. We would like to see a
wider sharing of, and learning from examples of good practice, as well as a
commitment to providing sound mental health awareness training to all
personnel providing mental health care services.

There has been a significant failure to develop a working link between
health and social care provision, and NHS Regional Offices have had limited
capacity to specifically address mental health issues, despite the fact that
the NSF also sets standards around social care and community services.

Whilst the state of health service provision for people experiencing mental
distress is in need of investment and modernisation, it is also essential
that individuals with mental health problems have access to meaningful life
experiences and opportunities in the realms of work, leisure, education and
housing. Additionally, the voluntary sector is still not being actively and
meaningfully involved in service planning, commissioning, provision and
evaluation.

There is an urgent need for investment in community services, especially
developing early intervention to assist in the prevention of inappropriate
hospital admissions. This is further evidenced by the "Under Pressure"
report.

Lindsay Foyster, Director of Mind Cymru said: "Proper approaches to crisis
prevention results in considerably less stress to both service users and
service provision. The current insufficient funding for appropriate and
supportive community services is resulting in delayed transfers of care from
hospital, with many patients returning to hospital due to poor provision of
community support services. Mind Cymru wants community services to be seen
as a priority development in modernising and developing mental health
service provision in Wales."

The fact that a Mental Health Action Plan is being published must not mask
the fact that there has been significant slippage in progress on
implementing the National Service Framework, and that there is huge scope
for improvement. This will require strong commitment including clear
leadership and lines of accountability at both a local and national level
that goes beyond the bare statement that mental health is one of the
Assembly's top three health priorities.