Oral - Proposed Mental Health (Wales) Measure

Yesterday, I laid the Proposed Mental Health (Wales) Measure, along with an explanatory memorandum and a written statement explaining the intentions of the proposed Measure. The National Assembly for Wales gained legislative competence in relation to the assessment of mental health and treatment of mental disorder in February. Today, less than six weeks later, I am pleased to formally introduce the Proposed Mental Health (Wales) Measure to the National Assembly.

Before moving on to the detail of the proposed Measure, I would like to extend my thanks to the range of stakeholders who have worked with my officials over the past months in helping to develop it. The input and expertise of those campaigning and service user groups, health professionals and representative bodies has directly influenced the proposed Measure before us today. So, I thank them for their hard work thus far and hope that they will continue to work with us during the formal scrutiny of the proposed Measure.

The report of the All Wales Mental Health Promotion Network, published last week, reminds us that mental health promotion and early interventions for those experiencing mental health problems can not only improve the quality of life of the individual, but may even provide economic benefits for our country as a whole. The proposed Measure recognises this and includes policy intentions that seek to provide early intervention for individuals who may be experiencing mental health problems as well as supporting the promotion and maintenance of good mental health.

The proposed Measure has five main policy intentions. First, it seeks to ensure that assessment and treatment for individuals who are or may be experiencing mental health problems is available throughout Wales at primary care level. We aim to achieve this by placing statutory duties on health boards and local authorities to deliver primary mental health support services. It is expected that these services will operate within or alongside GP practices. I will now set out what they will deliver.

There will be in-depth, focused mental health assessments for individuals who have first been seen by their GP, but for whom the GP considers a more in-depth assessment is required. Short-term interventions will also be delivered, either individually or through group work, if this has been identified as appropriate following assessment. These may include counselling, psychological interventions, cognitive behavioural therapy, and stress and anger management. Information and advice will be provided to individuals and their carers about treatment and care, as well as signposting to other sources of support, such as that provided by voluntary organisations. Also, support will be given to GPs and other primary care workers to enable them to safely manage and care for people with mental health problems. Assistance will be provided with onward referral to secondary mental health services, where this is felt to be appropriate for an individual. It is intended that these services should be available to all individuals aged 18 or over who are experiencing mild to moderate and stable severe and enduring mental health problems.

Secondly, the proposed Measure creates statutory requirements around care and treatment co-ordination and planning within secondary mental health services. Health boards and local authorities will be required to ensure that they act in a co-ordinated manner to improve the effectiveness of the mental health services that they provide to individuals. Importantly, the proposed Measure will also require that all service users aged 18 and over receiving secondary mental health services should have a care and treatment plan. These written plans will be developed by a care co-ordinator in consultation with the service user, and the delivery of the care and treatment identified in the plan will be overseen by the care co-ordinator. Plans will outline the expected outcomes of services and explain how those outcomes are to be achieved. They will be kept under review and updated to reflect changes in the type of care and treatment that may be required over time.

Thirdly, we will require mental health services to have in place arrangements to ensure the provision of timely access to assessment for previous secondary service users. This will enable individuals who have been discharged from secondary services, but subsequently believe that that their mental health is deteriorating to such a point as to require treatment again, to refer themselves back to secondary services directly, without needing to go first to their GP or elsewhere for a referral. Health boards and local authorities will be required to have arrangements in place to receive such self-referrals and to undertake timely assessments.

The fourth objective of the proposed Measure extends the group of qualifying patients under the Mental Health Act 1983 entitled to receive support from an independent mental health advocate, which means that all patients subject to the formal powers of the Act will be able to receive support from an independent advocate if they so wish. The 1983 Act currently enables patients subject to the longer term sections to receive help and support from an independent mental health advocate. However, this provision does not extend to those patients on the short-term emergency sections of the Act—sections 4, 5, 135 and 136. The proposed Measure proposes that these patients should also be entitled to support from an IMHA if they so wish.

Finally, the proposed Measure seeks to ensure that all patients receiving care and treatment for mental health problems in hospital have access to independent advocacy. Many patients receiving care and treatment in hospital for their mental health problems are not detained under the 1983 Act, but are voluntary or informal patients. These patients sometimes require help from an advocate during their stay in hospital, but such services may not always be available. This proposed Measure will create statutory duties to ensure that such help and support is available to all in-patients. The explanatory memorandum, which was published alongside the proposed Measure, goes into a much greater level of detail in relation to these proposals than my limited time allows me to do today. It also provides Members with information on the funding that I will be making available to support these initiatives. I look forward to working with Members over the coming months as scrutiny of this proposed Measure is taken forward.