Twin attack on Welsh services as studies cast doubts on blueprint

Mental health services in Wales have been severely criticised by two major reports in a week.

A review of adult mental health by the Wales Audit Office finds major gaps in community services, a lack of co-operation between agencies and shortages in professionals and funding.

And the Welsh assembly’s health and social care committee reports that agencies are not engaging properly with service users and their carers.

Both reports conclude that the problems threaten the success of the assembly’s National Service Framework for Mental Health and further undermine plans to implement in Wales measures in the draft Mental Health Bill.

The assembly government has made it a priority to tackle problems in community services, which are the biggest concern. It has set a target for every local health board to have a round-the-lock crisis resolution and home treatment team by April 2006, but these are in place in just nine of 22 areas so far.

The audit office report says supportive outreach and early intervention services are poorly developed, while some community mental health teams jointly run by the NHS and councils are not doing joint assessments and only two have joint team managers.

Less than half of councils have fully implemented the Care Programme Approach – a management system used to assess needs. The lack of psychiatrists and approved social workers also continues to hamper reform, says the report.

Alun Thomas, deputy chief executive of voluntary organisation Hafal, said there had been little progress since the framework was launched in 2002.

“It’s still difficult to access services and many areas don’t have the full range of community services,” he said. “It just reinforces the arguments against implementing the draft Mental Health Bill in Wales.”

The health and social care committee review finds that many users and carers thought professionals took a “tokenistic” approach to involving them in care planning, despite it being one of the underpinning standards of the framework.

“Some professionals still have the attitude that they know best what is appropriate for the user and do not recognise the expertise the patient or carer has acquired,” the report says.