Peter Black and South Wales West Liberal Democrats

The Health, Wellbeing and Local Government Committee's Report on Mental Health Services

Peter Black: I start by endorsing David Melding's comments on the recovery model. It requires an holistic approach to services including housing, employment and support, and such an approach is not currently present in large parts of Wales, so that certainly needs to be worked on if we are to deliver that model and help people to recover from mental illness. I am also delighted to see that the emphasis of that model is on placing the sufferer at the centre of the process. So many mental illness sufferers carry poor self-esteem with it, which can be compounded by services that adhere too closely to the medical model, in which the person is not involved in choices about his or her life. That is central to the recommendations in the report in relation to that particular approach to mental illness.

I also want to refer to a number of other sections in the report. First, on the section on the black and minority ethnic community, given cultural differences, the behaviours that are acceptable in one country may be viewed entirely differently by those in the host community. While targeting mental health services directly at BME sufferers will have some effect, raising awareness among us all will prove more effective and less ghettoising in the long run. It is important that we take that lesson on board.

A number of speakers have referred to the proposal for the vice-chairs or directors of local health boards to have the responsibility for driving forward mental health services, and I know that the report is uneasy about that. It will work only if that person has the sole responsibility for driving forward mental health in the local health board. Too often, local health boards treat mental health as a lesser priority, and someone must have a clear responsibility for it that is untrammelled by other responsibilities that could distract from that focus.

The report also makes the point that the national service framework is not being delivered evenly. Paragraph 2.22 of the report makes a significant point, which does not show up in the recommendations, namely that early intervention is vital to prevent escalation. The part of the national service framework that deals with early intervention should be strengthened and resourced accordingly, particularly the funding of psychologists' posts in local health boards.

The other point that I wanted to make before moving to the main thrust of my speech is in relation to court diversion schemes, which are absolutely vital. The recommendation is important, but what is happening in England possibly goes further. The Minister of State for Care Services recently made an announcement establishing a national network of liaison and diversion services that will be up and running in five years' time. Under that proposal, staff throughout the criminal justice system will be trained to spot health problems and learning disabilities, while a diversion and liaison team will work in each court in England to assess offenders' needs. I am not entirely clear on whether that applies to the courts in Wales, and it would be useful to have some clarity on that. However, ensuring that prisoners are registered with GPs and that the process of sending psychiatric reports to court is speeded up are an important part of that.

My main concern about mental health services, and I raised it earlier in questions today and in previous Plenary meetings on child and adolescent mental health services, and the report is strong on the concerns around that service. A recent briefing document from children's charities made the point that there is a lack of consistent implementation in the delivery of CAMHS:

'Despite some targeted non-recurrent funding made available to CAMHS in Wales, we are extremely concerned that there has been a complete lack of a long-term commitment to sustainable investment. We are unaware of any fulfilment of the specific recommendation made by the independent advisory group to the Welsh Assembly Government that, based on its ten year strategic vision, £10 million per year for the first three years would be required.'

The Children's Commissioner for Wales has also consistently raised concerns about CAMHS, and has put that down to a lack of investment. In his report, he showed that children in Wales are

'the poor relations to their peers in England'.

The Deputy Presiding Officer: Order. Could you wind up, please?

Peter Black: The report from children's charities concludes on that note, saying that

'the commissioning process is unduly complicated, needs to be far more transparent and should routinely seek the views and experiences of service users and their families in developing and evaluating services'.

The point is, Minister, that ring-fencing is one thing, but we need additional resources to tackle the structural problems with CAMHS.