Below follows a statement from the Gibraltar Mental Welfare Society on the Mental Health Board Report:

The GMWS welcomes the Mental Health Board report for 2023. Once again, the report provides an excellent overview of how things are working in the mental health services. We cannot cover all the many points addressed in the Report, which are all important, but would like to focus on what we consider some of the most salient matters.

We are pleased to note the ‘much improved provision’ in Gibraltar Young Minds, which deals with children and adolescents, but also echo the Board’s call for ‘a full time child psychiatrist’. Waiting times are still too long.

The fact that there is finally ‘a full complement’ of psychiatrists and psychologists is also good, as is the taking on by the GHA of two more counsellors. The Report mentions the benefits of having access to six trainee counsellors. We are very disappointed to hear therefore that the trainee counsellors placements have been cut short and ceased in May. Not only do we feel that it is crucial to employ all resources available to cut down waiting times but it is imperative too that locally trained counsellors are given the opportunity to develop and grow within our mental health system.. This decision by the GHA is incomprehensible to us. These trainee counsellors have managed to see 45 service users during the time they have been allowed to work. They would also have been able to provide this service to those in prison, if they had been allowed to do so.

Regarding Assisted Living accommodation there are only seven beds in the system, and this service is staffed by ‘untrained Medoc workers’ who depend heavily on accessing advice from CMHT as regards the necessary care of the service users they are responsible for. Moreover, Kent House, which offers two of the 5 beds available, is considered ‘not fit for purpose’ by the Board as they already stated in their previous report. The Board recommends that fully trained mental health nurses staff such facilities. An obvious requirement which the GMWS has always maintained should be the case. It also believes that there are more service users in the community who would benefit from this kind of fulltime support

 We welcome the fact that the Activities’ Coordinator in Ocean Views is ‘much more embedded in the system’ than previously, but unfortunately there is ‘no official job description or operational policy to go with the role’ which would safeguard the post, and ensure that the activities consistently take place when they’re supposed to. This needs to be put right.

The Mental Health Liaison Team is also a very positive addition to the service but the fact that the team also fulfils other roles means that they cannot always carry out their duties in this area, something which can seriously undermine their effectiveness. The Report informs that ‘there are not enough resources for all the work they do.’ This is not an acceptable state of affairs.

The report notes that there has not been a Second Opinion Doctor appointed since 2022 as required by the Mental Health Act 2016 but in her recent appearance in Parliament Minister Gemma Arias Vasquez said that this matter had already been sorted.

The Report also points out that there is no Code of practice available for staff in mental health, neither are there ‘job descriptions for either psychiatric or enrolled nurses working at the Community Mental Health Team…making the establishment of good practices and pathways difficult to implement.

A further point highlighted by the Report is the lack of an electronic data system in place which ‘would be a game changer for the system’. The Minister for Health has since said that this is also being worked on.

The report says that given the modern focus on trying to keep service users in the community and out of hospital, it is more important than ever to offer "whole person" care. In order to do this it is essential to have a good system of personalised care plans. The GMWS has campaigned for this for many years. It is a practice that should be at the heart of mental health provision so that there are clear aims and objectives for each service user in all areas, to include health, care, leisure, education, housing, training and employment. Plans which need to be periodically assessed, revised where necessary, and which are easily accessible to all relevant professionals.

Overall, what the Report seems to reflect is that although some very good initiatives have been introduced over a number of years, that the necessary resources are often not put in place to ensure that these services run smoothly and efficiently at all times. The services offered need to be consistently reliable for all service users, and not just function sporadically. The GMWS welcomes all improvements to the system but is acutely aware of the pitfalls which still exist and which need to be ironed out. It hopes that the Government will take on board the excellent recommendations in the report so that mental health services can continue to improve.

 In its concluding paragraph the Board speaks of an aspirational objective which would involve ‘the blending of mental health services and social care in Gibraltar …. the cultivation of an ecosystem where every individual is seen, supported, and strengthened and where comprehensive health needs can be more effectively acknowledged and met.’ The GMWS wholeheartedly agrees with this vision which should be at the heart of mental welfare provision.