The Gibraltar Mental Welfare Society has welcomed the sixth annual report of the Mental Health Board.

A statement continued: “The report aims to 'offer an objective assessment of the current landscape of services' and is thereby of crucial importance to the continued development of such services. The Report is an extensive, detailed document which offers great insight on how mental health services are functioning at the moment. Although the GMWS cannot presume to comment on all the aspects mentioned, we would like to give our own overview of some of the salient points covered, with a view to informing a wider selection of the public, than those who might read the whole Report.

“In a couple of years we hope that the new Mental Health Hub will be up and running. This Hub will deal with all aspects of the service, When this happens we hope that some of the concerns raised in the Report will no longer be relevant eg the fact that there is no appropriate office for the Mental Health Liaison Team to work from in St Bernard´s. However, in the short term, this is a matter which needs to be addressed. The Board also advises that there should be an increase in personnel and that they should receive specialized training. The team has had 912 referrals between January 24 and October 24, a number which clearly reflects the important role this team is playing in the mental health service. 

“The MHB reiterates a number of points, mentioned in past reports, which still need to be addressed in order for services to run a lot more smoothly eg it expresses concerns about the shortage of Registered Mental Health Nurses. Although the cohort of such nurses being trained presently, in the University of Gibraltar, will alleviate this problem in the long term, in the meantime the shortage still has an impact on services.

“The lack of clerical staff and of more junior posts in the service is also mentioned. This situation means that senior professionals, and staff in general, are at times tied up with administrative tasks, rather than freed up to deal directly with service users, which should be the priority.

“The Report refers to the interaction between addiction and mental health and highlights the need for safe detoxification procedures, a number of times. The Board expresses very serious concerns about the present practice of having this process take place in OV. This could involve “ high risk scenarios” which OV is not set up to handle.  This concern is echoed by staff and other professionals in the service. The GHA is urged to come up with an alternative solution.

“The Report speaks of the “ Importance of structured roles for the Activitiy Corrdinator and Housing Outreach, in Ocean Views.” Both these posts need to have a “ formal job description, operational policy [and ]succession plan for their roles” if they are to be treated with the seriousness they deserve.

“The need for the Code of Practice, a requirement under Section 106 of the Mental Health Act 2016 is also underlined.

“Another point made in previous Reports by the MHB, and in PR's by the GMWS, is the need to transition to an electronic system of note taking. Also the “ critical lack of data”,  identified  by the Head of Psychological Services in 2023, is seen as something which needs to be redressed as quickly as possible. It is essential for a service to have access to a data system which can accurately identify specific issues that can then be addressed, rather than simply respond in a “reactive” way.

“It is very disappointing to hear that four years after the retirement of the prison counsellor no therapeutic programme for prisoners has been put in place. The GMWS knows that prisoners often have serious mental health issues which need to be properly addressed by the service. 

“The lack of a smoking cessation programme in mental health facilities is also of concern, as is the need for a holistic approach to service users, who don't just have mental health problems but also general health issues which also need attention.

“Altogether, although the report does refer to numerous areas which  still need much improvement, it seems that the general trend is towards offering a much better service. The report speaks positively of Gibraltar Young Minds,  the recently implemented ASD pathways, and the closer coordination between mental health services and the care agency, for example. The improved monitoring of Clozapine and Lithium is also good news, as is the hugely increased role of the mental health Occupational Therapists.

“The GMWS is very pleased to see that the Report advocates for more beds for those who need continuous support, such as exists in Sandpits and Kent House at the moment. The Board believes, as does the GMWS, that the initial investment this would require would be be well worth it in the long term.. In the same way that the Gibraltarian community has embraced the construction of flats adapted to accommodate the elderly, so should there be different models of  housing to suit those living with serious, chronic mental health conditions.

“The GMWS believes that the MHBR is a really useful tool in assessing how our mental health service is doing, and in ensuring that progress continues to be made, It is a very valuable document for anybody interested in this aspect of our health service.”