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Mental health service sees caseload explosion

24 Jan 2023 5 minute read
CADMHAS Advocate Kate Ross-Bowker, from Anglesey, with a client.

A mental health service that covers more than half of Wales is having to take on more staff after an increase in people suffering with severe mental health issues.

CADMHAS – the Conwy and Denbighshire Mental Health Advocacy Service – covers a vast area of north Wales and Powys and will take on 15 news staff members to help cope with its increasing case load.

The independent service deals with 1800 cases a year with a large proportion of those mainly elderly and suffering from dementia, who have no family and lack the capacity to make vital decisions on where and how they live, all on a budget of £1.2m.

Its headquarters at St Asaph Business Park is the hub for a network of trained advocates who act for vulnerable people who can struggle to make their own health and welfare decisions and have no family to step in.

Its efforts have been praised by Lynette Viney-Passig, of leading law firm Swayne Johnson, a CADMHAS board member for over ten years who said: “The service that their dedicated team provide is so important and yet so little is known about it.

“It is a testament to the quality and dedication of their work that they have grown to cover not just Conwy and Denbighshire but such a huge area of Wales and with amazing dedication.

“Without them so many of the most vulnerable people in our society would have no-one to safeguard their interests, no-one to make sure their voice is heard and their wellbeing safeguarded.”


CADMHAS Director of Services Elfed Williams now leads a team which will have grown to 48 by the end of 2023 – in 2013 there were just six with the number up to 19 last year as their services expanded to deal with a rocketing caseload.

All advocates have to gain a Level 4 advanced qualification provided by City and Guilds for a course of a minimum of 12 months, mostly taken online and CADMHAS are currently advertising for more advocates.

Elfed Williams said: “As well as people suffering from dementia, we also support people with anything from depression and anxiety up to those who have been sectioned under the Mental Health Act or have severe issues like schizophrenia or a serious brain injury.

“The majority are those have severe learning difficulties and increasingly with dementia as people live longer, but it is anything that causes them to lack or lose capacity to take care of themselves.

“We are seeing an increasing number of people being referred to us and this could also be down to Covid and the greater isolation it has imposed which has been detrimental to so many people’s mental health.

“The cost of living crisis is increasing anxiety and mental well-being has been affected by factors like the lack of medical and social services while other voluntary organisations which might have helped in the past have seen funding shrink or disappear.”

CADMHAS staff at their St Asaph headquarters, from left, Louisa Moore, Lynette Viney-Passig, Elfed Williams, Director and Kate Ross-Bowker.

Ideal place

North Wales was seen in the past as an ideal place to house young people with special needs and local authorities from across England would pay for them to be housed in residential homes across the region.

Many have been here for over 20 years but according to CADMHAS the economics of the system have changed and many local authorities are looking to save money by repatriating their former residents.

Kate Ross-Bowker, an experienced Independent Mental Capacity Advocate from Anglesey, said: “This was seen as a nice area with wide open spaces where people could be looked after in tranquil surroundings.

“But now the economics have changed and some local authorities are saying they can now look after them better themselves and more cost effectively closer to where they were brought up.

“This is where it is vital to have an advocate who can evaluate the situation and speak on behalf of the resident.

“We don’t make the final decision, but we are there to be the voice for that person who doesn’t have anyone else to speak on their behalf, we are there to fight for what we think is in their best interests.

“This doesn’t just cover where they live and how they are cared for but can cover what medical treatment they receive – there may be medical reasons for a treatment, but we also have to evaluate the personal circumstances of that person.”

Elfed Williams added: “People are often unaware of the service we provide but we need more resources because the need is growing.

“That’s especially true of dementia and because economic need is affecting people’s mental health.

“The cases we are seeing now are much more serious and much more complex than they were in the past.”

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Cathy Jones
Cathy Jones
1 year ago

Ahh that’s okay, the CMHTs have a new policy of withdrawing help for anyone diagnosed with a personality disorder so they can concentrate on convincing people that their depression is something that can be solved with a pack of tablets and ten counselling sessions… “No its fine, that your partner died in the lockdown, we stand on the precipice of WWIII, the world is on fire, all the rich people are building bunkers and you have to work seventy hours a week to be able to put the heating on for an hour a day, just have some more tablets,… Read more »

Cathy Jones
Cathy Jones
1 year ago

…ask your G.P about “S**t Life Syndrome” today!

Mab Meirion
Mab Meirion
1 year ago
Reply to  Cathy Jones

Good on you, Cathy…

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