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Mental health strategy in Wales finds itself at a crucial point

16 May 2024 6 minute read
Photo Anna Gowthorpe PA Images

Simon Stephens

Another Mental Health Awareness Week is upon us and, this year, we’re taking the opportunity to talk about the Welsh Government’s draft mental health and wellbeing strategy for Wales, as the consultation around its formation draws to a close.

This is a key moment that will mark the beginning of a new chapter for mental health in Wales. For Mind Cymru, it’s an important opportunity to ensure the best possible outcome for the estimated one in four people in Wales who will need mental health support in Wales.

Overall, the draft strategy is strong, with a good commitment to future provision. However, in focusing on countrywide strategies, we must not become too preoccupied with the national picture.

Mental health is about people
Of course, without leadership and a national commitment there would be no locally-delivered services. But at its core, mental health is about people and, as we all know from our own experiences, people and communities are nuanced. That’s why services work best when they’re supported by an appropriately financed strategy, but also anchored in their communities and driven by local need.

It’s this local commitment that’s really the driving force behind any strategy; the heart that beats for people with mental health problems. But the reality for services on the ground – particularly those being delivered by the third sector – is extremely challenging and uncertain.

We see that although charities are well sighted on the needs of their communities, they are not always equipped to respond in the way they’d like because of pressures beyond their control.

In 2021 alone, the Cranfield Trust estimates that Welsh Charities’ funding reduced by around £620m. Against this, many local support services are working tirelessly to prop up our communities.

In 2022/23, Mind’s local network of 16 charities achieved the following:

-Provided mental health support for 37,806 (a 27% increase on the previous year)
-Delivered our Supported Self-Help programme to 6,400 people, with 87% reporting in improvements in depression symptoms as a result
-363 volunteers giving more than 22,000 hours of support – a contribution worth £363,000

These figures show that the need for support services has never been higher, yet the sector – and often those people it supports – are more financially vulnerable than ever.

As an example, there was a 16% increase (on the previous year) in people accessing our Supported Self-Help service who stated they were experiencing poverty. The breadth of people needing support also increased, with a 40% increase in young people seeking help through that service while it was operational. However, once again, this demonstrably effective service has come to an end because of a lack of funding options.

Do more – or the same – but with less
Whilst it’s important not to scaremonger – we can’t shy away from highlighting the threats to the long-term sustainability of the third sector. Pressured finances across the board have meant the undermining of contract values. A ‘do more – or the same – but with less’ narrative has become the norm. Contracts are increasingly moving to a place of being considered more in terms of economic advantage than the tangible impact they are delivering, meaning local services are losing the ability to help those in their times of need, whilst contract values race to the bottom, not to mention the lack of longer-term commitments, providing uncertainty to workforce and service users alike.

Many senior leaders in our network tell us that what they’re facing is a real-terms reduction in the value of contracts, and utilising their own money to plug the gaps, as the need isn’t going away.

Yet some of the projects, often devised by and for local people, continue to be an absolute lifeline. Take a project run by Mid and North Powys Mind – Mums Matter. This eight-week early intervention programme was established in 2017 specifically for mums with mental health challenges in the perinatal period. It has helped more than 400 women and has been so effective it’s being rolled out to nine courses per year and taken up by other local Minds in Wales.

It’s helping women at their point of need and reducing pressure on primary services by providing all-important early prevention. But it wouldn’t exist if it wasn’t for the network of volunteers who’ve benefited from the programme themselves, and gone on to generously gift their time and expertise to making it a success.

Uncertain futures
Other projects making life-changing differences are facing uncertain futures, such as a rural workers support project run by Mind in Gwent. This project has helped more than 1,500 agricultural workers, including farmers – a lifeline at a time when the farming community is under more pressure than ever. As one participant simply said: “Without them I wouldn’t be here”. This is powerful yet, once again, the sad reality is that when the funding ends, these projects risk simply disappearing.

There are also wider issues at play for the third sector. The public sector financial squeeze has, naturally, meant a hyper focus on the most critical, which has seen people facing delays to assessment and intervention, despite well established and trusted third sector organisations sitting outside of the clinical settings with a track record of delivering effective support to people when they need it most.

This was the case for a young woman in Swansea, now a campaigner for Mind Cymru. Once grappling a new mental health diagnosis and at crisis point, she credits her local Mind with literally saving her life having been turned away by statutory services.

Aside the viability of existing projects, the wider general landscape for the third sector is under immense pressure. Mind and others are operating in a challenging fundraising environment – with more competition for funding than ever. The cost-of-living crisis has also seen a huge squeeze on the giving landscape, so Mind is being squeezed from all sides.

Local services have never been so valued
Clearly, local services have never been so valued. But now is an opportunity for Welsh Government and public sector partners to look at what can be done to make sure that resources are reaching the widest range of support.

The importance of preventative services and the third sector are well evidenced, and we’ll be feeding this back to Welsh Government in our consultation response. The third sector is more critical than ever, but services cannot continue on goodwill alone.

The next mental health strategy must acknowledge this, recognise the role that third sector services are playing in keeping the nation healthy, and ensure it is adequately supported to continue doing so.

Simon Stephens is Head of Networks at Mind Cymru

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