The government must be bold in developing its new mental health strategy for Wales

As the Welsh Government publishes its draft Mental Health Strategy for Wales, Sue O’Leary, Director at Mind Cymru, sets out calls for a bold successor strategy that’s fit for the complex mental health landscape

This week marks an important mental health milestone in Wales as the Welsh Government launched its new draft mental health strategy for Wales for people to feed into.

It’s the successor to a 10-year plan called Together for Mental Health – the cornerstone on which decision-making and investment centred over the past decade.

As the old strategy draws to a close, while there is always a place for reflection, we must not be under any illusion that the challenges facing Wales are starker than ever. Rarely have mental health services been so stretched, at a time when they’re needed most.

The emergent strategy must therefore set a clear vision for not only how we can improve the mental health of the nation, but also how we can strengthen protective factors by ensuring all aspects of Welsh Government policy are utilised to help deliver one progressive system for mental health in Wales.

Together for Mental Health

Together for Mental Health was a blueprint to drive forward a more socially just and mentally healthy Wales. Billed in 2013 as an age-inclusive strategy, it also factored in the legal framework set out in the Mental Health Wales Measure (2010) – a progressive, rights-based approach to mental health support in Wales. This was a widely supported vision and much of it is still as relevant today as it was 10 years ago.

There have been many notable successes that can be directly attributed to Together for Mental Health – not least improvements to perinatal mental health support, primary and crisis care. However, the world has changed hugely in the last decade, in particular since the pandemic where our lives were turned upside down and many continue to struggle to process their experiences even now.

The time is right to look at where we are and ensure we have a strategy to meet current and future needs.

The scale of the challenge

There is no doubt that we have seen increased political momentum around mental health in Wales that has helped to bolster support, but we know that there is still much to do. Currently in Wales, it is estimated that mental health problems affect around one in four people in any given year, with the pandemic and cost of living crisis worsening things for many.

Mind Cymru’s research showed that, one in four people reporting worsening depression because of the cost of living crisis. The link between poverty and mental health has never been so apparent, with more people seeking help for financial and mental health problems.

The strategy will need to both address and deliver on the ongoing challenges within the system that leaves some of us waiting for support, alongside the wider experiences that place some of us at a higher risk of experiencing poor mental health. This will take not only a response from the mental health system as a whole, but right across the support offered to our communities. Achieving this means understanding and reflecting the complexity of our lives and the variety of factors that can impact our mental health.

No one organisation or agency can solve everything, it will take greater collaboration, based on shared outcomes and resources. We are pleased to see that the draft strategy recognises this and seeks to take a truly cross governmental approach, with clear indicators to track progress.

What people with mental health problems tell us

To feed into the new strategy, Mind Cymru carried out our own consultation. We spoke to around 400 people on their priorities for the next strategy, including running focus groups to understand the efficacy of existing services.

People told us:

-Major improvements are needed in the NHS to address lengthy wait times

-The availability of expertise for complex diagnoses must be improved
-The value placed on community and voluntary sector support, providing safe spaces to talk and be listened to

-Ongoing experiences of stigma, preventing people seeking help or support

– The need to effectively address mental health inequalities.

Many participants talked about the value of services being delivered through the voluntary sector for groups more likely to struggle with their mental health, with services like community walk-ins proving a lifeline for people who may otherwise reach crisis point.

The support from peers within these communities was highly prized; talking to someone who has had a similar experience was part of the recovery process for many. For example our Mums Matter perinatal mental health programme – delivered by a number of local Minds – has helped hundreds of women experiencing poor maternal mental health to build their own support communities.

We know from our experience in Wales of delivering our national Supported Self Help programme with our network of local Minds since 2020, that self-referral is attractive to people who may not wish to approach a GP for help. The service will have supported almost 20,000 people in Wales by March this year, delivering improved mental health for 90% of participants. Sadly, we know only too well that many of these type of voluntary sector services face uncertainty or closure in the current financial climate.

Investment into these types of programmes, being delivered locally, to well-evidenced effect, must be prioritised.

Issues around equality

 We also heard issues around equality and discrimination – with people from racialised communities and those in poverty still facing additional barriers to accessing support, as well as some conditions including schizophrenia, bipolar disorder and personality disorders carrying high levels of stigma.

Positively, the draft strategy explicitly recognises that more needs to be in place to embed ways to tackle inequality, both in our communities and within the mental health system. Recognising that there are many who currently do not even get to the point of a referral. However, there is a need to go beyond identifying these experiences; we have to commit to tangible action to improve access and support, working to understand what could be done more effectively.

People also told us about the need to drive for an equal focus on support for children and young people as for adults, including that staff in schools need a better understanding of mental health. Recent studies estimate that around one in five children reports high levels of mental health symptoms in Wales. Our schools and colleges are key places for children and young people to learn about mental health, how to access support and feel safe to seek help.

Whilst Mind Cymru continues to champion improvements in support for young people, for example   through our Sort the Switch campaign – which highlighted the often-traumatic experiences of young people who transfer from child into adult services, more needs to be done to ensure timely and seamless support.

Towards a brighter future

 Perhaps the biggest learning from the previous strategy has been the need to ensure strong governance arrangements and accountabilities are in place. Alongside a transparent data and reporting system, so that progress can be tracked, these must be central to the next strategy.

The pandemic was a pivotal moment for many, drawing us together despite physically pushing us apart. There is a need to learn from what happened during those years.

Digital support options grew, which enabled people to access support when face to face support ended. However, we consistently hear that most people want a mix of online and face to face support. The new strategy has to centre on how people want to receive support, providing options that meet these needs.

 The future

It is of course impossible to set out a realistic vision for the future of mental health in Wales without recognising the context of current financial constraints. Investment must therefore be strategic and data-led, so that it can be targeted to those areas known to have the biggest impact.

We have to ensure every penny going into protecting and improving our mental health is making the biggest difference.

We need to know if people are getting better – and if not, then what would help them improve. But this can only be achieved through clearer goal-setting – short, mid and long-term – and better outcome tracking to understand what works.

An informed and ambitious plan could positively change the way Wales’ mental health system works from top to bottom, and it must detail how different departments will work together to put mental health at the heart of everything.

Now is the time for renewed momentum on mental health in Wales. The green shoots of progress from the old strategy must be nurtured to create a happy, healthy Wales for the future.

We look forward to engaging in the consultation process in the coming weeks to ensure this strategy delivers for all communities in Wales.