Written Statement - World Mental Health Day 2015: Celebrating improvements to mental healthcare in Wales

As we celebrate World Mental Health Day, we are also marking the third anniversary of the publication of the Welsh Government’s 10-year mental health strategy Together for Mental Health.

This statement sets out, in detail, the significant progress we have made to improve the care and support of people living with mental ill health in Wales. In highlighting some of the achievements, I also want to put on record my thanks to all those working in health and social services for their contributions to this success.

When Together for Mental Health was published in 2012, it sent out a clear message that improvements in mental health and wellbeing would only be achieved by concerted effort and commitment on behalf of the Welsh Government working with its partners.  

The strategy has been supported by a delivery plan, which sets out the detailed actions needed to improve services and outcomes. The first action in the delivery plan is designed to ensure mental wellbeing is given equal priority with physical wellbeing in the development and delivery of both policy programmes and services.

Parity of esteem with physical health, together with encouraging emotional wellbeing; providing effective services at an early stage, and ensuring people who need specialist services receive the highest quality of care and treatment, are also at the heart of the Mental Health Measure (Wales) 2010.

This unique and ground-breaking piece of legislation is central to Together for Mental Health and is the legal framework by which we will continue to improve mental health delivery in Wales. The implementation of the services required by the Measure began, on a phased basis, in January 2012, and has been supported by recurrent funding of £5m from 2012-13 onwards.  

Wales introduced waiting times for assessment and treatment by local primary mental health support services in 2012.  From April 2013 to March 2015 the all-Wales performance against our 28-day target for referral to assessment has improved from 50% to more than 80% and performance against the 56-day assessment to treatment target from 82% to 87%. From this month, we will change the 56-day target to a 28-day target to ensure people have timely access to treatment.

Mental health funding in Wales has been ring-fenced since 2008-09 to protect and enhance core services; the ring-fence was expanded in 2010-11 to include specialist services and primary care spending. It provides a floor below which expenditure on mental health services should not fall and any savings must be re-invested in mental health services.

We are committed to continuing the ring-fence and will consider carefully the recent review by PriceWaterhouseCoopers, which contains some important recommendations about how to better link investment in services with outcomes.

This year, the budget for mental health services in Wales is £587m, up from £389m in 2009-10. This equates to 11.4% of the total NHS budget – the single biggest area of NHS expenditure.

This year, I have announced extra recurrent funding of £15.6m for mental health services in Wales. This will make further improvements in a number of key areas, including child and adolescent mental health services (CAMHS) and dementia care, ensuring people who need care and support receive the right services in the right place at the right time.

Almost half – £7.6m – will be invested in CAMHS, representing an 18% increase in funding. It will be targeted at the following areas:

• £2m to develop neuro-developmental services, including ADHD and autistic spectrum disorders. A significant number of referrals to specialist CAMHS services relate to children with autism or ADHD even though they do not meet the criteria for treatment by CAMHS. This can delay access to the support they do need and access to specialist CAMHS for those who need this  service;
• £2.7m to improve out-of-hours and crisis CAMHS response; 
• £1.1m to expand access to psychological therapies for young people;
• £800,000 to improve local primary mental health support services;
• £250,000 to expand provision for children and young people in the criminal justice system;
• £800,000 to address the needs of young people who have an early onset of a severe illness, such as a psychosis. This will mean the service can support young people aged 14 to 25.

In February, I launched Together for Children and Young People, the NHS-led CAMHS service change and development programme. The Welsh Government supports this initiative and has asked Professor Dame Sue Bailey, chair of the Academy of Medical Royal Colleges, to provide advice and support.

There has been more than a 100% increase in the number of referrals to specialist CAMHS over the last four years, but a third of children referred have no mental illness, and a further third have low-level difficulties which do not reach the threshold for treatment by specialist services. Together for Children and Young People is designed to ensure CAMHS is able to properly support those children and young people with serious mental health problems who need specialist CAMHS care and develop appropriate referral systems for those children with less serious problems.

I also announced an additional £5.5m for older people’s mental healthcare from this year onwards, which includes:

• £240,000 for dementia link nurses; 
• £800,000 for 32 new primary care support workers to provide face-to-face support and information to patients and their families; 
• £4.05m for services to improve older people’s care in hospitals and develop psychiatric liaison services;
• £500,000 for occupational therapy support in older people’s mental health units to improve daily activities and quality of care. This is in direct response to the findings from the unannounced spot checks of mental health wards.

We have invested a further £1.9m to support adult talking treatments and £1.5m to improve care and outcomes for women with perinatal illnesses, their babies and families. This will be used to develop community-based services and will form an important part of the Welsh Government’s early years approach, which is linked to the tackling poverty agenda.  

A further £3m has been given to voluntary organisations to deliver mental health projects across Wales over the next three years. These organisations play a key role in supporting people with mental health problems, and the projects will provide services which will complement those delivered by the Welsh NHS and other public services.

The Welsh Government is also continuing to fund the Time to Change Wales campaign. The second phase of the campaign will raise awareness, break down myths and stereotypes, and challenge stigma and discrimination across Wales.

We are working on the development of the second Together for Mental Health delivery plan, which will cover 2016-19. The priorities, which will be subject to a public consultation, are being developed in partnership with service users, carers and stakeholders. And, for the first time, they will be mapped against the goals in the Wellbeing of the Future Generations (Wales) Act 2015.  

We are also developing a core mental health data set.  The first stage of this work, which is being jointly developed with Public Health Wales, has been piloted and it will now be tested through a phased roll-out across all health boards. We are also proud to have developed a service user perspective set of outcomes, working with service users across Wales.

We have made significant progress in improving services, care and the support available for people experiencing mental ill health in Wales over the course of the Assembly. As we develop the next Together for Mental Health delivery plan, mental health and improving outcomes for the one in four of us affected by mental ill health will continue to be a key priority for this Welsh Government.