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WQ.50/2018
WRITTEN QUESTION TO THE MINISTER FOR HEALTH AND SOCIAL SERVICES
BY DEPUTY G.P. SOUTHERN OF ST. HELIER
ANSWER TO BE TABLED ON TUESDAY 6th MARCH 2018
Question
"Can the Minister advise what psychiatric services his department currently makes available and whether the level of service provision has recently declined?"
Answer
Improving mental health and treating mental illness are two of Jersey's biggest public health challenges. A mental health strategy was launched in 2015, which sets out the vision for promoting mental health and preventing ill health. Significant new investment through P82 has already been made to improve, develop and expand services including, Jersey Talking Therapies, Primary Mental Health Workers working in CAMHS and Education, and the Jersey Recovery College. An increased incidence and prevalence of mental health needs has led to more people accessing mental health services. Mental health is everyone's business and addressing these issues requires a whole system approach. Psychiatric services are integrated across all services and across all ages. I can confirm there has been no reduction in service provision.
Child and Adolescent Mental Health Service – CAMHS
This service provides assessment, diagnosis and treatment for Jersey residents below the age of 18. Development work is ongoing to strengthen mental health services for those aged 16 to 25. Demand for CAMHS has steadily increased in line with more people presenting with mental health needs. The mental health strategy identified the need to respond to emotional and mental health issues early in the life of the problem and two primary mental health workers were appointed in 2016 who work across CAMHS and Education. Young people may require hospitalisation and can access inpatient services for acute mental health problems on Robin Ward or at Orchard House. There are currently two Child and Adolescent Consultant Psychiatrists based at CAMHS supported by two interim part-time Psychiatrists.
Adult Mental Health
Adult Mental Health is a service for clients between the ages of 16-65 and includes: Acute Inpatient Service
The inpatient services for working age adults with acute mental health problems requiring hospitalisation are based at Orchard House on the St Saviour's site. This is an accredited inpatient mental health service. Care is provided to people whose mental health care cannot be provided safely in the community.
The unit consists of 17 beds and provides flexible accommodation for people who need high levels of support and clinical intervention to enable recovery from acute illness. An assessment period of the mental, physical and psychological needs of the person is followed by appropriate treatment, which may be provided in either hospital or in a community setting.
The Clinical Lead for the unit is a Consultant Psychiatrist who is supported by lower grade Psychiatrists. The other 3 Consultant Psychiatrists in Adult Mental Health have input as Responsible Medical Officers for their patients. Individual support is provided by the nursing staff as well as a group therapeutic programme. Other members of the multi-disciplinary team who provide direct one to one work with patients include Occupational Therapy staff, Psychiatric Social Workers and a Consultant Psychologist. Advocacy Workers, provided through Mind Jersey, provide support for service users and their families across the directorates. They work closely with the community mental health teams to ensure that on discharge people have, when appropriate, an identified community worker and a package of care is in place.
The Acute Community Mental Health Services (Liaison Service)
The ACMHS (Jersey Adult Mental Health Services) team delivers a range of clinical interventions for service users and their families in community settings. It provides a single point of entry for all referrals into Adult Mental Health.
The service aims to provide information, screening, assessment and onward referral where appropriate for persons presenting with an acute mental health problem. The team is multi-disciplinary and provides evidence-based interventions in the least restrictive environment. An important function of the team is to act in a "gatekeeper" role.
Alcohol and Drug Service
The Alcohol and Drug Service provides a free and confidential service to those experiencing problems relating to substance misuse. A range of services is offered including detoxification at home or in hospital, substitute prescribing, counselling and support, needle exchange and training on issues relating to substance misuse.
There is Psychiatric input from Adult Mental Health with two Consultant sessions and two Staff Grade sessions weekly.
Older Adult Mental Health Services
The Older Adult Mental Health Service is part of the Specialist Services Directorate. The service consists of inpatient and community services.
Inpatient Services come under the responsibility of the Head of Older People's Services. There are 14 inpatient assessment beds (primarily for people over the age of 65 experiencing functional mental health problems, although the service is flexible in relation to younger people who have needs best met by an older adult team); 11 inpatient assessment beds (for people requiring inpatient assessment for dementia), and 37 continuing care beds (for people experiencing dementia or severe/enduring mental health needs, whose needs cannot be met within independent sector nursing or residential home provision locally due to complexity of need). Day to day general medical input on continuing care units is provided by a local GP practice commissioned by Health and Social Services, which has specific skills and knowledge in care of the older person.
The Older People's Community Mental Health Services also come under the responsibility of the Head of Older People's Services. These services include the Community Mental Health Team, the Primary Care Mental Health Team, the Memory Assessment Service and the Hospital Liaison Service. The Memory Assessment Service is accredited through the Royal College of Psychiatrists and Centre for Quality Improvement, Memory Services National Accreditation Programme (MSNAP).