Mental health services

21.07.19

3 Deputy of St Martin of the Minister for Health and Social Services regarding mental

health services: (OQ.160/2021)

I am grateful to Deputy Tadier and to the Assembly for allowing this to happen. Will the Minister inform the Assembly how many positions there are in both the Adult Mental Health Service and the Child and Adolescent Mental Health Service, and how many of those positions are currently unfilled?

The Deputy of St. Ouen (The Minister for Health and Social Services): My Assistant Minister, Deputy Pointon, will take this question.

Deputy T. Pointon of St. John (Assistant Minister for Health and Social Services  -

rapporteur):

I thank the Deputy for his question. In the order it appears in the question, there are 307 full-time equivalent positions in Adult Mental Health Services. There are currently 46 vacancies, 13 of which are covered by agency staff. In the Children and Adolescent Mental Health Services there are 22 full- time equivalent positions and of these positions there is only one vacancy, a medical secretary post.

1. The Deputy of St. Martin :

I am grateful to the Assistant Minister for his answer. Does he or can he tell the Assembly what he believes to be the main reason why he has so many positions unfilled in his Adult Mental Health Services?

The Deputy of St. John :

Included in that number are 17 vacancies newly created because we are putting money into services this year. There are 8 complex trauma team vacancies, 8 crisis and home treatment team vacancies, and one administrative post dealing with mental health legislation. The remainder of the vacancies are being sent out to advertisement and we are searching for further agency staff to fill those vacancies. The problem we have is we are working in an atmosphere in which most of our staff are drawn from the United Kingdom and they themselves are having extreme difficulty recruiting staff. We are making efforts to fill the vacancies but that is a difficult process.

2. Deputy L.M.C. Doublet of St. Saviour :

Could I ask the Assistant Minister specifically about C.A.M.H.S. (Child and Adolescent Mental Health Services) please? Whether there are any new positions that are being created on top of those existing ones that are either filled or vacant at the moment?

The Deputy of St. John :

In C.A.M.H.S. we have new money this year, which has meant that we have been able to appoint 5.4 additional staff places to cover specifically ... the primary focus being on the duty and assessment service, which is assisting the increase with the increase in need. There is a focus on supporting children, families and young people in the community. So there are additional agency positions that have come into being because of the advent of COVID.

3. Deputy L.M.C. Doublet :

Does the Assistant Minister agree with me that more posts need to be created on a permanent basis specifically to address the waiting list for A.S.D. (autism spectrum disorder) assessments but also for the wider C.A.M.H.S. functionality as well?

I could not agree more and the team are looking at development of the service. For next year, 2022, there is £1.75 million allocated for development of service, and that of course will include a number of clinical posts to be able to support the facet of C.A.M.H.S. that are currently struggling.

4. Deputy G.P. Southern of St. Helier :

Could I ask the Assistant Minister whether the position he describes, with something like 16.5 per cent vacancy rate, whether that situation for adult level care is sustainable?

The Deputy of St. John :

As I say, we have 17 vacancies that are currently being recruited to. One would hope to be able to fill those vacancies. That being possible then the service should retain its sustainability.

5. Deputy G.P. Southern :

Was that answer directed at adult mental health? I thought I heard some much bigger numbers than 17, and if so would he like to respond, if he was talking about C.A.M.H.S. rather than adult mental health to my question, which was about adult mental health.

The Deputy of St. John :

Yes, I was referring to adult mental health. The overall number of vacancies is 46, 17 of those vacancies are out for advert and 13 of those vacancies that are currently filled by agency staff. We are endeavouring to fill the gaps and to create resilience within the service.

The Greffier of the States (in the Chair):

Senator Ferguson. Senator, we cannot hear you, I am afraid. I think maybe Senator Ferguson needs some technical support. If you have a question, Senator, I can make sure you are taken during questions without notice.

6. Deputy K.G. Pamplin of St. Saviour :

Can the Assistant Minister give us an update of the feedback his department are receiving on the recruitment process? We know it is a daunting challenge to get people to come to the Island for various reasons that we have explored previously together in our mental health review, but could he provide the Assembly with an update on any information he is getting on the difficulties of the recruitment campaign for those issues we have outlined?

The Deputy of St. John :

Let me give you an example. Only this morning I learned of a new consultant psychiatrist who has been appointed but he is having difficulty or will be having difficulty finding accommodation. If he were a locum psychiatrist accommodation would be found for him. We have to do something. We are having this conversation. We have to do something to ensure that people coming to the Island who have no knowledge of the Island previously are assisted with accommodation.

7. Deputy K.G. Pamplin:

I thank the Assistant Minister for his candid answer, as always. On a further note of the recruitment process, the H.R. (human resources) process is something that he will know from our time together as well, has slowed up processes. Can he give us an update on any indication on what is happening that may be delaying things there, if he is aware of any?

I am not personally involved with the H.R. process as such. But clearly if I have one report of difficulties with the introduction of individuals to posts in the Island then there are more than one, and it is significant and we have to overcome those difficulties.

8. Senator S.C. Ferguson:

I understand that there are therapeutic services being set up at Greenfields. How many children need the therapeutic services that will be offered at Greenfields?

The Greffier of the States (in the Chair):

I hate to disappoint but the question is about staff positions in Adult Mental Health Services and C.A.M.H.S.

Senator S.C. Ferguson:

I am sorry, they would not need the staff if they have not got the numbers of children. I think we are entitled to have an idea of the number of staff, the number of children that are required by so many staff being required. Perhaps the Minister could give us an idea please.

[15:15]

The Greffier of the States (in the Chair): That is a fair point.

The Deputy of St. John :

What I can say is that there is certainly no current consideration being given to setting up Greenfields as a C.A.M.H.S. in-patient unit. What is being looked at in relation to children social work is developing a therapeutic facility for looked-after children. That is not my department as such. It is that of the Children Social Work Department. I cannot really help the Senator any further with that.

9. The Deputy of St. Martin :

I thank the Minister for his answers. A 16 per cent vacancy rate is not good. I have to say that I expected that number to be higher, certainly my own personal experience is that it is higher. But I will take the Minister on his word. It makes me slightly angry to hear that we have people who could come to the Island to work for our service and it is an issue of accommodation. I would urge the Assistant Minister to try to get this Government to join up their services, because this is urgent. My final question to him is this: can you please make sure that if he is short of staff that he is exhausting every local third sector agency that he could to provide mental health services for both adults and children? I realise the Minister has got a tough job and staff are difficult to find, but can I urge him please to try to find anybody locally who can help his situation?

The Deputy of St. Ouen :

We are locally training mental health nurses and we are embarking upon a training programme for healthcare workers. It is not difficult to find - I do not use the term disparagingly - people who are in the less-skilled group. It is difficult to find fully-qualified people across the board and that is where we have most difficulty.