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The Government Plan Response from Mind Jersey |
Political commitment
In October 2018, Jersey's Ministers listed improving islanders' wellbeing and mental and physical health' as one of the top five priorities for the Government of Jersey over the next four years. This public recognition of the importance of mental health is a major step forward and demonstrates how much perceptions have changed over the last few years.
At Mind Jersey, we have worked hard to build and sustain this increased attention, both nationally and in Jersey. During the 2018 election mental health was mentioned at most hustings and featured in the literature of many of the candidates. It has, undeniably, taken its rightful place on the agenda and we will ensure that is where it will stay well into the future.
We were actively involved in the development of the Mental Health Strategy where real attempts were made to engage with service users in the development of ideas and the identification of priorities. It is gratifying to recognise many of the emerging priorities have been included in the Government Plan.
One in four of Jersey's population, and one in ten of children and young people, are currently experiencing some form of mental ill health. Half of all mental health problems have been established by the age of 15, rising to 75% by the age of 24.
Mental health therefore needs this level of priority and investment as it is going to take a long time and require strong leadership to get local services and support to where they need to be. We must aim for genuine parity of esteem' for mental health alongside physical health and Mind Jersey will continue to campaign to ensure that this happens.
A joined up approach
Whilst the Government of Jersey, and Health and Community services in particular, has prime responsibility for delivering this strategy neither can do it alone nor in isolation. A new spirit of partnership and co-operation is required and Mind Jersey is committed to work constructively with the statutory services, and other partners, to implement many of these priorities.
We need to recognise that mental health is about more than health services alone. All Government departments should have one eye on wellbeing when making decisions. There's little point in investing very significant sums in health and community services – to help people when they are unwell – if, at the same time, we are not working hard to make sure that everyone has a safe place to call home and that they are supported in their places of work or in school through the promotion and maintenance of good mental health and wellbeing. It has been estimated that only a third of the people who need it actually access any kind of support; those who do don't always get what they need – there is a long way still to go.
The Government of Jersey needs to bring together a cross-governmental strategy for mental health that involves all organisations providing services to Islanders. This should include sustained investment in prevention and early interventions delivered through strategic partnership with the voluntary and community sector where there is often latent talent, experience and capacity.
Prevention and early interventions
Amongst the themes which emerged in the Mental Health Strategy was strong recognition that prevention and early interventions – and the provision of low intensity input – can make all the difference, whether in adults (18-65), older people (65+) or most obviously in relation to children and young people.
A step change in the focus on young people is required. They can be taught to understand their mental health, to look after it and to speak up as early as possible when they need help. This approach would do a lot to reduce the impact on a range of services. Sorting things out before they escalate can reduce suffering, save resources and take some of the escalating pressure off secondary services.
Mind Jersey is proud of its Youthful Minds' group which includes upwards of 30 young people, aged between 11 and 25 years, many of whom have lived experience. Together they have ensured that we keep young people in mind and have pioneered the concept of real youth participation which we believe is a model of effective service user involvement that is worthy of replication in adult and older people's services.
We have introduced a Peer Support service which continues to make a significant impact for those adults receiving and giving support. It enables people to help each other on the basis of shared experiences, empathy and mutual agreement about what might be helpful and purposeful – be it practical, social or emotional in nature.
Mind Jersey believes that the voluntary and community sector, rather than government, can often be more effective in realising this objective and we retain the hope that investment in some of our existing services (peer support, those for families and carers as well as those in support of children and young people) as well as new ones, will finally be forthcoming.
Care in the community necessitates a whole community approach
The emphasis being placed upon care in the community is laudable and to be welcomed. But this must mean that new and additional resources are committed and that real attempts are made to capitalise upon and support existing services already active in this domain.
Changing the way in which islanders can access services, with more of them being provided in the community, and addressing sometimes long waiting times should be key priorities. More still needs to be done to ensure that people can be seen quickly and that the access routes are clear, affordable and appropriate. This must mean that islanders with long term, and sometimes chronic conditions – be in for their physical or mental health –should have improved access to Primary Care services and that services such as Jersey Talking Therapies should significantly reduce their waiting times.
Mind Jersey provides a well-established and highly regarded Family and Carers service. Carers are given practical and emotional support, including representation in multi-disciplinary meetings, and have access to our educational programmes. We operate an active carers' forum that represents the voice of mental health carers and are a founder member of the Carers' Partnership group. As part of this group we helped drive the development of the Carers' strategy and we continue to campaign strongly for the introduction of a local Carers' Law.
Jersey's population is ageing and there has been a sharp increase in the number of Carers over the age of 75. It has been estimated that one in in seven islanders are currently fulfilling an unpaid caring role. It is regrettable that in the Government Plan there is no mention of the need to support carers or expressed intent to introduce a Carer's Law.
Capital investment in the short and longer term required
We welcome the acknowledgement that the mental health estate is in need of significant and urgent investment. In many service areas there are recurring and significant staff shortages; high turnover and sometimes poor morale. These difficulties are compounded by the generally poor working environment as the mental health estate has been much neglected during past decades. The interim measures outlined in the plan to improve facilities are welcomed; they are modest and will take time to implement and it is vital that the longer term service requirements are not ignored.
In the drive to provide a new hospital – and the significant capital investment that this will demand – mental health requirements must not be forgotten. They should be central to a comprehensive, overall plan, that will deliver integrated services – devoid of stigma – where physical and mental health services are given real parity.
Only when we truly accept that all areas of our lives are impacted by and can affect our mental health, and start looking at all of this as part of one picture, will we really get to grips with one of the most pressing issues of our time.