Wales 180Primary mental health services in Wales have made no improvement in patient outcomes since the implementation of the Mental Health (Wales) Measure in 2012, a new report has claimed.

Described as ground-breaking and passed with cross-party support, the Mental Health Measure aims to improve the treatment of people with mental health problems in Wales. Part 1 of the Measure aims to improve access to primary mental health services and improve outcomes for patients.

But the new report by Welsh mental health charity Gofal, ‘Snapshot 4: Three years on’, says that these aims have not been achieved.

The report compares data from four Wales-wide surveys of people’s experiences of primary mental health services since Part 1 of the Mental Health Measure came into force in October 2012. More than 800 people responded to each of Gofal’s annual surveys – some 3,600 people – which asked for their views and experiences of four key areas: the understanding and empathy demonstrated by primary care staff; the range of advice, treatment and support options offered to people; waiting times for assessment, treatment and support and the impact of these services on people’s mental health and wellbeing.

Gofal’s report found that, over the 4 years, there has been a general increase in the proportion of people offered alternative forms of treatment and support to prescription medication. But medication is still offered to the highest proportion of people (79%), compared to a further assessment (36%), cognitive behavioural therapy (22%), other talking therapies (32%), referral to another service (26%), signposting to another service (17%), physical activity (12%), books on prescription (10%) and befriending (3%).

A number of respondents complained that they had only been offered medication and several expressed the wish to be offered psychological therapies.

Meanwhile, waiting times appear to have improved over the past 4 years; only 35% of respondents in 2012 were able to access treatment or support within 4 weeks, but nearly 55% did so in 2015.

The survey data also showed that people tend to experience worse outcomes the longer they have to wait for treatment and support. Most comments about waiting times focused on psychological therapies, with people complaining about waiting times of over six months and others saying that they were not placed on the waiting list because it was deemed to be too long.

But the survey also found no improvement to the question ‘Did you manage to access the advice, treatment and/or support services you needed?’ since the first survey was conducted in 2012.

Respondents said that qualifying criteria, the interface between primary and secondary services, and the lack of out-of-hours provision, support for co-occurring conditions and Welsh language provision have been barriers to accessing the services they needed.

There was also no improvement in response to the question ‘Did the service lead to improved mental health and wellbeing’ since the first survey was conducted in 2012.

However, outcome data is not currently collected in a consistent manner by statutory services across Wales. As a result, Gofal admitted it had no official government or health board data to demonstrate the impact of these services on people’s mental health and wellbeing. The charity urged the Welsh Government and health boards to start collecting consistent outcome data across Wales as soon as possible.

Gofal’s chief executive, Ewan Hilton, said: “It is extremely concerning that outcomes do not appear to have improved since the implementation of Part 1 of the Mental Health (Wales) Measure. This report is evidence that we are far from ‘job done’ and the Welsh Government, health boards and local authorities must continue to resource primary mental health care and improve services. 

“It is absolutely essential that health boards and the Welsh Government start to collect consistent and transparent patient outcome data across Wales in order to determine whether this legislation is having the desired impact on people’s lives.

“Although there appears to have been improvements in the range of advice, treatment and support offered to patients, all other treatment options still trail behind the huge proportion of people offered prescription medication.

“Waiting times also appear to have improved but many survey respondents have told us that they are still waiting too long to access one-to-one psychological therapies. It is imperative that health boards and the Welsh Government start to collect waiting time data for one-to-one psychological therapies in order to shine a light and focus resources on this issue.

“We know that there are many people in health boards who are deeply committed to improving services, not least demonstrated by their funding of this latest survey. However, they need ongoing resources and support, as well as the tools to capture outcomes, act on the evidence and deliver improvements to services and outcomes.”