Mental health

Overview and key messages

• According to the Mental Health Foundation (2015) in any year one in four of us experience a mental health problem, yet three quarters of people with mental health problems receive no treatment.
• Many of us will require support with respect to our mental health throughout our lives whether this is low intensity support for difficulties such as low level anxiety / depression or longer term support.
• Mental illness can develop from a number of factors including social traumas, illegal drug use and genetic predisposition. Mental health does not discriminate and can affect anyone often leading to debilitating conditions.
• Early intervention is crucial and this can take the form of providing information or referral to community or third sector services. Admissions to inpatient services may occur in extreme situations, where the individual cannot be treated in the community and presents a risk to themselves and / or others.
• It has been estimated that the economic and social costs of mental health problems in Wales is estimated to be £7billion a year (Cyhlarova, 2010).
• In 2015-16, the Welsh Government ring-fenced £587m for mental health services across Wales – up from £389m in 2009-10. Earlier this year, Government announced an additional £15m of new funding is being made available for mental health services in Wales every year.

Demographics and trends

• 1 in 4 adults experiences mental health problems or illness at some point during their lifetime
• 1 in 6 of us will be experiencing symptoms at any one time
• 2 in 100 people will have a severe mental illness such as schizophrenia or bipolar disorder at any one time
• Approximately 50% of people with enduring mental health problems will have symptoms by the time they are 14 and many at a much younger age
• Between 1 in 10 and 1 in 15 new mothers experience post-natal depression
• 9 in 10 prisoners have a diagnosable mental health and / or substance misuse problem
• In Wales the number of people detained in police custody as a place of safety under section 136 of the Mental Health Act 1983 decreased from 8,667 in 2011-12 to 6,028 in 2013-14. 2014-15 saw this figure decrease further (Mental Health Foundation, 2016)

The following graph shows the percentage of people in the 3 counties aged 16 + who are free from experiencing a common mental health disorder (2013-14) when compared to West Wales and Wales. There are some small variations when compared to the Wales percentage (74%).

Dementia in people aged less than 65 is described as early onset dementia, young onset dementia or working age dementia. It is estimated that 1 in 1000 people in Wales have early onset dementia. This figure is slightly higher in Carmarthenshire and Pembrokeshire, and slightly higher still Ceredigion.

The symptoms of dementia may be similar regardless of a person's age, but younger people often have different needs, and therefore require some different support. There is a wider range of diseases that cause early onset dementia and a younger person is much more likely to have a rarer form of dementia. However, people under 65 do not generally have the co-existing long-term medical conditions of older people – for example diseases of the heart and circulation. They are usually physically fitter and dementia may be the only serious condition that a younger person is living with (Alzheimers Society, 2015). The following chart shows the numbers of people with early onset dementia in Pembrokeshire, Ceredigion, Carmarthenshire and Wales.

Gaps and Areas for Improvement

The TMHSP programme have developed a shared vision for a modern mental health service:
 

• Improving prevention and early intervention services, alternatives to hospital services such as a safe haven, respite and transfer of care liaison services, and access to services, especially for those in crisis
• Developing an outcome focused and ‘risk-enablement’ approach to service provision to support a flexible approach
• Improving access to specific mental health welfare rights support and increased support for carers and carers need to be involved in Care and Treatment planning
• Developing 24 hour direct access to alternative provision for those in crisis where hospital admission is not the best option
• Improving service user experience and conveyancing in relation to S136 of the Mental Health Act for those detained in police custody

• Developing co-produced services and community networks to support people in building confidence and skills using peer support and/or mentoring
• Developing a flexible and responsive workforce across health and social care to successfully deliver new models of mental health service
• Addressing the lack of transport links within very rural regions, which add to the difficulty of accessible service delivery and recruitment challenges