The service user voice in shaping mental health policy

Abstract

Abstract Background Over the last 7 years CMH Malta provided holistic evidence for a mental health strategic framework with the regular input of patients, families, NGOs and civil society. Methods This evidence featured in published Annual Reports, conference presentations, bilateral meetings, and media interventions. The National Mental Health Strategy 2020-2030 was published in July 2019. CMH proffered advice, experience and supporting documents to the Strategy Team. 80% of the action points in the strategy reflect CMH recommendations. Results The philosophy of care should emphasise person-centred multi-disciplinary care. The primary health care system must be an effective gatekeeper providing mental health promotion and care in the community thus preventing hospital admissions. Acute psychiatric care must be provided within the acute general hospital setting with active support of A&E and 24/7 intervention services that deal promptly with emergencies. Transition of youngsters to adult psychiatry and of adults to old age psychiatry should be flexible. Community-based rehabilitation is required for Adult Psychiatry, Child/Adolescent/Youth Psychiatry, Old Age Psychiatry, Forensic Psychiatry and Learning Disability. Policymakers must provide care options for older persons with chronic mental disorders, safe settings for youngsters with severely challenging behaviour, and shelters for persons suffering from substance misuse who resist treatment or rehabilitation. Conclusions Implementation of the Mental Health Strategy requires substantial capital investment and new resources. Service re-engineering and synergy are necessary to avoid duplication and waste. Better complements of professionals must be available to provide alternative therapies to the current medical pharmacological model. Key messages Patients, families, NGOs and civil society are critical partners in strategy development. Action points and implementation plans must reflect service user views and advice.