P-05-1045 To make shared-decision making and monthly mental health care-plan reviews a legal requirement, Correspondence – Petitioner to Committee, 24.08.21

Additional comments in relation to Petition P-05-10 45: to make shared decision making and monthly mental health care-plan reviews a legal requirement.

In addition to previous notes given to the committee on the 01.02.2021, we wish to provide further comments in relation to the petition at hand and in response to the letter received from the Minister for Health and Social Services Vaughan Gething.

We are not satisfied with the responses from the Minister as we although it is encouraging that this issue is being investigated, we believe that without this being a legality – the issue will get swept under the carpet in day-to-day practice and be forgotten as it has previously. As stated in our first response give to the committee, the NICE guidelines are for Care and Support Plans to be reviewed monthly – however as we all know, this is a guideline. Due to the mental health services currently being so overwhelmed, this is a priority for the staff members and therefore this vital part of individual’s care is being ignored as it is not a legality. Clinicians will not prioritise this work as we can evidence.

Additionally, there has not been a specific response in relation to ensuring that patients and their families are given the opportunity to consider and put forward suggestions during the Care and Support Plan review and again for this to be a requirement. Similarly, as the overworked staff members try to complete a Care and Support Plan – the quickest and easiest way to do this is by doing it themselves and not in collaboration with the service user and their family and this is more time consuming and again, this is not being done.

I fear that without creating a formality/requirement to complete regular care-plan reviews, as well as a requirement for the comments of the service user and their family – the service users will not be given this opportunity since is it not a legality, so it is unlikely be prioritised. We believe that no matter what recommendations or guidelines are put in place – Care and Support plan reviews will not be completed with the service user and their family due to the time this will take. It is simply easier for it to be completed quickly and without consultation to save time. However, in doing this they are taking away the patient’s autonomy and their right to have a say in their treatment. Also potentially not giving the right support at the right time, resulting in the patient receiving support and care that they do not want or will not engage with – only to be bounced to a different service later, putting more strain on the services. It is about giving the right support at the right time and this can only be achieved by consulting the service user regularly and ensuring the support they are receiving is right for them, as well as hearing from their family – the ones who know them the best.

I feel further investigation and research needs to be carried out so that the Minister for Mental Health can see the sheer amount of service users who have no say at all in their care, and their wishes and requests are being ignored. Resulting in more strain on crisis services and wider. I feel the committee or those responsible need to take time to speak with service users or complete a survey to understand how often the average service user is offered a Care Plan review and how much say they and their family have on their care. This will open your eyes to just how irregular this is and why we are so passionate about making this change. The service users themselves are the ones with the knowledge and truth of their experiences, so I urge you to use them as a resource to find out just how much a change like this would mean to them.

We would also like to note, that we would be happy to meet with the committee on Zoom or wherever is convenient to discuss this further and encourage any specific questions the committee might have.

Many thanks,

Tesni Morgan