Councillor Huw David – Leader
Councillor Jane Gebbie – Cabinet Member for Social Services & Early Help
Claire Marchant - Corporate Director Social Services & Wellbeing
Laura Kinsey – Head of Children’s Social Care
Mark Wilkinson – Group Manager, Learning Disabilities, Mental Health and Substance Misuse
Robert Goodwin – CTM UHB Service Group Manager
The Group Manager, Learning Disabilities, Mental Health and Substance Misuse introduced the report, which referred to the strategic document that they used as the point of reference which is the Mental Health Delivery Plan which was reviewed in 2019 due to the pandemic. He explained that the report contained a number of overarching themes and a number of priorities which applied to both adults and children mental health services. Those priorities guided them in how they delivered and developed the Mental Health Services in Bridgend. He advised the report moved on to an overview of the Community Mental Health Services and referred to the Operating Group, which was a group of senior managers from the Council and from Cwm Taf delivery unit which met every month to review the operating model, talk about developments in services and planning for future developments. He concluded that the report also talked about some of the work they had done with the Voluntary Sector, in particular the Wellbeing Retreat developed in 2020 particularly from mental health matters, the service had been in place for just over a year.
A Member referred to paragraphs 3.5 and 4.2 of the report where it stated the impact on mental health as a result of the pandemic had been evident during 2021, affecting the number and type of referrals to services and had almost doubled in 2021 from the level in 2020. She asked if they had an example of what the actual figures were and how many referrals they were looking at.
The Group Manager, Learning Disabilities, Mental Health and Substance Misuse explained it had doubled they thought because of the pandemic and the report gave a scale, and he could provide actual accurate figures following the meeting.
A Member referred to paragraph 4.2 and most referrals coming from the Police and asked what number of referrals they received from concerned neighbours or the public where there were aware that someone was on their own or they were concerned for them generally.
The Group Manager, Learning Disabilities, Mental Health and Substance Misuse advised that it was not a category in itself, however the Police referrals come mostly from them being called out to incidents in the community, which could have been reported by a neighbour. Once the Police had dealt with the situation, they would complete a referral form from them, but the identity of the person who contacted the police would not be shown.
The Cwm Taf Morgannwg University Health Board (CTM UHB) Service Group Manager replied that the pattern of referrals they had seen had been a growth in Tier Zero and Primary Care, but the number of people with serious mental health concerns had remained quite constant in terms of the numbers, which was evidenced by the number of people who had been detained under the Mental Health Act, which had not been significantly different to before the pandemic.
A Member commented on the alteration of the operating model to change methods of contact from face to face to phone and online contact and asked how they dealt with this as it can be difficult to ascertain how someone is feeling without seeing them, and also asked what about the digitally excluded without digital access digitally or via a telephone.
The Group Manager, Learning Disabilities, Mental Health and Substance Misuse explained that they had continued to see people but met them outside, so although regular contact with people had been done via the phone or digitally, if staff felt they were not satisfied with the phone or digital conversation and needed more information, they were able to meet following a process of risk assessment for every visit that they did and using personal protective equipment (PPE) and social distancing
A Member asked about the approach for those who appeared homeless and with mental health issues.
The Group Manager, Learning Disabilities, Mental Health and Substance Misuse advised they worked closely with the Wallich, a voluntary sector charity in Bridgend that assists homeless people. They would make a referral into mental health services it they thought it appropriate, and they would go wherever that person was and have a discussion and meet again, following a risk assessment process, using PPE and social distancing. He advised Princess of Wales Hospital had a single point of access, which provided an emergency response to people where they might be in the community, and they could either present at the hospital, or they may be brought there by the Police if on the street and in distress. There were different ways they would through their network of contacts in the Voluntary Sector and between themselves, people would be referred to the right place.
The CTM UHB Service Group Manager added that they had kept that part of their service open, which was a good service and one that was unique to Bridgend in the Health Board region. He advised it gave people some focused access to mental health services where they did not have to go through their GP or to Accident and Emergency. He continued that for people who were homeless, it was more difficult but supported by social care colleagues or people in the community, they could be referred with help.
A Member referred to paragraph 4.3 of the report, the Approved Mental Health Professional Hub which stated there had been a sharp increase in 2020, 117% from 18 to 39 people detained and an increase in the number of new people not previously known to mental health services and asked if this had led to a lack of beds or whether Covid had impacted on capacity in hospitals.
The CTM UHB Service Group Manager advised they had kept inpatient services open throughout the pandemic and had been able to admit all patients who needed to be admitted, and clinical colleagues had made decisions around planned discharge for people who they could discharge in a safe way and be supported at home, so they had been okay in terms of capacity for their inpatient units. There had been some issues around discharging people in their older people services but even there they had some spare capacity and had not been overwhelmed in the same way that other services had.
A Member referred to paragraph 4.4 in the report and the increase in the number of young people on the autistic spectrum being referred and asked how these referrals were made to the community mental health teams.
The Group Manager, Learning Disabilities, Mental Health and Substance Misuse explained that the bulk of referrals to the community mental health teams are made through the GP. So, people would go to their GP, and they would make a call on whether they refer onto a community mental health team, one of the prevention and wellbeing services or social prescribing into another service. He added that for a lot of the young people they go form child and adolescent mental health services into adult mental health services as they ASD became more apparent, as they became teenagers and young adults.
THE CTM UHB Service Group Manager explained the community mental health teams are in their secondary care service and hospital wards in the community. He advised they provide care for people with complex need and are all care coordinated so they would have an identified nurse or social worker to provide a treatment plan for them and update that with them. He advised they had been able to allocate care coordinators to all their patients who had been referred in and using the risk assessment process to maintain contact with them face to face.
A Member asked if they had seen any delays in referrals due to the potential problems with getting a GP appointment for individuals to be seen physically by their GP when they were doing online referrals.
The CTM UHB Service Group Manager advised that inevitably the pandemic had affected General Practice which impacted on the number of referrals going through the system and they were now seeing this rising quite quickly as GPs went back to a more usual way of working.
A Member asked how an individual would find out about the different groups available to them to access.
The Group Manager, Learning Disabilities, Mental Health and Substance Misuse explained that each of those groups would advertise in their own specific way and would have posters and leaflets available in the area in which they operated or in the local community centre. Workers in the assisted recovery in the Community Team and in their Wellbeing Retreat, would also all have information about how to access these services in the community. There were a number of different routes and the single points of access mentioned would also have information and be able to signpost people to services.
The CTM UHB Service Group Manager advised that they could always do more to publicise their services and how to get to them and thought well targeted posters could be helpful.
The Group Manager, Learning Disabilities, Mental Health and Substance Misuse added that there were a number of online routes as well for people who had digital access, via the Council website and the Community Coordinators had a website, but the challenge for them was to reach people without digital access and get posters, leaflets, and information in places where they were likely to see them.
The Member commented that some people may not look digitally and not realise they had a problem until they saw something that could signpost them.
The Group Manager, Learning Disabilities, Mental Health and Substance Misuse agreed that coming out the pandemic they needed to think about how to widen their range of providing information and advice.
The Cabinet Member for Social Services and Early Help advised she and the Cabinet Member for Wellbeing and Future Generations had spoken to a Special Advisor from Welsh Government and part of that discussion had been about the distribution of mental health provision and how they were going to make it more public. There was some planning work going on around that, and an opportunity for the Officers to be involved. She stated that there were not enough practitioners, and they could not appoint to positions and the importance of getting people into university taking up the qualifications to be lead practitioners. She added that they had a good provision in their schools as well, so young people were further advised in their education provision.
The Chairperson advised that there were no further questions from Members of the Committee for the Invitees for this report, thanked the Invitees for their attendance and advised that they may leave the meeting.
RESOLVED: That having regard to consideration of the content of the
report and the responses to the questions asked, the
Committee endorsed the report.