Tuesday, 22 November 2011

Landmark Moment



Time to reflect on the great news that mental health service users in Wales have won the legal right to holistic care plans. Years of campaigning by service users and carers have resulted in new Regulations which give patients in Wales the right to a Care and Treatment Plan covering all areas of life.

The new rights to holistic care planning have been set out in the Regulations for the Mental Health (Wales) Measure which were laid before the Assembly two weeks ago. The Regulations, which cover Care Coordination and Care and Treatment Planning, set out what professionals must do in order to deliver the new Welsh mental health law which comes into effect in 2012. The Regulations are now subject to the approval of the National Assembly on 29th November.

As Dave Smith, Hafal's Expert Patient Trainer, explains:

"The Regulations prescribe a comprehensive Care and Treatment Plan which covers eight areas of life, and they are accompanied by a template which clearly provides a space to address each of these important aspects of recovery in a holistic way.

"This has the potential to transform the service provided to people with a serious mental illness in Wales. It means that all secondary mental health service users will have a legal right to a Plan with spaces for all areas of life to be addressed ensuring that important issues such as accommodation, employment and physical health are covered in their Plans.

"Hafal Members have campaigned for years for the legal right to a comprehensive Plan so to have such a Plan prescribed in law is a massive victory. It’s truly a landmark moment for service users in Wales."

A reminder of the eight "life areas" to be covered in Care and Treatment Plans...

a) accommodation

b) education and training

c) finance and money

d) medical and other forms of treatment, including psychological interventions

e) parenting or caring relationships

f) personal care and physical well-being

g) social, cultural or spiritual

h) work and occupation.


Hafal’s Members pioneered this methodical, holistic approach to recovery from serious mental illness which was based on the experiences of hundreds of people and we published our methodology six years ago. This holistic approach was then rolled out through Hafal’s projects across Wales, resulting in remarkable recovery successes for Hafal’s clients.

Following the organisation’s adoption of the recovery model Hafal’s Members continued to campaign for the adoption of this model across Wales for all secondary mental health service users, and successfully lobbied for the creation of a mental health law in Wales.

The Assembly Member who initiated the new mental health legislation, Jonathan Morgan, said that the most convincing evidence for reform came from listening to the story of service user and Hafal Recovery Practitioner Lee McCabe. More recently, speaking about the Regulations, Lee commented:

"When the Regulations were published in draft it wasn’t made clear that the Care and Treatment Plan would need to include space to address all the eight life areas. Hafal launched a massive user-led campaign which was supported by hundreds of service users and carers across Wales to ensure that the eight areas are clearly given space in the Plans. We are very pleased the Government has listened to our standpoint and amended the Regulations to give proper prominence to the eight life areas."

It is to the credit of the Welsh Government that they listened to Hafal’s Members when we called for a Welsh law and latterly that they took on board the need to include the eight life areas explicitly in Care and Treatment Plans.

The next step is to achieve a robust Code of Practice which prescribes in more detail how health professionals will deliver the Measure; the first draft was published last month and service users feel that it needs to be improved to ensure that the eight areas of the Care and Treatment Plan are routinely addressed, that psychological therapy options are always covered, and that there are clear timescales for agreeing Care Plans.

Of course when the Measure comes into effect in June 2012 it doesn’t mean that it will solve all problems and guarantee a good service. But for the first time it will provide a solid platform of care planning so that people’s needs will be properly assessed and recorded and the required actions agreed with them. From this basis we can build great mental health services and help more people achieve recovery and become fully engaged in society, be economically active, and lead rewarding lives.