Mental health services should be at the forefront of the public health agenda, former health minister Godfrey Farrugia said in Parliament last night.

The Labour MP and government Whip called for improvement of the quality of services, measures to address Mount Carmel Hospital’s institutional stigma and ways to ensure that hospitalisation was the absolute last resort.

He referred to a recent report in the Times of Malta quoting experts who said that Malta’s public mental health system, centred on Mount Carmel, was in fact a throwback to Victorian-style services.

The previous administration’s inability to address the real issues obstructing badly needed development was still present to the detriment of this voiceless, vulnerable group making up three per cent of the Maltese population, he said.

Dr Farrugia recalled that during the 2013 World Mental Health Day, as health minister he had called for a radical shift of mental health services towards comprehensive community-based care.

This would include the implementation of the Mental Health Act and structural changes at Mount Carmel Hospital, ensuring the dignity of patients, as the first two building blocks.

A strong move towards the deinstitutionalisation of patients away from Mount Carmel through public private social partnerships, the development of a new 130-bed mental health hospital near Mater Dei Hospital and the restructuring of Mount Carmel into elderly residential care units were the next steps. In fact a scientific profiling of Mount Carmel patients was carried out between May and July 2013.

Dr Farrugia called for a bold effort to improve the quality of life of persons with mental health problems

This exercise indicated that 200 out of the 650 beds were being occupied by geriatric residents and prisoners at the forensic unit.

Another 100 persons were registered on Mount Carmel Hospital’s books as acute psychiatric patients but were out of hospital on prolonged leave.

Only 110 were acute patients and the rest required only normal medical and geriatric health management. Besides quality of life, Dr Farrugia highlighted the financial impact of the exist-ing situation.

The daily cost of a Mount Carmel patient was €100 against the €70 and €50 required to cover the daily cost of a resident at St Vincent de Paule Residence in a residential home and through the public partnership scheme respectively.

So why did the changes not happen even though they made sense, asked Dr Farrugia.

He challenged all involved to consider stepping out of the ‘comfort zone’ to ensure a better quality of life for mental health services users.

Besides staffing considerations that required a lot of overtime, the current scenario may be the result of the efforts to secure social assistance for the patients and to establish an ongoing relationship with particular consultants.

He also asked whether it was time to revisit the regulations establishing the contribution due by a resident in State-financed residential services (Legal Notice 259 of 2004) to prevent misuse and discourage institutionalisation.

Thanking the health professionals of good will, Dr Farrugia called for a bold effort to improve the quality of life of persons suffering from mental health problems.

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