In his annual report on the state of mental health facilities in Malta and Gozo, Mental Health Commissioner John Cachia found a mixed bag of results but overall reported an encouraging improvement in many areas. This is commendable, given that, in the past, it was clear that many aspects of the mental health facilities on offer were simply not up to the standard expected of an advanced and civilised country.
Mater Dei Hospital psychiatric unit represented the ‘gold standard’ when it came to the provision of good standards of care. Staff there seemed to be more professional and there was better patient interaction. On the other hand, the facilities at the two mental health wards at Gozo General Hospital and at St Vincent de Paul residential home, where medical records lacked details of patient status in 40 per cent of cases, highlighted the need for some improvement.
But the real focus of Dr Cachia’s report was on the 150-year-old Mount Carmel Hospital, which deals with the majority of mental health cases.
The 2015 annual report found that safety measures and the overall physical state of most wards were not up to scratch and needed urgent attention. Moreover, disturbingly, only one per cent of patient records at the hospital – which are designed to ensure the highest standard of patient care – met all the criteria set by the law.
It is encouraging to see that, in a quick response to the report, the Health Ministry has reported that the substandard state of the physical and safety environment is immediately being addressed. Although refurbishment work at the hospital is ongoing, the age and design of the building inevitably sets limits on what can be achieved. This follows hard on the heels of another full review of patient and staff security systems following a number of escapes of patients from the hospital.
Yet, the issue of key concern, which highlighted that 99 per cent of patients’ records at the hospital failed to meet the essential standards required, is not among the immediate matters being addressed by the Ministry of Health. The need for up-to-date and accurate patient records is crucial to ensure adequate care. The fact that this administrative deficiency is so large is clearly the result of years of neglect. It should be remedied as soon as possible.
The Minister for Health has announced that a call for tenders on legal services has been issued for a public-private partnership to carry out a major overhaul at Mount Carmel Hospital, which, it is hoped, will address these limitations. With the advances in technological improvements now available it must be hoped that a quick solution can be found.
On the other hand, the most positive aspect of the annual report concerned the standard of care of patients. The vast majority of patients (89 per cent) felt they were being treated with respect and dignity while 93 per cent thought staff members were “kind and caring”.
In a hospital which by definition is dealing with some of the most vulnerable in society, this was a most encouraging assessment, particularly as other aspects of the report had drawn attention to the inevitable discrimination in treatment that occurred as a result of the disparity in physical standards between those in good wards and others in substandard divisions.
Overall, the verdict on Malta’s mental health treatment is ‘could do better’. But it is encouraging that the trajectory appears to be one of improvement and that the Minister of Health has grasped the need for positive action.