Although the Opposition would be supporting the Mental Health Bill, it knew its implementation would not get very far because a lack of human resources.

This factor, Labour MP Marie Louise Coleiro Preca told Parliament on Wednesday, made it difficult to expand the mental health sector. The present structures were ancient and inadequate and could not support the Bill.

She said the Bill, which was important insofar as it gave a voice to the most vulnerable sector of society, had been 17 years in the making.

After so long one would have expected the Government to present a strategy outlining how the law would be implemented.

“Unfortunately those who are familiar with the sector realise that, although the Bill is positive, laws were not made to remain on paper,” she said. Human resources were lacking not only in terms of numbers but even in trained individuals.

The starting point of the Bill should be overcoming the stigma that haunted mental health patients, who faced major social and economic problems and were at a far higher risk of poverty. In Malta the extent of the impact of these problems was not calculated.

The Government had fallen short of focusing on prevention in the past 25 years and Malta did not even have the instruments to regularly measure work-related stress.

Ms Coleiro Preca emphasised there was a need for trained professionals, such as child psychiatrists and occupational therapists. Because of shortages, patients were not getting the daily sessions or the teachers they needed. Furthermore, at Mount Carmel Hospital the food trolleys were rusty and food was transported in trucks from the old airport. Old Enemalta vans were used to move patients.

The Government spoke of eradicating stigma, but it was useless to present the idea of a care plan and a multi-disciplinary team when there was no care transition between Mater Dei Hospital and Mount Carmel Hospital. It was a shame that the psychiatric ward at Mater Dei only had 15 beds and many patients were being admitted directly to Mount Carmel.

It was unacceptable that, on arrival, patients were being assessed in ambulances in the car park and not inside Mater Dei. Patients from Mount Carmel were being treated as third class patients at Mater Dei.

The role of the police in the mental health sector also needed to be addressed. Currently, in cases where a patient was involved in an argument with another patient, the police were called in to help. Ms Coleiro Preca believed that better ways could be found to tackle such situations and she intended to raise the matter at committee stage.

Speaking on voluntary jurisdiction to appeal decisions taken, she said that a person with mental health problems could not be expected to take up court proceedings.

There needed to be a holistic approach to the sector. The Young Persons Unit and the Hostel needed better management and a care plan for children needed to be set.

The approach towards a more holistic care plan in which the patient or carer would also be involved was a step forward. Some items in the Bill also needed time frames.

The Bill specified the criteria required for a person to be a carer, but what about when patients were not able to make a selection?

Ms Coleiro Preca said the Commissioner for Mental Health – currently John Cachia – should not be appointed by the Prime Minister without at least consulting the Leader of the Opposition.

There should be no political strings attached to the position; on the contrary, the commissioner should be independent. The job should mainly be as a promoter and a defender of patients’ rights.

With regard to involuntary admission to hospital and the criteria set out in the proposed Bill, there might be a risk with how the procedure would be handled. The provision should be clarified and, moreover, the term “informed consent” should also be defined to eliminate all misunderstandings.

The Bill should also set out the criteria at law allowing a carer to refuse treatment to a mentally ill individual when justified.

Concluding, Ms Coleiro Preca said the legal instrument could do no good if the Government did not follow up with a strategic plan bound by time frames.

Opposition spokesman on justice José Herrera also contributed to the debate.