Mental health – “the chronic disease of the young” – is the Cinderella of the health sector, and Malta needs to invest in human resources, continuous training and an adequate environment, experts warn.
“While in Malta there are enough practitioners in general medicine compared to Europe, there is a lacuna when it comes to mental health,” child and adolescent psychiatrist Nigel Camilleri told the Times of Malta.
In the UK, there are at least 25 general psychiatrists for every 100,000 people, but in Malta there are three for every 100,000, one of the lowest ratios in the EU.
The child and adolescent sector fares even worse.
According to the Royal College of Psychiatrists UK, there should be one child psychiatrist for every 50,000 people. For Malta, this translates to nine child psychiatrists, however only three are employed (part-time) within the public sector.
Because of a lack of human resources, children were put on long waiting lists and given short appointments. This often resulted in the prescription of medicine, contrary to evidence-based re-search showing that parental training, for example, had a higher chance of preventing delinquency in the long-term, Dr Camilleri noted.
His colleague Gianella Caligari, a psychology assistant, insisted that taking action in the first 1,000 days of a child’s life and again during adolescence, decreases the chance of mental disorders in later years. This is when people learn to regulate their emotions and take responsibility for their actions.
The two noted that in the long-term, it would not only be the child that benefited from adequate treatment at the right time but society at large.
“The number one cause of morbidity and mortality in people aged between 15 and 24 is mental health. Untreated young people are the future’s chronically ill.
“By dealing with challenging behaviour at a young age, the State saves money in the long run on health, forensics, prison and unemployment services for the rest of the individual’s life,” Dr Camilleri said.
The concept of consequences is missing from Maltese culture
In recent years, Malta has witnessed incidents involving teens and young adults whose challenging behaviour put the public at risk. Society had to do its part, as the concept of consequences was missing from Maltese culture.
From a young age, children needed to be taught there were consequences for their actions. If they damage a tablet, they have to replace it. If they violated the law – such as hitting a nurse – legal action was taken. That way people learned to respect the law, Dr Camilleri added.
Faced with such concerns, the Malta branch of the Association for Child and Adolescent Mental Health, which Dr Camilleri chairs, is stepping in to push mental health as a public health priority.
ACAMH started by raising awareness through conferences and is now moving towards workshops and masterclasses for professionals. The aim is that people working with children reach international standards based on evidence-based practice.
Though it is still providing training for those able to afford training, it hopes such training becomes mandatory for all professionals in Malta.
The association will be reaching out to the public through parenting courses and child attachment assessment training.
Dr Camilleri and Dr Caligari noted those investing in mental health needed to keep three pillars in mind: increasing human resources, providing continuous training and having an adequate environment that allowed education, mental health, social services and the legal entities to work closely together. There is yet no such physical environment that was also attractive to people who required support.
Dr Caligari, vice chairwoman of ACAMH Malta, said when a country did not provide adequate mental health services, it breached fundamental human rights.
“Considering the lack of re-sources and training, this human rights breach in Malta is consistently being ignored and it seems no one is willing to take action.
“When it comes to physical [public] health services, patients are well taken care of and followed up, and mental health services need to be of the same standard,” she added.
ACAMH will hold masterclasses on the autism diagnostic observation schedule, autism diagnostic interview, child attachment interview and personalised individual parent training in the coming months. Those interested can get in touch on malta@acamh.org.