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Locked away: Jersey’s mental health crisis laid bare

Locked away: Jersey’s mental health crisis laid bare

Wednesday 06 March 2019

Locked away: Jersey’s mental health crisis laid bare

Wednesday 06 March 2019


Islanders suffering a mental health “crisis” are being locked in police cells rather than sent to an appropriate place of safety, while children and young people are being detained in the Hospital, a damning report laying bare grave flaws in the island's mental health service has found.

The failing is one of many with the service catalogued by a Scrutiny Panel led by Deputy Mary Le Hegarat.

They concluded that, while “dedicated and hardworking” staff do their best in challenging circumstances, islanders with mental health problems are still not receiving adequate support due to chronic underinvestment in the service.  

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Pictured: Islanders were described as having to wait for a long time for treatment - for some, this meant their mental health deteriorated in the process.

Other issues noted in the wide-ranging report included an “unacceptable” wait to access help, leading some service users’ mental health to deteriorate even further. 

When they did get help, some of the services provided were described as “unwelcoming” and there was a lack of out of hours provision, leaving those facing a “crisis” to be sheltered in police cells or the hospital.

Police lamented this fact in a statement they sent to the Scrutiny Panel, explaining that there was a lack of “suitably qualified staff to restrain and manage problematic patients, as well as an appropriate place of safety suite”.

A carer and family support manager from mental health charity Mind Jersey explained the process in stark terms: “I always try to relate it to a loved one, so I think of my daughter, who is 21, and I think that if she developed a mental health crisis, I phone the police, the police turn up with their flashing lights, she goes into the car, sometimes that can be traumatic in itself. They then take her to the place of safety, which can be the police station, so she is in a cell where she has got to wait for a psychiatrist to come in.

“The whole experience ... and this is for a mental health problem, this is not for somebody that has broken the law, but this is all we have got in Jersey.”

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Pictured: Children and young people were found to sometimes be "detained" in Robin Ward, the children's ward at the General Hospital.

Those receiving residential care were not found to be much better off.

Adult in-patient service Orchard House was found to be “dilapidated” and “uninviting” and the rooms inside were described as being similar to “prison cells”.

The Panel recalled: “In a non-patient area, there were pictures on the wall detailing how staff would restrain patients in the event that they were violent. The communal areas were tired with nothing much to do but watch TV.

“At the time of our visit, there was no visible interaction between staff and patients or between patients. There appeared to be no therapeutic practice taking place with patients. People’s rooms felt like prison cells, again with little, if anything, to do. Some patients appeared to be wearing hospital style clothes and others were wearing their personal clothes.”

The finding led the Panel to conclude that finding a replacement for Orchard House should be deemed a “priority” by the government, who should consider co-locating it with the future hospital. 

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Pictured: The Panel said that the old St. Saviour's Hospital building "looms" over Orchard House, where residential mental health care is provided.

Across the service, staffing was a major issue, with an ongoing “struggle” to fill vacant positions.

Panel members learned during their research that there had previously been candidates for positions within the island’s mental health service, who had gone on to reject offers of employment “when they understand the implications of Jersey’s high cost of living”. 

They noted that a number of programmes aiming to increase staff numbers had been “very positive”, but that they were “unlikely to solve the immediate staff shortage problem”. 

In reality, what was needed was more support from the government in the form of resettlement loans/grants and/or assistance with vehicle and childcare costs, they said. 

Above all, chronic underinvestment in the island’s mental health services and a lack of political leadership on the matter appeared to be the issue. 

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Pictured: The Panel behind the report was chaired by Deputy Mary Le Hegarat, who was joined by Deputies Kevin Pamplin, Carina Alves and Trevor Pointon.

“Mental health services have suffered from a lack of investment over a sustained period of time.

"The improvements required in mental health services are dependent on increased financial investment. Some of these improvements are essential to ensure that the service is able to function properly and include recruiting and retaining staff and enhancing the mental health estate,” the report read. 

Having considered a breadth of evidence from staff, service users, charities and 340 survey responses, Deputy Mary Le Hegarat concluded her panel’s report by calling for mental and physical health to be taken with equal seriousness by the government. 

Subsequent recommendations also included:

  • The Government working with service users to reform mental health services;
  • More support for community and voluntary organisations providing what are essentially frontline services and fill gaps in statutory services;
  • Helping GPs play a greater role in supporting patients with mental health problems;
  • Ensuring the transition from the Child and Adolescent Mental Health Service (CAMHS) is smooth;
  • Greater support for transgender people during the process of transitioning, which can impact their mental health.

Deputy Le Hegarat commented: “We wanted to make sure that the people who use mental health services were at the heart of our review. It is clear from the evidence we received that Jersey’s mental health services are falling short of people’s needs and expectations."

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Pictured: Health Minister Deputy Richard Renouf, who said that the government were already keen to treat mental and physical health equally.

She continued: "If the Government wants to have high quality, safe and modern mental health services, it should provide stronger leadership and significant investment. This will help to support service users, the staff running mental health services and improve the mental health estate.”

The Health Minister, Deputy Richard Renouf, has welcomed the report, which he described as an improvement “springboard”. 

He added that his Department had “already started addressing” many of the issues raised in the report, explaining: “We’ve established a Mental Health Improvement Board to drive the required changes forward, we have a plan under development to replace Orchard House and we will soon have a new place of safety in the hospital to assess patients in crisis.”

According to government officials, the new board’s priorities include forming a strategy to improve mental health facilities, a recruitment campaign to fill vacancies, a focus on crisis prevention and intervention, and investment in clinical and professional leadership of mental health services.

Read the full Scrutiny Panel report by clicking here.

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