Over 60% of all involuntary mental health admissions are persons under 45

A mental health report for 2017 has confirmed the high burden of mental disorder in the younger segments of society, with 63% of acute involuntary admissions to psychiatric facilities having been found to be persons under 45.

The Office of the Commissioner for Mental Health’s 2017 annual report, moreover, showed that, in 2017, the relative risk of an acute involuntary admission was again much higher for residents of the Southern Harbour and Northern regions, compared to the rest of Malta.

There are also more marked “considerable relative risk” differences for admission when it comes to women, the report said.

Persons from medium and less-developed countries had a five-fold risk of admission, while those from very highly and highly developed countries and non-Maltese EU/EEA nationals had a two-fold risk.

Taken together, 25% of all acute involuntary admissions were foreigners living in Malta.

The report praised the fact that nationals from foreign countries are organising themselves into self-help and support groups, saying that their engaging with their leaders and getting encouragement to take up mental health issues is “a step in the right direction”.

Length of stay significantly reduced        

The report found that patients deprived of their liberty are being followed up on a regular basis by their respective caring teams, also highlighting that the length of stay in involuntary care has “diminished radically”.

“Patients are being discharged from compulsory treatment orders or transferred to community treatment orders, rather than being left on ‘leave of absence from hospital’ for years on end,” the report noted.

It said, however, that while care plans are being submitted, their completeness and quality merit revision.

“The availability of adequate human resources is a critical issue, which regularly features in feedback with care teams concerning care plans,” the report underlined.

Men three times more likely to abuse drugs       

Schizophrenia, with 32%, psychoactive substance abuse, with 25%, and mood disorders, with 21%, represent close to 80% of the total acute disease burden, the report findings state, with men three times more likely to engage in substance abuse than women.

When it comes to people aged 18 to 44, 80% of all acute psychiatric admission were directly or indirectly linked to substance abuse.

Infrastructure at Mount Carmel “being addressed”

The report pointed out that the overall physical environment of mental health facilities was somewhat improved in 2017 when compared to 2016, with patients “[seemingly] better kept”.

Safety, however, is still an issue in some wards at both Mount Carmel Hospital and Gozo General Hospital, it said, underscoring that all stakeholders agreed that further investment in safety measures and ward environments remains needed.

The Office said it could report that “infrastructural and safety issued at Mount Carmel are being addressed”, remarking that the refurbishment and upgrading plans shown to it, and the progress of preparatory remedial works, “augurs well”.               

It called for renewed efforts to develop as soon as possible 24/7 crisis intervention services based at Mater Dei Hospital, to support emergency care for persons suffering mental health emergencies.

Awareness increasing      

Patients appear to be more aware of their condition and their rights, and are more ready to speak up, the report said - more than 70% of patients know the mental condition they suffer from, and almost 70% said they knew who was on their care team.

It advised, however, that on the basis of Mount Carmel patients’ opinions, certain aspects had to be addressed by the hospital’s managment.

Over 40% of patients said the food served was not of adequate quality, almost 30% said they had uncomfortable beds, and more than half showed concern that their privacy, when it came to showering and toilet facilties, was not sufficiently respected.   

Carers not sufficiently informed of duties            

While 80% of interviewed responsible carers said they knew what their duties entailed, almost 60% said their responsibilities had not been explained to them.

More than 60% said that their patients’ needs had not been communicated to them, with the report stressing that these results indicate “an urgent need for the responsible carers to be better involved and empowered to carry out their full duties in this crucial area of patients rights”.