[WATCH] Economic growth can’t come before social wellbeing, national conference hears

The pursuit of economic growth, while necessary for the country to continue developing, also poses risks to many people’s mental health and the wellbeing of society in general.

Malta’s first national conference on mental wellbeing heard a number of stakeholders within the field discuss the challenges facing society in this regard.

The spirit of the conference was perhaps best summed up by Education Minister Evarist Bartolo, who stressed that policy makers can’t ignore their responsibility towards social wellbeing.

“We need to have economic, social, environmental alignment, otherwise we will simply be solving one problem only to create another,” he said.

Education Minister Evarist Bartolo

“It’s contradictory to talk about how many more psychiatrists we are going to need to employ in order to solve the problems our system is creating.”

Bartolo insisted that a holistic approach needed to be applied to policy-making, with an emphasis on the various aspects of the system.

“We must ensure that we not a part of the problem but a part of the solution,” Bartolo said.

Bartolo said that society needed to be sensitized to issues of mental health, including in schools, where children often face very big pressures to perform, as well as the workplace, where more often than not people end up taking their work home.

Depression will affect quarter of the population

Social Solidarity Minister Michael Falzon said it was estimated that one in four people were likely to experience some form of mental health problem in their lifetime.

In Malta, he said that 7% of the population will be affected by depression, which when taking about their family members, meant that a quarter of the population was being affected.  

He stressed that this often placed people in a position where they were unable to maintain a job or relationships with others, leading them into a destructive vicious cycle.

Falzon said that one of government’s responsibilities was to identify what cases certain types of mental health issues. “We must ensure that we match economic advancement with steps forward in this field as well,” Falzon said.

Social Solidarity Minister Michael Falzon

He too stressed that people needed to know that they can, and should, seek help. “The worst thing one can do is close up and see the things that once gave you pleasure cause you pain.”

Falzon emphasised that without a multi-disciplinary approach, authorities couldn’t hope to help those suffering because of such conditions.

He said that a consequence of problems going untreated were intergenerational vicious cycles.

“You sometimes sign a care order and notice that the child’s mother also had a care order issued. It’s the same with drugs,” Falzon said.

Mental health problems cost €314 million in 2015

Amanda Borg, an economist specializing in social investment, stressed that any economy was the product of the people who worked within it. As such, she said that human resources were an important resource that needed to be protected, especially for small island with little resources like Malta.

She said that according to OECD, the direct and indirect costs of mental health problems - including the cost of people who have been forced out of the workforce and those who are underperforming because of a mental health problem – amounted to some €314 million in 2015, equivalent to 3.3% of GDP or €734 for every person in Malta.  

Economist Amanda Bugeja

She said the data suggested that this would continue to increase. The increase in the number of foreigners, who often have less of a social network, as well as the fact that people are living in denser, more congested areas with less open space, were contributing factors.

Borg explained that an analysis of the data from different EU member states indicated that the spend on mental health increased with increasing economic performance.

The reasons for this were better awareness, leading to more people seeking help, as well as the increase in work and performance-related pressures.

Foreigners, the elderly more susceptible

Mental Health Commissioner John Cachia said that an analysis of acute involuntary admissions for 2018 revealed differences in different groups’ susceptibility to mental health problems.

People living in the Southern Harbour region were 30% more likely to be admitted than the average, while those living in Western region of Mala were 40% less likely.

Those in residential care or prison were three times more likely to be admitted, as were African migrants. EU citizens in Malta were 40% more likely to require involuntary admission.

Cachia said that more awareness was needed for people to understand the importance of taking care of themselves and those around them. More awareness, he said, meant less stigma, and increased likelihood of people seeking the help they need.

Mount Carmel to be up to standard in three years

Health Minister Chris Fearne insisted that he was the one that was ultimately responsible for the sector. He stressed that work on a 10-year plan for the sector was well underway. “It’s an ambitious strategy, which has been costed and which has clear targets,” he said, adding that it was “nothing short of revolution”.

Health Minister Chris Fearne

The minister acknowledged the problems which continue to plague Mount Carmel Hospital, insisting however that work was underway to resolve the situation. Fearne said that some 200 patients that didn’t need to be at Mount Carmel had already been relocated, with the hospital expected to be up to standard within two to three years.

The government, he said, believed in community-based care and would be looking to offer services, including outpatient services at community health centres. The remaining 300 or so people that can’t receive this sort of care would be moved to a new hospital at Mater Dei.

As regards prevention, Fearne insisted that everyone was at risk and that after setting up a clinic at the University of Malta and MCAST, the ministry would also be looking to have help available in secondary schools.

Pain endured by families often underestimated

Connie Magro, a psychiatric nurse, said that while society often found it easy to empathise with patients, it often underestimated the suffering of family members who have to see their loved ones deteriorate.

Connie Magro

“It’s not easy to see someone you married and were happy with until recently believe that you are trying to kill him,” she said.

She said there were also added financial burdens on carers, as well as the fact that they must be on call all day and night.

Magro said that while services had improved significantly in recent years, the reality was that family members were still unprepared to deal with the realities they must face.

“I needed to be taught how to be a psychiatric nurse, but then we expect family members to be a nurse, psychiatrist, social worker, everything.”   

She said it was no surprise that research has shown that 60% people who care for family members suffering from severe mental health issues tend to develop problems of their own.

All of society needs to do its bit

President George Vella said that from the very first day of his presidency he had decided to make mental health a priority. The reason for the conference, he said, was to strengthen dialogue among the various stakeholders in the sector, from physicians to social workers, NGOs and policymakers.

The sector, he said, had been neglected for many years, however it was now time to bring the subject into the mainstream.

President George Vella

Vella said he hoped the conference, and others like it, would lead the country to implement a holistic mental health policy.

“We must understand that mental health requires all of society to contribute,” Vella said. “The government and the Opposition must be a testament to the collaboration required in different sectors of society.”  

Above all, he said there was need for concrete action to address social exclusion and inequality, as well as environmental concerns and the development within Maltese cities and villages, which, he said, required more open spaces for people to unwind.