7.5 Mental health
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National strategy(ies)
A National Strategy for Mental Health targeting for the whole population, with a specific focus placed on promotion and preventive efforts in children and adolescents, was published in 2019 and covers the period between 2020 and 2030. This strategy will guide the implementation of investment and reforms which will truly place mental health and treatment of mental illness at the heart of the health policy agenda in the years to come.
The strategy upholds the values of dignity, autonomy and rights of all people with mental disorders. It recognises that everyone has an equal opportunity to attain mental well-being throughout their lifespan and all individuals are entitled to appropriate health care, including mental health care. It embraces a modal shift in the locus of care away from institutions towards community-based mental health care.
It is based on a vision that a society that promotes mental health and well-being for everyone, prevents mental disorders among individuals at high-risk and provides quality treatment, care and support to individuals with mental health problems This vision will be implemented through a series of actions grouped under four clusters:
- Promoting mental health and wellbeing by addressing the wider determinants of health
- Transforming the framework within which mental health services are delivered
- Supporting all persons with mental disorders and their families
- Building capacity and fostering innovation to improve the performance of our mental health services
The strategy falls under the direct responsibility of the Ministry for Health.
Improving the mental health of young people
The Ministry for Health and Active aging offers a number of services for young people.
The Child and Young People's Services (CYPS) at St. Luke’s Hospital offers assessments and management for mental disorders in young people. The service is delivered by a multidisciplinary team composed of child and adolescent psychiatrists, psychiatric trainees, nurses, psychologists, psychology practitioners, occupational therapists, social workers and a speech language pathologist he young person can access it through a referral by a general practitioner.
The Child & Adolescent Psychiatric Emergency Services (CAPES) is an emergency service which offers assessments for young people aged 3 to 18 years presenting with acute mental disorders. This means that one's mental state is severe enough to make the person feel that their life or the life of others may be at risk and therefore require immediate attention.
The Crisis Intervention and Home Treatment (CHIT) teams is an outreach team which offers an intensive intervention to young people who have either been recently discharged from in-patient care or else they have attended CAPES and require extra support to address their mental health needs within the community. This service's intervention is offered for a maximum length of 4 weeks, after which the young person is referred to CYPS for follow up care.
The Generic child and adolescent mental health clinics offer an assessment and intervention to all young people aged 3-18 years with difficulties of anxiety, depression, psychosis, bipolar disorder, adjustment disorders, oppositional defiance disorders, attachment disorders.
There are also a number of Specialised Clinics. The Neurodevelopmental Clinic includes a specialist team that carries out multimodal assessments for Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD), as well as offers interaction for an ADHD follow up clinic.
The Innovation Team aims to offer an in depth multidisciplinary assessing and intensive individualised tailored therapy for young people (aged 13-25yrs) with multiple complex mental disorders within the community.
Family Focused Clinic is multidisciplinary team that provides a specialized service to children and young people and their families. The aim of the clinic is to address situations where children's and young people's mental health is being negatively impacted by family dynamics.
Learning Disability Clinic carries out assessments and follow ups of children and adolescents under the age of 18 years with an intellectual disability and mental health disorder.
The Anger Management Group Therapy is aimed at young people up to18 year olds. The goal of the group is to equip young people with necessary skills to be able to better control their anger outbursts in different contexts. Individual screening sessions is offered to young people. Support is also provided to parents/carers of these young people.
The Young People’s Unit at Mount Carmel Hospital within Mental Health services uses a pre-admission system to screen patients and only admits young people between the ages of 12 and 18 with mental issues such as bipolar disorder, depression, and autism with aggression issues.
The Children Development Assessment Unit (CDAU) at St. Luke’s Hospital assesses and treats young people up to 16 years referred by consultants/doctors. Young people seen at CDAU are referred for various limitations and difficulties including Autism, Global Developmental Difficulties, Learning Difficulties, ADHD, Cerebral Palsy, Head Injuries, Down syndrome and other syndromes. Children may be treated individually or in groups. Group therapy includes the Sensory Motor, Handwriting, Prewriting, Perceptual Motor and the Alert Group. The CDAU aims to provide assessment, therapy and support to patients with cognitive impairment and their families from a very early age. Children can be referred to the unit as early as, immediately after birth.
The assessment and treatment services at the CDAU, are provided by a multidisciplinary team of professionals consisting of paediatricians, nurses, psychologists, physiotherapists, occupational therapists and speech and language pathologists.
The Ministry for the Family, Children’s Rights and Social Solidarity offers a number of services targeting the mental health of young people.
Youth in Focus provides social work intervention to adolescents and young persons, aged between 13 and 18, with the scope of assisting them throughout their adolescence, by addressing their needs and empowering them to reach their full potential. There is a wide range of presenting difficulties and issues that the team encounters and deals with. These may include, anger management, mental health difficulties, turbulent relationships, alcohol/drug abuse & other addictions, promiscuity, time management, prostitution, criminal behavior, employment, petty crime, past traumas, poverty & homelessness, etc.
Embark for Life (E4L) targets young people aged 15-25 years and supports them in finding employment. This service was already in existence as it was a service funded by the EU under the European Social Fund and, following its success, local funds were provided and the service started operating in July 2013. E4L contributes towards the community strategic guidelines by matching project participants to avail of the already existing schemes and educational/vocational training in the country, whilst supporting them in finding suitable employment. Disadvantaged young people are often likely to fall into the social benefit trap. Thus, by supporting them to lead a sustainable healthy lifestyle and have job security, their dependence on social assistance and the revolving syndrome of attaining support from various public services is minimized.
The Adolescent Day Programme (ADP) addresses the needs of young people who are at risk of poverty and social exclusion. The service caters for young people between the ages of 14 to 18 who exhibit challenging behaviour. The programme supports young people by providing them with a secure environment where they can easily express their feelings and emotions without any judgement.
Kellimni.com is a joint effort between Ministry for the Family, Children’s Rights and Social Solidarity and SOS MaltaThis initiative is an online support service run by trained staff and volunteers reachable through Chat, Email, Whatsapp, Messenger, Instagram and Telegram for support. Young people can, express their concerns and talk about the issues directly affecting them in an anonymous way. Kellimni.com is aimed at young people who are suffering from any form of social exclusion, abuse, neglect, and/or psychological difficulties and are in need of immediate emotional, moral and social support. The service also offers up to 12 free online counselling sessions with professionals.
Agenzija Zghazagh offers a number of services targeting the mental health of young people.
Mindful Mosiac is a programme during which young people embark on a dynamic journey that helps them cultivate their mental resilience. It explores practical strategies for navigating challenges, for well-being and unlock potential for persona growth and building mental health.
Youth Worker Online is an online service developed during Covid-19 pandemic, through which young people can contact a youth worker and discuss anything that is causing them stress. The youth worker will keep in contact with young people and will provide information on services that would help the young person solve the issues they are facing.
In Tune with Myself is a programme that enables young people to d widen their emotional literacy, whilst also acknowledging their potential to deal with stressful events. The programme creates the space for young people to touch base with their mental and physical well-being whilst identifying and applying coping techniques.
ZenZone is a programme through which young people learn to break free from negative though patterns. Young people explore effective techniques to reduce stress, reconnect with their inner selves and achieve a state of balance. Through guided activities young people learn how to better understand and support others, foster a sense of community and develop emotional well-being.