Issue link: https://maltatoday.uberflip.com/i/1185664
16 maltatoday | SUNDAY • 17 NOVEMBER 2019 INTERVIEW In an article dated March 2014, you were quoted calling for more awareness and education about depression and other mental health conditions. This week, you raised the alarm about the number of self-harm/ attempted suicides at Mater Dei's Accident and Emergency department. Does this mean that your earlier call went unheeded? Has not enough been done about the issue since 2014? No: on the contrary, a lot has been done in these past five years. Luckily, mental health is on the agenda at last: both in terms of society at large – as evidenced by how the issue is reported in the media, and so on – but also in terms of gov- ernment policy. Recently, we launched a 10-year strategy plan for men- tal health. The plan will actually cater for all areas of healthcare: but it prioritises mental health to make a point. So a lot has been, and is being done. But unfortunately, there is an increase in cases present- ing themselves [to Accident and Emergency]: not just in Malta, but around the world. It's a global phenomenon. The main reason is that stress has increased. Stress is one of the biggest causes of mental health conditions worldwide. And our lifestyle has undeniably become more stressful… Could it also be that the levels of awareness have increased, too? That is part of it too. Thanks to growing awareness, more people today are seeking help for problems that previously would have been kept hidden. Before, there was the mental- ity that psychological problems were things that had to be kept out of sight. This is increasingly no longer the case. And there is also more access to services. Today, mental health services are provided in strategic places like University and MCAST, for instance. There are more sup- port services available; and peo- ple are using them more. In the same article you mentioned the substandard conditions of Mount Carmel Hospital. I was under the impression that there were plans for a new psychiatric hospital on the grounds of Mater Dei. Has this plan been put on the backburner? No. Plans for a new acute psychiatric hospital are still in place. In fact, I am one of the authors of the medical brief. Now we have reached the stage where architects get involved. So things are moving. But the point that perhaps has not come across, is that it makes no sense to wait for the construction of the new hospital, in order the solve the ongoing problems at Mount Carmel. It's not fair on the patients. So, apart from building a new hospital, we are also in the pro- cess of changing our approach to mental health issues. Be- fore, when people presented themselves with serious mental health conditions, they would be admitted to Mount Car- mel…. and in most cases, they would stay there. This is why the patient population there is so high. It might also explain the traditional reluctance to seek medical help for mental health problems… Precisely. Even the language we tend to use in such cases is unhelpful: 'jaqfluk' [they will lock you up]; 'jigbruk' [they will cart you away]… This was the mentality, before. Today, we are trying, as much as pos- sible, to provide support within the community itself: so that the person concerned can re- ceive treatment in his or her own home. First of all, it is a more dignified approach; sec- ondly, even the therapy has a higher rate of success. Because the social aspect of therapy is very important. This is why we are focusing on providing more services within the community. Unfortunately, however, there will still be cases which are se- vere enough to require hospital- isation. In such cases, the idea is for the patient to be admitted for as short a time as possible. But to me, the real success in the mental healthcare sector is not measured in how many state-of-the-art hospitals we build – even though we do need one – but rather, by how few people are actually admitted to hospital. The emphasis in our strategy is that people would not need hospitalisation, even when Following alarming reports that as many as one to three cases of self-harm end up in Mater Dei's A&E department daily, psychiatrist ANTON GRECH calls for a radical overhaul of our cultural approach to stress: a leading cause of suicide worldwide Let's talk about stress Raphael Vassallo rvassallo@mediatoday.com.mt