Mae AGIC wedi archwilio profiadau pobl sy'n cyrchu gofal a thriniaeth – i ddeall sut mae gwasanaethau'n eu helpu nhw i reoli eu cyflyrau iechyd meddwl ac atal argyfwng. Bu’r adolygiad hefyd yn ystyried sut mae meddygon teulu a gwasanaethau eraill y GIG ledled Cymru yn darparu gofal diogel ac effeithiol i helpu i atal argyfwng iechyd meddwl, a’r hyn y mae sefydliadau trydydd sector yn ei wneud i gefnogi hyn.

Canfyddiadau Allweddol

Aneffeithlonrwydd yn y broses – Mater allweddol a amlygwyd gan AGIC yw'r anhawster sy'n ymwneud ag atgyfeirio'n uniongyrchol i wasanaethau. Gall hyn arwain at unigolyn yn cael ei ddal mewn cylch, yn gorfod mynd at ei feddyg teulu dro ar ôl tro er mwyn ailddechrau'r broses atgyfeirio. Canfuodd adolygiad AGIC y gall prosesau atgyfeirio fod yn gymhleth, gan arwain at amseroedd aros a allai fod yn hir pan nad oes gan unigolion ddigon o gymorth. Bydd angen i fyrddau iechyd ystyried sut y gallant fynd i’r afael â’r bwlch hwn yn y ddarpariaeth, gan gryfhau’r ymgysylltiad rhwng meddygon teulu a gwasanaethau gofal sylfaenol a chymunedol eraill a gwasanaethau iechyd meddwl eilaidd.

Staff ymrwymedig – Mae’r rhai sy’n gweithio ym maes gofal iechyd, gwasanaethau brys a gwasanaethau trydydd sector, a ledled Cymru wedi ymrwymo ac yn ymroddedig i ddarparu cymorth a gofal i bobl ag anghenion iechyd meddwl.

Cydweithio – Canfuodd AGIC y gall sefydliadau trydydd sector ddarparu cymorth amhrisiadwy i unigolion, gan leihau’r tebygolrwydd o ddirywiad sylweddol neu gyflym a lleddfu’r galw ar wasanaethau’r GIG. Mae cyfleoedd clir i gryfhau cydweithio â’r trydydd sector mewn perthynas ag atal argyfyngau, yn enwedig ar gyfer yr unigolion hynny sydd angen lefel uwch o gymorth nag y gall meddyg teulu ei darparu.

Un pwynt mynediad - Nododd AGIC nifer o fentrau cadarnhaol ledled Cymru, gan gynnwys gweithredu un pwynt mynediad. Lle'r oedd hyn ar waith, roedd yn sicrhau bod gweithwyr iechyd meddwl proffesiynol arbenigol ar gael i ddarparu brysbennu clinigol, atgyfeirio ymlaen, a chyfeirio effeithiol i unigolion mewn argyfwng. Mae’r gwasanaeth yn cael ei dreialu ar hyn o bryd mewn rhai byrddau iechyd fel ffordd o fynd i’r afael â’r broblem o oedi cyn derbyn cymorth o ganlyniad i bwyntiau cyswllt ac atgyfeirio niferus. Darparodd meddygon teulu a oedd wedi defnyddio'r gwasanaeth enghreifftiau cadarnhaol o sut roedd y dull hwn wedi caniatáu iddynt gysylltu â neu atgyfeirio at y tîm iechyd meddwl mwyaf priodol mewn modd amserol. Mae AGIC wedi gwneud argymhelliad bod yn rhaid i fyrddau iechyd sicrhau bod gwasanaethau un pwynt mynediad yn cael eu gweithredu ledled Cymru a’u bod yn hygyrch i bob gweithiwr proffesiynol a’r cyhoedd.

Dywedodd Alun Jones, Prif Weithredwr dros dro Arolygiaeth Gofal Iechyd Cymru:

“Mae’n bleser gennyf gyhoeddi’r adroddiad hwn, sy’n cyflwyno canfyddiadau ein Hadolygiad Cenedlaethol o Atal Argyfwng Iechyd Meddwl yn y Gymuned. Mewn cyfnod mor heriol, gellir dadlau nad yw cynnal iechyd meddwl a llesiant da erioed wedi bod mor bwysig. Mae ein gwaith wedi ein galluogi i amlygu meysydd o arfer da, taflu goleuni ar ymrwymiad staff, a nodi meysydd i'w gwella. Yn y darn hwn o waith, rydym yn dangos unwaith eto pa mor hanfodol yw hi fod pob rhan o wasanaeth iechyd yn cydweithio mor ddi-dor â phosibl, a bod cyfleoedd i weithio gyda phartneriaid trydydd sector yn cael eu defnyddio i'r eithaf er mwyn sicrhau canlyniadau gwell i bobl sydd angen gofal a chymorth.”

HIW explored the experiences of people who access care and treatment, to understand how services help them to manage their mental health conditions and prevent crisis. The review also considered how GPs and other NHS services across Wales provide safe and effective care to help prevent mental health crisis, and what third sector organisations do to support this.

Key Findings

Inefficiencies in process – A key issue highlighted by HIW is the difficulty surrounding direct referral into services. This can result in an individual being caught in a cycle, having to access their GP repeatedly in order to re-commence the referral process. HIW’s review found that referral processes can be complex, leading to potentially lengthy waiting times, during which individuals lack sufficient support. Health boards will need to consider how they can address this gap in provision, strengthening the engagement between GPs and other primary and community care services and secondary mental health services.

Committed staff - Those working within healthcare, emergency and third sector services and across Wales are committed and dedicated to providing support and care to people with mental health needs.

Collaboration - HIW found that third sector organisations can provide invaluable support to individuals, lessening the likelihood of significant or rapid deterioration and easing the demand on NHS services. There are clear opportunities to strengthen collaboration with the third sector in relation to crisis prevention, in particular for those individuals who require a greater level of support than a GP is able to provide.

Single point of access – HIW noted several positive initiatives across Wales, including the implementation of a single point of access. Where this was in place, it ensured that specialist mental health professionals were available to provide clinical triage, onward referral and effective signposting to individuals in crisis. The service is currently being piloted in some health boards as a means of addressing the issue of delayed support resulting from multiple contact and referral points. GPs who had used the service provided positive examples of how this approach had allowed them to contact or refer to the most appropriate mental health team in a timely manner. HIW have made a recommendation that health boards must ensure that single point of access services are implemented across Wales and are accessible to all professionals and the public.

Alun Jones, the Interim Chief Executive of Healthcare Inspectorate Wales, said:

“I am pleased to be publishing this report which presents the findings from our National Review of Mental Health Crisis Prevention in the Community. In such challenging times, maintaining good mental health and well-being has arguably never been more important. Our work has enabled us to highlight areas of good practice, shine a light on the commitment of staff and identify areas for improvement. In this piece of work we again demonstrate how critical it is that all parts of a health service work together as seamlessly as possible and that opportunities to work with third sector partners are maximised to deliver better outcomes for people who need care and support.”