The mental health well-being in the country is being eroded by too many buildings, cars, pollution and a lack of greenery, Commissioner for Mental Health Denis Vella Baldacchino said.
There should be an inter-governmental approach to issues relating to mental health, as the subject should not be just a concern for the health sector. There are other factors that contribute to people’s mental well-being, or lack of it, he said.
The kind of life that we are living, which has added more stress while giving little respite, is not helping our collective and individual mental state.
Mental health problems have been on the rise globally, affecting many individuals, even at a young, delicate age. Ahead of the European Mental Health Week, to be held between 22 and 28 May, The Malta Independent on Sunday spoke to Vella Baldacchino, who expressed his concern about what he sees as a growing deterioration in mental well-being, one that needs to be addressed as soon as possible.
In the interview, Vella Baldacchino said it is hurtful to see, for example, that in Malta on average two suicides are taking place every month or that the number of people on medication for mental issues is on the rise.
Information tabled in Parliament by the Education Minister indicated that some 600 cases regarding children and young people, who showed signs of mental stress, were flagged by teachers in primary and secondary schools.
Asked about this, Vella Baldacchino confirmed that various studies show that mental health problems are becoming more frequent in the younger generation.
Vella Baldacchino named several issues which educators are seeing before their eyes, such as anxiety in children, depression, an element of deprivation of open spaces and bullying, which are all “real problems and feelings children are facing at such a delicate age”.
He said that some of these youths leave school early or without qualifications and are thrown into the world of work carrying stress which may accumulate.
“These are youths who are developing their characters, having interactions with friends and developing their skills. We must work towards healthy communities,” Vella Baldacchino said.
He continued that education is a major stakeholder which should take every initiative to help children grow their resilience, capabilities, participation in society, sense of belonging, as well as lead them to where they can find help if they do not know where to look.
Vella Baldacchino also said that a study by mental health NGO Richmond Foundation shows that many Maltese students do not open up about their issues or do not know where to find support.
He said that while many of them confide in friends and family, there are others who seek services provided, both inside and outside their school. Vella Baldacchino praised the positive initiatives being carried out, such as at MCAST and the University of Malta, with both institutions having a strong unit taking care of psychological needs of a large cohort of students.
Vella Baldacchino also named several services and foundations operating their programmes within the education system, such as the foundation led by President Emeritus Marie Louise Coleiro Preca, The Malta Foundation for the Wellbeing of Society, which also provides services of support for children.
He detailed the importance of children, adolescents and adults of having a welcoming environment which helps them identify that they have a problem and that it is okay to have a problem.
“All of us experience difficult periods in life, so problems related to mental health do not only refer to pathological problems, or having to go to Mount Carmel Hospital, or having to start medication,” Vella Baldacchino said, highlighting the importance of mental health literacy, and knowing where to go to find their help.
Is there still a stigma? Vella Baldacchino said that the stigma was, is, and will still be there, depending on how much we want to speak about this problem.
“Mental health problems are not only in Mount Carmel, but they are also in the community, in our homes, places of work and schools. If we turn a blind eye to all this, and say there aren’t any problems, then that is the stigma,” Vella Baldacchino said, adding that identifying and educating individuals from a young age is the key to avoiding stigma and persons should not be regarded as weak for having a problem.
Judge Joseph Zammit McKeon had proposed that the commissioners for Mental Health, Children and the Elderly should be operated under the Ombudsman’s Office, saying that public entities and ministers often ignore recommendations to collaborate, increasing the injustice suffered by victims.
Asked if the Office of the Mental Health Commissioner should fall under the Ombudsman’s remit, Vella Baldacchino said that this discussion has already been done by his predecessor, but ultimately, the Office should answer to Parliament.
He said that to his knowledge, there was no intervention by any politician on the method of how the Office works, which is guided by the Mental Health Act.
Vella Baldacchino said that an internal project is currently underway, to see how the Office can put forth proposals and improve the Mental Health Act.
Vella Baldacchino was asked about the government’s amendment to the Abortion bill, which, as has been proposed until now, is to include a reference to the mother’s mental health. He said that he does not wish for mental health issues to become politicised.
“I do not want that problems related to mental health to enter the equation where abortion is concerned. The Mental Health Act is already a topic where the stigma needs to be removed and make sure it is not politicised. The discussion should go beyond this,” Vella Baldacchino said.
He said that abortion is already a psychological torment on the person and their relatives and the mental health concept should not be put in that discussion, while ensuring that support continues to be given and avoid abusing and stigmatising the mental health of an individual.
Last year, government stopped funds going to Richmond’s 24/7 mental health helpline, opening another government-operated 24/7 mental health helpline instead.
Asked about this, Vella Baldacchino highlighted that the duplication of services could be seen as a positive thing, but also a weakness.
“Implementing more services is good and important, but from the service-user point of view, I believe that this increases confusion, especially at a moment of crisis. I support the government's mental health helpline, but should we have all these helplines available?” he said.
Vella Baldacchino suggested that all parties should sit around a table and see how everyone can consolidate and work together to build up the services and identify gaps which remain unaddressed.
Vella Baldacchino said that he strongly believes in NGOs, as if it weren't for the mental health NGOs, the problem of mental health in Malta would be much worse, as the state cannot take care of everything.
“We need to appreciate the valid and critical work of NGOs that have been offering services for a while, but if we instigate that together, we can see where we can consolidate to address the demand of work to be done,” Vella Baldacchino said, adding that the lack of services offered by the public service was felt.
He said that it does not make sense for entities to have their own “empire”, which is essentially a waste of resources, rather than identifying areas where services are lacking.
“I tried making a list of helplines and it amounted to many. The individual who needs to find help, where will he find it? I would prefer having a common service that people can go to,” he said.
Nowadays, mental health awareness has increased. But has it increased in such a way that we always blame mental health for our decisions and maybe find it as an easy way out?
Vella Baldacchino said that mental health problems have always been there, during periods of war, in other periods and countries. He also said that criminality could be a symptom and a result of a person with mental health problems who lacked support and treatment.
Many initiatives are being taken, also because there is a growing awareness on the need to tackle mental health issues, but perhaps they are a bit disjointed, providing a weak net result.
He said that the focus should be in the community; the people who are more hands-on with individuals and can identify and help the individual at grassroots.
Asked if he thought a Mental Health Hospital would fix some of the issues, Vella Baldacchino said that he wished the Mental Health Hospital was already inaugurated and opened.
“The fact that it would be in the Mater Dei Hospital campus continues to implement the concept that mental health should not be segregated from physical health. Obviously, no building is built overnight, but the priority must be there,” he said.
The health clinics and facilities for rehabilitation we currently have also need to be made attractive to encourage persons to seek help and make them feel at ease at their moment of crisis, Vella Baldacchino said.
He continued that this also applies to the staff working at these facilities, who could be experiencing stress and burnout under the pressure they are put under.
“Managing mental health problems in individuals is quite difficult. The government, without any criticism, must emphasise more on the facilities we have at the moment and improve them,” Vella Baldacchino said, commending the opening of the Southern Hub, which will offer healthcare services in the southern region.
Vella Baldacchino also said that from data he is gathering, the number of people taking medication for mental health problems is increasing and all the medicines are on the increase.
With regards to suicide rates, Vella Baldacchino said that even one death is significant, as we would be losing individuals with talents.
He said that around two suicides are taking place every month. “We need to work more on the prevention, the helplines and the services. How effective are we, for those people in crisis who see nothing but black, to remind them that there is someone there to help them,” he said.
“I worry about the people they leave behind – the relatives. If there are children whose relatives have performed a successful suicide, how supportive are we to them? Not just in the first week, or month, but after. We must be more proactive that these people are identified and supported,” Vella Baldacchino said.
He also said that many foreign workers and third-country nationals in Malta are not given enough support, despite partially driving the country’s economy.
“Imagine these people left abruptly, imagine how our society would collapse. These people are on their own,” Vella Baldacchino added.
He said that more support services should be made available to these people, who experience language problems, receive a poor salary and paying most of it as rent leading to sharing of the premises, the option of considering healthy food and having to send money back to their families.
“Do we care about them or are we just using their services? They are important people in the community, but who will take care of them?” he said, adding that if these individuals are to be sent back to their countries, they should at least be sent back with skills required to lead a productive life.
He also said that they should be given increased awareness on mental health problems, as often these individuals are not educated about it or refuse to talk about it in their culture.
Vella Baldacchino thanked the staff of all government services and NGOs, run by volunteers, who often experience limitations such as funds and a shortage of human resources.
“That is why there should be more collaboration between the two,” he said, adding that awareness on mental health problems should be spread as much as possible.