Closing the psychiatric outpatients’ department at Mater Dei Hospital has dealt another blow to people with mental health conditions who are already dealing with heightened anxiety brought on by COVID-19, according to concerned psychiatrists.

“Patients were told they will be seen to in community clinics. However, they are still waiting in limbo as their appointments were postponed,” said Nigel Camilleri, president of the Maltese Association of Psychiatry (MAP).

“Who is going to shoulder medical legal responsibility for anything that happens to patients who are missing out on outpatient care, including self-harm and suicide?”

Camilleri questioned the timing of the closure of the department and the psychiatric unit at a time when mental health services need to be bolstered.

Psychiatrists, he said, were concerned about the absence of a transition plan from hospital services to community clinics for patients previously receiving care as psychiatric outpatients.

This uncertainty increased anxiety for both patients and professionals, he added.

All they see during this second wave, is uncertainty that has never been felt before

“During the first wave people made a sacrifice for a few months, pulling through because there was hope at the end of the tunnel. Now all they see, during this second wave, is uncertainty that has never been felt before.

“This is a result of a higher number of coronavirus cases and a seemingly wider spread across different clusters, and the unknown long-term effect on education, socialisation and financial income,” Camilleri said.

The Alliance for Mental Health, of which MAP is a member, is warning that since there had to be changes in the way services operate during the first wave, including shifting online, people with mental health conditions might be more at risk during the second wave. This was especially so if they did not have the right follow-up and monitoring to prevent a relapse.

'Closure goes contrary to mental health strategy'

The closures, it said, meant the complete removal of any mental health presence at the general hospital, going contrary to the mental health strategy published for 2020 to 2030.

“The development of community mental health services is important, however, substantial investment should be allocated to improve in-patient care and to train staff to provide and expand mental health care in the community. The need for 24/7 service for urgent care remains imperative,” the alliance said.

It warned that if mental health care was not up to standard and all necessary resources were not in place, community care would turn into family care, resulting in an excessive burden on the family and putting more strain on the population.

Mental health services are already experiencing a strain and the alliance believes demand will continue to increase, as grief, anxiety and depression will continue to affect people even when the virus is under control.