The health authorities have defended the closure of the psychiatric outpatient department at Mater Dei Hospital as part of the local mental health strategy for the next decade.

Earlier this month, psychiatrists said the closure of the department dealt another blow to people with mental health conditions already dealing with heightened anxiety brought on by COVID-19.

Patients were told they will be seen to in community clinics, however, they were in “limbo” as appointments were postponed.

A Health Ministry spokesperson has now told Times of Malta the transition of the psychiatric outpatient services from Mater Dei to mental health teams in the community was in line with the National Mental Health Strategy 2020-2030.

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She said that when appointments were halted during the first wave of the pandemic, the community teams took on part of the outpatient department load and carried on with face-to-face meetings and online or over-the-phone advice.

Subsequently, various healthcare professionals were divided into regional teams and more resources were gradually being mobilised in the community, she added.

Some patients who were previously receiving care at the outpatient department have been seen to at community clinics, while others are being contacted with a new date and location.  

This process is ongoing, the spokesperson said, adding that over the next four weeks, four additional clinics will start providing the service at the Qormi health centre. More community clinics will be set up in the coming weeks.

When contacted, the Commissioner for Mental Health said having more services in the community was in line with the Mental Health Act and he could not object to services that kept patients in the community as much as possible without need for hospital.

John Cachia said he was concerned that “some stakeholders seem to have forgotten” that changes in community mental health, day care and outpatient services were clearly delineated in the mental health strategy. 

On behalf of patients he called on “professionals and staff to join forces and push management to expedite the tempo of implementation of this reform”.

Cachia said his office was aware of “numerous challenges linked to adequate premises and improved human resources for community mental health teams in certain parts of the country and we augur that solutions are found quickly in the interest of all”. 

As patients wait for their new appointments, psychiatrists have questioned who is going to shoulder medical legal responsibility for anything that happens to them, including self-harm and suicide.

The commissioner believes the responsibility is joint and falls on management, professionals, patients, families and responsible carers. 

“Management is bound to offer an adequate and safe environment where staff can provide services. Professional care teams are bound to monitor patients entrusted to their care and offer services as needed. 

“Patients, families and responsible carers have a duty of care and are encouraged to contact the respective caring teams or the emergency services at Mater Dei, Gozo and Mount Carmel hospitals in case of deterioration.” 

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