Yesterday the Senedd’s Health and Social Care Committee launched a new inquiry, focusing on mental health inequalities across different groups in society.
The inquiry will concentrate on the experiences of people who are disproportionately affected by poor mental health in Wales and look at what barriers exist to accessing mental health services.
In its role holding the Welsh Government to account on behalf of the people of Wales, the Committee is looking at the extent to which Welsh Government policy recognises and addresses the mental health needs of these groups.
The Centre for Mental Health describes a ‘triple barrier’ of mental health inequality, which affects large numbers of people from different sections of the population:
- Some groups of people are disproportionately at risk of poor mental health. This is often linked to inequalities in society.
- Groups with particularly high levels of poor mental health can have the most difficulty accessing services.
- When they do get support, their experiences and outcomes are often poorer.
Russell George MS, Chair of the Health and Social Care Committee said:
“Today we’re launching an inquiry to get to the bottom of mental health inequalities across Wales. It isn’t right that some people in society are disproportionately at risk of poor mental health and often struggle to receive the help and support they need.
“We know, for example, that children from the poorest 20% of households are four times as likely to have serious mental health difficulties by the age of 11 as those from the wealthiest 20%.
“We want to hear the experiences of those affected and to give a voice to under-represented groups to help us hold the Welsh Government to account. We want to use the experiences of people across Wales to help us set the direction for Welsh Government policy on mental health.”
The inquiry begins on 10 January 2022, with a call for written evidence. The Committee will be hearing from a wide range of people over the coming months and will report with findings and recommendations later in the yea
The call for written evidence will close on Thursday 25 February 2022.
Work by the Centre for Mental Health and others (including the Mental Health Foundation, Royal College of Psychiatrists, Autistica, and the All Wales Deaf Mental Health & Well-Being Group) shows that the following groups are likely to experience mental health inequalities. These examples are illustrative. The Committee is asking stakeholders to identify which groups of people in Wales are most affected by mental health inequalities and is keen to hear evidence from a wide range of people, not limited to the groups identified below.
- Older people – 85% of older people with depression receive no help from the NHS. Older people are only a fifth as likely as younger age groups to have access to talking therapies, but are six times as likely to be on medication.
- Autism – 70% of children and 80% of adults with autism have at least one co-occurring mental health condition. Autistic adults (without a learning disability) are nine times more likely to die by suicide. Children with autism are 28 times more likely to think about or attempt suicide.
- Poverty – E.g. children from the poorest 20% of households are four times as likely to have serious mental health difficulties by the age of 11 as those from the wealthiest 20%.
- Ethnicity – Black adults are the least likely ethnic group to report being in receipt of medication, counselling, or therapy for mental health issues. Additionally, black people are far more likely to experience police involvement in their first contact with mental health services.
- LGBT+ people – Half of LGBT people reported that they have experienced depression in the last year. One in eight LGBT people said they’ve attempted suicide in the last year. Almost half of trans people said they’d thought about taking their own life in the last year.
- Deaf people – Deaf people are twice as likely to experience mental health difficulties, and may be further disadvantaged by a lack of mental health pathways and poorer access to health services generally.
- Learning disability – Children and young people with a learning disability are three times more likely than average to have a mental health problem. Only around a quarter of those who experience both a learning disability and a mental health problem have had any contact with mental health services.
- Severe mental illness – People experiencing severe and enduring mental health problems die, on average, 15–20 years earlier than the general population.
- Gender – Gender influences an individual’s mental health risk, and there are also gender differences in the ways that mental distress manifests itself. For example, young women were found to be three times more likely than men to experience common mental health problems, and rates of self-harm, PTSD, and eating disorders are significantly higher among young women than men. Men however, represent three quarters of deaths by suicide, and are three times more likely than woman to become alcohol-dependent.
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Ddoe lansiodd Pwyllgor Iechyd a Gofal Cymdeithasol y Senedd ymchwiliad newydd, sy’n canolbwyntio ar anghydraddoldebau iechyd meddwl ar draws gwahanol grwpiau yn y gymdeithas.
Bydd yr ymchwiliad yn canolbwyntio ar brofiadau pobl sy’n cael eu heffeithio’n anghymesur gan iechyd meddwl gwael yng Nghymru ac yn edrych ar yr hyn sy’n rhwystro mynediad at wasanaethau iechyd meddwl.
Yn rhinwedd ei rôl o ddwyn Llywodraeth Cymru i gyfrif ar ran pobl Cymru, mae’r Pwyllgor yn ystyried i ba raddau y mae polisi Llywodraeth Cymru yn cydnabod anghenion iechyd meddwl y grwpiau hyn, ac yn mynd i’r afael â’r anghenion hynny.
Yn ôl y Ganolfan Iechyd Meddwl, mae anghydraddoldeb iechyd meddwl yn rhwystr triphlyg sy’n effeithio ar nifer fawr o bobl o wahanol rannau o’r boblogaeth:
- Mae rhai grwpiau o bobl yn wynebu risg anghymesur o iechyd meddwl gwael. Yn aml, mae hyn yn gysylltiedig ag anghydraddoldebau yn y gymdeithas.
- Gall grwpiau sydd â lefelau arbennig o uchel o iechyd meddwl gwael wynebu’r anawsterau mwyaf o ran mynediad at wasanaethau.
- Pan fyddan nhw yn cael cefnogaeth, mae eu profiadau a’u canlyniadau yn aml yn waeth.
Yn ôl Russell George AS, Cadeirydd y Pwyllgor Iechyd a Gofal Cymdeithasol:
“Heddiw, rydym yn lansio ymchwiliad i fynd at waelod anghydraddoldebau iechyd meddwl ledled Cymru. Dyw hi ddim yn iawn bod rhai pobl yn y gymdeithas yn meddu ar risg anghymesur o iechyd meddwl gwael, ac maen nhw’n aml yn ei chael hi’n anodd cael yr help a’r gefnogaeth sydd eu hangen arnyn nhw.
“Rydym yn gwybod, er enghraifft, bod plant o’r 20% tlotaf o aelwydydd bedair gwaith yn fwy tebygol o gael anawsterau iechyd meddwl difrifol erbyn eu bod yn 11 oed na’r rheini o’r 20% cyfoethocaf.
“Rydym eisiau clywed profiadau’r rheini sydd wedi’u heffeithio a rhoi llais i grwpiau sydd heb gynrychiolaeth ddigonol er mwyn ein helpu i ddwyn Llywodraeth Cymru i gyfrif. Rydym eisiau defnyddio profiadau pobl ledled Cymru i’n helpu i bennu’r trywydd ar gyfer polisi Llywodraeth Cymru ar iechyd meddwl.”
Mae’r ymchwiliad yn cychwyn ar 10 Ionawr 2022, gyda galwad am dystiolaeth ysgrifenedig. Bydd y Pwyllgor yn clywed gan ystod eang o bobl dros y misoedd nesaf a bydd yn adrodd yn ddiweddarach yn y flwyddyn, gyda chanfyddiadau ac argymhellion.
Mae’r galwad am dystiolaeth ysgrifenedig yn cau ar Ddydd Iau, 25 Chwefror 2022.
Mae tystiolaeth gan y Ganolfan Iechyd Meddwl ac eraill (yn cynnwys Y Sefydliad Iechyd Meddwl, Cyngor Coleg Brenhinol y Seiciatryddion, Autistica ac Iechyd Meddwl a Lles Byddar Cymru) yn dangos bod y grwpiau canlynol yn debygol o brofi anghydraddoldebau iechyd meddwl. Mae’r esiamplau yma yn rhai enghreifftiol. Bydd y Pwyllgor yn gofyn i rhanddeiliaid i fynegi pa grwpiau yng Nghymru sydd yn cael eu heffeithio fwyaf gan anghydraddoldebau iechyd meddwl ac maent yn dymuno clywed tystiolaeth gan ystod eang o bobl, nid yn unig y grwpiau sy’n cael eu sôn isod.
- Pobl hŷn – nid yw 85% o bobl hŷn ag iselder yn cael unrhyw gymorth gan y GIG. Nid yw pobl hŷn ond un rhan o bump mor debygol â grwpiau oedran iau o gael mynediad at therapïau siarad, ond maen nhw chwe gwaith yn fwy tebygol o fod ar feddyginiaeth.
- Awtistiaeth – mae gan 70% o blant ac 80% o oedolion ag awtistiaeth o leiaf un cyflwr iechyd meddwl sy’n cyd-ddigwydd. Mae oedolion awtistig (heb anabledd dysgu) naw gwaith yn fwy tebygol o farw trwy hunanladdiad. Mae plant ag awtistiaeth 28 gwaith yn fwy tebygol o feddwl am hunanladdiad neu geisio lladd eu hunain.
- Tlodi – e.e. mae plant o’r 20% tlotaf o aelwydydd bedair gwaith yn fwy tebygol o gael anawsterau iechyd meddwl difrifol erbyn eu bod yn 11 oed na’r rheini o’r 20% cyfoethocaf.
- Ethnigrwydd – Oedolion du yw’r grŵp ethnig lleiaf tebygol o nodi eu bod yn cael meddyginiaeth, cwnsela, neu therapi ar gyfer materion iechyd meddwl. At hynny, y tro cyntaf iddyn nhw ddod i gysylltiad â gwasanaethau iechyd meddwl, mae pobl dduon yn llawer mwy tebygol o brofi sylw’r heddlu.
- Pobl LGBT+ – Dywedodd hanner y bobl LGBT eu bod wedi profi iselder yn ystod y flwyddyn ddiwethaf. Dywedodd un o bob wyth o bobl LGBT eu bod wedi ceisio lladd eu hunain yn ystod y flwyddyn ddiwethaf. Dywedodd bron i hanner y bobl traws eu bod wedi meddwl am ladd eu hunain yn ystod y flwyddyn ddiwethaf.
- Pobl fyddar – Mae pobl fyddar ddwywaith yn fwy tebygol o brofi anawsterau iechyd meddwl, ac fe allan nhw fod dan anfantais bellach oherwydd diffyg llwybrau iechyd meddwl, a mynediad salach i wasanaethau iechyd yn gyffredinol.
- Anabledd dysgu – Mae plant a phobl ifanc ag anabledd dysgu deirgwaith yn fwy tebygol na’r cyfartaledd o fod â phroblem iechyd meddwl. Dim ond tua chwarter y rheini sy’n profi anabledd dysgu yn ogystal â phroblem iechyd meddwl sydd wedi cael unrhyw gysylltiad â’r gwasanaethau iechyd meddwl.
- Salwch meddwl difrifol – Mae pobl sy’n profi problemau iechyd meddwl difrifol a pharhaus yn marw, ar gyfartaledd, 15-20 mlynedd ynghynt na’r boblogaeth gyffredinol.
- Rhywedd – Mae rhywedd yn dylanwadu ar risg iechyd meddwl unigolyn, ac mae gwahaniaethau ar sail rhywedd hefyd yn y ffyrdd y mae trallod meddwl yn amlygu ei hun. Er enghraifft, canfuwyd bod menywod ifanc dair gwaith yn fwy tebygol na dynion o brofi problemau iechyd meddwl cyffredin, ac mae cyfraddau hunan-niweidio, Anhwylder Straen Wedi Trawma (PTSD), ac anhwylderau bwyta yn sylweddol uwch ymhlith menywod ifanc na dynion. Fodd bynnag, dynion sy’n cynrychioli tri chwarter y marwolaethau trwy hunanladdiad ac maen nhw deirgwaith yn fwy tebygol na menywod o fynd yn ddibynnol ar alcohol.