English: Can I thank the Chair for his introduction and quite detailed explanation of the report? It doesn't leave us much to say. Can I also thank the clerking team and the witnesses who came before the committee? Dirprwy Lywydd, we regularly discuss in this Chamber the way in which Wales addresses mental health provision. In fact, we just had a debate that highlighted very much mental health and how we tackle that and the prevention of suicide. We often reflect upon the ability to deliver crisis care and care and treatment planning, sometimes linked to physical health care and sometimes, as well, to mental health care. Just look back at the debates of the past few years, both on the health and social care committee's reports and on the children and young people committee's reports. They've produced several reports around mental health in particular. Now, we all know the figures. I know it's often quoted: one in four will suffer from mental health. And it's hugely frustrating that this still exists in society. There remains a stigma about mental health, and that, undoubtedly, stops people from speaking out and getting the support they need, though I am pleased to see action being taken to change that and I very much support all the steps being taken to do so. There are many recommendations in the report, and I'm pleased that the majority have been accepted by the Government or accepted in principle. However, I have concerns regarding the rejection of recommendation 11. I have had representations from many organisations in my role as chair of the cross-party group on mental health around crisis care and care and treatment planning and the pace at which previous recommendations and actions for their consequent delivery has been undertaken. Now, we all recognise that the mental health crisis care concordat is an ambitious agreement between Welsh Government and partners to improve the care and support for people experiencing or at risk of a mental health crisis. The concordat is underpinned by the following four core principles and expected outcomes: effective access to support before crisis point; urgent and emergency access to crisis care; quality treatment and care when in crisis; and recovery and staying well. Providing excellent crisis care requires a resolute focus on the person experiencing crisis, recognising them as an individual in need and responding in a person-centred way. The concordat makes clear that supporting individuals experiencing crisis is a multi-agency responsibility, which requires a joined-up approach, and we must not lose sight of the key issue: the needs of the person experiencing a mental health crisis. The committee heard that since 2015, when the concordat was introduced, there has been a 90 per cent reduction in the number of individuals detained in police cells who are in mental health crisis, so it can help. Whilst this inquiry looked specifically at the use of section 136, recommendations, if implemented effectively and with pace, can have a broader impact and support the delivery of transformative change, which was the ambition of a crisis care concordat. The Twilight Sanctuary in Llanelli - the first of its kind in Wales - is an example of partnership working under the concordat with Dyfed Powys Police, Carmarthenshire County Council and Hywel Dda health board, having commissioned the service working with Mind and Hafal. I look forward to seeing the reflection of the good practice in Llanelli being introduced across Wales. I'd also like to discuss recommendation 8, which is based around care and treatment planning. Care and treatment planning is vital to people, irrespective of whether they're suffering with a physical health condition or a mental health condition. However, for those living with mental health illness, the failure to deliver a holistic care and treatment plan can be hugely detrimental, and we can see many getting caught in the revolving door of coming out, going back in, coming out, going back in and being detained. We've still not seen enough progress on care and treatment planning. Effective care and treatment plans are a great tool to prevent crises from occurring, as well as ensuring that people, whether it be those suffering with mental health or their carers and families, know how to access urgent support when they need it. However, there is significant evidence to show that care and treatment plans, in particular crisis plans, are not being used effectively. We are falling short in this area, and as a Welsh Government it's important that we must ensure that this is addressed as a matter of urgency. Now, I raised this during business questions back in November, and I raise it once more here: we must get the care and treatment plans right and we must ensure that those people using them have confidence in their care and treatment plans and don't feel that they're merely warm words that do not deliver for them. Dirprwy Lywydd, mental health care, whether it be in the community or in police custody, must continue to improve and we must do more.
Welsh: A gaf fi ddiolch i'r Cadeirydd am ei gyflwyniad a'i esboniad manwl o'r adroddiad? Nid yw'n gadael llawer i ni ei ddweud. A gaf fi hefyd ddiolch i'r tîm clercio a'r tystion a ddaeth gerbron y pwyllgor? Ddirprwy Lywydd, yn y Siambr hon rydym yn trafod yn rheolaidd y ffordd y mae Cymru'n mynd i'r afael â darpariaeth iechyd meddwl. Yn wir, rydym newydd gael dadl a oedd yn tynnu llawer o sylw at iechyd meddwl a sut yr awn i'r afael â hynny ac atal hunanladdiad. Rydym yn aml yn myfyrio ar y gallu i ddarparu gofal mewn argyfwng a chynllunio gofal a thriniaeth, sydd weithiau'n gysylltiedig â gofal iechyd corfforol ac weithiau, yn ogystal, â gofal iechyd meddwl. Edrychwch yn ôl ar ddadleuon yr ychydig flynyddoedd diwethaf, ar adroddiadau'r pwyllgor iechyd a gofal cymdeithasol ac ar adroddiadau'r pwyllgor plant a phobl ifanc. Maent wedi cynhyrchu sawl adroddiad ar iechyd meddwl yn arbennig. Nawr, rydym i gyd yn gwybod y ffigurau. Gwn ei fod yn cael ei ddyfynnu'n aml: bydd un o bob pedwar yn dioddef o broblemau iechyd meddwl. Ac mae'n rhwystredig iawn fod hyn yn dal i fodoli yn y gymdeithas. Mae stigma'n parhau ynglŷn ag iechyd meddwl, ac mae hynny, yn ddi-os, yn atal pobl rhag siarad a chael y cymorth sydd ei angen arnynt, ond rwy'n falch o weld bod camau'n cael eu cymryd i newid hynny ac rwy'n cefnogi'n fawr yr holl gamau sydd ar waith i wneud hynny. Mae llawer o argymhellion yn yr adroddiad, ac rwy'n falch fod y mwyafrif wedi'u derbyn gan y Llywodraeth neu wedi'u derbyn mewn egwyddor. Fodd bynnag, mae gennyf bryderon ynghylch gwrthod argymhelliad 11. Cefais sylwadau gan nifer o sefydliadau yn fy rôl fel cadeirydd y grŵp trawsbleidiol ar iechyd meddwl ynglŷn â gofal mewn argyfwng a chynllunio gofal a thriniaeth, a pha mor gyflym y cyflawnwyd argymhellion a chamau gweithredu blaenorol o ganlyniad. Nawr, rydym i gyd yn cydnabod bod y concordat gofal mewn argyfwng iechyd meddwl yn gytundeb uchelgeisiol rhwng Llywodraeth Cymru a phartneriaid i wella'r gofal a'r cymorth i bobl sy'n wynebu argyfwng iechyd meddwl neu sydd mewn perygl o wneud hynny. Mae'r concordat yn seiliedig ar y pedair egwyddor graidd a'r canlyniadau disgwyliedig canlynol: mynediad effeithiol at gymorth cyn cyrraedd pwynt argyfwng; mynediad brys at ofal mewn argyfwng; triniaeth a gofal o ansawdd mewn argyfwng; ac adferiad a chadw'n iach. Mae darparu gofal rhagorol mewn argyfwng yn galw am ffocws pendant ar y person sy'n dioddef yr argyfwng, gan eu cydnabod fel unigolion mewn angen ac ymateb mewn ffordd sy'n canolbwyntio ar yr unigolyn. Mae'r concordat yn nodi'n glir fod cefnogi unigolion sy'n wynebu argyfwng yn gyfrifoldeb amlasiantaethol, sy'n galw am ddull gweithredu cydgysylltiedig, a rhaid inni beidio â cholli golwg ar y mater allweddol: anghenion y sawl sy'n dioddef argyfwng iechyd meddwl. Clywodd y pwyllgor fod gostyngiad o 90 y cant wedi bod yn nifer yr unigolion mewn argyfwng iechyd meddwl a gafodd eu cadw mewn celloedd heddlu ers 2015, pan gyflwynwyd y concordat, felly mae'n gallu helpu. Er bod yr ymchwiliad hwn wedi edrych yn benodol ar ddefnyddio adran 136, gall argymhellion, os cânt eu rhoi ar waith yn effeithiol ac yn gyflym, gael effaith ehangach a chefnogi'r broses o sicrhau newid trawsnewidiol, sef uchelgais y concordat gofal mewn argyfwng. Mae Noddfa Gyda'r Hwyr yn Llanelli - y gyntaf o'i bath yng Nghymru - yn enghraifft o weithio mewn partneriaeth o dan y concordat gyda Heddlu Dyfed Powys, Cyngor Sir Caerfyrddin a Bwrdd Iechyd Hywel Dda, ar ôl comisiynu'r gwasanaeth i weithio gyda Mind a Hafal. Edrychaf ymlaen at weld myfyrio ar yr arferion da yn Llanelli yn digwydd ledled Cymru. Hoffwn drafod argymhelliad 8 hefyd, sy'n seiliedig ar gynllunio gofal a thriniaeth. Mae cynllunio gofal a thriniaeth yn hollbwysig i bobl, boed eu bod yn dioddef o gyflwr iechyd corfforol neu gyflwr iechyd meddwl. Fodd bynnag, i'r rheini sy'n byw gyda salwch meddwl, gall methu darparu cynllun gofal a thriniaeth holistaidd fod yn hynod niweidiol, a gallwn weld nifer yn cael eu dal yn y drws troi o ddod allan, mynd yn ôl i mewn, dod allan, mynd yn ôl a chael eu cadw yn y ddalfa. Nid ydym wedi gweld digon o gynnydd o hyd o ran cynllunio gofal a thriniaeth. Mae cynlluniau gofal a thriniaeth effeithiol yn arf gwych i atal argyfyngau rhag digwydd, yn ogystal â sicrhau bod pobl, boed eu bod yn dioddef salwch meddwl eu hunain, neu eu gofalwyr a'u teuluoedd, yn gwybod sut i gael cymorth brys pan fydd arnynt ei angen. Fodd bynnag, dengys tystiolaeth sylweddol na chaiff cynlluniau gofal a thriniaeth, yn enwedig cynlluniau argyfwng, mo'u defnyddio'n effeithiol. Rydym yn methu yn y maes hwn, ac fel Llywodraeth Cymru mae'n bwysig inni sicrhau bod sylw'n cael ei roi i hyn fel mater o frys. Nawr, codais hyn yn ystod cwestiynau busnes yn ôl ym mis Tachwedd, ac fe'i codaf yma eto: rhaid inni gael y cynlluniau gofal a thriniaeth yn iawn a rhaid inni sicrhau bod gan y bobl sy'n eu defnyddio ffydd yn eu cynlluniau gofal a thriniaeth ac nad ydynt yn teimlo mai geiriau'n unig ydynt nad ydynt yn cyflawni ar eu cyfer hwy. Ddirprwy Lywydd, rhaid i ofal iechyd meddwl, boed yn y gymuned neu yn nalfa'r heddlu, barhau i wella a rhaid inni wneud mwy.