Mental health problems aren’t rare, and they’re not “just in your head” in the dismissive sense. They affect housing, work, benefits, relationships, and sometimes whether someone survives the next year.
A few hard truths:
- In 2024, Wales had a suicide rate of 15.7 deaths per 100,000 people, higher than England’s 11.1.
- Between April 2023 and March 2024 there were 350 suspected deaths by suicide in Wales – over three quarters were men.
- Samaritans Cymru note that more than three in four suicides in Wales are men, with the highest rates in middle-aged men.
So when people call mental health a “silent killer”, it’s not just a dramatic phrase. The deaths are counted quietly in official reports; the pain around them usually isn’t.
On top of that, the Welsh Government’s own Wellbeing of Wales reporting shows a clear link between poor mental wellbeing and things like poverty, housing insecurity and caring responsibilities.
That’s the backdrop for everything else in this post: when the system drags its feet, real people pay the price.
2. How the Welsh system is supposed to work: your core rights
Wales actually has some pretty strong laws on paper. The problem is often getting those rights turned into reality.
a) Mental Health (Wales) Measure 2010
This Welsh law sits alongside the Mental Health Act, but it’s mostly about support and rights, not detention. It includes:
- Part 1 – primary care: GPs and primary care should have better mental-health services (like counselling or psychological therapies).
- Part 2 – Care and Treatment Plans (CTPs): Anyone under secondary mental health services has the right to a named Care Coordinator and a written plan that covers all areas of life.
- Part 3 – right to re-access services: Adults discharged from secondary services can refer themselves back within a set period without starting from scratch.
- Part 4 – inpatient advocacy: Everyone detained in hospital must be offered an Independent Mental Health Advocate (IMHA).
If someone under the Pembrokeshire CMHT doesn’t have an up-to-date Care and Treatment Plan, the system already isn’t following the law.
b) Social Services and Well-being (Wales) Act 2014
This Act is the foundation for social care in Wales – including carers’ rights and advocacy. It’s built around well-being, not “services first”.
Local authorities must:
- Assess anyone who may need care or support (including for mental health).
- Assess carers in their own right.
- Provide information, advice and assistance about community resources, benefits, housing, and prevention.
- Safeguard adults at risk of abuse, neglect or self-neglect.
c) Independent Professional Advocacy (IPA)
Under Part 10 of the same Act, councils must:
- Make sure people can access advocacy generally, and;
- Arrange Independent Professional Advocacy where someone has difficulty understanding or expressing their views, and there’s no one suitable to support them.
So, if someone is in a social-services process and can’t take part without help, the council must consider and arrange IPA. That’s a statutory duty.
d) Health and Social Care (Wales) Act 2025 & the new Mental Health Strategy
Two newer developments:
- Health and Social Care (Wales) Act 2025: focuses on integrating health and social care, enabling direct payments in NHS Continuing Healthcare, and tightening oversight of profit-making in care settings.
- Mental Health and Wellbeing Strategy 2025–2035: a 10-year plan aiming for same-day mental health support through a stepped system, and recognition that housing, poverty and trauma are inseparable from mental wellbeing.
On paper, the law and policy are progressive. The reality, as many in Pembrokeshire know, is often delayed, confusing, and underfunded.
3. Spotting when things are slipping – in yourself or someone else
This isn’t a diagnostic checklist, just the common warning signs that show up before a crisis:
- Sleep completely out of sync.
- Not eating or eating excessively.
- Losing track of bills, appointments, hygiene or cooking.
- Withdrawing from others.
- Increased anger or emotional volatility.
- Thoughts like “What’s the point?” or “Everyone would be better off without me.”
- Substance misuse creeping up.
For people with learning disabilities or dementia, distress is often misread as “behaviour” or “confusion”. It’s still distress, and it still deserves support.
4. Crisis today in Pembrokeshire: what actually happens and who to call
If things hit crisis point:
- 999 if in immediate danger.
- 111, option 2 for the 24/7 mental-health line covering Pembrokeshire, Carmarthenshire and Ceredigion.
- Crisis Response & Home Treatment Team – Pembrokeshire, based at Bro Cerwyn, for intensive short-term support at home.
- CALL Mental Health Helpline for Wales: 0800 132 737 or text HELP to 81066.
- Samaritans: 116 123.
5. Day-to-day support: GP, CMHT and waiting realities
Under the 2010 Measure, primary care should provide early help like talking therapies and advice – not just prescriptions. If accepted by secondary services (CMHT, Crisis Team, Older Adult Mental Health), you must have:
- A Care Coordinator.
- A Care and Treatment Plan.
- Clear crisis instructions.
If you don’t, it’s entirely reasonable to request a review.
6. Money, housing and benefits: mental health in another language
Much of Pembrokeshire’s distress is tied to poverty and instability.
Key benefit links
- PIP: supposed to cover mental-health impacts, but assessments are inconsistent.
- Universal Credit / LCWRA: stressful Work Capability Assessments are common.
- Carers: often doing 50+ hours a week without proper recognition.
Who helps locally
- Citizens Advice Pembrokeshire – welfare rights, debts, and appeals.
- Path (Pembrokeshire Action for the Homeless) – tenancy and homelessness prevention.
- HOPE (Age Cymru & partners) – rights and advocacy for over-50s and carers.
- Pembrokeshire County Council Housing / Welfare teams.
DCAG and similar community advocacy projects help fill the paperwork and understanding gaps between individuals and those formal systems.
7. Advocacy in Pembrokeshire: who does what (and how they differ)
Statutory / commissioned advocacy
- Advocacy West Wales (Eiriolaeth Gorllewin Cymru) – statutory advocacy including IMHA, IPA, IMCA, and social-care advocacy.
- Age Cymru Dyfed / HOPE – older adults and carers.
Peer and learning disability self-advocacy
- Pembrokeshire People First (PPF) – peer-led advocacy for adults with learning disabilities and/or autism. It focuses on empowerment, group voice, and training.
Independent, community-based advocacy and guidance
- Dyfed Community Advocacy & Guidance (DCAG) – independent, non-statutory, community-rooted advocacy and guidance service, focusing on mental health, wellbeing, and daily living navigation.
- DCAG operates where statutory or peer services don’t reach – bridging gaps in mental health, housing, benefits, and general wellbeing.
- It’s distinct from PPF (learning-disability focus) and AWW (statutory focus), providing the mental health and wellbeing counterpart in the community network.
Together, these three forms of advocacy form the backbone of rights support in Pembrokeshire.
8. Community, connection and “non-clinical” mental health support
Local community services matter:
- PAVS Community Connectors – link people into local groups and resources before crisis hits.
- The VC Gallery – creative arts for veterans and the community to support mental health.
- Carer Support West Wales, Age Cymru Dyfed, and local befriending networks.
These groups keep people connected — which is often the most powerful form of prevention.
9. Learn it yourself: education, resources and self-help
For people waiting months for therapy or care plans:
- IAWN – Hywel Dda’s online wellbeing hub.
- NHS 111 Wales – clear guidance on support and the 111/2 service.
- CALL Helpline – 24/7 information and listening.
- Mind Cymru – accessible guides to mental health conditions and rights.
- Samaritans Cymru – brilliant resources on how to talk safely about suicide.
- WWAMH Directory – regional list of community services.
Self-education isn’t a cure, but it makes systems less intimidating.
10. Closing: why this is everyone’s business
The suicide rate in Wales remains stubbornly high. Every number is a name — and behind each one is a story of waiting, silence, or missed chances.
The laws in Wales give people rights to care, advocacy, and wellbeing. The challenge is making sure those rights mean something in practice.
If we all understood that:
- It’s not “being awkward” to ask for a Care and Treatment Plan.
- It’s not “being difficult” to bring an advocate.
- It’s not “someone else’s problem” to check in on a neighbour, friend, or client — then Pembrokeshire’s mental health landscape could start looking very different.
Because silence is what lets the system stay as it is. And every time someone speaks — for themselves, for another, or through advocacy — that silence cracks a little.
When enough cracks form, things start to change.
References and Resources
Samaritans Cymru & ONS: Suicide statistics for Wales, 2024 – https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths
Welsh Government (2024) Wellbeing of Wales report – https://www.gov.wales/wellbeing-wales
CALL Mental Health Helpline – https://www.callhelpline.org.uk/
Samaritans – https://www.samaritans.org/
Mind Cymru – https://www.mind.org.uk/about-us/mind-cymru/
Adferiad Recovery – https://adferiad.org/
Advocacy West Wales – https://westwalesadvocacy.org.uk/
Age Cymru Dyfed – https://agecymrudyfed.org.uk/
Pembrokeshire People First – https://pembrokeshirepeople1st.org.uk/
Citizens Advice Cymru – https://www.citizensadvice.org.uk/wales/
PAVS – https://pavs.org.uk/
WWAMH Directory – https://www.wwamh.org.uk/
