Patients waiting months in inappropriate Ocean Views placements, Board report finds

Patients inappropriately placed at Ocean Views, alongside shortages of housing, and delays in social care packages has resulted in bed blockages, the Mental Health Board Report 2026 has found.

Inappropriate placements include those who are undergoing drug and alcohol detox, in need of access to Elderly Residential Care facilities, or have a disability.

The 230-page report detailed that these blockages prevent wards from fully delivering their primary function of rehabilitating patients and facilitating their safe transition back into the community,

Due to shortages in housing, or patients waiting for a placement in ERS or elsewhere, there are patients instead spending months in Ocean Views when they should be elsewhere.

In one case, a patient has been waiting in Ocean Views for a placement in Dr Giraldi Home for two years despite it being acknowledged that a long-term solution is needed.

The report called this situation untenable, highlighting the need for a prompt and sustainable solution.

“Individuals with learning disabilities should reside in environments designed to meet their specific developmental and social needs, rather than in settings intended for acute psychiatric treatment,” the report said.

“Addressing this issue is essential to ensure that care provision remains both appropriate and ethical.”

Figures from the report provide a snapshot of patient needs within wards at Ocean Views.

In Dawn Ward, the rehabilitation ward, seven of ten patients were awaiting ERS support, suitable housing, or appropriate packages of care.

The report found that for Dawn Ward, which has 20 beds, the most significant challenge remains the delay in discharging patients.

“Staff reported that these delays are not clinical in nature, but stem from systemic barriers within housing and social care pathways,” the report said.

“The lack of assisted living options and delays in securing appropriate accommodation were identified as the primary obstacles to patient transition. In some cases, family circumstances further complicate discharge planning.”

“One long-term patient, ready for discharge for a considerable period, continues to await housing, raising concerns about potential regression and loss of progress.”

The report noted that given Dawn Ward's rehabilitative focus, it is common for patients to have longer stays.

But this situation differs in Horizon Ward, the acute ward, which is intended for short-term stays.

“In practice, however, this is not reflected,” the report found.

“On 18 September 2025, seven of the 11 beds were occupied, with several patients remaining for several months. By 21 October 2025, Horizon Ward was at full capacity.”

Chairman of the Mental Health Board George Parody, and Vice Chair Emily Adamberry Olivero, told the Chronicle inappropriate placements are a concern, particularly for those detoxing from alcohol.

“Every single time we go to the wards, the staff tell you, this is not appropriate,” Mr Parody said.

He highlighted that Ocean Views does not have the appropriate medical facilities, including a resuscitator.

He said that St Bernard’s Hospital was an appropriate setting and there should be a programme which links to Bruce’s Farm.

When it comes to long-stay patients, Mr Parody pointed out that it costs more to have someone as an inpatient in Ocean Views rather than in assisted living or in the community.

The report highlighted that it was acknowledged that moving patients to more appropriate placements is not an easy task, which “more often than not depended on other Government Departments and services, rather than mental health issues”.

NURSE SHORTAGE

The report stressed that the ongoing shortage of registered mental health nurses (RMNs) remains a significant challenge locally and globally, but on a positive note that the GHA was actively engaged in seeking qualified professionals who may be interested in relocating to Gibraltar.

The board also welcomed that “strengthening of clinical leadership” through the appointment of posts that had been vacant for a prolonged period.

Gibraltar-based RMNs are currently being trained at the University of Gibraltar where 11 are expected to graduate in 2027. The board commended this initiative and expressed its support, and asked if the course would be offered again after 2027 to which the Government has responded that this is dependent on future service needs.

As of October 2025, there were 28 RMNs and two Nursing Assistants employed with 10 RMN vacancies, two of which were covered by locums and four vacancies covered by supply staff.

The board said that vacancies continue to place pressure on service delivery, and the figures reflect the ongoing reliance on temporary staffing.

Mr Parody and Ms Adamberry Olivero also urged for a Code of Practice to be published which could provide guidance to staff, patients, and families.

SUNSHINE WARD REOPENING

Since the closure of Sunshine Ward in July 2022, the board said it has consistently advocated for the facility to be repurposed effectively, whether for mental health services or other healthcare departments.

The board was therefore very pleased that a final decision has been made to put Sunshine Ward to productive use as an ERS facility, particularly given the ongoing shortage of beds across all sectors.

The report said development represents a significant step towards addressing capacity pressures while ensuring that patients receive appropriate and specialised care.

Mr Parody said Sunshine Ward has not yet been opened, adding that this will mean an ERS ward will be in the centre of Ocean Views. He said there should be a separation between a mental health and elderly care facility.

The four beds currently used at Hillside for family respite will be transferred to Sunshine Ward and, the report said, the facility will be fully staffed with personnel trained in dementia care.

Sunshine Ward will serve primarily as a staging post for short-term stays, with the goal of supporting patients to return to living at home whenever possible. It is not intended for long-term residency.

The report said logistical arrangements, including the transportation of patients to and from the facility and the use of lifts, will need careful coordination.

The external areas of the ward will be primarily available to Ocean Views patients, providing safe and accessible outdoor space as part of their care environment.

GIBRALTAR YOUNG MINDS

After years of increase in childhood referrals to Gibraltar Young Minds (GYM), the service has projected a 10% reduction.

Referrals sharply increased after the pandemic, from 106 in 2021, to 242 in 2022 and 294 in 2023.

After a reduction in referrals in 2024 to 230, this has further reduced to 155 in the first 10 months of 2025.

The report found that these figures do not necessarily indicate reduced need, but likely reflects more effective early intervention or a potential plateau level showing signs of early stabilisation.

“Additional data in the coming years will be needed to confirm whether this marks the start of a stable and consistent pattern,” the report said.

It added that there are currently 198 young people registered with GYM. Common referral reasons include anxiety, self-harm, school avoidance, eating disorders, behavioural challenges, ADHD assessments and autism spectrum disorder with co-occurring mental health concerns.

POSITIVES

The board highlighted positive changes throughout the report including changes to the lithium and Clozapine list.

The report detailed that Clozapine is now very effectively regulated with blood test results sent directly to the UK, where any inconsistencies are flagged before a new prescription is issued.

“This system provides a strong safety net for both patients and clinicians,” the report said.

The report added that the lithium monitoring list continues to rely on local blood testing, however, controls have improved significantly, resulting in far fewer minor inconsistencies.

The board also highlighted that the appointment of a counsellor within the prison has been a major step forward.

“The role is already showing a positive impact, with early intervention helping to de-escalate tensions and prevent behavioural problems,” the report said.

Further positive notes include the inclusion of Drugs and Alcohol Rehabilitation Service (DARS) within the new Community Mental Health Team, and the partnership with e-Gov for service users to gain access to services.