Every adult detained by police in a mental health crisis in west Wales is taken to the same place.
A ward at Prince Philip Hospital in Llanelli.
That could be about to change. Hywel Dda University Health Board will be asked on Thursday to approve public engagement on moving the service to Carmarthen.
Its own board papers spell out what that means. Shifting the place of safety to the Hafan Derwen site in Carmarthen would cut journeys for people in Ceredigion and Pembrokeshire, they say, but “will increase distance and travelling times for others, particularly individuals and staff from Llanelli.”
What a place of safety actually is
Section 136 of the Mental Health Act lets a police officer take someone they believe to be mentally unwell out of a public place, without a warrant, to a designated place of safety. There they are assessed and offered support.
The health board is legally required to provide somewhere for them to go.
It happened 198 times last year. Most of those detained were adults, and 57% were women. Carmarthenshire accounted for 39% of detentions, Pembrokeshire 34% and Ceredigion 16%.
How everything ended up in Llanelli
Until three years ago there were four places of safety across the health board’s three counties.
Bryngofal Ward at Prince Philip Hospital in Llanelli. Cwm Seren Ward at Hafan Derwen in Carmarthen. St Caradog Ward at Bro Cerwyn, the mental health unit on the Withybush Hospital site in Haverfordwest. And Gorwelion community mental health centre in Aberystwyth.
St Caradog was temporarily closed in February 2023 because there were not enough staff to run it. In October 2023 Gorwelion was stood down with immediate effect over safety concerns, and Cwm Seren stopped taking detentions the same day.
All three are still shut. Everything was diverted to Bryngofal, and it has stayed there ever since.
Llanelli was on the list, and was rejected
Five options went to a multi-agency group that included Dyfed-Powys Police, all three county councils, West Wales Action for Mental Health and the patient body Llais.
Keeping the service at Prince Philip was one of them. It was rejected because Llanelli is “geographically peripheral for a significant proportion of the population”, meaning longer trips for people and professionals from Ceredigion and Pembrokeshire.
A site at Glangwili was ruled out because the building work would cost more than the money available. Using sanctuary services was ruled out because they have no registered nurses.
The preferred option is a suite next to the psychiatric intensive care unit and low secure unit at Hafan Derwen, on the St David’s Park site in Carmarthen. The board papers say it offers immediate access to specialist staff, a safer building and quicker access to A&E at Glangwili if someone needs physical treatment.
Andrew Carruthers, the health board’s chief operating officer, said the people affected were often at their lowest ebb.
“People who are detained under Section 136 are often experiencing some of the most difficult moments of their lives, and it is essential that we provide a safe, supportive environment where they can receive timely assessment,” he said.
He said the options had been worked through with partner organisations before Carmarthen was chosen.
“The preferred option at Hafan Derwen has been identified because it offers the strongest benefits in terms of patient safety, clinical support and sustainability,” he added.
Mr Carruthers stressed the outcome was not yet fixed.
“No decisions have yet been made,” he said. “Subject to Board approval, we will want to hear from staff, people with lived experience, carers, partner organisations and members of the public before any final decision is considered. Their feedback will be an important part of the process.”
The one impact the paperwork marks as negative
The equality assessment attached to the papers found no adverse impact on any protected group. It made one exception.
Socio-economic deprivation.
The same document lists the most deprived communities in the health board’s area. Four of the eight named are in Llanelli: Tyisha, Glanymor, Bigyn and Llwynhendy.
The papers also record that the current Llanelli arrangement has not produced a single breach of the legal time limits under the Mental Health Act.
Another service, another move to Carmarthen
For Llanelli this lands in a familiar pattern.
The minor injuries unit at Prince Philip was cut to 12 hours and will not return to a 24-hour service. Under stroke plans out to consultation, Glangwili would become the only 24-hour acute unit in west Wales, leaving Prince Philip as a transfer-only site. Llanelli Town Council has asked for the stroke unit to be strengthened instead.
Blood tests moved to Pentre Awel. And pregnant women in Llanelli planning to give birth at Singleton will lose some Prince Philip appointments, under changes also going to public engagement next month.
Not everything has gone one way. In May, Prince Philip became the first hospital in Wales to offer a pioneering cancer diagnosis technique.
What happens on Thursday, and when it is settled
The board meets at Ceredigion County Council Chambers in Aberaeron from 10:15, and the meeting is streamed online. The Section 136 item is scheduled for 12:40.
If approved, engagement runs from 1 September to 26 October. The results then go back to the board in January 2027 for a final decision.
So nothing is settled this week. But the direction is on the record.
Anyone in west Wales who needs urgent mental health support can call NHS 111 and press option 2.
