The HEAT target, 'Deliver faster access to mental health services by delivering 18 weeks referral to treatment for Psychological therapies from December 2014', was approved by the Scottish Government in November 2010:
Psychological therapies can have demonstrable benefit in reducing distress, symptoms, risk of harm to self or others, health related quality of life and return to work. NHS Boards have made good progress in recent years in improving access to many psychological therapies.
Although this is a target about improving access to and waiting times for psychological therapies, it is intended to drive improvement across mental health services. In order to meet the target, Boards will need to have in place services that meet the full range of people's needs, including lower-intensity interventions, such as bibliotherapy or computer-based CBT, that can prevent people needing to access higher intensity treatments. It will also require all areas of mental health services to be working effectively together. The delivery of psychological therapies is a core part of NHS activity. Scotland is the first country to introduce a waiting times target of this nature.
Psychological therapies are often delivered alongside medication. We have produced a short document on antidepressant prescribing in Scotland:
Further information about the scope of the target:
Mental Health Strategy Commitments
- Commitment 13: We will continue our work to deliver faster access to psychological therapies. By December 2014 the standard for referral to the commencement of treatment will be a maximum of 18 weeks, irrespective of age, illness or therapy.
The Matrix: A Guide to delivering evidence-based Psychological Therapies in Scotland
The Matrix was published in 2011. It sets out the available evidence base for psychological therapies for common mental health problems for adults, children, young people and families and some aspects of long term conditions management and physical health care:
It is not intended to be prescriptive but does offer guidance in the strategic planning and delivery of psychological therapies. To remain relevant and current it will be reviewed and updated regularly to ensure ongoing attention to expanded scope of coverage and to incorporate new evidence as this becomes available.
Routine Collection and Recording of Clinical Outcomes
As well as improving waiting times, we want to ensure that patients benefit from the treatment they receive. We have carried out work and produced a report aiming to support NHS Boards to move to a position where all mental health services are routinely collecting and recording session by session clinical outcome data. This data is being used at a patient, practitioner and service level to measure the quality and effectiveness of the interventions being delivered.
Psychological Therapies for Older People
We are carrying out development work to build capacity within the older adult psychology workforce. The Older People’s Psychological Therapies Working Group reported in December 2011 with its recommendations. The report was circulated to NHS Board chief executives and built in to the commitments in the Mental Health Strategy:
Equality and Diversity Impact Assessment
The target is designed to cover everybody experiencing mental illness or disorder who could benefit from a psychological therapy. However, there are potentially access issues in relation to gender (men), age (older people), ethnicity (ethnic minorities), sexuality and transgender.
- During development of the HEAT target, we held a workshop with key partners to inform an equality and impact assessment
- NHS Education for Scotland carried out a literature review in order to identify barriers to access
- NHS National Services Scotland's Information Services Division (ISD) produced an Equality and Diversity Impact Assessment Report