- 30 Sep 2020
Attendees and apologies
- Professor Andrew Gumley (Chair), University of Glasgow
- Alan McNair, Scottish Government
- Alix Rosenberg (AR), Scottish Government
- Anne Armstrong (AA), Scottish Government
- Dr Daniel Kopasker, University of Aberdeen
- Dr John Mitchell (JM), Scottish Government
- Emma Hogg (EH), Public Health Scotland
- Gordon Johnston, VoX
- Innes Fyfe (IF), Scottish Government
- Jessica Galway (minute), Scottish Government
- Karen Martin, Carers Trust
- Lucy Mulvagh (LM), Health and Social Care Alliance
- Professor Matthias Schwannauer (MS), University of Edinburgh
- Professor Rory O’Connor (RO), NSPLG Academic Reference Group
- Professor Steve Platt (SP), NSPLG Academic Reference Group
- Ruth Flynn (RF), Public Health Scotland
- Sarah Martin (SM), Scottish Government
- Stephen McLeod (SMc), Scottish Government
- Neil Quinn, University of Strathclyde
- Lee Knifto, Mental Health Foundation
Items and actions
Welcome and introductions:
The Chair welcomed members to the meeting and invited introductions from the new members of the group:
- Karen Martin – Carers Trust Scotland
- Gordon Johnston – Voices of Experience
- Dr Daniel Kopasker – University of Aberdeen
Discussion of ‘Mental Health Impacts of the Covid 19 Pandemic in Scotland: A Think Piece’
The Chair invited Dr John Mitchell to present his paper on ‘Mental Health Impacts of the Covid-19 Pandemic in Scotland: A Think Piece’
The paper sets out preliminary observations on the known and predicted effects of the Covid-19 pandemic on the mental health population in Scotland as well as commentary on how this might affect the mental health landscape in Scotland. It sets out eight key messages:
- pre-covid, rising public awareness and demand for mental health treatment was outstripping supply
- there are, and will be, different impacts on different populations mostly associated with traditional inequalities
- traumatic experience in acute hospitals and care homes for patients and those involved with them, including staff, could lead to mental health morbidity, requiring additional help
- early impact is higher level of distress. Later formal anxiety and depressive disorders are likely to emerge, as will greater rates of substance misuse, traumatic reactions, self-harm and suicide
- an 8% current worsening of the incidence of mental health disorders is estimated. This is particularly for anxiety and mood disorders and particularly in young people and females
- there will be challenge in meeting new need, and gearing back up services, but opportunities arise for better individualised approaches to personal wellbeing and mental health service delivery
- the critical influence of inequalities will require cross Government work and commitment
- joint focus will be needed on both population wellbeing and on mental ill health. The evidence base is still developing but suggests there is a need for whole population approaches alongside targeted support for at risk and vulnerable groups
It was noted this paper is informed by background evidence, but it is not based on a systematic review process and does not assess the quality of evidence included. It was also noted that the evidence base is still developing and the quality is variable.
The paper was welcomed by members. It was noted that it reflects important early findings and that these would develop as the evidence base expands.
RO noted that the key messages largely echo the early findings from the Scottish Mental Health and Wellbeing Tracker Study, led by the University of Glasgow in collaboration with Samaritans and SAMH. It was noted that the data from this study would help to understand further the impact of the pandemic on mental health in Scotland. It was agreed that the group would have an opportunity to consider the findings from both the Scottish Mental Health and Wellbeing Tracker Study and the UK wide study also led by University of Glasgow in more detail when they are available.
Health and Social Care Analysis briefing update
The Chair invited Alix Rosenberg to present the July Health and Social Care Analysis (HSCA) briefing.
AR noted that the HSCA briefings capture a snapshot of emerging evidence and that Scottish Government and Public Health Scotland are looking to develop further thematic papers on specific topics. Arrangements to facilitate those updates are being finalised between the two organisations and AR will update the group further in due course.
AR also noted that work is underway to progress a further iteration of the Rapid Evidence Review. Both Scottish Government and Public Health Scotland are engaging with other UK government colleagues through four nations calls to understand what analytical work is being undertaken in regards to the mental health impacts of Covid-19. This will promote collaboration and information sharing in this area.
Lived experience engagement into MHRAG
The Chair updated the group on developments to engage the voice of lived experience within the group. The Chair noted that he had discussed with both LK and LM who are giving further consideration to options for facilitating lived experience engagement within the Advisory Group. The Chair welcomed GJ and KM to the Advisory Group and invited them to share their expertise on this issue.
LM noted that there are a range of different ways to facilitate positive and meaningful engagement with individuals with lived experience. She noted that the importance of accessibility and in setting a clear remit for any lived experience group/ panel that would support the work of the Advisory Group.
GJ noted echoed these points, noting the importance of establishing a clear terms of reference for any lived experience group. He also noted the importance of making research findings accessible. He noted that engagement with lived experience could support the wider dissemination and awareness of emerging data and evidence.
JM welcomed further engagement with lived experience and thanked members for their consideration of this. He agreed with the need to set out a clear remit for the group. JM noted that further consideration of resource implications for establishing a panel would need to be undertaken, given that the Advisory Group does not currently have a dedicated financial budget.
Early intervention psychosis
The Chair invited Dr John Mitchell to update members on the on emerging research on early intervention psychosis
JM noted that there has been previous improvement work on early intervention psychosis by Healthcare Improvement Scotland but that this has paused due to Covid-19.
JM noted that there is emerging literature to suggest an increase in people presenting with a first episode of psychosis during the pandemic, highlighting the two academic publications circulated to members:
- Brown, E., Gray, R., Monaco, S.L., O'Donoghue, B., Nelson, B., Thompson, A., Francey, S. and McGorry, P., 2020. The potential impact of COVID-19 on psychosis: A rapid review of contemporary epidemic and pandemic research. Schizophrenia research
- Hu, W., Su, L., Qiao, J., Zhu, J. and Zhou, Y., 2020. COVID-19 outbreak increased risk of schizophrenia in aged adults. PsyChinaXiv. doi, 10(202003.00003))
JM noted that this emerging research underlines the importance of continuing policy action in this area.
SM welcomed the update and noted that it would be useful to capture qualitative data on psychosis presentations from Boards over the past 3 months in parallel to the data.
DK signposted members to a recent research publication which examines the impact of Covid-19 on levels of psychological distress through the lens of socio-economic inequalities data: (Davillas, A. and Jones, A.M., 2020. The COVID-19 pandemic and its impact on inequality of opportunity in psychological distress in the UK. Available at SSRN 3614940).
LM also updated members that she is aware of work ongoing in Healthcare Improvement Scotland in regards to Mental Health Services. She noted that it would be good for the Advisory Group to connect in with this work.
JM also noted that he would shortly be retiring and thanked members for their contributions thus far. JM will be replaced by Dr Alistair Cook who will also be a member of this group.
The Chair thanked JM for his energy and efforts to establish the group and to bring forward its programme of work.
The Chair thanked members for their contribution.
The next meeting will be held on 7th September.