Mental health in primary care
Plans for the initial investment into mental health and well being teams in primary care have all been to the oversight group and each system has had feedback and approval to progress. Delays in agreement of budgets have meant delays in decisions for the next phase. It is likely that a re-phasing and possibly some reshaping of the approach will be required once budgets are clarified.
Quality and Safety Board
The Quality and Safety Board continue to develop quality standards to support general adult secondary mental health services. They are also supporting the development of standards for phycological therapies. This is part of a wider ambition to develop a suite of standards for mental health services, to improve the quality and safety of mental health services and to ensure that individuals, their families and carers know what they can expect from mental health services, ensuring a person-centred approach is at the heart of the approach. The standards should provide an opportunity to build a collective understanding of performance and enable effective benchmarking to drive improvements in quality of care. In addition, they should reduce scope of unwanted variation of quality of care and therefore reduce inequalities in experiences and outcomes. The standards should provide a basis for continual improvement though enabling greater scrutiny and assurance of services against the standards.
The Quality and Safety Board are also supporting the delivery of two of David Strang’s recommendations from his Independent Review of Mental Health Services in Tayside. These are:
- recommendation 12: Conduct a national review of the assurance and scrutiny of mental health services across Scotland, including the powers of Healthcare Improvement Scotland and the Mental Welfare Commission for Scotland
- recommendation 32: A national review of the guidelines for responding to substance misuse on inpatient wards is required
Perinatal and Infant Mental Health Programme Board
The Perinatal and Infant Mental Health Programme Board is taking a strategic oversight of the commitment to improve perinatal and infant mental health services across Scotland. This includes the development and implementation of community and inpatient statutory services, third sector provision, workforce/training development and awareness raising/stigma reduction. The priorities for each year are laid out in the annual Delivery Plan and the plan for 2021 to 2022.
Current priorities for the Perinatal and Infant Mental Health Programme Board include the ongoing provision of statutory services (including regional working and development of a service specification for perinatal mental health services), work on requirements around additional perinatal mental health inpatient provision and forward planning for the conclusion of the Programme Board in March 2023.
Mental Health in Schools Working Group
The Mental Health in Schools Working Group continue to work together to embed the new online professional resource which was published in June 2021. The free online professional learning resource supports school staff to understand and recognise the range of mental health and wellbeing concerns that children and young people may experience. The resource complements the Whole School Approach Framework for schools to support children and young people’s mental health and wellbeing.
Digital Mental Health Programme Board
The Digital Mental Health Programme is progressing several workstreams:
- computerised CBT (cCBT) treatment for anxiety has been rolled out across the 14 Health Boards and is available in 6 Health Boards through CAMHs referrals channels
- new treatments for low mood and depression and currently being introduced through Test of Change across three health boards
- work is currently underway in partnership with the NES LIAM Programme to open supported access to cCBT through secondary schools
- self-referral psycho-educational support for parents and carers is now available across all areas with a new national digital platform being developed to further support access and increase usage
- work continues across the programme to develop digital services for young people as a priority activity
Wellbeing and prevention
Early intervention and prevention are key priorities for the Scottish Government in taking forward our approach to mental health and wellbeing. Our aim is to support people to positively engage with their mental health at an early stage, promoting and supporting the conditions for good mental health and wellbeing at a population level.
The Scottish Government is taking forward a range of key actions focused on prevention and early intervention by promoting and supporting the conditions for good mental health and wellbeing at population level and providing accessible signposting to help, advice and support. These programmes of work are focused on upstream support for mental health and wellbeing with the aim of reducing the need for clinical interventions by helping to address some of the social determinants of mental health.
Key actions include:
- the launch of Mind to Mind in May 2022, a new site to support the mental wellbeing of the general population in Scotland by offering tips and advice from people with lived experience of mental health issues and associated professionals. The site focuses on five themes - anxiety and panic, sleep, stress, grief and loss and low mood – and signposts to a range of trustworthy resources. Money worries can also have an impact on our mental health and wellbeing. Mind to Mind ‘Coping with money worries’ page includes links to sources of practical advice to support people struggling with money worries and the cost of living
- an online platform for employers to support the promotion of mentally healthy workplaces, was launched on 11 August 2022. This provides an easy-to-access platform for employers with signposting to appropriate resources to help them support positive mental health and wellbeing at work
- support for grassroots community groups, through the Communities Mental Health and Wellbeing Fund, to deliver activities and programmes for adults facing social isolation, loneliness and mental health inequalities. £21 million was made available in 2021 to 2022- involving over 1800 awards to community groups - and a further £15 million is being invested for a second year of the Fund in 2022/23. This fund is currently live with more information available at the Communities Mental Health and Wellbeing Fund - TSI Scotland Network
Impacts of Costs Crisis on Mental Health and Wellbeing
The Scottish Government know that poverty is one of the key drivers of poor mental health and that those already struggling with poor mental health and money worries are likely to be amongst the hardest hit. As the cost crisis continues, we are likely to see more people across the population experiencing rising levels of anxiety and increased levels of distress. We also anticipate an increased demand for signposting and community support as well as a rise in demand for specialist mental health services.
The Scottish Government has a range of work designed to ensure that the right help is available, in the right place, at the right time. This includes record levels of investment in mental health services, doubling our investment in community mental health services, and ongoing work to ensure the right advice and signposting is available for anyone affected by the crisis.
Key actions we have already taken to provide support on the cost crisis and mental health include:
- the Scottish Government has launched a dedicated Cost of Living portal, signposting to helpful information across a range of subjects including energy and bills; debt and money; children and families; and health and wellbeing
- we have placed greater emphasis on mitigating poverty and deprivation within the £15 million Adult Communities Mental Health and Wellbeing Fund in 2022 to 2023 supporting community groups and projects across Scotland
- we have developed specific content in relation to coping with money worries on Mind to Mind; and we have signposted this content, and other sources of mental health support, on the recently launched my.gov cost crisis portal
We are also working across government and with key partners to look at what else can be done to support people facing mental health issues as a result of the cost crisis.
Mental Health Strategy
Scottish Government are committed to producing a new Mental Health and Wellbeing Strategy in the coming year, building on the implementation of our Mental Health Covid Transition and Recovery Plan.
The new strategy will allow us to look ahead to make sure we are doing the right things to meet changing mental health needs over the coming years as we recover from the pandemic; and will set out a clear vision for future population mental health, wellbeing and care, and our priorities to help us get there.
The scope of the strategy will be wider than before, with an increasing focus on wellbeing and prevention. We will also consider how the strategy can take account of social factors and inequalities that may impact a person’s mental health and wellbeing.
Our public consultation closed on the 9 of September, and we are now in the process of having the responses independently analysed. Approximately 500 responses in total were received, and these will be considered alongside the information we have gathered from the various engagement events that have been held so far.
Scottish Government received a broad range of feedback to consider, and are keen to ensure there is ample opportunity to engage further on the important issues that have been raised. In light of this, a decision has been made to delay the publication of the strategy to Spring next year. This will allow more time for detailed work to take place to shape the Strategy and Delivery Plan; and this opportunity will be used to work directly with stakeholders to develop and co-design the final documents. This will include further engagement with organisations working with and representing children and young people.
In the Programme for Government 2021 to 2022, and the Green Party Agreement, Scottish Government have committed to deliver a longer term workforce plan in the first half of this Parliament. We want to ensure that commitments in the forthcoming Mental Health and Wellbeing Strategy are underpinned by a sustainable workforce, that feel valued and supported to deliver services and promote better mental health and wellbeing outcomes. This work will be informed by the consultation for the Mental Health and Wellbeing Strategy.
Following the publication of the Mental Health and Wellbeing Strategy, we will be working closely with partners to identify short, medium and long term actions for Mental Health Workforce Plan, to be published in 2023. The Plan will build on the published National Health and Social Care Workforce Strategy, which sets out a new framework to shape Scotland’s health and social care workforce over the next decade, placing training, wellbeing, job satisfaction and the principles of Fair Work at its heart. It will look at the whole workforce journey and how we can plan for, attract, train, employ and nurture our Mental Health and Wellbeing Workforce.
The Scottish Government is determined to improve our responses for people who self-harm, and has committed to developing a self-harm strategy which will be separate from (but linked to) our suicide prevention strategy. The views of people with lived experience of self-harm – and their families – will be at the heart of developing the strategy, and it will be informed by insights from services that already provide compassionate support to people who self-harm.
Although this is our first standalone self-harm strategy, we have some good work to build on, including engagement undertaken by Samaritans around their Hidden Too Long - uncovering self-harm in Scotland report. However, many aspects of self-harm are hidden and not well understood and we will build our approach in an iterative way. The initial phase of the strategy will be exploratory, where we will listen to the views of people with direct experience of self-harm and organisations that support them. This will help us understand the changes that are needed, and how we go about delivering them and will be the foundation of the strategy. We know how important it is to get this exploratory phase right, and so will be working alongside people with lived experience to design the programme of engagement.
Progress to date:
- we have now set up a small ‘self-harm strategy design group’ which brings together ‘experts by experience’ and some services which support people who self-harm (Penumbra, Samaritans, Childline, Parentline, SeeMe) to help us plan a programme of engagement which will inform what the strategy and action plan could look like. This will include gathering insights from a wider range of services, including those working with children and young people and their families
- we have also held a self-harm data and evidence workshop bringing together a wide range of academics, analysts and practitioners. This was very positive and as a group we are continuing our conversations about how data and evidence can inform and support the development of the strategy
- given the exploratory nature of the work, we are not yet able to put firm timelines around the development of the strategy but will keep the Joint Delivery Board updated as the work develops
We have also provided funding to Penumbra to pilot new self-harm services in three local areas, which will test out a range of approaches, including some work with children under 16, and to develop an online national support portal and learning from this work will also inform the development of the strategy and action plan. Further information about the new pilot services will follow shortly.
Suicide Prevention Strategy – ‘Creating Hope Together’
At the end of September, a new 10-year strategy and action plan for suicide prevention was launched. The strategy will draw on levers across national and local government to address the underlying social issues that can cause people to feel suicidal, while making sure the right support is there for people and their families.
This fresh approach will help people at the earliest possible opportunity and a key focus is placed on ensuring children and young people’s needs are being considered.
The strategy calls for a whole of society and cross government approach be taken to creating hope together and preventing suicide
Every Life Matters action plan - suicide prevention action in Scotland 2018 to 2022, key achievements:
Support for local action planning.
- publication of Local Area Action Plan Guidance
- established opportunities for local leads to share experience
- and provide peer support
- established Implementation Lead roles in Public Health Scotland
Refreshed mental health and suicide prevention learning resources.
- development of Mental Health Improvement and Suicide Prevention Framework
- development of free Ask, Tell, Respond resources
- facilitation packs to support delivery
Co-ordinated approach to public awareness campaigns.
- developed United to Prevent Suicide (UtPS) social movement
- @_FCUnited campaign
- Better Tomorrow social media campaign aimed at young people
Timely effective support for those affected by suicide.
- pilot bereaved by suicide support service
- cruse workplace support
Crisis support recommendations.
- Time, Space and Compassion report
Support innovations in digital technology.
- Surviving Suicidal Thoughts – NHS inform vlogs
Actions targeted at risk groups.
Key achievements: i
- improved understanding of the needs of veterans and racialised communities
- supported by a number of action 3 campaigns
- improved understanding of risk and protective factors
Consider the needs of children and young people in all actions.
- establishment of Youth Advisory Group (YAG)
- development of Ask, Tell, Respond resources for the workforce
- to support needs of children and young people
Data, evidence and guidance used to maximise impact.
- establishment of Academic Advisory Group (AAG) providing evidence and intelligence to support delivery of all actions
- establishment of Lived Experience Panel (LEP) – recognised by World Health Organisation (WHO) as good practice example of meaningful participation
Develop multi-agency reviews into all deaths by suicide.
- review process developed and tested in three areas with key learning identified
Related policy area: Keeping The Promise
The Scottish Government is committed to Keeping The Promise by 2030, working in partnership with Local Government, The Promise Scotland, the third sector, health boards and importantly the care community to do so.
In March of this year, we published the Scottish Government’s Promise Implementation Plan that sets out how we will work across Government to Keep the Promise we have made to Scotland’s children and young people who are care experienced. The Plan has over 80 actions across nearly all Ministerial portfolios that we will take to Keep The Promise. The Plan is presented in two clear parts: Part One sets out the vision for what the future will look like and how as Scottish Government we will achieve this. Part Two sets out the actions and commitments we will take.
This is a cross Portfolio Plan the covers the activities of 26 Directorates across Government and brings our action together in line with the structure set out by The Promise
The Promise Implementation Plan sets out a number of key commitments that we will take forward to Keep The Promise.
Related policy area: Whole Family Wellbeing Funding (WFWF)
Scottish Government have committed £50 million in 2022 to 2023 for WFWF, split into three elements:
- element 1: £32m to CSPPs to build capacity for transformation and scale up existing holistic family support services
- element 2: Up to £6m to support national and local transformation. This includes CSPP collaborative partnerships, and evaluation of WFWF
- element 3: Up to £12m to support new, Scottish Government led national policy delivery that will help transform how families are supported
Element 1 - Children’s Services Planning Partnership (CSPP) Engagement
Scottish have been undertaking a series of informal engagements with CSPPs to learn about local WFWF planning and to introduce lead contacts from the Family Support Unit.
An independent social and market research agency, IFF has been recruited, to undertake the independent evaluation of WFWF (E1 and E2) for year 1. The overview of IFF’s evaluation approach will be available towards the end of October.
CSPPs were asked to submit Initial Plans for WFWF. An initial findings report based on the Initial Plans will be available from early November.
Element 2 - Intensive Collaborative Support for three CSPPs
Three CSPPs have been selected for involvement in Element 2 of WFWF. The CSPPs selected are:
- East Ayrshire
- East Lothian
- Glasgow City
These CSPPs will enter into two-year Intensive Collaborative Partnerships with a National Support Team to accelerate local and national transformation in the delivery of holistic whole family support
A broad range of policy areas submitted their proposals for element 3 of the WFWF. As part of the assessment process we sought the advice from the Collective Leadership Group (CLG) and the Family Support Advisory Group (FSAG) on the ambition and scale of these proposals.
Scottish Governemnt hope to be in a position to announce the successful proposals soon.
Tackling Child Poverty Delivery Plan
The Scottish Government published ‘Best Start, Bright Futures’ - the second Tackling Child Poverty Delivery Plan for the period 2022-26 - at the end of March 2022. The Plan outlines transformational action to deliver on Scotland’s National Mission to tackle child poverty.
The plan has a wide ranging action set out in the Plan will help to drive progress toward the interim child poverty targets set for 2023-24, to lift more children out of poverty and to provide much needed support for families facing the cost of living crisis.
In June, the Scottish Government published its fourth annual Tackling Child Poverty progress report which sets out the range of action taken across government to tackle and reduce levels of child poverty over 2021-22. This is the final report of progress delivered against the first Tackling Child Poverty Delivery Plan ‘Every Child, Every Chance’, covering the period 2018-2022, and shows that all 68 of the actions committed have been delivered. Over the life of ‘Every Child, Every Chance’ (2018-22), the Scottish Government invested an estimated £8.5 billion in supporting low income households, of which £3.3 billion directly benefitted children.
The COVID-19 Children and Families Collective Leadership Group
The COVID-19 Children and Families Collective Leadership Group (CLG) has been taking immediate action throughout the pandemic to support children and families in vulnerable situations based on the data and intelligence that it receives and engagement work with children, young people and families. CLG will continue to receive regular updates on data trends, identify areas of concern, undertake deep-dive work to establish immediate actions to be taken; and monitor the impact of the response.
As the emphasis now shifts from crisis response to intermediate and longer-term recovery, CLG will focus on providing support for Covid recovery and renewal. CLG’s priorities for this year include maintaining momentum on work to Keep The Promise and the development of a Children, Young People and Families Outcomes Framework.
The Children, Young People and Families Outcomes Framework will be aligned to the National Performance Framework and provide a set of wellbeing outcomes, based on what matters to children and families, and a means of measuring progress against these in a meaningful and transparent way. It will provide a way of connecting what is done at national and local level, with the difference it is making to the lives of children and families in Scotland.
CLG’s last Meeting on 12 May covered the following items:
- a “Lessons Learned” session arising from the work undertaken to date on supporting Ukrainian refugees.
- CoSLA presented a report highlighting the work taking place across local government and related services to Keep The Promise:
- issues and recommendations resulting from a review of the 30 Children’s Services Plans (CSPs) published in 2020 to 2021 and strategic engagement with the CSP Strategic Leads Network and other stakeholders
Further information on the Collective Leadership Group can be found on the group page.
The National Care Service
The Independent Review into Adult Social Care (IRASC) recommended the establishment of a National Care Service, with Scottish Ministers being accountable for the delivery of consistent and high standards in health and social care services.
Last year the Scottish Government undertook a public consultation on its proposals for a National Care Service (NCS) to achieve changes to the system of community health and social care in Scotland; and published an independent analysis of the consultation responses. The feedback received has been used to shape and develop new legislation - the National Care Service (Scotland) Bill was introduced to the Scottish Parliament on 20 June 2022. The Bill provides the foundation for the NCS, and enables the fine detail of the new service to be co-designed with people who have direct experience of social care services. Plans have also been published to explain how that collaboration will work. In parallel with further consultation about mental health services, independent research will be commissioned by the Scottish Government to build the evidence base on the current delivery models of children’s services. This research project will consider the different models of delivery to develop an understanding of which delivery models can most effectively implement The Promise and support the improvement of outcomes for children and families.
You can find out more information about the National Care Service can be found on our website.
We have recently published a news article on the National Care Service Bill.
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