Areas of further work
Mental Health and Substance Misuse
Mind the Gap and A Fuller Life set out the issues in relation to meeting the needs of people with co-occurring mental health and substance misuse problems and while highlighting good practice in some areas, paint a picture of unmet need, service gaps and lack of clarity about pathways and ongoing support. These findings are reflected in the Centre for Addiction Research and Education Scotland ( CARES) report on co-morbidity and the recent evaluation of the Choose Life suicide programme. Over the course of 2006 a short life working group has been in place pulling together and extracting the key actions required to be delivered that will also help to shift the agenda in relation to substance misuse.
Commitment 13: We will translate the principles of Mind the Gap and A Fuller Life into practical measures and advice on what action needs to be taken to move the joint agenda forward and support joined-up local delivery by the end of 2007.
Improving services for older people with mental health problems
More people in Scotland are living longer, with a better quality of life, but the number of people living into old age with chronic physical and mental health problems is also increasing. In addition to the number of elderly people who develop dementia, the number of people with anxiety and depression is also increasing. We will ensure that this population group is properly taken account of in the work on depression and in respect of their physical health needs. In addition, with the growing numbers of people suffering from dementia (assessed as around 65,000 now, but likely to grow to 192,000 by 2040) we will put in place work to develop services.
Commitment 14: We will work with the Dementia Services Development Centre at Stirling University and NHS Forth Valley to undertake a pilot programme in improving dementia services. The pilot will be evaluated in 2008.
Learning Disability Co-Morbidity
People with learning disability who have challenging behaviour and mental health needs require improved access to evidence based support and services. Evidence shows that challenging behaviour does not respond to short and medium term interventions and requires a sustained approach over decades. Therefore the role of assessment and treatment beds needs to be considered carefully within a whole system approach. We will to continue to work with NHS Boards and Local Authorities to share and build on positive practice through the development of local and regional networks and we will take this work forward during 2007/08.
Mental Health and Employment
We know that employment can be key to recovery for many people suffering from mental illness and programmes to maintain employment or to facilitate re-entry into the labour market can be very effective in supporting social inclusion. Pilot work in primary care and in particular labour markets will be evaluated and where appropriate the lessons applied more generally. We will also learn from the work being taken forward by the Scottish Development Centre for Mental Health on behalf of the European Commission.
Implementation of the Mental Health (Care and Treatment) (Scotland) Act 2003
The implementation and research programme that underpins the new Mental Health Act will continue and we will support work between Health Boards, Local Authorities and the Mental Health Tribunal for Scotland to improve the overall efficiency of the system to better secure the objectives and principles of the legislation. We will also evaluate how the Act is operating to improve the quality of care and the experience of service users and carers.
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