Executive Summary 

Purpose of the report 
This is the initial monitoring report for Scotland’s Mental Health and Wellbeing Strategy, launched in June 2023. It provides an update on early progress towards the Strategy’s summary and short-term outcomes, using national-level data where available, and identifies where monitoring is limited due to data gaps. 

Mental Health and Wellbeing Strategy and outcomes framework 
The Strategy aims for “a Scotland free from stigma and inequality, where everyone can achieve the best mental health and wellbeing possible.” It is underpinned by 34 sequenced outcomes (short-, medium- and long-term) and nine high-level summary outcomes, which form the core focus of ongoing monitoring. The outcomes seek to drive change across individual, community and population-level factors; services and support; societal influences; and the use of data and evidence. 

Approach to monitoring outcomes 
A monitoring framework is published alongside this report and provides detailed descriptions of the measures (or “metrics”) used to track outcomes over time. The framework draws on routinely collected, national quantitative data from sources such as the Scottish Health Survey. Metrics were selected from national-level sources based on their relevance to the outcomes and whether the data were publicly available, quantitative, and regularly updated. Where available, baseline data provide context before the Strategy was published, with updated data providing early indications of change. 

Data gaps 
While most outcomes can be partially monitored, gaps remain in areas such as mental health literacy, stigma and discrimination, and equalities data, limiting the ability to fully assess progress. Some outcomes are also better captured through qualitative insight rather than quantitative measures and are therefore beyond the scope of this report. 

Progress against the Strategy’s summary outcomes 
Overall, the evidence presents a mixed picture. Some indicators show early signs of improvement, but progress is uneven and mental health inequalities remain persistent. The sections below summarise key findings for each of the nine summary outcomes. Findings for short-term outcomes are set out in the full report. 

Summary Outcome 1 

The overall mental health and wellbeing of the population is increased, and mental health inequalities are reduced 

There have been some improvements in population mental health and wellbeing since 2022, including a statistically significant improvement in average adult mental wellbeing and a significant reduction in the proportion of adults scoring 4 or more on the GHQ-12 (indicating possible psychiatric disorder). Other measures, such as symptoms of anxiety and depression and life satisfaction, show small but non-significant improvements. GP-recorded prevalence of depression, eating disorders, and severe mental illness has remained broadly stable. 

However, mental health inequalities remain persistent. Women, younger adults, people living in the most deprived areas, and people with limiting long-term conditions consistently report poorer outcomes across multiple indicators. 

Summary Outcome 2 

People with mental health conditions experience improved quality and length of life, free from stigma and discrimination 

Most of the available data for this outcome establishes a baseline for future monitoring rather than clear trends. 

The data highlight some inequalities. People with mental health conditions experience poorer quality of life, including higher levels of anxiety and depression, more chronic pain, lower employment rates, and poorer self-reported health. Premature mortality remains substantially higher among people in contact with mental health services compared with the general population. 

Survey data also indicate that experiences of mental health-related discrimination and harassment increased between 2022 and 2023. 

Summary Outcome 3 

People have increased knowledge and understanding of mental health and wellbeing and how to access support 

Available data provide only a partial picture. Most adults attending a GP for a mental health reason report understanding the information provided, though this is slightly lower than for patients attending for non-mental health reasons. Most adults seeking mental health support report it is easy to contact their GP or out-of-office services when practices are closed. Among children and young people, self-referral is a common route into school-based and community services, suggesting awareness of access routes. 

However, broader population mental health literacy remains largely unknown due to data gaps, limiting the ability to monitor progress on this outcome. 

Summary Outcome 4 

Communities are better equipped to support mental health and wellbeing and provide opportunities to connect 

Data show that communities continue to play an important role in prevention and early support. Investment through the Communities Mental Health and Wellbeing Fund for Adults demonstrates wide geographic coverage and a broad range of activities, with increasing focus on families facing disadvantage or complex needs. Community-based services for children, young people, and families also show evidence of reach and impact. 

However, perceptions of neighbourhood support have declined since 2022, and inequalities between more and less deprived areas persist. Adults in more deprived areas consistently report fewer welcoming spaces, weaker sense of belonging, and lower perceived support. While overall loneliness has decreased (including a statistically significant reduction among urban residents), sense of belonging has declined in the most deprived areas, widening inequalities. There is no routinely collected data to monitor whether communities are reducing stigma and discrimination. 

Summary outcome 5

We adopt a ‘mental health and wellbeing in all policies’ approach to facilitate cross-policy actions that more effectively address the wide-ranging social, economic and environmental factors that impact people’s mental health and wellbeing, including poverty, stigma, discrimination, and injustice

There are currently no routinely collected data that track the adoption of a ‘mental health and wellbeing in all policies’ approach across sectors. As a result, progress against this outcome cannot be robustly monitored using quantitative indicators and would be better assessed through qualitative evidence. 

Summary Outcome 6 

Comprehensive support and services are available in a timely way and meet individual needs 

Overall, the evidence presents a mixed picture, with some improvements in access but continued inconsistency across services and settings. CAMHS waiting times have improved and the 18-week standard has been consistently met since late 2024. Referrals to Distress Brief Intervention services have expanded. 

However, performance remains below target in adult psychological therapies. Experiences of urgent access to GP appointments are variable, with some patients seen on the same day and others waiting longer. Community follow-up after discharge varies across health boards, and delayed discharges from mental health inpatient settings have increased slightly. 

Measures of person-centred care suggest that many GP patients feel listened to and supported, but fewer report being offered opportunities to involve family or carers. 

Summary outcome 7

Mental health policies, support, care, and treatment are better informed and shaped by people with lived experience of mental health issues and staff practitioners, with a focus on high quality provision that is recovery orientated 

There are currently no routinely collected data that track how policies, support, care and treatment are informed by people with lived experience and practitioners. As a result, progress against this outcome cannot be robustly monitored using quantitative indicators and would be better assessed through qualitative evidence. 

Summary outcome 8

Decision-makers and practitioners (including the third sector) are better able to access the evidence, research and data they need to ensure a more evidence-based approach to policy formation and practice. 

There are currently no routinely collected data that track how decision-makers and practitioners access, interpret, or apply evidence, research and data in their work. As a result, progress against this outcome cannot be robustly monitored using quantitative indicators and would be better assessed through qualitative evidence.

Summary Outcome 9 

The mental health and wellbeing workforce is diverse, skilled, supported, and sustainable 

Workforce capacity in CAMHS and Psychology Services has increased since 2023. Vacancy rates have fallen to their lowest levels on record, and turnover has generally declined, suggesting improvements in recruitment and retention. Training pipelines remain stable, with improving rates of graduates entering NHS employment. There is limited routine data on workforce wellbeing and experiences, and no comprehensive data source capturing the wider mental health workforce beyond CAMHS and Psychology Services.