Mental Health and Wellbeing Strategy: Initial Monitoring Report and Monitoring Framework

Short Term Outcome 3: When people seek support for their mental health and wellbeing, they experience a response that is holistic, flexible and takes a whole person approach, supporting them to achieve their personal outcomes and recovery goals.

The Mental Health and Wellbeing Strategy’s Short Term Outcome 3 (STO3) describes that people seeking support for their mental health and wellbeing receive a holistic, flexible, whole-person response and are supported to achieve their personal outcomes and recovery goals.

Metrics for monitoring STO3 are grouped under three core components of the outcome:

• Whole-person and holistic support
• Flexible support
• Personal outcomes and recovery

Table 17 presents the specific metrics grouped under each component.

Table 17: Metrics for Monitoring Short-term Outcome 3

Core Components	Metrics
Whole-person, holistic support	Percentage of welfare guardianship care plans considered person-centred Percentage of GP patients reporting that people took account of the things that mattered to them Percentage of GP and out-of-hour patients reporting support to involve important people in their care Percentage of adult mental health inpatients who received a physical health check during admission
Flexible support	Percentage of GP patients reporting ease of contacting their GP for a mental health reason Percentage of GP patients reporting ease of arranging to speak to a mental health professional Percentage of GP patients reporting choice and satisfaction with type of GP appointment Percentage of GP patients reporting timeliness of GP response to urgent mental health need Mode and location of CAMHS and Psychological Therapies appointments
Personal outcomes and recovery	Percentage of GP patients reporting improvements in mental health symptoms and wellbeing after a GP appointment Percentage of GP and out-of hour patients reporting staff helped them feel in control of their treatment and care Percentage of GP patients with a mental health condition who feel able to look after their own health, compared to those without Percentage of adults with mental health problems supported at home who agree that their services and support had an impact in improving or maintaining their quality of life Percentage of community-based support service users reporting improvements in mental health

The following sections present each of these components and associated metrics in detail, offering insight into baseline measures and observed changes related to STO3.

1. Whole-person and holistic support

The first component of STO3 outlines that when people seek support for their mental health and wellbeing, they receive a response that is holistic and takes a whole-person approach. There are four metrics used to monitor this component.

Percentage of welfare guardianship care plans considered person-centred

The Mental Welfare Commission for Scotland monitors the use of welfare guardianship orders [1] under the Adults with Incapacity (Scotland) Act 2000, as part of its safeguarding role for adults with mental illness, learning disability, dementia, and related conditions. The Commission defines person-centred care plans as those that reflect each individual’s hopes and aspirations.

In 2023/24, 19,078 individuals were subject to a welfare guardianship order. The Commission visited 327 of these individuals, reviewing care plans for 295. Of those, 80.4% (n=263) were considered person-centred. This is a slight decrease from 2022/23, when 83% of 196 care plans met this standard.

Percentage of GP patients reporting that people took account of the things that mattered to them

The HACE survey asks GP patients whether the care they received took account of the things that mattered to them. This metric reflects a holistic, whole-person approach, measuring whether patients feel their priorities and preferences are considered. This data is available from PHS’s Mental Health Quality Indicators.

In 2023/24, 56% of people with a mental health condition agreed that their priorities were taken into account.

Percentage of GP and out-of-hours patients reporting feeling supported to involve important people in their care

The HACE survey asks GP and out-of-hours patients whether they were given the opportunity to involve people important to them. This metric reflects a holistic, whole-person approach, measuring whether patients were supported to involve people that mattered to them in their healthcare decisions and treatment.

In the 2023/24 survey:

• 47% of patients contacting a GP for a mental health reason reported being given this opportunity, broadly consistent with 49% of patients contacting for other reasons.
• 54% of patients contacting out-of-hours services for a mental health reason reported being given this opportunity, compared with 64% of patients contacting for other reasons.

Percentage of adult mental health inpatients who received a physical health check during admission

Data from the Scottish Government’s Mental Health Inpatient Census tracks the proportion of adult inpatients who received some form of physical health check.

On admission to an inpatient setting, patients are offered a physical health check, which usually includes basic observations such as blood pressure, weight, and other assessments to identify immediate health needs. This metric reflects a holistic, whole-person approach by capturing whether patients’ physical health is assessed during their mental health inpatient stay.

In 2024, 89% of adult mental health inpatients were recorded as having received a physical health check within a day of admission during their inpatient stay, compared to 94% in the 2023 census.

2. Flexible support

The second component of STO3 outlines that when people seek support for their mental health and wellbeing, they receive a response that is flexible. There are five metrics used to monitor this component.  

Percentage of patients reporting ease of contacting their GP for a mental health reason

The HACE survey asks GP patients how easy it was to contact their GP in the way they wanted. This metric reflects a flexible approach, capturing whether patients can access services in a way that meets their needs.

In the 2023/24 survey, 73% of patients who contacted their GP for a mental health reason found it easy to do so, compared with 76% of people who contacted their GP for other reasons.

Percentage of GP patients reporting ease of arranging to speak to a mental health professional

The HACE survey asks GP patients how easy it was to arrange contact with health professionals. This metric reflects flexible care, capturing how easy it is for patients to access support across different professions.

In 2023/24, of patients who were contacting their GP for a mental health reason:

• 63% of patients rated arrangements to speak to a GP as positive (21% negative)
• 67% of patients rated arrangements to speak to a nurse as positive (13% negative)
• 69% of patients rated arrangements to speak to a pharmacist/chemist as positive (11% negative)
• 44% of patients rated arrangements to speak to a mental health professional as positive (39% negative)

Percentage of patients reporting choice and satisfaction with type of GP appointment
The HACE survey asks GP patients whether they were offered a choice in the type of appointment (e.g., phone, video, or in-person) and whether they were satisfied with the appointment they received. This metric reflects flexible care, capturing whether patients are offered an appointment type that meets their needs and whether they are satisfied with it.

In 2023/24:

• 37% of patients attending for a mental health reason were offered a choice in appointment type, compared with 31% of those attending for other reasons. 52% were offered no choice.
• 76% were satisfied with the type of appointment offered, compared with 81% of those attending for other reasons.
• 23% attended an appointment they were dissatisfied with, and 1% declined the appointment altogether.
• Among those who were dissatisfied, 56% reported that the appointment type did not match their preference.

Percentage of GP patients reporting timeliness of GP response to urgent mental health need

The HACE survey asks GP patients who required urgent support how long they waited for an appointment. This metric reflects flexible care, capturing the timeliness of GP support for patients with urgent mental health needs.

In 2023/24:

• 49% of patients needing urgent GP support for a mental health reason were seen on the same day, compared with 50% for other reasons.
• 16% waited more than two working days, compared with 12% for other reasons.

Mode and location of CAMHS and Psychological Therapies appointments
The Child, Adolescent, and Psychological Therapies National Dataset (CAPTND) records quarterly appointment details for specialist mental health services across NHS Scotland, including delivery mode and location. As this dataset is still in development, data returns vary across Health Boards, and results should be interpreted with caution. This metric reflects flexible care, capturing the different ways specialist mental health services are delivered to patients.

Findings for the quarter ending June 2025 show:

• CAMHS: Most appointments were in an outpatient clinic (50%), followed by NHS Near Me (6%). Location was unknown or missing for 31% of appointments.
• PT: Most appointments were in an outpatient clinic (47%), followed by NHS Near Me (7%). Location was unknown or missing for 26% of appointments.

3. Personal outcomes and recovery goals

The third component of STO3 outlines that when people seek support for their mental health and wellbeing, they are supported to achieve their personal outcomes and recovery goals. There are five metrics used to monitor this component.  

Percentage of GP patients reporting improvements in mental health symptoms and wellbeing after a GP appointment

The HACE survey asks GP patients attending their GP for a mental health reason to describe the effect of the treatment they received on the symptoms they were experiencing and on their overall wellbeing.

In 2023/24,

• 40% of respondents reported an improvement in their mental health symptoms following a GP appointment. However, 29% said symptoms stayed the same, 12% reported worsening, and 14% said it was too early to tell.
• 38% of respondents reported an improvement in their overall wellbeing following a GP appointment. However, 31% said symptoms stayed the same, 15% reported worsening, and 13% said it was too early to tell.

Percentage of GP and out-of hour patients reporting staff helped them feel in control of their treatment and care

The HACE survey asks GP and out-of-hours patients attending their GP and out of hours services for a mental health reason whether staff helped them feel in control of their treatment and care.

In 2023/24:

• 61% of patients contacting a GP for a mental health reason reported that staff helped them feel in control of their treatment and care, slightly lower than 66% of patients contacting for other reasons.
• 56% of patients contacting out-of-hours services for a mental health reason reported feeling in control, compared with 71% of patients contacting for other reasons.

Percentage of GP patients with a mental health condition who feel able to look after their own health, compared to those without

The HACE survey asks GP patients attending their GP and out of hours services how well they feel they are able to look after their own health

In 2023/24:

• 76% of patients contacting a GP for a mental health reason reported feeling able to look after their own health and wellbeing, compared with 93% of patients contacting for other reasons.
• 61% of patients contacting out-of-hours services for a mental health reason reported feeling able to look after their own health and wellbeing, compared with 88% of patients contacting for other reasons.

Percentage of adults with mental health problems supported at home who agree that their services and support had an impact in improving or maintaining their quality of life

The HACE survey asks people with mental health problems who are supported at home whether their services and support have helped improve or maintain their quality of life. This data is available from PHS’s Mental Health Quality Indicators.

In 2023/24, 55% of adults with mental health problems supported at home reported that their services improved or maintained their quality of life.

Percentage of community-based support service users reporting improvements in mental health

The Scottish Government collects data from local authorities on access to community-based mental health support for children, young people and their families. The latest report covers an interim nine-month period (July 2023 to March 2024), as reporting transitions from six-monthly to annual cycles aligned with the financial year. This change limits direct comparison with previous years.

Recovery-focused support also includes access to and impact of community-based services, which can help people maintain wellbeing and manage mental health in everyday life.

Data from local authorities for the interim nine-month period July 2023 to March 2024 show that 82,938 people used community-based supports and services, including 10,120 family members and carers.

• 78% of users accessed positive mental wellbeing services, which are generally preventative and may include self-guided or educational supports, such as digital cognitive behavioural therapy or wellbeing training.
• Of these service users, 24,425 (58%) reported an improved outcome. Among users of emotional distress services, 7,106 (58%) reported an improved outcome.
• For at-risk groups, 5,409 (71%) of positive mental wellbeing service users reported improvement, and 2,863 (52%) of emotional distress service users reported improvement.

Reflections on Short Term Outcome 3

Short Term Outcome 3 focuses on whether people seeking mental health support experience care that is holistic, flexible, and aligned with their personal outcomes and recovery goals. Due to data availability, most metrics provide a baseline picture from 2023 and 2024, with only a small number showing early change since the Strategy was published.

Evidence shows some adoption of a whole-person approach. Many people feel their priorities are considered and some are supported to involve important others in their care. In inpatient settings, most people receive a physical health check. However, not all care plans meet person-centred standards, and fewer than half of people consistently report that what matters to them is fully taken into account.

People report mixed experiences of flexibility when accessing mental health support. While most patients are satisfied with the type of GP appointment they receive, many say they are not offered a choice. Urgent GP support is available quickly for some but others experience delays. Patients report greater ease in arranging to speak to GPs, nurses, and pharmacists than to mental health professionals. Specialist services such as CAMHS and Psychological Therapies are most often delivered through outpatient clinics, though reporting gaps limit a complete picture.

Experiences of personal outcomes are varied. Many people feel able to look after their own health and in control of their treatment, though fewer report improvement in their mental health symptoms after GP appointments. Around half of those supported at home feel their quality of life is maintained or improved. Community-based support services are reaching large numbers of people, with many reporting positive changes in their mental wellbeing.

Data gaps

There is one overarching data gap that limits the ability to fully monitor STO3.

• Data on a range of support and services: There is limited information on whether a broad range of services are delivering holistic, person-centred care. Evidence on flexibility mostly comes from primary care, with little data from other parts of the mental health system. There is a lack of data on long-term recovery or clinical outcomes.