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

Short-term Outcome 5: People are able to more easily access and move between appropriate, effective, compassionate, high-quality services and support (clinical and non-clinical).

Short-Term Outcome 5 (STO5) of the Mental Health and Wellbeing Strategy outlines that people can more easily access and move between appropriate, effective, compassionate, high-quality services and support.

Metrics for monitoring STO5 are grouped under two core components of the outcome:

1. People are more easily accessing services and support
2. People are more easily moving between services and support

Table 22 presents the specific metrics grouped under each component.

Table 22: Metrics for Monitoring Short-term Outcome 5

The following sections present each of these components and associated metrics in detail, offering insight into baseline measures and observed changes related to STO5.

1. People are more easily accessing support and services

The first component of STO5 outlines that people are more easily accessing support and services. There are six metrics used to monitor this component.

Percentage of patients who started treatment within 18 weeks of referral to CAMHS and PT

NHS Scotland has set a standard that 90% of patients referred to PT and CAMHS, should begin treatment within 18 weeks of referral. This standard is a key indicator of timely access to specialist mental health and substance use services.

Quarterly data from PHS, covering the period from January – March 2023 to Jul–Sep 2025, show variation in performance across services:

• CAMHS: Performance has steadily improved, rising from 74.2% of patients starting treatment within 18 weeks in Jan-Mar 2023 to 91.5% in Jul-Sep 2025. The 90% target was first met in Oct–Dec 2024 (90.6%) and has been sustained since.
• Psychological Therapies (all ages): Performance remained consistently below target, fluctuating between 78.3% and 80.6%. The highest level over the period was recorded in Jul–Sep 2025 (80.7%), following the lowest level in Apr–Jun 2025 (78.3%).

Figure 7: Percentage of patients starting treatment within 18 weeks of referral to CAMHS and Psychological Therapies, Scotland, Jan–Mar 2023 to Jul–Sep 2025

Waiting times performance statistics, Public Health Scotland 2025

Percentage of adults who started treatment within 3 weeks of referral for community drug and alcohol services

In 2011, the Scottish Government set a Standard that 90% of people referred for help with problematic drug or alcohol use should wait no longer than three weeks to start specialist treatment that supports their recovery.

PHS reports that community-based drug and alcohol services have met or exceeded the 90% Standard in every quarter from quarter ending March 2023 (92.1%) to quarter ending June 2025 (94.2%), maintaining timely access throughout this period. Hospital-based and prison-based services have also exceeded the Standard over the same reporting period.

Percentage of referrals accepted for CAMHS and Psychological Therapies

Referral acceptance rates show how often people referred to specialist mental health services are taken on for treatment. A higher acceptance rate indicates that individuals are successfully entering the service, while changes in rates over time can highlight variations in service availability or responsiveness.

Quarterly data from PHS, covering April–June 2023 to April–June 2025, show variation across services:

• CAMHS had the lowest acceptance rates over this period, falling from 75% in April–June 2023 to 68% in the same quarter in 2025.
• PT consistently reported higher acceptance rates than CAMHS, decreasing from 97% in April–June 2023 to 93% in the same quarter of 2025.  

Percentage of appointments not attended (DNA) for community-based mental health services

Non-attendance at community-based mental health services is an important measure of ease of access and engagement. Although the reasons for missed appointments are not reported, high DNA rates may indicate barriers to access or difficulties in sustaining engagement with services.

Quarterly data from the Mental Health Quality Indicators show DNA rates across health board areas. In the most recent quarter (April–June 2025):

• NHS Ayrshire & Arran (17.08%) and NHS Dumfries & Galloway (15.69%) recorded the highest DNA rates.
• NHS Fife (8.9%) and NHS Western Isles (9.07%) reported the lowest rates.

DNA rates have remained relatively stable over time, with most NHS Boards showing changes of less than 1–2 percentage points between Apr – June 2023 and Apr – June 2025. Notable decreases were observed in NHS Tayside (from 19.1% to 16.64%) and NHS Lanarkshire (from 13.63% to 11.70%). In contrast, NHS Dumfries & Galloway showed a notable increase (from 12.4% to 15.69%).

Percentage of appointments not attended (DNA) for CAMHS

Non-attendance at CAMHS is an important measure of access and engagement. Although the reasons for missed appointments are not reported, higher DNA rates may indicate barriers to access or difficulties in sustaining engagement.

Quarterly data from PHS shows that the percentage of CAMHS appointments recorded as DNA across Scotland decreased slightly from 12% in the quarter ending June 2023 to 10% in the same quarter in 2025.

Percentage of GP and out-of-hours service patients who found it easy to access mental health support in primary care settings

The HACE survey asks GP patients attending their GP how easy it was to contact their GP in the way they wanted. In addition, patients are asked who they contacted the last time they tried to get treatment when their GP was closed. This metric provides insight into how easily people can reach their GP and whether they are aware of other support options.

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.

When GP practices were unavailable, patients seeking mental health support turned to recognised alternatives. As shown in Table 20 63% of respondents contacted NHS 24, while smaller proportions used the NHS website (16%), spoke to a pharmacist (25%), or sought advice from family or friends (23%).

Table 23: Source contacted when GP closed for mental health support, 2023/24

Source: Health and Care Experience Survey

2. People are more easily moving between services and support

The second component of STO5 outlines that people are more easily moving between support and services. There are two metrics used to monitor this component.

Number of delayed discharge days in mental health inpatient settings

The Scottish Government’s Mental Health Inpatient Census reports on the percentage of inpatients who had a delayed discharge. Delayed discharges happen when a hospital patient, who is ready for discharge, continues to occupy a bed. While the reason for delayed discharge are not recorded, it may indicate challenges in arranging follow-up services and support.

In 2023, 11% of patients experienced a delayed discharge, up slightly from 10% in 2022. During the same period, the average delayed discharge days rose from 68 in 2022 to 87 in 2023.

Percentage of Alcohol and Drug Partnership (ADP) areas with referral pathways to mental health or multidisciplinary services

The Scottish Government’s Alcohol and Drug Partnership [1] (ADP) survey reports on pathways to mental health services for people with co-occurring substance use and mental health diagnosis. Clear referral pathways are important to help people move between services and to ensure that their needs are met in a coordinated way.

In 2023/24, 80% of ADP areas reported having pathways in place for referral to mental health services or other multidisciplinary teams.

Reflections on Short-Term Outcome 5

STO5 focuses on whether people can more easily access and move between appropriate, effective, compassionate, high-quality services and support. Most of the available data comes from after the launch of the Strategy in mid-2023, with measures across 2023, 2024 and 2025 providing a baseline and some early signs of change.

Access to specialist mental health services varies. CAMHS has steadily improved and now consistently meets the national 18-week standard, while psychological therapies for adults and older adults continue to fall short, with older adult services declining. Drug and alcohol services have consistently maintained timely access. Referral acceptance rates remain high for most services but have dipped slightly for CAMHS. Missed appointment rates are stable across community services and CAMHS, suggesting consistent engagement. In primary care, most people report it is relatively easy to reach their GP, with NHS 24, pharmacists and family or friends commonly used when practices are closed.

In inpatient settings, delayed discharges have increased slightly, and high occupancy in some ward types, particularly acute wards, may affect transitions. Alcohol and Drug Partnership areas report strong referral pathways to mental health services, supporting more coordinated movement between services.

Data Gaps

There is one overarching data gap that limits the ability to fully monitor STO5.

• Data on a range of support and services: Most available data focuses on NHS services, with limited coverage of third sector and social care provision. There are also gaps in understanding how people move between services, particularly across sectors, and limited systematic data on referrals and service use in non-clinical settings. There is also minimal insight into whether transitions are effective or result in improved outcomes for service users.