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

Summary Outcome 3: People have an increased knowledge and understanding of mental health and wellbeing and how to access appropriate support.

Summary Outcome 3 (SO3) of the Mental Health and Wellbeing Strategy focusses on ensuring that people have increased knowledge and understanding of mental health and wellbeing, and about how to access appropriate support.

Monitoring progress towards this outcome is structured around two core components:

1. Knowledge and understanding of mental health and wellbeing
2. People know of how to access appropriate support

Taken together, SO3 can be understood as referring to mental health literacy. This includes peoples’ understanding of how to maintain good mental health, recognising symptoms of mental health conditions and knowing available support and treatments. It also encompasses public attitudes toward mental health and people’s willingness to seek help when needed (Kutcher, Wei, & Coniglio, 2016).

Improved mental health literacy across the population has been identified as a protective factor against poor mental health and wellbeing (Campion, 2019). For example, greater mental health literacy may mean that people are better equipped to recognise early signs of distress, seek support when needed, and offer help to others.

Table 8 presents the specific metrics grouped under each component.

Table 8. Metrics for Monitoring Summary Outcome 3

The following sections present each of these components and associated metrics in detail, offering insight into baseline measures and observed changes related to SO3.

1. Knowledge and understanding of mental health and wellbeing

The first component of Summary Outcome 3 is about improving knowledge and understanding of mental health and wellbeing. There are two metrics used to monitor this component.

Percentage of GP and out-of-hour patients who understood information provided during a GP appointment for a mental health reason

The HACE survey asks GP patients whether they understood the information provided during their appointment.

In the 2023/24 survey, 85% of patients attending their GP for a mental health reason reported that they understood the information, compared with 91% of patients attending for other reasons.

For those attending Out of Hours [1] services, 72% of patients with a mental health reason reported understanding the information, compared with 88% of patients whose contact was for another reason.

Percentage of adults who believe mental ill health was a reason for which they have experienced discrimination or harassment in the last 12 months

The Scottish Household Survey asks adults living in Scotland whether they experienced discrimination or harassment in the past 12 months because of their mental health.

Experiences of discrimination and harassment can reflect broader levels of knowledge, understanding, and attitudes toward mental health in the population (Grosselli et al., 2025).

In 2023, 15% of adults reported experiencing discrimination, up from 9% in 2022, a 6-percentage point increase. Similarly, 14% of adults reported experiencing harassment, an increase from 8% in 2022, also a 6-percentage point rise.

2. People know of how to access appropriate support

The second component of Summary Outcome 3 is about people know of how to access appropriate support. There are three metrics used to monitor this component.

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 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 9, 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 9: Source contacted when GP closed for mental health support, 2023/24

Source: Health and Care Experience Survey

Number of children and young people self-referring to school counselling

The Scottish Government collects data from local authorities on access to school-based counselling. 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.

Self-referral data to school counselling provides insight into the extent to which children and young people are able and willing to seek help for mental health concerns.

Between July 2023 and March 2024, 2,077 children and young people self-referred to school counselling services. Self-referral was the second most common route into school counselling services after referral by school staff (14,296 referrals).

Number of people self-referring to community mental health services

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.

Self-referral data to community-based support and services provides insight into the extent to people are able and willing to seek help for mental health concerns.

Local authorities reported that 82,938 people used the community-based supports and services between July 2023 and March 2024, 10,120 of whom were family members and carers.

Between July 2023 and March 2024, 13,110 people self-referred to community supports and services. Self-referral was the second most common route into community supports and services after referral by school staff (21,494 referrals).

Reflections on Summary Outcome 3

Summary Outcome 3 of the Mental Health and Wellbeing Strategy focuses on increasing people’s knowledge and understanding of mental health and wellbeing, as well as how to access appropriate support. Together, these components can be understood as mental health literacy.

As much of the data was collected during 2023/24, which overlaps with the launch of the Strategy, it serves as the earliest available baseline for assessing future change.

Some data provide insight into knowledge and understanding of mental health and wellbeing. Most people attending a GP for a mental health reason report understanding the information provided, although this is slightly lower than for other GP patients. Experiences of discrimination and harassment related to mental health increased between 2022 and 2023, indicating that this aspect of public attitudes was worsening prior to the launch of the Strategy.

In terms of accessing support, most adults seeking mental health support from primary care reported it was easy to contact their GP or an alternative service such as NHS 24 when practices were closed. Among children and young people, self-referral was the second most common route into school-based counselling and community mental health services, indicating awareness of how to access these services.

Data gaps

There is one overarching data gap that limits the ability to fully monitor SO3.

• Mental Health Literacy: The available metrics provide only a partial picture of mental health literacy in Scotland. Data is largely drawn from those engaged with services, particularly GP, leaving the mental health literacy of the wider population largely unknown. There are gaps in data on key aspects of mental health literacy, including: understanding how to maintain good mental health, recognising symptoms, awareness of available supports and treatments, public attitudes, and willingness to seek help when needed.

Footnotes