Mental Health and Wellbeing Strategy: Leadership Board minutes - April 2025

Attendees and apologies

• Maree Todd MSP, Minister for Social Care, Mental Wellbeing and Sport – Joint Chair
• Councillor Paul Kelly, Spokesperson for Health and Social Care, COSLA – Joint Chair
• Stephen Gallagher, Director of Mental Health, Scottish Government
• Gavin Gray, Deputy Director, Improving Mental Health Services, Scottish Government
• Robby Steel, Principal Medical Officer for Mental Health (representing the multidisciplinary group of Professional Advisors to the Scottish Government)
• Cat Dalrymple, Director of Justice, Scottish Government
• Claire Renton, Deputy Director, Employability, Scottish Government
• Eddie Follan, Chief Officer, Health and Social Care, COSLA
• Alan Webb, Chief Officer of Third Sector Dumfries and Galloway, representing the Scottish Third Sector Interface (TSI) Network
• Laura Kerr, Head of Policy and Workforce, Social Work Scotland
• Daryl Regan, Unite, representing NHS National Staff Side
• Dr Chris Provan, Royal College of General Practitioners Scotland, representing the Academy of Colleges and Faculties
• Dr Jane Morris, Royal College of Psychiatrists (RCPscyh), representing the Academy of Colleges and Faculties
• Lindsay Thomson, NHS State Hospitals Board for Scotland  
• Lee Knifton, Chair of Scotland’s Mental Health Partnership
• Catherine McWilliam, Nations Director, Institute of Directors Scotland
• Gordon Johnston, Chair of Voices of Experience (VOX) Scotland
• Angela Jackson, Diverse Experience Advisory Panel 
• Hussein Patwa, Diverse Experience Advisory Panel 
• Rebecca Hoffman, representing the Equality and Human Rights Forum
• Siobhan McDill, Portfolio Office, Scottish Government
• Victoria Beattie, Head of Mental Health Workforce, Unscheduled and Primary Care, Scottish Government
• Andrew Drought, Deputy Director, Place-Based Social Justice, Scottish Government
• Matthew Smith, Public Health Intelligence Advisor, Public Health Scotland
• Chris Byrne, Public Health Intelligence Advisor, Public Health Scotland
• Ian MacNeill, Health and Social Care Analysis, Scottish Government
• Ally Winford, Mental Health Directorate, Scottish Government
• Hannah Axon, Policy Manager, COSLA

Items and actions

Welcome

The Minister for Social Care, Mental Wellbeing and Sport, as co-Chair, welcomed attendees to the third meeting of the Mental Health and Wellbeing Strategy Leadership Board. She specifically welcomed Dr Robby Steel who is joining the board for the first time, replacing Dr Alastair Cook as the Scottish Government’s Principal Medical Officer.

The Minister advised that we had received one new conflict of interest in advance of the meeting, which would be added to the register. Members were reminded to declare any conflicts of interest in relation to any specific item on the agenda as they arose.

Minutes and actions from previous meeting

The board confirmed that the minutes were a true reflection of the previous meeting, and were therefore approved. The minutes will now be published on the Scottish Government website.

The board received a copy of the action log and the Minister confirmed there were no actions to be carried forward from the last meeting. No queries were raised on any of the completed actions. 

Update on the Service Renewal Framework (SRF)

Gavin Gray, Deputy Director, Improving Mental Health Services provided an overview of the framework which will set out the Scottish Government’s strategic policy intent for health and social care in Scotland for the medium to longer term​. 

Discussion

• Dr Jane Morris, Royal College of Psychiatrists (RCPscyh), representing the Academy of Colleges and Faculties - highlighted that this would work well for people with neurodiversity who require structured, psychological interventions, but we must also remember the smaller group of people who require outpatient hospital-based psychiatry
• Claire Renton, Deputy Director for Employability, Scottish Government – emphasised the importance of connections with employability and economic activity, especially in terms of amplifying the reach and messaging about what we are trying to achieve. The Scottish Government policy team can raise awareness and are happy to support this work
• Gordon Johnston, Voices of Experience (VOX) – the graphs in the presentation mainly focus on physical health, but we know that similar trends are seen in mental health. We must consider all of the strategy’s three P's - promote, prevent, provide - to ensure people with severe mental illness are not overlooked. Anti-stigma work is foundational, and as we move towards digital solutions, we must always ensure non-digital alternatives, as research shows those with severe mental illness are less likely to use digital options. Gavin Gray confirmed that the digital programme is built on a principle of choice, which will remain a core focus moving forward
• Dr Chris Provan, Royal College of General Practitioners Scotland, representing the Academy of Colleges and Faculties – appreciated the emphasis on strengthening community services and primary care general practice. Rising demand and a surge in mental health issues have placed increasing pressure on GPs, while access to secondary care has become more restricted. Agreed with the direction of travel, but we must continue to consider how we strengthen general practice
• Dr Robby Steel, Principal Medical Officer for Mental Health, Scottish Government – need to ensure the principle of “no health without mental health” is embedded at every stage. The vision of the framework is of care in three places: in acute hospitals, in community hubs, and at home. We need to ensure that mental health is appropriately and robustly represented in all three of these settings
• Hussein Patwa, Diverse Experiences Advisory Panel (DEAP) – supported shifting focus to community care, but notes that with services centralised around hospitals, reliance on the third sector and additional community services will be crucial to provide local support networks. Interested in how this will integrate with the other two frameworks and what the co-design and co-production processes will look like, ensuring collaboration with people and supporters of those who will benefit from this
• Laura Kerr, Head of Policy and Workforce, Social Work Scotland – interested to know what emphasis has been placed on the social care aspect of this work particularly around the role of social work services within health and social care partnerships. Keen to see it explained clearly throughout the planning around the link between community health and social care provision
• Lindsay Thomson (NHS State Hospitals Board for Scotland) – highlighted the importance of ensuring that individuals with severe and enduring mental illness receive adequate support in accessing necessary services
• Councillor Kelly, COSLA, Co-Chair – noted that employability and wider social determinants had been discussed at previous board meetings with strong commitment from local authorities and COSLA to the work that it does in the community. The importance of training, employability and access is clear, particularly for individuals facing significant challenges

Action

• secretariat to circulate the Service Renewal Framework presentation to board members

Forthcoming refresh of the mental health and wellbeing delivery plan and workforce action plan (LB(25)03-01)

The Minister introduced this paper, which set out the indicative timeline and proposed sequencing for the publication of a refreshed delivery plan. The Minister confirmed that Scottish Government and COSLA have reached an agreement to formally extend the lifespan of the current delivery plan and workforce action plan, and delay publication of a refreshed plan until early 2026. 

An interim report on the current delivery plan and workforce action plan will also be published in mid-2025. It will include next steps, indicative timings for the forthcoming refresh and highlight key achievements.  

Board members were reminded that they have a central role in shaping the forthcoming plan, which will involve drawing on the expertise and networks that members bring. 

The Minister described how the purpose of this board meeting was to discuss potential content for the refreshed plan. Board members were asked to bring feedback and suggestions on four questions. The information gathered will help lay the foundations for strategic themes and potential actions for the refreshed plan.

The Minister asked the following questions and opened up for discussion -

• emerging Scottish Government Frameworks (Population Health, Strategic Renewal) seek to take a public health approach to prevention, and shift the balance of care. What action could/should be taken within the revised delivery plan to support this work?
• given the current context, where else should specific focus be placed in the next iteration of the delivery plan to best support progress towards the strategy’s vision?
• where are the gaps or challenges in current mental health and wellbeing support, and what feedback have you collected from your networks on areas that need improvement? Are there barriers that need to be removed in order to achieve the outcomes we want?
• are there any emerging policy ideas or collaborative opportunities that have been identified through discussions with your networks that should be considered, and which could enhance the impact of the revised plan?

Discussion on Q1

• Hussein Patwa, DEAP - given the well-known challenges in dedicated mental health services, how can we better educate and support carers and guardians, ensuring they are effectively involved in care networks - either by sharing responsibility or strengthening the overall support system during these challenging times
• Rebecca Hoffman, Equalities and Human Rights Forum (EHRF) – while members are supportive of the plans, much of the EHRF discussion has focused on the reality that public health efforts often overlook marginalised communities, such as racialised and LGBT people, as we already know there are significant unmet health needs

Discussion on Q2

• Lee Knifton, Chair of Scotland’s Mental Health Partnership – we know that early childhood and school transitions, especially for girls and early teens, are critical points for mental health support to prevent long-term disadvantage, with early intervention being key. It's also important to focus on the health and wellbeing of people with physical health conditions by strengthening non-health organisations to support them, helping ease system pressure, particularly for those with comorbidities and during transition points
• Dr Chris Provan, Royal College of General Practitioners Scotland, representing the Academy of Colleges and Faculties – noted the increasing over-medicalisation of mental health, and a tendency to label it as an illness when that is not always the case. We need to focus on using community resources, including education, to better support young people. Engaging secondary care mental health teams in meaningful dialogue as we develop the concept of hubs is also important. The next delivery plan should clearly define these hubs, how they function, and the workforce needed to support them effectively
• Gordon Johnston, VOX – it is crucial to consider the physical health of people with mental health conditions, as this is often overlooked. Specific populations, such as neurodiverse individuals and those with dementia, frequently have co-morbid mental health conditions and find themselves caught between services. Regarding the refreshed plan, there is still uncertainty about its duration and how delayed actions will be addressed. We also need to focus on long-term priorities, such as law reform and other complex issues that won’t be resolved in one or two years
• Dr Jane Morris, RCPscyh, representing the Academy of Colleges and Faculties – members would appreciate a time-stamped set of aspirations, acknowledging the challenges of the next 12 months, but highlighting any actions that could realistically be achieved within that timeframe

Discussion on Q3

• Lindsay Thomson (NHS State Hospitals Board for Scotland) - Scottish Government commissioned valuable work on physical healthcare, addictions, and mental health for prisoners, but it has been sidelined. It is crucial to refocus on this within the next delivery plan, as we already have the plans and information needed to make meaningful progress
• Daryl Regan, Unite, representing NHS National Staff Side - one of the draft priorities proposed for inclusion in the refreshed delivery plan was improving the accessibility of mental health services. In terms of gaps, challenges, and barriers, a key issue is the financial pressures and the current realities on the ground and particularly in the NHS, where services are being cut actively and directly, including primary care, mental health services and specialist services
• Hussein Patwa, DEAP – highlighted members’ aspirations for the third sector or non-primary secondary care mental health services and how these are funded. Appreciate that Government cannot do everything and maybe this is an opportunity to start a national conversation as to how we fund those services, where that funding comes from and where that funding requirement should fall in terms of grant funding, the public sector, the private sector individuals themselves. Another point raised was around honesty from everyone, including service providers, about what will not be feasible to achieve
• Alan Webb, Scottish Third Sector Interface (TSI) Network – we need to rethink messaging around transferring people to the third sector, especially when services are closing. While professional clinical support should absolutely be available when needed, not everyone needs that level of intervention, and alternative support from the third sector can often be more appropriate. It's essential to recognise the crucial role of unseen community organisations in mental health and wellbeing. The transfer from health services to community-based support should emphasise that health and wellbeing start within communities, with strong community health as the foundation, rather than services being the starting point and communities filling the gaps
• Rebecca Hoffman, EHRF – the forum previously discussed the impact and over-reliance on third sector services for marginalised groups. They highlighted the need for support for older people, carers’ mental health and wellbeing and accessible services. It’s essential to consider intersectionality and human rights-based approaches to address mental health inequality in marginalised communities

Discussion on Q4

• Gordon Johnston, VOX - The strategy includes several cross-cutting themes that don't align neatly with individual workstreams, and we need to address these more effectively in the next plan. A key example is peer support. Despite its strong evidence base, it is often treated as a side activity by voluntary organisations and should be integrated into mainstream health services. Similarly, anti-stigma and discrimination work must not only continue but expand to reach the entire system
• Alan Webb, TSI Network – the network are having conversations in other areas of government (public service reform and social justice in tackling poverty), in the development of a new third sector collaborative model which will focus on shared outcomes and community based delivery focus and outcomes rather than a repetitive model of delivery across different communities, for example
• Lee Knifton, Chair of Scotland’s Mental Health Partnership – Scotland has made strong progress with innovative commissioning models, raising the question of whether long-term collaborative funding models could be developed with the third sector, allowing them to leverage their own resources. In addition, non-health actors also have a significant role to play. Non-health actors, such as employers and colleges, also play a crucial role in promoting mental health and wellbeing, particularly for disadvantaged groups. These sectors offer valuable opportunities for engagement and should be formally integrated into the strategy, rather than relying on vague commitments to "work with" them
• Councillor Kelly, COSLA, Co-Chair - acknowledged many of the points raised, including financial pressures and reality on the ground as shared challenges

The board was asked to –

• note the draft indicative timeline which includes the publication of an interim report in June 2025, and the publication of a revised delivery plan and workforce action plan in early 2026
• note the planned involvement of the board in developing the refreshed delivery plan over the course of 2025; and
• note the wider context as outlined at section 4 of the paper

Discussion and questions relating to paper 2 - monitoring and evaluation work of the Mental Health and Wellbeing Strategy and paper 3 - delivery progress report

The Minister advised that papers 2 and 3 would not be presented at the meeting, but officials were available to address any questions raised by members.

Paper 2 provided an update on the monitoring and evaluation work being carried out by Public Health Scotland (PHS) and Scottish Government analysts. It outlined the next steps and expected outputs.

Discussion

• Hussein Patwa, DEAP - the panel expressed some disappointment with the list of prioritised groups in the paper and would like to gain a clearer understanding of the reasoning behind the decision. For example, certain key groups that may require support, such as individuals with physical health challenges and the strong link to mental health, as well as disabled people, were not explicitly mentioned
• Rebecca Hoffman, EHRF - questions were raised about the transparency of the experts involved in this process, including how experts were identified and how targeted groups were measured. Some members also noted a lack of consideration for equality, diversity, inclusion, and human rights. Chris Byrne confirmed that the population groups were identified based on those likely to be affected by the actions outlined in the strategy and delivery plan. Additional suggestions were received from the Health Equity team at PHS, and panellists involved in the process also had the opportunity to propose other relevant population groups for consideration. The full report which outlines some of this critical justification that was shared with the monitoring evaluation subgroup will provide more information and will be circulated to all Board members
• Lee Knifton, Chair of Scotland’s Mental Health Partnership – it was highlighted that key groups, such as those with disabilities, LGBTQ+ individuals, and racialised communities, should also be included in the list of prioritised groups

Paper 3 provided a high level summary on delivery progress for the Mental Health and Wellbeing Strategy Delivery Plan and the Workforce Action Plan up to February 2025. This included a summary and high level breakdown on overall action delivery status, and a specific focus on areas of risk.

Discussion

• Hussein Patwa, DEAP – would like to know what is meant by ‘items which are delayed but which do not impact upon the strategic risk? Also, the panel welcomed the focus on communication, particularly in actions 2.1.2 and 3.2.3, but felt there may be missed opportunities in not fully utilising third sector umbrella organisations, which have established networks. These organisations could play a key role in reaching marginalised groups through more targeted communication channels aligned with specific needs or challenges. Siobhan McDill advised that the categorisation was introduced to ensure that if an item was largely complete - say 90% - but slightly off track, it wouldn't disproportionately impact the overall delivery plan status. This approach may be worth revisiting in the future
• Gordon Johnston, VOX - some actions have missed or are at risk of missing their delivery dates, which were likely set with the original end date of 31 March. Now that the delivery plan has been extended by 10 months, does this mean there is an opportunity to revisit and potentially complete some of these items? There are also a few items that were not progressed because of lack of resources. Does the fact that there are a whole number of actions that have been completed now mean that resources can be moved to some of the actions where there has been no progress to date? Finally, for actions identified as foundational, it's important to have a clear process for reporting progress and considering next steps. This will help ensure that the next delivery plan builds on the current one, rather than it being a totally separate document

Action

• share PHS full monitoring and evaluation report with board members

Close

• on behalf of herself and Councillor Kelly, the Minister thanked everyone for attending and for their contributions
• the date of the next meeting is 21 August 2025 (moved to 2 September)