Mental Health in Scotland 2016: consultation

1. Focus on prevention and early intervention for pregnant women and new mothers.

• Perinatal mental health - improve the recognition and treatment of mental health problems in the perinatal period. This will initially be done through the introduction of a network of specialist staff working together, which is formally known as a Managed Clinical Network.
• Perinatal mental health - focus interventions on the most vulnerable mothers who are at the highest risk.

Health services are alert to, identify, and address mental health issues of pregnant women and new mothers.

Better long-term outcomes for children.

2. Focus on prevention and early intervention for infants, children and young people.

• In 2016-17, develop a range of evidence-based programmes targeted to promote good mental health, support key vulnerable populations of infants, and children and young people. These programmes will be delivered by children's services during 2017-20.
• By 2018-19, support the work above by better assessing which early intervention programmes are proven to work for different vulnerable populations.
• By 2019-20 have completed the national roll-out of targeted parenting programmes for parents of 3- and 4-year olds with conduct disorder.
• Psychosis - by 2017-18, have improved the recognition and treatment of first episode psychosis through early intervention services.
• Develop further actions to support health and wellbeing of children and young people, recognising the link between mental and physical health through our Children and Young People's Health and Wellbeing strategy.
• Utilise our universal services such as the new health visiting pathways to support good mental health, prevention and early intervention.

Children's services focus in the promotion of good mental health based on prevention and early intervention.

Children's services are equipped to quickly identify risk factors and implement action, using evidence-based programmes, to support children and families at risk of developing mental health problems.

Improvements in partnership working between specialist Child and Adolescent Mental Health Services ( CAMHS) and other children's services so children, young people and families get the help they need quickly.

Improved longer term life outcomes for vulnerable groups - for example, better mental health, increased attainment, and a reduced chance of involvement in the criminal justice system.

3. Introduce new models of supporting mental health in primary care.

• By 2018-19 have tested and evaluated the most effective and sustainable models of supporting mental health in primary care. These models will be rolled out in 2019-20.
• By 2019-2020 we will have completed an evaluation of the Distress Brief Intervention and be in a position to recommend next steps.

Easy access to mental health support in primary care with access to information, peer support, social support, employability support, integrated with physical healthcare.

The needs of people with mental health issues are identified more quickly and supported in a variety of settings.

Increase in the use of care plans to identify problems and solutions in people's lives, and to better prepare them when something goes wrong.

4. Support people to manage their own mental health.

• By 2017-18, develop more accessible psychological self-help resources.
• By 2018-19 have increased the number of link workers and peer support workers in primary care providing information to support self-management and to support people with mental health challenges to access and stay in employment.

People are better able to manage their own mental wellbeing in the community, using information and peer support.

5. Improve access to mental health services and make them more efficient, effective and safe - which is also part of early intervention.

• By 2017 publish a new mental health outcomes framework.
• Continue to support the Scottish Patient Safety Programme in Mental Health.
• By 2019-20 have delivered a programme of work on improving access to mental health services to increase capacity and address waiting times issues in CAMHS and psychological therapies.
• By 2017-18 have improved access to psychological therapies by rolling out computerised Cognitive Behavioural Therapy nationally.

More efficient, effective and safe services to treat mental health problems with a reduction in variations across Scotland, evidenced by national outcomes data.

Integrated service provision between community, primary, secondary and acute care settings, both in and out of hours.

Improve access by older people to support for mental health problems, including access to psychological therapies.

6. Improve the physical health of people with severe and enduring mental health problems to address premature mortality.

• By 2019, have evaluated the effectiveness of the Scottish Association for Mental Health's programme to increase the physical activity levels of people living with mental and/or physical health issues.
• Ensure that prevention programmes - e.g. smoking cessation, alcohol, screening for preventable conditions - are accessible to people with mental health problems. This will ensure that our public health strategy delivers health improvements for people living with mental health problems.
• By 2018-19, have improved responses to, and monitoring of, physical health issues associated with the psychiatric medications clozapine and lithium.

People with mental health challenges live longer with improved quality of life.

In the long term, reductions in the number of years by which people with severe and enduring mental health problems die earlier than the rest of the population (currently 15 to 20 years).

7. Focus on 'All of Me': Ensure parity between mental health and physical health.

• We will develop mentally and physically healthy workplaces linked to the See Me programme to eliminate stigma and discrimination.
• We will ensure that our employment and welfare programmes are designed to take account of mental health conditions.
• We will develop more effective alignment with wider population health improvement e.g. alcohol, diet, activity.
• We will increase our focus on improving access to mental health services for people living with other long term conditions.
• We will continue to improve the focus on recovery through supporting the work of the Scottish Recovery Network.

People are supported to stay well and stay in work.

Improvements in mental health and physical health outcomes.

8. Realise the human rights of people with mental health problems.

• By April 2017 we will begin a review of learning disability, autism and dementia in the definition of "mental disorder" in the mental health legislation.
• By April 2017 we will have started a review of how deaths of patients in hospital for mental health care and treatment are investigated.
• In 2016-18 we will be conducting a review of the incapacity legislation.

People with mental health problems successfully lead lives where autonomy, choice and control are supported and their human rights are protected and enjoyed.

People with mental health problems successfully lead lives where expectations around privacy, employment, and other issues can be expected and supported as standard, as they would be for someone without a mental health problem.

People with mental health problems experience less discrimination, fewer health inequalities, improved access to mental health services, and improved employment.

We will develop indicators that measure clinical and personal mental health outcomes. These will be applicable across the range of services such as primary care and specialist mental health services. They will assist Integrated Joint Boards in their strategic responsibilities for improving mental health.