Health Improvement, Efficiency, Access and Treatment targets ( HEAT)
There are currently (2007) three identified HEAT targets for mental health. HEAT targets form the basis of the performance management of the NHS. The associated 2006 published targets focus on antidepressant prescribing; reducing suicide; and reducing hospital readmissions. Co-occurring problems are relevant to all of these issues.
- There are high rates of anti-depressant prescribing in alcohol dependence. In some locations more than 30% of males and more than 60% of females with alcohol dependence were prescribed anti-depressants on referral from general practice.
- The relationship between substance misuse, mental health problems and suicide is also highlighted in this guidance.
- Substance misuse (alcohol and drugs) is the main diagnosis in 14% (2512/18115) of psychiatric hospital readmissions and is the most common admission diagnosis for men. 28% (943/3309) of people admitted with an alcohol main diagnosis had a secondary psychiatric diagnosis. (Alcohol Statistics Scotland 2007).
The intention of these targets in improving access to psychological therapies, preventing suicide and developing alternatives to hospital admission will be of value to those with co-occurring problems. The aim is not to prevent the use of anti-depressants or hospital admission where this is the best treatment option.
In this and other aspects the Scottish Government recognise the need and interdependency of agencies in delivering change. The same consideration and priority attaches to the Scottish Government's own approach on the cross cutting action required for cohesion of policy and direction.