Delivering for Mental Health: plan

Enhancing specialist services

In Delivering for Health we said that we would develop a national and regional analysis of specialist service needs and the actions required to meet those needs, including the implications for service redesign. That work has been completed during 2006 in respect of forensic, eating disorder, specialist child and adolescent and perinatal services.

Forensic Services

In July the Health Department published HDL (2006) 48 on Forensic Mental Health Services. The HDL sets out the national and regional need for high, medium and low secure beds for men and women and for those with mental disorder and learning disability. Work is ongoing to develop the forensic estate with the redevelopment of the State Hospital and a new medium secure unit opening in Glasgow in spring of 2007 and planning for new medium and low secure accommodation for the North of Scotland and Tayside in 2012. Statutory guidance on how the Care Programme Approach should operate for patients subject to the provisions of the Management of Offenders (Scotland) Act 2005 will be published shortly and will support better discharge planning and risk management. Further work to develop forensic services in Scotland is underway and is detailed in the HDL.

Commitment 12: We will implement the new Care Programme Approach for all restricted patients by 2008.

Perinatal Services

Mental health problems which occur during pregnancy, or in the first postnatal year, affect 10-15% of women, but, if detected, respond well to treatment. While severe illness is relatively rare, its onset is usually rapid and requires urgent intervention. The Mental Health (Care and Treatment) (Scotland) Act 2003 placed a specific responsibility on NHS Boards to provide specialist facilities for admitting mothers with their babies where necessary (0.2-0.4% of cases). The first unit opened in Glasgow in 2005 and provides services for the west of Scotland and a further unit will open in early 2007 in Livingston to provide services for the east and north. Two Health Boards, Grampian and Forth Valley have developed local solutions. In addition, Health Boards have been developing care pathways for delivery of perinatal services covering both community and inpatient services.

Eating Disorders

The Health Department, Regional Planning Partnerships and Health Boards have been working to develop eating disorder services in Scotland to improve the coverage and quality of inpatient and specialist community services. The Regional Planning Groups have agreed a service specification for inpatient services, the level of need for inpatient beds at national and regional level and functions to be taken forward in each regional area. This work fits with the work that has been taken forward by NHS Quality Improvement Scotland in developing recommendations for the management and treatment of eating disorders in Scotland, launched in November this year.