Mental Health Strategy 2017-2027

What is the context?

The term mental health is used in many different ways. It applies to a continuum from emotional wellbeing like happiness and sadness, to mental disorder like the acute reaction that can happen to stress, to mental illness like schizophrenia.

Environmental, social and individual factors help to determine mental wellbeing. ^[4] Genetic and environmental factors affect the prevalence and level of severity of mental illness in a population. These interactions are complex, but they offer different ways to influence mental health at an individual and population level.

This Strategy is part of a wide range of measures that the Scottish Government is taking to help create a Fairer Scotland. ^[5] The inequalities that drive differences in physical health outcomes are the same inequalities that detrimentally impact on mental health. Poverty and social exclusion can increase the likelihood of mental ill-health, and mental ill-health can lead to greater social exclusion and higher levels of poverty. ^[6]

This Strategy should also be seen in the context of the Scottish Government's 2020 Vision for health and social care delivery, which emphasises integrated care and prevention, anticipation and supported self-management; and in the context of the Scottish Government's Health and Social Care Delivery Plan, which reinforces the equal importance of mental and physical health and the need to address the underlying conditions that affect health. ^[7] When the ambitions of this Strategy and other areas of work are achieved, then it will be clear that people are able to start well, live well, age well and die well.

Inequality related to disabilities, age, sex, gender, sexual orientation, ethnicity and background can all affect mental wellbeing and incidence of mental illness. Some groups are more likely than others in our society to experience mental ill-health and poorer mental wellbeing - for example, people who have experienced trauma or adverse childhood events, people who have substance use problems, people who are experiencing homelessness, people who are experiencing loneliness or social isolation, veterans, refugees and asylum seekers. There may also be specific issues around access to services and support for those living in remote and rural communities.

Legislation that underpins the current arrangements for the National Health Service in Scotland already includes a parity of approach in relation to mental and physical health. It also places a duty on Local Authorities to provide services for those who have or have had a mental health problem, to promote their well-being and social development, and a duty to minimise the effect of mental disorder and give people the opportunity to lead lives which are as normal as possible. ^[8]

In addition, since April 2016, there has been a key role for Integration Authorities relating to local health and social care services, including hospital and community mental health services.

Scotland's commitment to meeting the needs of those who require access to mental health services reflects the importance we attach to realising the right of every individual to the highest attainable standard of physical and mental health. ^[9] The actions set out in this Strategy contribute to the progressive realisation of that internationally-recognised right, and directly support the shared vision of a socially inclusive and successful Scotland where every member of society is able to live with human dignity.

Put simply, this Strategy's context is not just a question of how the NHS, Local Authorities and Integration Authorities deal with mental health, but how our wider society thinks about mental health in how decisions are made.