Mental Health Strategy for Scotland: 2012-2015 (published with corrections, November 2012)

Policy Context

National Performance Framework

This Mental Health Strategy supports the Purpose of the Scottish Government which is to “focus Government and public services on creating a more successful country, with opportunities for all of Scotland to flourish, through increasing sustainable economic growth.”^[11] This Purpose applies across all the activities and responsibilities of the Scottish Government and creates the overall context for our work on mental health. It is supported by the Strategic Objective for Health which is “Helping people to sustain and improve their health, especially in disadvantaged communities, ensuring better, local and faster access to healthcare”^[12] and by 16 National Outcomes, a number of which are directly applicable to the objectives set out in this Strategy, notably^[13]:

We live longer, healthier lives.

We have tackled the significant inequalities in Scottish society.

We have improved the life chances for children, young people and families at risk.

Our people are able to maintain their independence as they get older and are able to access appropriate support when they need it.

Our public services are high quality, continually improving, efficient and responsive to local people’s needs.

The National Outcomes also mark out the territory for the work of local Community Planning Partnerships in developing and taking forward their Single Outcome Agreements which connect the high-level national objectives with local priorities. This approach was reaffirmed in the Statement of Ambition earlier this year, which reinforced the commitment to delivering demonstrable improvements to people’s lives, promoting preventative approaches and to strengthening community engagement and participation in delivering better outcomes^[14].

Delivering for Mental Health and Towards a Mentally Flourishing Scotland

Scotland’s Mental Health Strategy is the successor document to Delivering for Mental Health^[15] and Towards a Mentally Flourishing Scotland^[16]. It builds on that work as well as on policy and service improvements taken forward alongside those main policy documents. It reflects the mature development of mental health policy in Scotland in the context of a population that increasingly understands mental health and mental illness, service user and voluntary sector engagement and leadership in taking forward improvement and change, and a Scottish Parliament that recognises the importance of the issue and regularly debates and considers mental health.

Mental health was established as a priority on the global agenda by the World Health Report of 2001 Mental Health: New Understanding, New Hope^[17], which was endorsed by the World Health Assembly of the World Health Organization (WHO) in 2002. In Europe, in 2005, the Regional Office of the WHO adopted the Helsinki Declaration and Action Plan at a special Ministerial Conference held in Helsinki ^[18]. These Reports and Declarations set an agenda for action to support rights for people with mental health problems and develop community based services. The European Commission launched its European Pact on Mental Health and Wellbeing in 2008 ^[19] and the European Union has now established a Joint Action on Mental Health and Wellbeing starting in 2012 ^[20]. The Scottish Government collaborates with both the European Commission and the WHO Europe office in developing and taking forward mental health policy and improvement.

A Health Promoting and Preventative Approach

The Mental Health Strategy is fully consistent with the 2020 Vision:

Our vision is that by 2020 everyone is able to live longer, healthier lives at home, or in a homely setting.

We will have a healthcare system where we have integrated health and social care, a focus on prevention, anticipation and supported self-management. When hospital treatment is required, and cannot be provided in a community setting, day case treatment will be the norm. Whatever the setting, care will be provided to the highest standards of quality and safety, with the person at the centre of all decisions. There will be a focus on ensuring that people get back into their home or community environment as soon as appropriate, with minimal risk of readmission.

The focus on “prevention, anticipation and supported self-management” is central to taking forward mental health policy in Scotland. As indicated above, services in Scotland have already reduced the number of mental health readmissions by around 25%. In this strategy we have a focus on a range of improvements and interventions that are in accordance with the best evidence for return against investment over time, including:

Early intervention for conduct disorder in children through evidence-based parenting programmes;

Treating depression in those with long-term conditions such as diabetes;

Early diagnosis and treatment of depression; and

Early detection and treatment of psychosis^[21].

In addition, there is a strong focus throughout this strategy on actions that people can take for themselves, and with their communities, to maintain and improve their own health. There is a good evidence-base for such approaches, in particular for physical activity.