Mental health and wellbeing strategy: delivery plan 2023-2025

Priority 6

Improve mental health and wellbeing support in a wide range of settings with reduced waiting times and improved outcomes for people accessing all services, including Child and Adolescent Mental Health Services (CAMHS) and psychological therapies.

Outcomes: 1, 2, 6, 7, 9

Challenges and opportunities:

• Delivering supports and services
• Primary and community care
• Workforce
• Benefits of investing

Key area of focus

We want mental health and wellbeing supports and services to be responsive to individual need, so that people can access them at the right time, in the right place and in the right way. Support, care and treatment need to be delivered in a way that is as local as possible and as specialist as necessary. We know that there will always be some people who will need short-term mental health support. Others will have mental health conditions that are long-term or lifelong, requiring ongoing support for the rest of their lives. Ensuring access to a range of supports and services in the community to help keep people well, alongside investment and improvement in specialist services, such as CAMHS or psychological therapies, is key to more effectively meeting the demand for services. A range of new standards and clear pathways to treatment, informed by evidence and designed around GIRFE and Getting it right for every child (GIRFEC) principles, will help to ensure the delivery of effective, person-centred services.

During 2023/24, Scottish Government will invest over £50 million in its Mental Health Outcomes Framework, in addition to Boards’ core funding, to support the delivery of clinical services in priority areas. The new standards aim to set out what good looks like and, over the medium to long-term, will improve monitoring and measurement of the equity of care and include a focus on supporting people from different social, economic, ethnic and cultural backgrounds and addressing their specific needs. This work will take an improvement approach and seek to understand what is required in the system to implement standards and specifications, recognising current resource and capacity challenges.

Outcomes

• The overall mental health and wellbeing of the population is increased and mental health inequalities are reduced.
• People with mental health conditions, including those with co-existing health conditions experience improved quality and length of life, free from stigma and discrimination.
• Comprehensive support and services that promote and support people’s mental health and wellbeing are available in a timely way that meets and respects individual needs.
• Mental health policies, support, care, and treatment are better informed and shaped by people with lived experience of mental health issues and staff practitioners, with a focus on high quality provision that is recovery orientated.
• The mental health and wellbeing workforce is diverse, skilled, supported and sustainable.

Strategic Action 6.1: Scottish Government will support Boards to meet the 90% waiting times standard for CAMHS and Psychological Therapies (PT), and to clear waiting list backlogs.

6.1.1 Commission Boards to produce trajectories for when they expect to meet the CAMHS and PT waiting times standard. These will be analysed by the end of 2023 and used to inform targeted improvement work to ensure all Boards consistently meet the CAMHS and PT standards. Trajectories should be updated at least annually to reflect local changes.

Lead and Key Partners: Scottish Government NHS Boards, IJBs, PHS

6.1.2 Over the lifespan of this Delivery Plan, proactively engage with Boards to monitor progress and identify challenges, including finance, governance and leadership. This will inform the support required to enable Boards to contribute to the implementation of the Mental Health and Wellbeing Strategy and make best use of funding to deliver better outcomes.

Lead and Key Partners: Scottish Government NHS Boards, IJBs

Strategic Action 6.2: Taking a quality improvement approach, Scottish Government will support the implementation of Mental Health Core Standards for Mental Health Services and consider subsequent service specifications to ensure high quality specialist care for all patients.

6.2.1 Continue work with Health Boards to agree an initial timeline to deliver the CAMHS and Psychological Therapies National Data set (CAPTND) with the aim of using the improved data to support improvements to CAMHS and PT services and to better understand the needs of those accessing them.

Lead and Key Partners: Scottish Government PHS

6.2.2 Develop and pilot a self-assessment tool to support initial implementation of the core mental health standards (published September 2023) in a proportionate way, recognising ongoing pressure facing services and enabling continuous improvement.

Lead and Key Partners: Scottish Government NHS Boards, PHS, IJBs, HIS

6.2.3 Using a similar approach to the core standards, work with partners to measure and implement the Service Specification for Psychological Interventions and Therapies (published September 2023), recognising that some of the outcomes are already being delivered.

Lead and Key Partners: Scottish Government NHS Boards, Heads of Psychology, HIS, IJBs

6.2.4 Scottish Government and NES launched a new digital version of the Psychological Therapies Matrix in autumn 2023 to provide accessible and up to date evidence and best practice for psychological services. NES will continue to update the Matrix iteratively, reflecting any changes in the available evidence base.

Lead and Key Partners: Scottish Government NES

6.2.5 Consult on and publish a National Specification for Eating Disorder Care and Treatment in Scotland by early 2024.

Lead and Key Partners: Scottish Government NHS Boards, third sector organisations

6.2.6 Using the learning from the self-assessment of core standards, develop a specification for adult secondary care mental health services (inpatient, Community Mental Health Teams and associated services).

Lead and Key Partners: Scottish Government Voices of Experience (VOX) Scotland, the Alliance, the Royal College of Psychiatrists, HIS, Mental Welfare Commission (MWC), Unison

Strategic Action 6.3: We will continue to work with delivery partners to develop integrated care pathways in line with GIRFEC and GIRFE national practice models ensuring a holistic approach to wellbeing for people with complex care needs.

6.3.1 Develop integrated care pathways in children’s mental health services in line with the GIRFEC national practice model and ensure a holistic approach to wellbeing for people with complex care needs accessing specialist CAMHS services, such as Adolescent Intensive Psychiatric Care, secure, forensic and learning disability CAMHS services.

Lead and Key Partners: Scottish Government HIS, NHS Boards, local authorities

6.3.2 Over the next 18 months, build on the work we have done with HIS through our Early Interventions in Psychosis programme, and facilitate the rolling out by Boards improvements in patient care and support for those experiencing a first instance of psychosis.

Lead and Key Partners: Scottish Government HIS, NHS Boards

6.3.3 In line with the recommendation from the National Review of Eating Disorder Services, establish the National Eating Disorder Network by the end of 2023 to provide support, guidance and alignment for children, young people and adult eating disorder services.

Lead and Key Partners: Scottish Government NHS Boards

Strategic Action 6.4: Scottish Government will support NHS Boards to move towards a self-improving system using benchmarking data.

6.4.1 Establish a Scottish Benchmarking Network, which supports sharing of data and best practice across Boards to drive improvement, with the aim of moving to a self-improving system. Scottish Government will fund individual Board membership of the NHS Benchmarking Network up to March 2025.

Lead and Key Partners: Scottish Government NHS Benchmarking, NHS Board

6.4.2 Hold an event in 2024 to share the findings of the three core benchmarking projects of 2023 with all Health Boards.

Lead and Key Partners: Scottish Government NHS Boards

Strategic Action 6.5: We will work together to expand the gathering, reporting and use of information on patient journeys, protected characteristics, outcomes and experiences of people seeking care and support from NHS mental health services.

6.5.1 Through the lifespan of this Delivery Plan, improve data collection and published statistics that describe access to and performance of key NHS mental health services. In particular, improve data systems to deliver the CAMHS and Psychological Therapies National Data set (CAPTND) with the aim of using improved equalities data to better understand and meet the needs of people accessing these services.

Lead and Key Partners: Scottish Government NHS Boards, IJBs, PHS, NES, eHealth Directors

6.5.2 By June 2024, deliver the first phase of work to develop a set of national measures that provide robust and accessible evidence of the functioning of key mental health services at HSCP and Health Board level.

Lead and Key Partners: Scottish Government NHS Boards, IJBs, PHS, NES

6.5.3 Throughout the lifespan of this Delivery Plan, work with NHS Boards to improve management information to help support improvement activity and outcomes.

Lead and Key Partners: Scottish Government NHS Boards, PHS

6.5.4 Develop options for a dedicated Mental Health Patient Experience Survey by September 2024. This will report on how expectations set out in the Core Mental Health Standards are met for individual and intersectional equalities groups.

Lead and Key Partners: Scottish Government NHS Boards, IJBs

6.5.5 Continue to work with delivery partners to ensure patient experience is central to decision making and governance processes in IJBs, NHS Boards and TSIs.

Lead and Key Partners: Scottish Government NHS Boards, IJBs, TSIs

Strategic Action 6.6: We will progress with reform of Adults with Incapacity (AWI) Legislation to ensure stronger rights, protections and safeguards.

6.6.1 By autumn 2024, develop policy proposals to address all of these issues identified with Adults with Incapacity legislation and have publicly consulted on the proposed changes.

Lead and Key Partners: Scottish Government

6.6.2 Improve awareness of the functions and operation of the Adults with Incapacity (Scotland) Act 2000, including engagement with HSCPs and continuing to fund partners to deliver AWI training to the health and social care workforce until March 2024.

Lead and Key Partners: Scottish Government MWC, NES, local authorities, Social Work Scotland, HSCPs