Mental health and wellbeing strategy

4. Our vision

Our vision is of a Scotland, free from stigma and inequality, where everyone fulfils their right to achieve the best mental health and wellbeing possible.

Summary outcomes

Our outcomes describe the differences or changes that we want to see as a result of this Strategy. They are:

1 Improved overall mental wellbeing and reduced inequalities.

2 Improved quality of life for people with mental health conditions, free from stigma and discrimination.

3 Improved knowledge and understanding of mental health and wellbeing and how to access appropriate support.

4 Better equipped communities to support people's mental health and wellbeing and provide opportunities to connect with others.

5 More effective cross-policy action to address the wide-ranging factors that impact people's mental health and wellbeing.

6 Increased availability of timely, effective support, care and treatment that promote and support people's mental health and wellbeing, meeting individual needs.

7 Better informed policy, support, care and treatment, shaped by people with lived experience and practitioners, with a focus on quality and recovery.

8 Better access to and use of evidence and data in policy and practice.

9 A diverse, skilled, supported and sustainable workforce across all sectors.

Key areas of focus

To achieve these outcomes, we will:

Promote positive mental health and wellbeing for the whole population, improving understanding and tackling stigma, inequality and discrimination;

Prevent mental health issues occurring or escalating and tackle underlying causes, adversities and inequalities wherever possible; and

Provide mental health and wellbeing support and care, ensuring people and communities can access the right information, skills, services and opportunities in the right place at the right time, using a person-centred approach.

We seek to have a stronger emphasis and focus on promoting good mental health and wellbeing for all and also on early intervention and prevention. We will do this while ensuring high-quality services are in place so people can access the right support at the right time to meet their needs.

We will publish a Delivery Plan to complement this Strategy. The Plan will be refreshed regularly and lay out the actions we will take to achieve our vision and make progress towards our outcomes. The actions will be developed in partnership with those with operational responsibilities and those with lived experience. They will focus on meeting the outcomes, responding to the priorities in this document, and take account of Scottish Government's recently published 'Policy Prospectus' and the COSLA plan 2022-2027.

Our overarching outcomes

We want to be clear about what this Strategy is trying to achieve. Specifically, we want to lay out the changes that are needed and describe how the actions in the forthcoming Delivery Plan will lead to that change happening in a sustainable way.

To do this, we have developed a set of outcomes. These are the differences or changes that we want to see as a result of this Strategy.

These outcomes are intended to be for the whole population of Scotland. People will have different starting points and require different kinds of support to get them where they want to be. For example, the needs of children and young people will differ from those of adults. So, too, will the needs of someone with severe and enduring mental illness when compared to someone struggling with their mental wellbeing.

The needs of those who experience social and structural inequality and discrimination, such as those with protected characteristics, will also vary.

The outcomes we aim for are the same for everyone, although the actions we need to take to get there will likely differ for different groups. We will use these outcomes to help monitor and evaluate progress as this Strategy is implemented.

Graphic text below:

To realise our Vision for a Scotland, free from stigma and inequality, where every person experiences and has the right to achieve the best mental health and wellbeing possible.

This Strategy aims to achieve

Positive changes in cross-cutting outcomes will contribute to changes for people over time

Positive changes in support and services outcomes

Positive changes in outcomes for the mental health and wellbeing workforce

Positive changes in how information, data and evidence is accessed and used to support the improvement outcomes for people

And these will help us achieve

Positive changes in outcomes for individuals

Positive changes in outcomes for communities (geographic communities, communities of interest and of shared characteristics)

That will over time contribute to

Longer-term, population outcomes [Dependent on action across policy areas and funding streams]

And throughout this we will be working towards our High Level Summary Outcomes

Whole Population Level 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.

People have an increased knowledge and understanding of mental health and wellbeing and how to access appropriate support.

Communities are better equipped to act as a source of support for people’s mental health and wellbeing, championing the eradication of stigma and discrimination and providing a range of opportunities to connect with others.

We adopt a ‘mental health and wellbeing in all policies’ approach to facilitate cross-policy actions that more effectively address the wide-ranging social, economic and environmental factors that impact people’s mental health and wellbeing, including poverty, stigma, discrimination, and injustice.

Our priorities

Through the actions laid out in the Delivery Plan for this Strategy, we will seek to:

Tackle mental health stigma and discrimination where it exists and ensure people can talk about their mental health and wellbeing and access the person-centred support they require.

Improve population mental health and wellbeing, building resilience and enabling people to access the right information and advice in the right place for them and in a range of formats.

Increase mental health capacity within General Practice and primary care, universal services and community-based mental health supports. Promote the whole system, whole person approach by helping partners to work together and removing barriers faced by people from marginalised groups when accessing services.

Expand and improve the support available to people in mental health distress and crisis and those who care for them through our national approach on Time, Space and Compassion.

Work across Scottish and Local Government and with partners to develop a collective approach to understanding and shared responsibility for promoting good mental health and addressing the causes of mental health inequalities, supporting groups who are particularly at risk.

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.

Ensure people receive the quality of care and treatment required for the time required, supporting care as close to home as possible and promoting independence and recovery.

Continue to improve support for those in the forensic mental health system.

Strengthen support and care pathways for people requiring neurodevelopmental support, working in partnership with health, social care, education, the third sector and other delivery partners. This will ensure those who need it receive the right care and support at the right time in a way that works for them.

Reduce the risk of poor mental health and wellbeing in adult life by promoting the importance of good relationships and trauma-informed approaches from the earliest years of life, taking account where relevant adverse childhood experiences. We will ensure help is available early on when there is a risk of poor mental health, and support the physical health and wellbeing of people with mental health conditions.

Our principles

The Strategy, and the actions in the forthcoming Delivery Plan, are based on 10 core principles. Our work is:

1 Founded on equality and human rights.

2 Focused on the mental health and wellbeing of individuals, families, communities and society, supporting those who are impacted by mental illness.

3 Outcomes-focused.

4 Trauma-informed and trauma-responsive.

5 Based on a 'whole person' approach. This means looking at a person and their wider circumstances (like housing, relationships, physical health, employment etc.), not just their mental health.

6 Driven by data and evidence.

7 Developed and delivered in partnership with partners, stakeholders and the public.

8 Based on a 'no wrong door' approach. This means anyone asking for help with their mental health and wellbeing should be able to access the right support, care and treatment, regardless of where they first request it.

9 Informed by the voice of people with lived experience and practitioners, including marginalised groups, children and young people.

10 Based on a 'life stage' approach. This means it is focused on prevention, early detection, recovery and treatment of mental illness and poor mental wellbeing, identifying opportunities for minimising risk factors, enhancing protective factors and providing appropriate support at important life stages.

Graphic text below:

The Life Stage Model

Delivering mental health care from preconception and the earliest years: opportunities to influence intergenerational health and wellbeing

• Preconception care
• Perinatal mental health care
• Parent-infant relationship care
• Infant and early years mental health care
• Children, young people and family mental health care
• Adult and older adult mental health care

Across a lifetime, people will have different experiences with their mental health and wellbeing. Certain stages of life can significantly impact future mental health and wellbeing, such as when a relationship breaks down or the death of a loved one. Establishing the conditions for good mental health is essential even before birth and throughout infancy, and we know that mental health within the perinatal period (before, during and after birth) has lifelong implications in relation to later mental and physical health.

Positive relationships are an important protective factor for good mental health. As babies grow into children and young people, they must develop resilience and coping strategies to support life's ups and downs. Families, parents and carers play a central role in this. Our commitment to keep The Promise drives an ambition to keep families together where it is safe to do so. The provision of joined up, whole family mental health support at the right time and in the right way can be a key contributor to this.

In relationships with families, carers and adults, it is important that children and young people feel listened to and that their mental health and wellbeing needs are recognised and not dismissed. Children, young people and families should be able to easily access support in their local community when needed, and this support should be focused on prevention and early intervention. More serious issues can develop for some children and young people, so early intervention is vital, wherever possible.

Whilst prevention is key, the impact of family breakdown, for whatever reason, on children and young people can be lifelong. It is important that where this occurs, mental health support services recognise that this impact may occur at different age and stage of life.

Improving the connections between children and adult services to better support smooth and informed transition from one service to another can help improve outcomes for young people who are leaving the care system; and over the longer term aid a reduction in the generational impact of being care experienced.

Our work on this will also align with our ambitions to improve outcomes for babies, children, young people and families through Getting it right for every child (GIRFEC), and Children's Services Planning duties, with our approach to change being driven through a preventative approach to whole family wellbeing.