Psychological therapies and interventions specification: consultation analysis

Appendix B: engagement events

Introduction

This chapter presents a summary of the main points raised at the five stakeholder engagement events which supplemented the public consultation. The narrative below has been drawn from a review and synthesis of the event notes provided by the Scottish Government client team.

The engagement events covered the two consultations – Delivery of psychological therapies and interventions: national specification, and Quality standards for adult secondary mental health services.

Some events were facilitated by the Scottish Government while others involved other stakeholders. The events were structured in different ways – some aligned more closely to the various sections or themes contained in the consultation documents, others encouraged a more general conversation about mental health services. Some but not all event notes clearly separate out discussion points of relevance to each consultation.

There was limited specific reference to the themes of the national specification consultation contained in the notes. Where feedback was provided, the points raised at the events largely chime with themes that emerged from the public consultation.

Key themes

Overarching points

Overall there was positive feedback from stakeholders who attended the events on the specification – it was “welcomed” and considered very much “needed”. Not least in response to the negative and detrimental impact of the COVID-19 pandemic and the current cost of living crisis. Here, stakeholders pointed to increasing demand for, and pressure on, mental health services in Scotland and its workforce.

Accessibility of the specification and psychological therapies and interventions

Stakeholders considered there to be a range of barriers which make access to psychological care services, and mental heath services more generally, difficult. In particular, stakeholders highlighted the importance of ensuring that groups who are more likely to experience poor mental health have improved access to the support and services that meets their diverse and complex needs (for example, engagement and support should be tailored to a person’s particular needs where possible). Groups mentioned in the event notes included disabled people and people from an ethnic minority community.

This included calls for accessible and inclusive information and communication. Suggestions included: plain English and less jargon; the use of visuals and diagrams; translation services; and a suitably skilled workforce to engage and support people with a range of different needs and preferences.

Stakeholders also considered it important that people should be able to access the same range and quality of mental health services regardless of where they live or their personal circumstances. For example, people who live in rural areas and people with lived experience of substance use were specifically mentioned at the events.

A wider point raised by stakeholders included that: people should have access to ongoing care and support if it is needed again (that is access to support and services that is not time-limited and without a predetermined end date).

Collaboration between services and professionals

Stakeholders felt that there was scope to improve communication, collaboration and coordination between mental health and other services (for example, addiction services, primary care services) to help ensure a smooth transition for people as they move between and out of services.

Workforce

Stakeholders considered that mental health services in Scotland and its workforce were under significant pressure and under-resourced – and that this may make meeting the specification more challenging, particularly where there is increased reliance on the third sector to meet demand. Some stakeholders highlighted that long waiting times for access to psychological care would make it challenging to deliver on the specification.

Stakeholders also felt that there could be a stronger approach to tackling stigma in mental health and wellbeing, including reducing stigma among healthcare providers, as well as increased provision of more trauma-informed support. Training and workforce development across the sector was viewed as crucial to meeting the national specification.

Stakeholders noted that workforce development would also help ensure that mental health support services were better able to tailor support and meet the different needs of groups of people at a higher risk of poor mental health. For example, stakeholders at the Learning Disability Assembly engagement event, suggested that additional training was required to ensure the mental health workforce were better able to engage and support people with a range of disabilities and complex needs.

Wider points

Wider points raised by stakeholders are outlined below.

Stakeholders considered it important that people with lived experience of accessing and using psychological therapies and interventions were meaningfully engaged and consulted to help inform the design, delivery, and improvement of these services - and this would ensure that services better meet the needs of service users.

Stakeholders suggested that the measurement of outcomes could be more person-centred and related to an individual’s care rather than being driven by national indicators to minimise the potential for it being viewed as a “tick box exercise”.

Some stakeholders provided more positive feedback on the national specification and the standards – for example stakeholders who attended the Thrive on Thursday event felt that the proposals contained within the consultation document displayed empathy and helped to promote individual choice and control in mental health care and support.

Other stakeholders highlighted concerns with the language and terms used with the consultation document, and suggested that there could be less jargon.

Some stakeholders felt that the specification and standards could be improved or enhanced in some way, for example:

• by more fully recognising the links between addiction and poor mental health
• by reviewing the specification to remove any areas of duplication
• to ensure that the specification is clear and easy to understand