Psychological therapies and interventions specification: consultation analysis

3 Feedback on the overall aims of the specification

Introduction

Part one of the consultation sought feedback on the aims of the draft national specification. Everyone was invited to complete these questions, however, it was also aimed at those who had less time to answer each and every question in the consultation document.

Question 1

How far do you agree that the specification will improve the experiences of people accessing psychological therapies and interventions?

Table C1 presents the quantitative response to Question 1. This shows that:

• almost three-quarters of consultation respondents who answered Question 1 either agreed or strongly agreed (71%) that the specification will improve the experiences of people accessing psychological therapies and interventions
• 20% neither agreed nor disagreed
• 9% disagreed or strongly disagreed

Question 2

How far do you agree that the specification will improve the outcomes of people accessing psychological therapies and interventions?

Table C2 presents the quantitative response to Question 2. This shows that:

• over half of all consultation respondents who answered Question 2 either agreed or strongly agreed (58%) that the specification will improve the outcomes of people accessing psychological therapies and interventions
• 28% neither agreed nor disagreed
• 14% disagreed or strongly disagreed

Question 3

How far do you agree that the specification successfully sets out to individuals, their families and carers what they can expect when they access psychological therapies and interventions?

Table C3 presents the quantitative response to Question 3. This shows that:

• almost three-quarters of all consultation respondents who answered Question 3 either agreed or strongly agreed (74%) that the specification successfully sets out to individuals, their families and carers what they can expect when they access psychological therapies and interventions
• 13% neither agreed nor disagreed
• 13% disagreed or strongly disagreed

Question 4

We know that currently not everyone has the same experiences or outcomes when they access psychological therapies and interventions. We want the specification to help make sure that your needs are met, whoever you are and whatever your background. How far do you agree that the specification will help do this?

Table C4 presents the quantitative response to Question 4. This shows that:

• over half of all consultation respondents who answered Question 4 either agreed or strongly agreed (57%) that the specification will help to support equitable access to psychological therapies and interventions
• 24% neither agreed nor disagreed
• 19% either disagreed or strongly disagreed

Question 5

Do you have any suggestions for how the specification could help to ensure that there is more timely access to how people receive psychological therapies and interventions?

Almost two-thirds (63%) of all consultation respondents answered Question 5 which asked whether respondents had any suggestions for how the specification could help to ensure that there is more timely access to how people receive psychological therapies and interventions. The main themes are presented below.

Theme 1: A repeat of key themes that emerged from the consultation

Some respondents repeated points that they had made throughout the consultation - see Chapter 2 for more detail. For example, this included that:

• the specification was an ambitious and well-intended document but may be unrealistic to deliver
• further action may be required to build workforce capacity
• additional funding, resources and other support to ensure effective implementation of the specification
• more detail was requested on how the specification would be implemented in practice

Theme 2: Some groups of people face more barriers to access

Some respondents, mostly individuals, felt that the specification could contain greater consideration that some groups of people face more barriers to accessing psychological services – reference was made to older people, ethnic minorities, people with substance use issues, and people with learning disabilities. Barriers were reported to include a person having difficulty articulating their situation to a GP and/or difficulty being asked certain personal questions, GP receptionists screening calls, location of GP surgery, the time of appointments and stigma.

As some population groups are more likely to have poor mental health, it was considered important that the specification had sufficient focus on removing barriers to accessing psychological care – so that people have timely access to support.

Theme 3: Clear referral processes

Some individuals and Health Boards, HSCPs and services highlighted that the referral process from GPs and other practitioners is a crucial step which could be improved to support timely access to psychological care. For example, it was suggested that GPs could have a greater understanding of the broad range of psychological therapies and interventions available, and that this could help more people to access the right support at the right time.

Theme 4: Broad range of psychological therapies and interventions

A few individuals acknowledged the important role of people having awareness of, and access to, a wide range of evidence-based psychological therapies and interventions. As such, these respondents welcomed the recognition of third sector involvement and peer support within the specification.

Theme 5: Greater awareness of specification

A few organisations stated that there could be greater public awareness of the specification. These respondents felt that it would be important for the Scottish Government to organise a public communications campaign to raise awareness of the specification among the general public in due course (so that everyone knows what to expect when accessing psychological therapies and interventions).

Theme 6: SMART target setting and monitoring

A few respondents stated that monitoring and evaluation of the outcomes identified within the specification would be critical to better understand whether people are receiving timely access to psychological care. These respondents noted that targets should be SMART (specific, measurable, achievable, relevant, and time-bound).

Theme 7: National waiting times standard

A few respondents expressed concern that some waiting lists for psychological care significantly exceed the national waiting times standards of 12 weeks to assessment and 18 weeks to treatment. It was reported that people who find it difficult to get timely support are negatively impacted.

Question 6

Do you have any other comments on the specification overall?

Over two-thirds (68%) of all consultation respondents answered Question 6 which asked respondents for feedback on the specification overall. The main themes are presented below.

Theme 1: A repeat of key themes that emerged from the consultation

Some respondents repeated points that they had made throughout the consultation^[2] - see Chapter 2 for more detail. For example, this included:

• the specification was an ambitious and well-intended document but may be unrealistic to deliver
• the specification could be clearer, more concise and easier to understand
• the importance of involving people with lived experience to inform service development and improvement

Theme 2: Scope and responsibilities of specification

Some respondents called for greater clarity on the scope and responsibilities of the specification. It was suggested that providing a list of the applicable professions and roles relevant to the specification could improve the ownership, accountability and implementation of high-quality psychological care.

Similarly, some respondents felt that the specification could give greater consideration to the range of different settings where psychological care is provided and the different professions/roles involved.

A flexible approach was considered important to ensure that implementation of the specification adopted a person-centred approach and recognised regional variations.

The following quote was reflective of some of the pints raised above.

“…it must be recognised that local flexibility is required to meet the needs of individuals in different areas, what works in an urban setting may differ significantly to what works in a rural one for example. Consistency of outcomes is not achieved through the creation of identical services, and it is vital that the PT specification does not create this expectation.”

COSLA

Additional points

Raised to a lesser extent, a few respondents suggested that:

• there could be more explicit reference to informed consent, particularly around involvement of families and carers - this is viewed as critical to person-centred psychological care
• there could be greater consideration of and signposting to specialist therapies, including art and music therapies
• reference to timescales and waiting lists risks a focus on turnaround times rather than provision of high-quality psychological care

Question 7

We want this specification to be as accessible and easy to understand as possible to those who access psychological therapies and interventions. Do you have any suggestions on how this could be improved?

Over two-thirds (68%) of all consultation respondents answered Question 7 which asked respondents to share any suggestions they had to improve the accessibility and understanding of the specification for those who access psychological therapies and interventions. The main themes are presented below.

Theme 1: A repeat of key themes that emerged from the consultation

Some respondents repeated points that they had made throughout the consultation - see Chapter 2 for more detail. For example, it was considered important that the specification used language that was clear, concise, easy to understand, and avoided jargon. It was suggested that the specification could be further tested with people with lived experience prior to being finalised.

Some respondents also felt that the specification document was too long and detailed which could limit accessibility, particularly for people with cognitive difficulties or dyslexia. It was suggested that it could be broken down into different sections, for example where some sections are more relevant to service providers.

Theme 2: Specification should be provided in various formats and settings

Some respondents felt that more accessible and inclusive information and communication was needed - in plain English, in different languages, and in other accessible and user-friendly formats. For example, it was suggested that the specification could be presented visually with use of video, animation and/or infographics. Support was expressed for approaches which adopt the principles of inclusive information and communication.

Other suggestions to improve accessibility of specification included providing printed copies for people who are digitally excluded – these could be leaflets in public places, GP surgeries, libraries, and given at appointments when a person is referred to psychological care.

Theme 3: More detail on available psychological therapies and interventions

A few organisations felt that the specification could include more detail on the range and nature of psychological therapies and interventions available to increase awareness and understanding among people looking to access such services.

Theme 4: Specification could have more links to other mental health standards

Another suggestion raised by a few respondents was that the more generic outcomes or statements within the specification could link to other mental health standards. It was stated that this could also avoid duplication.