Adult secondary mental health services - quality standards: consultation

Annex A - Principles and the Wider Standards Landscape

The Health and Social Care Standards, published in 2017, set out what people should expect when using health, social care or social work services in Scotland.

These standards are not specific to mental health services They do however contain key principles which aim to ensure every person is treated with respect and dignity, and their human rights are upheld in line with the Equalities Act 2010.

The standards outlined in this document are one of a suite which will cover mental health services more comprehensively. We have already developed service specifications for CAMHS and the Neurodevelopmental services for Children and Young People and are currently developing a specification for Psychological Services and Therapies. Our ambition is that all of these standards be linked by a set of shared principles which are based on the Health and Social Care Standards.

These shared principles were developed through extensive engagement which was undertaken during the development of the CAMHS and Neurodevelopmental Service Specifications.

Mental Health Principles

1. High Quality Care And Support That Is Right For Me

2. I Am Fully Involved In The Decisions About My Care

3. High Quality Interventions And Treatment That Are Right For Me

4. My Rights Are Acknowledged, Respected and Delivered

5. I Am Fully Involved In Planning And Agreeing My Transitions

6. We Fully Involve Adults And Their Families And Carers

7. I Have Confidence In The Staff Who Support Me

These principles inform all of the standards below and we would expect these principles to be applied to each of the thematic areas.

Realistic Medicine

The standards are in line with the vision for NHS Scotland that by 2025 anyone providing health and social care will take a realistic medicine approach. This approach puts people at the centre of decisions made about their care and how it is delivered.

Realistic Medicine means that people should be provided with the highest quality supports that are right for them and evidenced based interventions on discussion with them and only when they require these.

The six principles of realistic medicine are:

• shared decision making
• building a personalised approach to care
• managing risk
• reducing harm and waste
• tackling unwarranted variation
• innovating and improving

Time, Space, Compassion

The Time, Space, Compassion approach aims to ensure that those who reach the point of suicidal crisis are able to access support at a Time they need it, in an accessible and available Space, and are shown Compassion by those who are providing the support. We would expect these standards to delivered in line with this approach.

Trauma Informed Practice

We would expect these standards to be delivered as part of our ambition for workforces and services across Scotland to operate in a trauma-informed and trauma-responsive way. Trauma-informed services assume that people have had traumatic experiences, and as a result may find it difficult to feel safe within services and to develop trusting relationships with service providers. Consequently, services are structured, organised and delivered in ways that promote safety and trust and aim to prevent retraumatisation. This helps to ensure that our services are delivered in ways that reduce barriers and prevent further harm or retraumatisation for people who have experienced psychological trauma or adversity at any stage in their lives.

Professional Standards

We would expect that all professionals delivering adult secondary mental health services to be guided by all recommended service and professional and regulatory standards set out, produced and monitored by individual professional bodies and other organisations.