A new Mental Health and Wellbeing Strategy - consultation

Effective preventative approaches. Improved life circumstances for all. Better access to support.

Empowerment and dignity are essential as is choice. We must normalise mental health as a reaction to what people have experienced using a social rather than medical model.

Community development is essential

To ensure reduction of stigma we must not pathologise mental health.

There must be much more respect for the third sector as a key provider with experienced and qualified staff. However lived experience involvement is also vital.

The evidence base for mental health is currently very limited leading to use of CBT widely. There should be further research undertaken into other forms of support to widen the evidence base.

Review and modernise the matrix

Trauma has a significant impact and adverse childhood experiences. Life circumstances particularly involving poverty and inequalities. Shame and guilt have a significant impact on mental health and wellbeing so we must tackle the stigma that people face when they struggle.

Many people who have experienced trauma also experience significant physical health issues and this link should be recognised as a further barrier to wellbeing.

Relationships with others, financial security, feeling fear and sadness. The experience of being outwith the window of tolerance can feel unbearable to cope with day to day.

We must be trauma informed and trauma aware but not in a way that we provide medicalised interventions to a normal reaction to adverse life circumstances.

Access to activities (financial or otherwise) or time for them if a carer can be very challenging

There can be multiple barriers including financial, availability, time, worry about relationships, controlling relationship

We know the activities that would lead to positive wellbeing but often even approaching each day can feel overwhelming for many people.

Money and debt issues have a massive impact on the people we support

Intensive debt and financial support linked to support services

Community development trust

People are often unaware of the range of community support that is available and there should be wider awareness

As an organisation we see significant positive outcomes reported by the people we support

The professionalism of the third and community sectors should be recognised

The above are all aspects reported by our service users when trying too access support through statutory services

There are a huge range of third sector agencies and there should be better co-ordination in local areas to ensure that the first response is not always in the NHS or Local Authority. This would vastly reduce costs and improve the experience of those accessing services. For example those using their self directed support often do not know what support they can access.

It is vital that the support is appropriate for those in need. There are a number of specialist trauma services in the third sector who can offer a range of holistic interventions appropriate to the need of those they support. Unfortunately trauma specialists are perceived to be clinical psychologists offering CBT. CBT can be helpful as part of an integrative approach but Wellbeing Scotland have long standing experience of trauma survivors reporting that this was not the right approach for them. The trauma training framework should be adapted to include different approaches and the third sector.

Often clients wait on long waiting lists for a clinical psychologist when they could be receiving a service in the third sector with a more appropriate response. Often survivors have to go through a formulation or other type of assessment when they are not ready to speak out, Building of the therapeutic or other type of relationship is vital as many will disengage when feeling under pressure. Services currently work very much to a stage based formulaic model that does not meet all needs.

There should have been better involvement with the third sector and those who have lived experience but this can be resolved now

Recognition of adverse childhood experiences. preventative approaches to identify families in crisis. Continuation of counselling in schools and wellbeing services for children and young people. Engagement with families to keep them together where appropriate and possible. Early intervention is vital.

The counselling in schools services end next year and they must be prioritised but to also include younger children.

Adverse childhood experiences
Relationships
Bullying
Social media and body image
Parents who are struggling
Poverty
Lack of opportunity

We need a partnership approach to tackling the wellbeing of children young people and families

I am responding on behalf of my organisation

I am responding on behalf of my organisation

I am responding on behalf of my organisation

I am responding on behalf of my organisation

our organisation works in partnership with NHS colleagues including a joint assessment process. This enables a better outcome for those we support

There are many barriers for people experiencing intersectionality for example mental wellbeing and physical disability or mental wellbeing and cultural barriers.

Services must be made accessible to all.

more long term sustainable funding for the third sector

NHS services are far more expensive on a unit cost basis than the third sector and less responsive. Funding should be differently distributed.

Recognise the diversity of experience and training in the third sector

There should be recognition that a wide diversity of training is appropriate as is lived experience

Joint training and development programmes across sectors
Review of the trauma training framework to involve the third sectors as specialists

There are a plethora of experienced and skilled workers in the third and community sectors. There should be better use of those workers. Training should involve a range of therapeutic approaches, not merely CBT. There should be less use of intermediary assessment services as this will require to speak out about their wellbeing to someone when they are not ready and the relationship has not been developed. It can mean developing relationships with more than one worker. Over the years we have been told by those we support that this is very challenging. It is important that people can access confidential non statutory services without the need to go through a statutory route if they choose not to

Again use of the third sector commissioning preventative services.

One matter Wellbeing Scotland were very concerned about was that SPS commissioned specialist abuse services using the third sector across all prisons. In a cost saving initiative this was provided by the NHS. Prisoners were very clear they wanted confidential services provided by an independent provider. The service had a very significant number of clients with very positive outcomes and we feel this move was an error.

Often the best form of support will be provided by peers and those with lived experienced as they fully understand what people are facing. Research shows that those accessing support gain more from the relationship with the worker than from their qualifications.

Multi agency (including those with lived experience) training is vital with trainers from the third and community sectors to statutory providers and lived experience training providers.

The third and community sectors provided most of the response through Covid utilising immediate funding. This should be continued learning the lessons from Covid.

Vicarious trauma and self care across sectors, appropriate supervision and wellbeing initiatives.

The final point on 800 additional mental health workers should be utilising the third sector workforce. This will have lower costs and more rapid response.

The trauma training framework should have much greater involvement of the third sector as specialists. Workers should be trained to know what support is available. People need to come out of their fixed ways of working. That will involve more integrated practice rather than training.

Wellbeing Scotland work closely with NHS FV in assessment and allocation of clients. In addition we are training providers and we are involved in forums and groups as are other mental health organisations locally. This enables integrated practice and the best outcomes for clients. In West Lothian we are part of an innovative initiative where all local providers are working together to ensure clients go to the right service at the right time. This is for adult and another initiative for children's services. GCVS in Glasgow are excellent at bringing services together in forms as are CTSI in Alloa and CVS in Stirling. Other TSIs are excellent too. School counselling services in Clackmannanshire were developed with the third sector and the third sector have a strategic involvement leading to a model of good practice. The Alliance are excellent in bringing sectors together and in educating the health and social care sector

Current mental health services are facing significant challenges. Wellbeing Scotland response is not intended to criticise our statutory partners who are excellent in providing support. It is to encourage more working together to reduce the pressure on our colleagues. The aim is to improve the mental wellbeing of everyone and for that we all need to work together. Before Covid there was a significant increase in mental health concerns and this has increased. There seems to be a move towards more intermediary workers where there should be more knowledge of the third sector in general and funds allocated more appropriately to the sector. The move to online packages for people to use as a form of psychoeducation is very worrying. We need to move away from CBT and towards f more holistic approaches. Self management will be a vital way forward for ongoing recovery,