Response 28228737

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Lorna Murray

3. Are you responding as an individual or an organisation?

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Ticked Individual

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1. Our framework sets out 8 priorities for a new Mental Health Strategy that we think will transform mental health in Scotland over 10 years. Are these the most important priorities?

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Ticked No
Don't know
If no, what priorities do you think will deliver this transformation?
I think all 8 are important but there is one I feel totally missing and that is development of communities. The focus of your plans is all on the individual who 'has' a mental health problem (with reference especially in early years to their family). But for people to live well - even with a diagnosed mental illness - we need friends and caring relationships with people who are around us and accept us 'just as we are'. Communities need encouragement to 'be good neighbours' by being friendly and by being aware of where/who to contact for help. This requires the "ask once get help fast" in the document to be easily accessible local resource. COMMUNITY DEVELOPMENT is needed in a mental health

2. The table in Annex A sets out a number of early actions that we think will support improvements for mental health.

Are there any other actions that you think we need to take to improve mental health in Scotland?
It is great to read of the commitment to mental health care being 'rooted' in primary care. But I would like to make the following comments: 1) when specialist care is needed it is often too far from home which particularly in mental illness is a huge disincentive to asking for help; and also making recovery more difficult. For example - the child inpatient unit in Dundee - how can being there really benefit a child from Western Isles? And from my experience in Aberdeen - people having to be inpatients at Cornhill Hospital from Orkney and Shetland have isolation and separation from support to deal with while there for treatment (so how beneficial can treatment really be?) I have several times visited mental health projects and hospitals in India where it is recognised that family needs a) support and b) education if a person is to be discharged to live well. 2) a good relationship with professionals/voluntary organisations is essential but so are good relationships within local community - these need encouragement (as in qu 1 above) 3) policy writes of whole-person approach which is good. But in reality how will this happen? an example from my local health centre - a recent newsletter published by health centre reminds patients to only talk about one issue when meeting their GP. Especially with mental health issues there are multiple concerns and such advice is likely to mean people do not ask for the help they need. This seems like an example of a policy having a principle while the practice is saying something different. 4) in no. 5 'improving access' there is 'computerised CBT' to be widely available. For some people this is great - but a) computerised is not inter-personal/relational which is vital to many for well-being and b) CBT is not appropriate for a wide range of mental health issues. There is a need - again relating to community development - for increase in 'drop in' centres; come in for coffee and find out sources of help days etc - very local and in places people go. eg in marts, at agricultural shows, in shopping centres as well as local halls

3. The table in Annex A sets out some of the results we expect to see.

What do you want mental health services in Scotland to look like in 10 years' time?
As you might expect from my answers, my vision includes communities being much more neighbourly and caring. I see this as being achieved mainly by: a) ensuring communities have the resources they need: when people feel cared about, supported and valued they are much more able and ready to care for and support people around them who may be needing that 'extra' support b) ensuring communities - especially in more isolated areas such as big housing estates and sparse rural areas - have meeting places such as hall, drop in centre etc where advice/information can be provided as well as 'tea and chat' for healthy relationships. My vision includes everyone being able to access what they need to live well, which includes: (I) information about what is good - and bad - for us eg diet, alcohol, exercise etc (ii) access to what is needed to live well eg for city folks, public transport to forest walks or beach; for rural folks, co-ordination of public transport with hospital appointments My vision re equality is that everyone has opportunity to live as well as possible within whatever problems and/or illness they experience at personal level. This does not mean that everyone is treated the same - but that everyone has access to what they need. My vision is that there are no 'labels' on people being identified as 'vulnerable' or 'in need of help' because of, eg where they live (just because someone lives on a particular housing scheme and has little money does not mean they have poor parenting skills); their illness (just because someone has depression it does not mean that they will always be taking time off work) My vision includes an understanding being developed a) within communities locally and b) by those involved in care and health policy that each person is - like all others (ie has human needs that need met) - like some others (ie may eg have schizophrenia and most people with this illness benefit from identified types of care) - like no others (ie eg has schizophrenia but has (or sadly does not have) family support, finds walking, or painting, or whatever helpful to overcome voices etc My vision also wants to enable everybody to be more aware than in recent medical and social history that life IS difficult and that individuals need help from others and this is NORMAL. Also that much of what is 'medicalised' or made into a 'problem' is actually a normal response to difficult circumstances (eg feeling 'depressed' after a death is bereavement which eg GP may well be able to offer support for and clearly GP judgement as to whether an individual may need anti-depressants - but more needs to be seen as normal part of life. Community support again vital here. And neighbours and friends encouraged to 'be there' while people experience pain - not just trying to 'fix' or 'get rid of' it. Finally - within all this JUSTICE is huge issue. Where pain/distress is caused by eg poor housing; lack of public transport leading to isolation etc then the cause must be dealt with not the person labelled as 'ill'