Response 42903838

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David Wright

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

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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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If no, what priorities do you think will deliver this transformation?
While our members recognise the importance of the eight priorities, we would like to see a commitment to engagement with carers as a clear priority. Triangle of Care as a policy has been a good start in this direction and should be built on. Carers need to be recognised as a valued resource and to have their own needs and opinions taken account of. There are already instances of good practice in this area, such as "carers cafes" and hospitals who are developing a progressive culture of involving/supporting carers. Access to "talking therapies" and in particular clinical psychology is something that is highly valued and should be made a priority. There is a perception that they are underused for long term conditions, yet can play a vital role in making recovery real and practical. This consistently emerges as a priority topic in group discussions.

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?
Regarding children and young people, mental and emotional health needs to be given the same priority as physical health, particularly in schools where bullying and exclusion can have lasting negative effects. Strong support was expressed for school teachers being mental health aware and able to recognise and talk about emotional and mental health issues early to prevent major problems. Along with physical health and body image issues, early damage to self confidence and self esteem was seen by many as having potentially lasting effects on inequality and stifling potential. Reducing social isolation, enabling access to community activities including the arts, social activities across all vulnerable groups. Link workers, befriending schemes and initiatives to reduce access costs were seen as vital if real changes to mental health and wellbeing are to be achieved. It was noted that much of the innovation in this area was being done by third sector agencies who often struggle for sustainability and legitimacy. The more socially connected individuals who gave feedback felt that very often the contribution of participating in activities that they enjoyed was at least equal to that of mainstream mental health services in promoting/sustaining recovery. Something as simple as public transport can make a great difference in accessing activities and services and is regularly cited as a barrier or enabler, particularly in rural areas.

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?
Easy and timely access to services remains a priority for many. Models of customer service that are becoming familiar in commerce and retail demonstrate what can be done with information, booking appointments and delivering services. We would like to see mental health services and health services in general approach the accessibility and efficiency of the commercial world. There are already examples of good practice, such as on line booking of appointments, text reminders and easy access services. Integration of services shows early promise but needs to simplify and clarify the process of assessment, referral and transitions. The work being done in this area will be challenging, detailed and should be done in partnership with patients and carers, taking account of the mundane glitches that cause delays and distress, inappropriate referrals and lack of involvement that has been the experience of many in the past. The behind the scenes structures and processes that make the system work in a joined up way (or not) are seen as having a major effect on the patient and carer experience particularly as services become more community focussed. There are too many reports from individuals who wait around for the promised elements of a care plan to materialise. The perception persists that robust community mental health services are not yet an alternative to hospitals in terms of people's awareness and confidence (in the way that, for example, commercial enterprises are establishing themselves beyond "bricks and mortar") The tradition of 9-5, Monday to Friday nature of services is seen as hopelessly old fashioned and unfit for purpose. The need to change this ranks as a top priority. It's not just about emergency or crisis services either. The very lack of continuity and possibility of contact with trusted professionals at evenings and weekends are seen as precipitating crisis. Where out of hours services are available, their very presence is seen as reassuring. The presence of mind from knowing that they are there is important. We would like to see mental health services where this is not an issue and evenings and weekends no longer a source of unnecessary anxiety. Choice is seen as important and attention needs to be given to providing and encouraging a range of services and options. A "one size fits all" approach is often cited as unhelpful.