Meeting of the Parliament 02 April 2014
I welcome the opportunity to have this debate. Mental health issues have a high profile in Scotland. Indeed, this Parliament has regularly debated mental health.
I want us to think about mental and physical health in the same way. That is what we are doing, in our approach to improving mental health services in Scotland. We have set access targets to measure performance, as we have done in the context of physical health. We publish data on how services operate, so that we can identify how services vary and where we need to make improvements. I measure success by what happens on the ground, and across Scotland there are improvements in services, while more transparent data allow us to identify areas where further improvement is needed.
Faster access to specialist mental health services for children and young people and to psychological therapies for people of all ages is one of our key challenges. Scotland is unique in developing that approach to improving access to mental health services. We want more people who are experiencing mental ill health to seek support. We know that people are increasingly likely to go to their general practitioner when they are experiencing problems and that they are more likely to receive a diagnosis of depression or anxiety and an evidence-based treatment for that. That reflects the reduction in stigma, the work that has been undertaken in primary care to improve diagnosis rates and better access to treatments.
We want more psychological therapies to be available. NHS boards have been working to increase the capacity of their services, using service redesign to improve the efficiency of the services and increasing the number of staff who are able to deliver evidence-based therapies. We now have data on how many people are accessing psychological therapies and how long they are waiting. We are also developing national workforce data on the staff who are delivering psychological therapies. We are now in a stronger position, with transparent information and a better understanding of how services are working in each health board area, which allows us to identify their priorities for further improvement. We do not expect all health boards to deliver identical services, but we expect them to use the information to identify where there are gaps in services and to support them in meeting their local needs.
We have set a challenging target for our NHS boards, and it was meant to be a challenging target. NHS Scotland delivered more than 8,000 psychological therapies in the past quarter and that number will continue to increase as data from other services are included. Half of those people started their treatment in nine weeks or less. Most important, we want people to get better as a result of the treatment that they receive and we have seen an increase in the routine use of clinical outcome measures to ensure the quality of the mental health services that are being delivered.
Ensuring access to mental health services for children and young people is a key priority. Since 2008, the specialist child and adolescent mental health services workforce has increased by over 40 per cent as a result of the significant investment that we have made in the service. The number of children who are being seen in CAMHS in a three-month period has varied from 2,400 to 3,900 and there has been a consistent performance on waiting times, with half of them starting treatment in eight weeks or less—a period that was reduced to seven weeks during the past quarter.
Richard Simpson’s amendment raises an important issue. We have recently seen an increase in the number of admissions of children to adult wards, but the answer is not simply to provide more beds for children and young people. We need a fundamental redesign of intensive CAMHS services. In the south-east of Scotland, the health boards invested heavily in the development of intensive treatment teams—hospital at home services—which provide treatment for young people at home and in a familiar environment. That has resulted in many admissions being avoided altogether, and when admissions do take place they tend to be for a shorter period. Therefore, the outcomes for children and families are good. We have seen an increasing number of admissions, but they have involved a shorter length of stay, which has built additional capacity into the system so that beds have been available when they have been needed.
However, the picture is not uniform across Scotland. Some areas have not progressed plans to develop intensive treatment teams as quickly as we would have liked, and an increase in the number of referrals of young people to in-patient units has created pressure in the system. In response to that, we will facilitate work across the three regions this year to address the pressure in the system and to reduce the number of admissions of young people to adult wards.
The progress that we have seen in the improvement of mental health services has been established on data that have helped us to understand the variation across Scotland, to identify gaps and to prioritise our work. The 10-year review that has been referred to is currently being undertaken by the Mental Health Foundation, voices of experience and Healthcare Improvement Scotland, and the report will be published later this year.
Tackling stigma and discrimination remain Government priorities. We have increased funding for the see me campaign, and the Scottish Government provides £1 million, alongside £500,000 from Comic Relief, bringing the total annual budget to £1.5 million.