Mental health: a national asset for Scotland
Mental Health Foundation works across the UK to bring together policy, research and practice in mental health. Today our Scotland policy team look forward to the Scottish Parliamentary elections in May, and the forthcoming Scottish Government mental health strategy.
We are calling for robust political discussion of mental health during the election campaign, followed by a commitment by the next Scottish Government to a cross-departmental approach to mental health policy - not just a technical, mental illness-focused mental health strategy.
We believe that the next Scottish Government should deliver a comprehensive policy approach to mental health to:
- ensure we all have the opportunity to flourish
- ensure we concentrate on those with the least power and most risk
- ensure that people with mental health problems can recover and thrive.
We have five asks, which we believe frame a requirement to build outwards from compassionate, rights based and recovery-focused mental health services, to a framework for building mental health as a national asset for Scotland’s future.
A comprehensive, prevention-focused strategy for mental health policy in Scotland, bringing together a drive for improved mental health services with a vision to improve mental health across our communities
We want to see an in-depth exploration of how the Scottish Government can use the powers now available to it to address the social and economic determinants of poor mental health and disparities, including options to mitigate the effects of challenging UK policies in Scotland.
Increasing our focus on prevention in mental health policy does not replace the urgent need to continue to focus on addressing mental health conditions when they arise. Prevention of distress, of relapse, of crisis, of suicide, and of lost opportunity and failure demand should address the issues that see people with mental health problems die younger and be disproportionately subject to inequalities.
In turn, this enables people to be more active in communities, use fewer services, and lead lives they value. To achieve this, it is critical that we maintain pressure to achieve social justice in mental health via support for evidence-led programmes such as See Me, which explicitly focuses on mental health inequalities.
We need to see flexible, equitable access to health and social care services that act early, hold hope, and focus on creating the circumstances for a person to thrive, not merely exist. That is critical for avoiding the economic and social impact of health inequalities that can lower life expectancy by 20 years.
Commitment to put into practice the 2011 Christie Commission recommendations with regard to addressing inequality, failure demand and co-production in mental health, in the context of wider public service reform.
Five years ago, the Christie Commission recommended that future delivery of public services in Scotland should have a presumption of addressing inequalities, a presumption of addressing failure demand, and use co-production to engage communities. We believe that these have not been fully implemented.
With health and social care integration underway and primary care reform on the horizon, now is the time to supply the leadership to change this.
We must prioritise prevention in mental health, even in the face of austerity and challenge, because the downstream risk of failure demand created by abandoning existing programmes such as early years support or suicide prevention, or rowing back from developing new approaches, will only lead to a future unmanageable demand for services.
Commitment to recognising the unique role of mental health in achieving our national outcomes, coupled with improved mental health literacy to enable mental health impact to be recognised
A key aim of all manifestos for government is to enable Scots to be healthier, happier, safer, more productive and engaged in their communities. These macro level political ambitions are in keeping with the factors that promote mental health and enable resilience.
How we feel, how we act, and the connections we make are key to success for education, economic development, community, health, justice, equality, transport and sustainability policies which build the national outcomes the next government will set.
With increasing localism, local structures, including Joint Integration Boards and primary care structures must have an understanding of and a due regard for mental health and wellbeing. This mental health in all policies approach has gathered traction across Europe and we have a huge opportunity in Scotland to use our national outcomes framework to implement this.
Commitment to supporting the development of comparable data and research evidence in mental health, coupled with a commitment to support and evaluate innovation in mental health
The Mental Health Foundation is an evidence-led organisation. We recognise that there must be a commitment to supporting mental health research that evaluates innovation, develops and synthesises the evidence base and brings this into practice at street level. We should draw on the ROAMER roadmap for mental health research in Europe.
We want to see a commitment to evidence-led scaling of innovation, based on evaluation, learning and original research across the spectrum of mental health and wellbeing – too often we see promising pilot practice discontinued because resource cannot shift to accommodate it.
We need to see a mental health data development plan for Scotland to provide improved, comparable data on mental health outcomes, service use, and services across Scotland. This should bring together data on mental health indicators with data on inequalities, economic impact, and service use. It must explicitly include data on the mental health of those with protected characteristics, particularly around ethnicity, gender and sexual orientation.
Establishment of a high-level commission on mental health in Scotland, to develop a human rights-based vision for mental health at the heart of Scotland’s future
The Foundation is proud to support the Scottish Mental Health Partnership call for a high-level commission on mental health in Scotland. In the past decade we have been fortunate to support two national reviews of mental health services, and a review of public mental health in Scotland. All of these were snapshots in time.
Mental health is a skeleton key that can unlock the challenges Scotland faces around health inequalities, attainment, equality, and poverty.
In recent years we have seen concerted effort for instance in early years youth services and education through the Getting it Right for Every Child (GIRFEC) approach. GIRFEC is a policy approach that has achieved transformational change at all levels. We are calling for the same type of unifying, holistic approach to addressing mental health across the life-course in Scotland.