Carolyn Lochhead says there is a still fight to be had over the ask once get help fast approach to mental health despite the Scottish Government’s commitment to it in its 10 year mental health strategy
In 2016, Scottish Association for Mental Health (SAMH) began campaigning for an ask once get help fast approach to mental health. We told the Scottish Government it would take 10 years to fully implement it, and they agreed. Now, they have published the 10 year strategy. We’re glad it still includes a commitment to an ask once approach. But without clear policy and real resources, it means nothing.
So does this strategy deliver?
It identifies some of the right priorities. Action on maternal and early year’s mental health, the importance of physical health and parity for physical and mental health are all recognised. And there are hopeful ambitions expressed within the document. But there were four specific areas where SAMH wanted to see action if we are truly to achieve Ask Once Get Help Fast.
Budget
First, the money. The Scottish Government has committed an additional £150 million for mental health which is welcomed. But most of it is already spent. And what’s left works out as around £13m per year for the first five years. We need a budget which stands up to that across the border, which in Scotland would be £100 million every year.
Children and young people
Half of all mental health problems begin before the age of 15. Three young people in every classroom have a mental health problem. We must take action.
Yet we are missing the target for those referred to child and adolescent mental health services (CAMHS) to be seen within 18 weeks – just seven health boards are achieving this. 17,598 children and young people were turned away from CAMHS in the last three years. We need investment in early intervention where children can be helped within schools and communities rather than specialist services. We welcome a commitment to audit rejected referrals. This audit must start quickly, report within 18 months and lead to firm action.
Psychological therapies
We know that psychological therapies, also known as talking therapies can help people change unhelpful thinking patterns and ultimately recover. But here, too, we are failing – just two NHS boards managed to see most people within 18 weeks of referral. And that’s before you consider that in most other areas of health, the target is just 12 weeks – an unfair discrimination that SAMH wants ended.
The Scottish Government has invested some money in this area. And the strategy says more will be done. But the only specific actions are on self-help and computer-based cognitive behavioural therapy. There is an evidence base for these, but they are not right for everyone. People need real choices if they are to recover.
Structure
Finally, there is the question of how this strategy will be implemented and measured. We have still never seen a report card on the achievements or failings of the previous strategy. We can’t risk being in the same situation again. We need a dynamic strategy that can flex and adapt. We asked for a plan with timetabled goals, a steering group reporting to the minister and an advisory group of people with lived experience. It’s good news that there will be a stakeholder group meeting twice a year with the minister. But we need to see a detailed, funded implementation plan.
We are glad the strategy has been published. Now we can stop speculating about what might or might not be in it, and get on with achieving ask once get help fast. But we need real investment, a clear plan and some long term thinking, if we’re going to really make a difference to Scotland’s mental health.
Carolyn Lochhead is Public Affairs Manager at SAMH (Scottish Association for Mental Health).
