Health

Where is Scotland in 2024?

Mental and physical health is foundational to wellbeing, and it is recognised that getting it right in the early years has benefits far into adulthood. Despite this, there are concerns that access to services is becoming harder—meaning children, young people, families, and care experienced adults cannot access timely support. While any individual experiencing delays in accessing treatment is unacceptable, it is felt most acutely by the youngest in the country.

There is recognition that timely access to holistic mental health support is essential for children, young people and families: a recent analysis of 2020-2023 plans indicated that 28 of 30 Children’s Services Planning Partnerships (CSPPs) had identified mental health or mental wellbeing as a local strategic priority. Despite this, there continues to be barriers to receiving support.

Positively, there are examples of collaborative, multi-agency work to develop holistic responses to the needs of children, young people, families, and care experienced adults. This work from pre-birth and beyond must continue in a sustainable way to support relationships and physical and mental health.

Organisations across the healthcare system are developing ways to support their workforces. This has included developments to existing training and development materials, and the creation of new resources. An example of this is work by COSLA, NHS Education for Scotland, Scottish Government and the Improvement Service to develop a robust quality assurance framework for trauma-informed services and including self-evaluation tools.

Where does Scotland need to be by 2030?

By 2030, Scotland will have a range of timely, trauma-informed, and thoughtful support therapies available to those that require it, regardless of diagnosis. This means:

Children and young people must not require a significant mental health diagnosis to be able to access support.
Scotland will ensure there is timely access to mental health support before crisis point, to avoid hospitalisation.
There will be criteria-free, community-based access to therapies that do not stigmatise, but instead help and support children, young people, families, and care experienced adults to work through difficulties they are facing.
There will be availability of services to support parents and carers’ mental health at all stages of their parenting journey.
There will be effective and flexible collaboration between services supporting adult mental health and statutory children's services.
Scotland will recognise its responsibilities to those who have spent significant time in hospital through the decisions of the State and ensure they are properly supported to access all they need.

The route map to get there

Focus must be on the fact that money is not always focused on the right things and budgets are decreasing, leading to overstretched services and increasing numbers of families in poverty. There are clear tensions in what Scotland says it wants for its children and families, and what it is doing with the resources it has. For progress to be made, work must prioritise resolving this to ensure the money that is spent is clearly aligned to need and impact across the 'care system' and all adjacent systems.

The reform of the Mental Health Act that has already been committed to must be progressed.

The new National Secure Adolescent Inpatient Service for Scotland is expected to open the first medium-secure adolescent inpatient service for young people in Scotland. The service will provide bespoke support to young people who have complex difficulties and need a high level of care.

The Children and Young People's Mental Health and Wellbeing Joint Delivery Board will consider how gaps in provision can be addressed.

The Scottish Government will have completed its investment of over £50million in the Mental Health Outcomes Framework to improve the quality and delivery of mental health and psychological interventions and therapies for all. Funding priorities included: Child and Adolescent Mental Health Services (CAMHS), psychological therapies, eating disorders and neurodevelopmental services, as well as innovation and service reform.

The actions outlined in the Voice foundation are fully embedded at every stage to progress actions on Health.

Prevention has to be a strong priority, as well as taking a ‘life stages’ approach that prioritises early years and family support.

Community-based holistic support must be available at the earliest opportunity to avoid lengthy waits and escalation to crisis situations.

What is helping?

The Scottish Government and COSLA published the Mental Health and Wellbeing Strategy for Scotland in June 2023. Early intervention and prevention, as well as taking a ‘life stages’ approach that prioritises early years and family support is a key focus.

Mental Health Strategy 2017-2027 sets out a 10-year vision of where mental health funding will be focused. This includes areas such as additional investment for mental health workers and improved provision of services including Child and Adolescent Mental Health Services (CAMHS). The £120million funding through the Mental Health Recovery and Renewal Fund has been allocated to "transform services", including £40m to ensure CAMHS is available, responsive, effective and equitable.

Currently, 11 health boards in Scotland have new infant mental health services. The Perinatal Mental Health Network Scotland have published an Infant Mental Health Service Development Guide and role descriptors for Parent-Infant therapists. An awareness-raising campaign and ‘Wellbeing for Wee Ones Hub’ has been launched on Parent Club, along with other activities and materials around infant mental health.

Mental Health COVID Transition and Recovery Plan sets out joint work to support mental health in schools.

In November 2023, The Scottish Government published the Mental Health and Wellbeing Strategy Delivery Plan (2023-25). One of the priorities is to reduce the risk of poor mental health and wellbeing in adult life by promoting the importance of good relationships and trauma-informed approaches from the earliest years of life, taking account adverse childhood experiences. The Delivery Plan commits to funding the enhancement of crisis and distress services, including trauma-informed support, giving particular consideration to the needs of children and young people who are care experienced or on the edges of care.

Children and Young People Commissioner Scotland’s 'accountability tracker' on mental health holds duty bearers to account. This will help children and young people, and the adults who are working with them, to also do so.

The Scottish Government’s work on suicide prevention is being progressed via Suicide Prevention Scotland. This is a partnership-led delivery model connecting national, local and sectoral partners together in a shared mission to prevent suicide.

Scotland’s 10-year Creating Hope Together: Suicide Prevention Strategy 2022 to 2032, is considered world-leading due to it focusing on tackling the inequalities of suicide, prioritising supporting groups at higher risk of suicide and taking a whole government and society approach to suicide prevention. The National Suicide Prevention Advisory Group provides strategic advice to Scottish Government and COSLA, as well as Suicide Prevention Scotland, ensuring delivery is achieving the strategy’s outcomes.

Scotland’s 3-year Suicide Prevention Action Plan Creating Hope Together outlines the commitment to work with The Promise Scotland to engage with care experienced people to better understand what action is needed to embed suicide prevention activity in all support.

Lived experience plays a central role in shaping Scotland’s suicide-prevention work. The Youth Advisory Group includes care experienced young people and their involvement and lived experience plays a central role in shaping Scotland suicide prevention work.

In November 2023, the Scottish Government and COSLA published the world’s first standalone Self Harm Strategy and Action Plan 2023 to 2027, based on evidence and partner feedback.

The Joint Strategic Board for Children and Family Mental Health was established in November 2023 and will build on recommendations made by the Children and Young People's Mental Health and Wellbeing Joint Delivery Board to consider how gaps in provision can be addressed. The Board will also take forward the work of the Perinatal and Infant Mental Health Programme Board.

In October 2023, Her Majesty's Inspectorate of Constabulary in Scotland (HMICS) published a thematic review of policing mental health in Scotland. In summary, the report finds that there has been a significant increase in demands on policing associated with mental health highlighting a potential gap in provision of crisis support particularly out of hours.