Associate Feature: Scotland’s Mental Health Services

How do we make sure Scotland’s mental health services are working well now, and work better in the future?

In 2023 that question is becoming more difficult to answer whether it is asked by government, or a national organisation such as the one I chair, or a local service.

Seemingly endemic staff shortages across medical and care professions are having a negative impact on people receiving care and treatment. Remaining staff try to deliver a full service but are under extra pressure, and are increasingly reliant on bank or agency workers to fill gaps. The problems can seem insurmountable when set against increased demand for services, and pressure on budgets.

All of us, including our government, have a responsibility to not lose sight of the individuals who are at the centre of our work. We must remember how good quality care can relieve immediate distress, and have a positive and long term impact on a person. Whereas a lack of care, or poor quality care due to pressured services, can do the opposite.

Meeting patients and NHS staff

One of the core roles of the Mental Welfare Commission is to visit mental health, learning disability and dementia wards across the country, talking to staff and patients to see and hear about what is actually happening for them. We make over 100 visits every year and we create a report for each visit, highlighting good practice and making recommendations for change. We publish all of our reports on our website so that local communities and services can see what we find. 

We also run our daily advice line for health and care professionals and for individuals or their families or carers who are seeking expert advice on care and treatment. Calls to the advice line also help us keep in close touch with the public’s experience of mental health care at any given time, and with the experience of social workers, nurses, doctors and other professionals working in mental health services. 

Sharing good practice

One action that can be done relatively quickly is sharing examples of good practice. A ward might introduce a new idea that works well for their patients and could be replicated successfully elsewhere. 

We intend to do more to encourage that wider sharing of ideas by increasing our joint working with other national organisations with routes into services. We are also hosting webinars, masterclasses and events where we discuss our national reports, offer specific legal and good practice guidance, and share experiences.

By doing all we can to share good practice where we find it, we aim to be more efficient and effective. Working this way also helps reduce the volume of information directed at health boards, local authorities and health and social care partnerships. 

Expand our visits programme

This year we are seeking to expand our visits programme by introducing visits to community mental health and learning disability teams, in addition to our hospital visits. 

We will increase our lived experience engagement work, with a particular focus on engaging with children and young people. 

We will publish a report on people receiving hospital care and treatment out with NHS Scotland services to learn more about their circumstances. 

And we continue to publish closure reports for all of our major themed visit reports, ensuring we are transparent in the responses we receive from those we have asked to make improvements.

A new opportunity - Scotland’s mental health laws

Last September the Scottish Mental Health Review published its final report recommending major changes to Scotland’s mental health and incapacity legislation. Scottish Government is due to publish its response this summer. 

Our legislation in this area is over 20 years old. In recent times there have been huge societal changes, and changes in care and treatment, that put the individual at the centre of care. Our legislation has yet to catch up.

The Review is a great opportunity to do that and more. It has been extensively consulted on and many people, including those with lived experience and their families, have expectations that much needed change is coming. We must not let them down. 

The Mental Welfare Commission is willing to support legislative change. We must grasp this chance.

Sandy Riddell is chair of the Mental Welfare Commission.

This article is sponsored by the Mental Welfare Commission.