NHS mental health services 'slow and complicated'

Access to adult mental health services is “slow and complicated”, a new critical report from Audit Scotland has concluded.

It warns ministers’ plans to improve access are “not on track” despite commitments to increase spending on mental health.

The report found people in rural areas, those living in poverty and those from ethnic minority backgrounds particularly struggle to get mental health help.

And auditors also say there is a lack of data to properly assess the quality of service and whether it is improving the mental health of those who do get support.

Stephen Boyle, the auditor general, said: “The Scottish Government needs much more information to understand the difference its investment in mental health services is making, from specialist services to community-based support.

“That planning must include moving beyond using waiting times as the sole measure of whether services are improving the lives of those in need. And it needs to include a costed delivery plan for the care that people can expect in their communities.”

Despite big funding increases for mental health services since 2017 and improved waiting times for psychological therapies, auditors warn of a “fragmented” system which “makes accountability complex”.

The report says the mixture of government, NHS board, council, integrated joint board and third sector involvement in funding, planning and providing support can also cause delays in developing care focused on the individual.

And while it says the government’s pledge to increase the proportion of frontline spending spent on mental health and the commitment to put community-based services in place are “essential”, the government is under “considerable” financial constraints which means it could miss targets.

On access, Audit Scotland says several NHS boards are not routinely offering face-to-face support post-Covid, while mental health services are “not yet working closely enough” with housing, welfare and employability support to address the causes of poor mental health.

It also says the workforce is “under pressure”, with a high vacancy and turnover rate, while efforts to relieve pressure on specialist services by making support available via primary care has been delayed.

A Scottish Government spokesperson said: "The Mental Health Strategy Delivery Plan and Workforce Action Plan will be published in later in the autumn. These will set out the actions we intend to take to address many of the issues set out in this report."

Scottish Labour’s mental health spokesman Paul Sweeney said the report highlighted many communities face a “labyrinthine struggle” to get help.

He added: “There is no reason why Scots from ethnic minorities, rural areas or poorer areas should have to put up with substandard services or extra barriers.

“It is also deeply worrying that the government does not do sufficient work to ensure that care quality and outcomes are properly measured.”