Thumbnail image of author Rachel King

Our mental health needs attention and care to allow us to feel well and manage our day to day lives.

We know that if we are struggling, we should ask for help, we also know that just because mental health problems aren’t visible, it doesn’t mean they aren’t real. This year, to support World Mental Health Day, we have spoken with Rachel King, our mental health lead, about our ongoing work to ensure that everyone across Scotland has access to good quality mental health services.

1 in 4 people will experience mental health struggles at some point in their lives – a massive number of people who will need either some support at one point in their life, or ongoing, life-long mental health support. It is essential that as the general public continues to gain a better understanding of mental health struggles, the health service continues improving and developing, offering support to people whenever they need it, wherever they are in the country. As the improvement agency for health services in Scotland, we are currently working on four different mental health programmes that help to solve specific issues faced by the health service or members of the public accessing it.

Pull quote graphic. Text reads: "1 in 4 people will experience mental health struggles at some point in their lives"

Scottish Patient Safety Programme Mental Health

The Scottish Patient Safety Programme (SPSP) is a national quality improvement programme that aims to improve the safety and reliability of care and reduce harm. The mental health work supports NHS boards to ensure that everyone in adult mental health inpatient settings experiences safe and high quality care, with their unique needs placed at the centre of care delivery. As part of this work, we are striving towards reducing incidents of restraint and seclusion, while also working with boards to create conditions for improvement within their teams and implementing the ‘From Observation to Intervention’ national guidance.

Since launching the mental health programme, we have achieved some significant milestones, such as a 57% reduction in restraint, a 70% reduction in the number of patients who self-harm, and a 78% reduction in the rates of violence on inpatient wards.

As this programme goes on, we hope to achieve even greater results and continue to improve the experience of mental health inpatients across Scotland.

Pull quote graphic. Text reads: "We have achieved a 70% reduction in the number of patients who self-harm in inpatient settings"

Personality Disorder Programme

The Personality Disorder Improvement Programme (PDIP) is one of our most recent pieces of work, launching in January 2022. While still in its early stages, the overall aim of the programme is to better understand the care currently provided to people with a diagnosis of personality disorder, which will in turn help to identify the areas that could benefit from improvement and then to develop proposals to deliver those improvements.

One of the main goals of this programme is to provide opportunities for care providers to learn together, sharing their experiences and knowledge. To date, we have hosted three webinars and one workshop, with over 1,385 people registering to date and over 550 people attending. Another of the programme’s aims is to better understand the current state of personality disorder care and identify the key opportunities for improving services. It will also enable us to make high-level recommendations about what would need to be in place to deliver these improvements.

The main approach for the gathering of information is virtual visits with NHS boards and Health and Social Care Partnerships (HSCPs). From June–August 2022, the PDIP team has been in active discussions with 11 of the 14 NHS boards and representatives from each of the HSCPs. We have commissioned the Scottish Recovery Network and Voices of Experience (VOX) to undertake a programme of engagement of people with lived experience of personality disorder, as their input would be invaluable.

Early Intervention in Psychosis (EIP)

The Early Intervention in Psychosis (EIP) programme supports the redesign and continuous improvement of healthcare services across Scotland, keeping people with lived experience of psychosis, families and carers at the heart of this work.

Pull quote graphic. Text reads: "The programme keeps people with lived experience at the heart of its work.

Currently in its second phase, the programme supports two pathfinder sites, NHS Dumfries and Galloway and NHS Tayside, while they prototype and test new models of early intervention services. The models are now live and they will provide easier access to services, evidence-based person-centred care and treatment, and an increased likelihood of getting well and staying well to people experiencing first episode psychosis.

In addition to supporting pathfinder sites, the EIP national programme is engaging with stakeholders, collecting and analysing service-level data emerging from pathfinder sites, and sharing learning through national network events, newsletters and case studies. At the end of this phase, the programme will produce an implementation guide to be used by health boards across Scotland who are considering setting up an EIP service locally.

Mental Health and Substance Use Programme

Studies have shown there are clear links between mental health and substance use. People who present with both often experience difficulty in accessing services and appropriate treatment. The aim of the Mental Health and Substance Use programme is to redesign care pathways to improve quality of care, access to treatment and health outcomes for those with mental health and substance use support needs.

Pull quote graphic. Text reads: "studies have shown clear links between mental health and substance use"

We are currently involved in ongoing work in NHS Tayside to develop and test an integrated approach to mental health and substance use. We are also working with NHS Grampian and NHS Greater Glasgow & Clyde to bring this work to the areas, with plans to work with NHS Lothian and NHS Lanarkshire in the near future. Measures of success will include the following phases: discover, define, develop and deliver. Measures of success will include improved and fair access to health and care services, reduction in harm arising from unmet needs in relation to mental health and substance use, and the extent to which individuals experience a person-centred, integrated service based on needs.

Our end goal for all of this work is to improve the care received by people affected by mental health conditions, making sure they can access the help they need quickly and efficiently, regardless of their geographical location.

Rachel King is the portfolio lead for the mental health work at Healthcare Improvement Scotland.

More information

Find out more about our work at the links below:

Scottish Patient Safety Programme Mental Health

Personality Disorder Programme

Early Intervention in Psychosis (EIP)

Mental Health and Substance Use Programme