Radical rethink required on mental health policy

The forthcoming Scottish Government Mental Health strategy must be radical and focused on delivery writes Ross Laird, Director of Public Affairs at Grayling Scotland, in the week of World Mental Health Day.

As many as one in four of us are likely to suffer from some form of mental health problem in our lifetime, yet does this issue get the political support and funding it needs? And will a new mental health strategy make any real difference?

There is a broad consensus across the political parties that mental health is an increasingly important issue that needs to be addressed and, only recently, the Scottish Government has published its long-awaited consultation on mental health – Mental Health in Scotland – a 10 year vision. But will the Government’s new strategy really meet the needs of a growing section of the population, or is a more radical re-think required?

Mental health is not only an important health issue, but also an economic one. The Scottish Association for Mental Health estimated the total expenditure, in terms of both social and economic costs, of mental ill health in Scotland to be in the region of £10.7 billion for 2009/10. So it is important for a range of reasons that the Scottish Government gets it right on mental health.

I worked in a mental health hospital while studying many years ago. It was illuminating to see how many patients were treated and, often, the lack of support they seemed to receive when leaving hospital. Care in the community was relatively new back then and things have since moved on, but mental health remains an understated problem in Scottish society.

A person’s mental well-being changes over time, much like your physical well-being, but the lowest mental well-being points tend to strike not when we’re old, but when we are young (particularly for women), or when we are middle-aged, when we face additional stresses and burdens.

According to the Mental Health Foundation 20% of adolescents may experience a mental health problem in any given year and up to one in ten children may suffer from mental health problems. Unfortunately, many people simply cannot see a way out of their problems or know who to turn to and sadly Scotland still has a very high rate of suicides. There were 830 suicides registered in Scotland in 2012 and suicide is known to be the leading cause of death of under 35‘s in Scotland.

The Scottish Government has used targets as one method of improving performance, dropping waiting times from the point of referral to treatment to 18 weeks. However, if you are a young patient prone to serious depression, a potential four and a half month wait for treatment could have seriously detrimental effects. Dropping waiting times will undoubtedly help, but is unlikely to solve the wider societal problems.

On the one hand, the Scottish Government has a great opportunity to reshape mental health policy, drawing on the newly integrated health and social care boards and their focus on more localised and personalised care. However, with such a complex and multi-faceted issue, it will be difficult to set out more than the key principles and overarching policies that will govern the delivery of mental health services. It will certainly require a more multi-disciplinary approach and one that draws on all parts of society to deliver it. That means that the strategy needs to make it clear which organisation does what and that there are clear signposts for the public to know who to ask for help.

Getting our mental health policy right will be an important step to giving this issue parity with physical health. However, without focus on delivery and clear designation of responsibility and adequate resources, there is a real danger of this being a missed opportunity.

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