The Scottish Government sets national policy direction for mental health and provides funding to NHS boards and local authorities to support implementation of policy. The management of local actions in implementing national policy, and decisions on local service planning and delivery, spending priorities, and the important contribution of the third sector in this, is the responsibility of relevant local agencies.

The Scottish Government also has a long history of supporting national mental health third sector organisations through direct grant funding with £596,000 Section 10 grant funding available this year alone.

The Scottish Government’s main third sector budget is increasing by 16 per cent to £24 million a year in 2011-12, reflecting the importance of the sector to the success of Scotland. This will support the important role that the third sector has to play in public service delivery and redesign through a range of measures. The Scottish Investment Fund, which was due to end in March 2011, will also now continue for a further year with an additional £3 million.

The Scottish Government sets national direction of policy on mental health and provides funding to agencies, including NHS boards and local authorities, to support implementation of policy. The management of local actions in implementing national policy, and decisions on local spending priorities are the responsibility of relevant local agencies. NHS boards are responsible for training and providing information about services for patients with mental health problems in their board area.

Spend on mental health promotion, early intervention and appropriate treatment for mental health patients will continue to be drawn from the overall funds allocated to NHS Scotland by the Scottish Government. In this respect the overall health budget will increase to a total of £11.4 billion in 2011-12.

The Scottish Government sets national direction of policy on mental health and provides funding to agencies, including NHS boards and local authorities, to support implementation of policy. The management of local actions in implementing national policy, and decisions on local spending priorities are the responsibility of relevant local agencies. It is therefore the responsibility of NHS boards to work with their partners and regularly review spending decisions to deliver fit for purpose services which respond to local needs.

The national performance framework underpins delivery against the government’s agenda and mental health services are monitored through NHS board annual review, local delivery plan, and single outcome agreement processes, including a rolling programme of Scottish Government mental health team implementation review visits to local service delivery partners.

Joint working between agencies and staff is essential to providing co-ordinated, quality care and support for people with mental health problems, their carers and families. Significant progress continues to be made by the NHS Scotland and local authorities in providing co-ordinated services including our focus on reducing delayed discharges and improving services for people with dementia through delivery of the National Dementia Strategy.

Improvement will continue through delivery of the Scottish Government’s £70 million change fund to enable NHS boards, local authorities and voluntary agencies redesign services for our growing older population, and development with NHS Scotland and COSLA of the integrated resource framework to provide more effective integration; improve people’s experience of services, and enable better models of care to be provided more efficiently.

The links between alcohol use and underlying mental health issues are well established and have been recognised in the Scottish Government’s Mind the Gap (http://www.scotland.gov.uk/Publications/2003/11/18567/29477) and Closing the Gaps (http://www.scotland.gov.uk/Publications/2007/12/10141643/0) reports and in the Alcohol Framework (http://www.scotland.gov.uk/Publications/2009/03/04144703/2.)

Guidance and recommendations contained in these reports are being implemented, where appropriate, by a range of relevant stakeholders including: NHS boards, local authorities, alcohol and drug partnerships and third sector organisations.

Information on waiting times for access to mental health services has not historically been collected.

The HEAT targets for 2010-11 were published in the local delivery plan guidance on 1 December 2010. This included a HEAT target to improve access to mental health services by delivering 18-week referral-to-treatment for psychological therapies from December 2014. It also encompasses the target to deliver the referral to treatment target for child and adolescent mental health services within 26 weeks by March 2013.

In 2011-12 ISD’s (Information Services Division) focus will be on supporting NHS boards to begin to collect the required information to enable monitoring against the target and to support the continual improvement of data quality, both in terms of completeness and comparability through the development and implementation of relevant data standards.

ISD is collecting the data on a monthly basis using a live database. The data collected will be published when it is of sufficient quality to ensure accuracy, reliability and comparability.

The Scottish Government sets national direction of policy on mental health and provides funding to agencies, including NHS boards and local authorities, to support implementation of policy. The management of local actions in implementing national policy, and decisions on local spending priorities are the responsibility of relevant local agencies.

Decisions on treatment, and referral to exercise schemes for people with a mental illness, are matters for clinicians to consider in consultation with the individual. In treating patients with mental illness, clinicians will take a holistic approach and consider a range of factors including ongoing attention to diet, weight management and healthy eating to ensure healthy and sustainable dietary habits.

Our Towards a Mentally Flourishing Scotland action plan recognises physical activity as an important factor in mental health improvement, and promoting mental health. We have reviewed current evidence based approaches on smoking cessation, weight management and physical activity for those experiencing mental illness and a range of tailored user and carer led health information is available.

We have published Standards designed to improve care pathways for mental health and this highlights the need for regular physical health assessments, with attention to diet and nutrition at:

http://www.healthcareimprovementscotland.org/programmes/mental_health/icps_for_mental_health.aspx.

We have also published guidance for NHS boards to help embed improving the physical health of those with mental illness within existing health improvement policies and practice at:

http://www.scotland.gov.uk/Publications/2008/11/28152218/0.

We are also funding The Thistle Foundation (£178,000 over 2008-12) to pilot a range of activities with the aim of improving local levels of physical and mental wellbeing. Work has included developing a referral network, for example from local GPs and other service providers, developing gym access and developing outdoor initiatives.

The Scottish Government sets national direction of policy on mental health and provides funding to agencies, including NHS boards and local authorities, to support implementation of policy. The management of local actions in implementing national policy, and decisions on local spending priorities are the responsibility of relevant local agencies. The provision of care for people with mental health problems is the responsibility of GPs, NHS boards and local authorities working with partners in the private and third sectors.

The Scottish Government sets national direction of policy on mental health and provides funding to agencies, including NHS boards and local authorities, to support implementation of policy. The management of local actions in implementing national policy, and decisions on local spending priorities are the responsibility of relevant local agencies. GPs and NHS boards are responsible for the care and treatment of patients who receive antidepressants.

The use of antidepressants has been an area of focused activity over the last few years, providing us with a more developed understanding of how they are being prescribed by GPs in Scotland.

An example of work developed to support delivery of the HEAT target on antidepressant prescribing was in NHS Ayrshire and Arran, supported by the local mental health collaborative, where they developed a prescribing audit tool that provides practices with an overview of their antidepressant prescribing behaviour. GPs can then use the information to manage patients who present with depression at an individual patient or practice level, and reflect on prescribing behaviours with a view to identifying local service improvements.

One way that GPs can review how patients being prescribed antidepressants is through the quality and outcomes framework of the General Medical Services contract. It requires that GPs undertake complete an internal peer review to look at variation in prescribing for a particular drug or group of drugs, then do an external review against a group of other practices and then finally make changes to care pathway following these reviews.

The Scottish Government sets national direction of policy on mental health and provides funding to agencies, including NHS boards and local authorities, to support implementation of policy. The management of local actions in implementing national policy, and decisions on local spending priorities are the responsibility of relevant local agencies.

Mental Health is included in the Quality and Outcomes Framework (QOF) of the General Medical Services (GMS) contract in the domains of dementia, depression and mental health. It is also included in other long-term conditions such as diabetes and coronary heart disease. The indicators identify individuals through appropriate registers, assess their mental health condition and severity, and tailor management according to their individual needs, taking account of the views and needs of their carers. Achievement against these indicators in GMS practices in Scotland continues to improve in most domains. The figures from 2009/10 are: dementia 99% of the available points achieved; depression 85.6%; and mental health 96.6%, diabetes 97.4% and coronary heart disease 99.7%.

The Scottish Government provided £548,000 funding for the three year Living Better partnership project led by Royal College of GPs in Scotland to help local primary care services respond to the mental health needs of people living with long term conditions such as diabetes, chronic heart disease, and chronic obstructive pulmonary disease. A final outcome report detailing findings is expected by June 2011.