Chamber and committees

General practitioners (GPs) are, as independent contractors, expected to highlight and address their own education needs throughout their careers, and GPs can access a range of training courses and learning materials on mental health issues to help meet their development needs. Access to these is facilitated through utilising flexible formats such as e-learning.

Scottish Government funded training and development on mental health improvement and suicide prevention encompasses mental health first aid, applied suicide intervention skills training, safeTALK, and pre-hospital crisis intervention, and are available to all sectors and, while not compulsory, are widely advertised.

The number of children admitted to an adult psychiatric ward are:

The figures above from the Mental Welfare Commission show the number of young people under 18 who were admitted to adult beds over a five year period. It should be noted however that monitoring of children admitted to adult wards only began with the introduction of the Mental Health (Care and Treatment) (Scotland) Act 2003 in October 2005 and therefore only covers a six month period from October 2005 to 31 March 2006.

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 number of clients with mental health problems who have received self-directed support for community care in the last five years, also expressed as a percentage of all recipients of self-directed support is provided in the following table:

Number and Percentage of Mental Health Clients Receiving Self-Directed Support (Direct payments)¹, 2006 to 2010:

Source: Self-directed support (direct payments) survey, Scottish Government.

Notes:

1. The self-directed support (direct payments) return is limited to the collection of direct payments information. Direct payments allow clients to purchase and manage for themselves some or all of the care they have been assessed as needing. This is only one of the different types of self-direct support currently available that allow people increasing flexibility, choice, and control over the care they receive.

2. Includes 97 dementia clients. Prior to 2010, the dementia client group was not collected separately and may have been included under either “Mental Health Problems” or “Other” client groups.

Latest publication: self-directed support (direct payments), Scotland, 2010 at:

http://www.scotland.gov.uk/Publications/2010/09/27093422/0.

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.

I have asked John Ewing, Chief Executive of the Scottish Prison Service, to respond. His response is as follows:

Mental health services are governed by Scottish Prison Service Health Care Standard 3 which can be found at:

http://www.sps.gov.uk/Publications/Publication104.aspx.

Referrals may be made to mental health services as a result of screening and assessments that are carried out during a prisoner's time in custody. Any member of staff can also refer any concerns they may have about a prisoner's wellbeing to health care services .

In addition, there is a robust system in place that allows prisoners to self refer to mental health services at any time during their period in custody.

Scottish Government officials have met with the DWP Work Programme Providers in Scotland and confirmed that specialist support will be provided to help people with mental health issues to find and remain in employment. In addition, Skills Development Scotland is working with Jobcentre Plus, other national partners and employability services funded locally through Community Planning Partnerships on better alignment of Employment and Skills Service. Through those links, adults with mental health issues will receive appropriate Careers Information Advice and Guidance.

Student teachers are given general tuition and guidance on how to recognise and support pupils with additional support needs, including mental health conditions, as part of a series of core and elective modules within initial teacher education courses.

In addition, there are many specific mental health awareness and emotional wellbeing continuing professional development (CPD) opportunities available for teachers. Identifying appropriate CPD opportunities and arranging to engage with them is a matter for individual teachers to agree with their local authority employers.

The police have a general duty of care, as well as specific duties under legislation such as the Adult Support and Protection (Scotland) Act 2007 to support those with mental health issues and to work with other agencies in doing so. Training on mental health and suicide prevention is a core part of the curriculum for probationers at the Scottish Police College. Since 2008, in association with NHS Health Scotland, 100 police officers have been trained in Scotland’s Mental Health First Aid programme and Applied Suicide Intervention Skills Training. Additionally, the police have received £1 million for adult protection activity generally as part of the overall £40 million funding provided by the Scottish Government since October 2008 to support the implementation of the Adult Support and Protection (Scotland) Act 2007.