Chamber and committees

I have asked Tony Cameron,Chief Executive of the Scottish Prison Service, to respond. His response is asfollows:

Such awareness training isnot offered routinely to Scottish Prison Service staff.

There is strong evidence tosuggest that thiomersal in vaccines does not cause any harm (except for skinrashes or local swelling at the site of injection). Despite this, and as partof a global goal to reduce exposure to mercury from avoidable sources ingeneral, the European Agency for the Evaluation of Medicinal Products (EMEA)has recommended that vaccine manufacturers phase out use of thiomersal whereverpossible as a purely precautionary measure. The Committee on Safety ofMedicines endorses this recommendation. As the body responsible for the safetyof all medicines available on the UK market, the medicines and health care products regulatoryagency is working with vaccine manufacturers to implement the EMEArecommendations.

At present, there are twostages to the research process in support of the Choose Life Strategy andAction Plan. The first of these – a scoping exercise – is being commissioned inJanuary 2004. The overall aim of this scoping exercise is to collect andco-ordinate information about the interests and areas of expertise oforganisations and individuals specialising in suicide-related research acrossthe UK and beyond and to establish the focus for the next stage.

The second stage, commencingbetween the end of spring and the beginning of summer 2004, involves thecommissioning of a series of reviews related to the objectives and prioritiesof the Choose Life Strategy. This will establish a systematic approach tounderstanding the extent and nature of the existing evidence base relating tosuicide prevalence, risk and protective factors. This work is being undertakenin 2004-05. Once completed, we will be in a position to better identify gapsand to set about commissioning further research to meet Scottish needs.

The information requested isset out in the following table. The information relates to students enrolled onthe Scottish Agricultural College’s degree programmes as at 28 October 2003

Campus	Degree Students (All Years)	Degree Students (Year One Only)
Student Headcount	Full-Time Equivalents	Student Headcount	Full-Time Equivalents
Aberdeen	130	105.5	44	33.5
Ayr	176	173.5	37	34.5
Edinburgh	79	79	7	7
Totals	385	358	88	75

The arrangements for theannual consultation for those aged 75 or over are contained in the terms of servicefor general practitioners set out in the NHS (General Medical Services) (Scotland)Regulations 1995.

The general practitioner isrequired to invite each patient who has attained the age of 75 to participatein a consultation for the purpose of assessing whether the patient requirespersonal medical services and to offer to make a house call. The invitationshould be made in writing and if first made orally should be confirmed inwriting. An entry should be made in the patient’s medical records of the dateof the invitation and whether or not it was accepted.

During the consultation thegeneral practitioner should consider any matter which may be affecting thepatient’s general health including sensory functions, mobility, mentalcondition, physical condition including continence, social environment and theuse of medicines. Appropriate entries of the general practitioner’sobservations should be made in the patient’s medical records.

Following any consultationthe general practitioner should offer to discuss with the patient theconclusions which have been drawn as to the patient’s state of health unless todo so would, in the opinion of the general practitioner, be likely to causeserious harm to the physical or mental health of the patient.

There are no plans to extendannual health checks to those who have attained 65 years of age.

“Precautionary” is commonlydefined as describing an action taken in advance to avoid potential risk orensure a good result.

The multi-agency ChildHealth Support Group Child and Adolescent Mental Health (CAMH) DevelopmentGroup met with the Child Health Commissioners in August to discuss the supportneeded for implementation of the recommendations of the Scottish NeedsAssessment Programme (SNAP) report on child and adolescent mental health. Itwas suggested that a “template” for child and adolescent mental health serviceswould be helpful to support implementation of the SNAP report, and the CAMHDevelopment Group is taking that forward. A national multi-agency event isplanned for Spring 2004 to inform this work.

Child and adolescent mentalhealth is one of the priority objectives for the Changing Children’s ServicesFund, an integrated funding stream to support development of better integratedservices for the most vulnerable children. Funding will almost double from £33 millionin 2002-03 to £65.5m by 2005-06.

A Framework for MentalHealth in Scotland (Bib. number 7392) includes a service elementsection for planners and commissioners of services specifically on child andadolescent mental health services and sections dealing with PsychologicalInterventions and Eating Disorders also refer to the appropriateness ofproviding age specific care.

The Child Health SupportGroup has established a multi-agency and multi-disciplinary Child andAdolescent Mental Health (CAMH) Development Group to work with the Scottish Executive Health Department and NHSScotland to ensure implementation of therecommendations of the May 2003 Scottish Needs Assessment Programme report (Bib.number 27884) on child and adolescent mental health. Following consultationwith the Lead Child Health Commissioners, the group is developing a"template" for child and adolescent mental health services.

The Child Health SupportGroup has established a multi-agency and multi-disciplinary Child andAdolescent Mental Health (CAMH) Development Group to work with the Scottish Executive Health Department and NHSScotland to ensure implementation of the recommendationsof the Scottish Needs Assessment Programme (SNAP) report on child andadolescent mental health.

Following consultation withthe Child Health Commissioners in August, the CAMH Development Group proposesto develop a “template” for child and adolescent mental health services tosupport implementation of the SNAP report, and will be organising a nationalmulti-agency event in the spring of 2004 to inform this work. The group is alsoworking with the National Programme for Improving Mental Health and Wellbeingto develop proposals for national initiatives to improve mental health andpromote emotional resilience in early childhood and at vulnerable points ofteenage transition. A dedicated short-life focus group has been established toconsider a strategic approach to the provision of child and adolescentpsychiatric in-patient services and is expected to report next year.

The Scottish Executive has not yet contacted NHS boards to ask about local progress onimplementation of the SNAP CAMH recommendations.

The following table showsthe amount of patients discharged from psychiatric units who have committedsuicide within one month of release, over the last five years:

Year	General Scottish Suicides	Inquiry Scottish Suicides	Community Scottish Suicides	Died Within 1 Month of Discharge
1997	686	161	149	14
1998	875	202	175	31
1999	873	215	190	27
2000	878	202	176	19
2001	887	214	200	22
2002	899	164	150	17

Source:General Register Office (Scotland). Compiled by the National Confidential Inquiry IntoSuicide and Homicide By People With Mental Illness, (University of Manchester).

Notes:

“Inquiry suicides” are thoseof patients who died within 12 months of contact with mental health services. “CommunitySuicides” are those of patients who were not in-patients at time of death. Thefigures for general Scottish suicides include those for “sequelae” or “lateeffect” and include those under 15 years of age. The remaining figures do notinclude those for “sequelae” or “late effect” or those under 15 years of age.

It is for this reason thatthe Scottish Executive identified people with mental health problems, inparticular those in contact with mental health services as a priority group foraction, as part of the Choose Life national strategy to prevent suicide in Scotland,which I launched in December 2002.