Mental Health Strategy 2017-27 Summary of Progress

SEC/09/18

MENTAL HEALTH STRATEGY 2017-27 – SUMMARY OF PROGRESS

Achievements since previous Report

ACTION / ACHIEVEMENT
1 - Review Personal and Social Education (PSE), the role of pastoral guidance in local authority schools and services for counselling for children and young people /

Review commenced (July 17)
Phase 1 - a desk study of existing PSE guidance for education professionals - completed (Oct 17):

Benchmarks have been developed to provide clarity on the national standards expected.

2 -Roll out improved mental health training for those who support young people in educational settings /

Analysis of existing training programmes completed.

3 - Commission the development of a Matrix of evidence-based interventions to improve the mental health and wellbeing of children and young people /

Ministerial approval for NES proposal (Aug 17)
First meeting of project Executive Group (Sep 17).

4 -Complete the rollout of national implementation support for targeted parenting programmes for parents of 3 and 4 year olds with conduct disorder by 2019-20 /

16 CPP areas actively implementing the Psychology of Parenting Project (PoPP) plan, with 4 new areas in early implementation stage
80 practitioners have completed full PoPP training - overall total almost 600
86 new PoPP groups delivered - overall total 590.

5 - Ensure the care pathway includes mental and emotional health and wellbeing, for young people on the edges of, and in, secure care /

First meeting of Secure Care Strategic Board (Oct 17)
Contract of Secure Care National Adviser extended to 31 March 2018.

7 -Support an increase in support for the mental health needs of young offenders, including on issues such as trauma and bereavement /

Funding for Barnardos to deliver trauma, bereavement and loss projects in Polmont for 2 years
Research conducted bythe Centre for Youth and Criminal Justice (CYCJ) about Adverse Childhood Experiences among young people at high risk of harm to others
Webinar delivered by CYCJ and Kibble on loss, bereavement and adversity.

9 -Support the further development of "Think Positive" to ensure consistent support for students across Scotland /

Record numbers of colleges and universities signed up to take part in Think Positive in 2017-18
‘Supporting Students: Mental Health Journeys’ available on the Think Positive website
Student Mental Health Agreements promoted with stalls and workshops at a range of events
Completion of the Scottish Mental Health First Aid (MHFA) instructor training course by Student Health Project Coordinator
Three year bid submitted to the Scottish Government, which would expand and develop the Think Positive project.

11 -Complete an evaluation of the Distress Brief Intervention (DBI) by 2021 and implement the findings from that evaluation /

Systematic programme of developing the DBI level 1 on-line training and DBI level 2 face to face training, led by University of Glasgow
Lanarkshire DBI service commenced in June 17, with learning from controlled testing supporting roll out in Aberdeen, Inverness and Borders
All four key front-line DBI level 1 pathways now line in at least one of the test site regions
Commissioning of DBI independent evaluation completed and contract awarded.

12 -Support the further development of the National Rural Mental Health Forum to reflect the unique challenges presented by rural isolation /

Further £25k of support secured from SG Rural Communities Team to assist activities from Oct 2017 to March 2018
Rural Mental Health campaign launched (June 17).

13 -Ensure unscheduled care takes full account of the needs of people with mental health problems and addresses the longer waits experienced by them /

Presentation at Glasgow City HSCP on delays experienced by MH patients in front door areas
Meeting with MH Service Lead, GRI General Manager and Clinical Lead MH Service Redesign to discuss plans for improving MH access in front door areas (July 17)
Participation in NHS24 scoping exercise around redesign of their MH service (Aug 17).

14 -Work with NHS 24 to develop its unscheduled mental health services to complement locally-based services /

NHS 24 draft Strategy 2017-22 published and 5 year programme of Organisational Improvement commenced
NHS24 Stakeholder event held (Aug 17)
Discussions with Police Scotland to establish a possible mental health collaboration between NHS 24, SAS and Police Scotland
NHS 24 invited by several Board areas to support Out of Hours services reviews and option appraisals

15 -Increase the workforce to give access to dedicated mental health professional to all A&Es, all GP practices, every police custody suite, and to our prisons. Over the next five years increasing additional investment to £35 million for 800 additional mental health workers in those key settings /

Meeting of Primary Care Workforce subgroup on building the community multidisciplinary team (Oct 17)
NHS24/Police Scotland/Scottish Ambulance Service (SAS) collaborative working group established (Oct 17).

16 - Fund the introduction of a Managed Clinical Network to improve the recognition and treatment of perinatal mental health problems /

Perinatal Mental Health Clinical Network (PMHN) established, core team appointed
5-year workplan created following stakeholder strategy day.

17 -Fund improved provision of services to treat child and adolescent mental health problems /

£54 million comprehensive package of support put in place to improve access to mental health services.

18 -Commission an audit of CAMHS rejected referrals, and act upon its findings /

Audit commissioned and started (Oct 17).

19 -Commission Lead Clinicians in CAMHS to help develop a protocol for admissions to non-specialist wards for young people with mental health problems /

Comments collected from Lead Clinician’s group regarding the Standards developed by the Royal College of Psychiatrists (RCP)
Permission given by RCP for the standards to be used and amended by NHS Scotland.

20 -Scope the required level of highly specialist mental health inpatient services for young people, and act on its findings /

LD CAMHS inpatient needs assessment published - with support in principle for recommendation of a national LD CAMHS inpatient unit (Nov 17)
Strategic assessment submitted to Capital Investment Group (April 17; accepted June 17)
Specification and financial assumptions approved by Board of Chief Executives (Nov 17).

21 -Improve quality of anticipatory care planning approaches for children and young people leaving the mental health system entirely, and for children and young people transitioning from CAMHS to Adult Mental Health Services /

Existing transitions protocols collected from NHS Boards and summarised
Draft anticipatory care plan documents developed
Meeting of stakeholders, with a multi-site study on transition presented by the lead researcher and discussion held on draft anticipatory care plan documents (Aug 17)
Scottish Youth Parliament approached to actively involve young people in this work - project proposal agreed to.

22 -Support development of a digital tool to support young people with eating disorders /

BEAT project officer successfully recruited
Online platform content developed in conjunction with parents and carers
Filming of young people, professionals and parents and carers has started to support the development of the interactive resource - content started to be uploaded to online platform
Training of parent and young person volunteers for online peer support commenced.

24 -Fund work to improve provision of psychological therapy services and help meet set treatment targets /

£54 million comprehensive package of support put in place to improve access to mental health services.

26 -Ensure the propagation of best practice for early interventions for first episode psychosis, according to clinical guidelines /

An approach to identifying current best practice, explored and agreed with stakeholders.

29 - Work with partners who provide smoking cessation programmes to target those programmes towards people with mental health problems /

Complete roll-out of IMPACT guidance to all community mental health care staff and settings in Lothian Health Board area.

30 - Ensure equitable provision of screening programmes, so that the take up of physical health screening amongst people with a mental illness diagnosis is as good as the take up by people without mental illness diagnosis /

Presentation at Screening Inequalities Event to stakeholders on £5 million cancer strategy funding to tackle inequalities in access to screening services
Screening Inequalities Fund Letter 2017/18 issued to NHS Health Boards and third sector orgs
Screening Inequalities Fund bids received from numerous Health Boards and third sector orgs

31 -Support the physical activity programme developed by SAMH /

Leisure Trust Service Level Agreements in place for Fife, North Ayrshire & West Lothian in 2017, first cohort referrals completed.
eLearning platform set up for physical activity staff and volunteers with Mental Health Awareness training
Comprehensive community mapping data collection carried out across three cohort areas
ALBA project introduced to over 70 organisations, services and local community groups
Induction pack produced and comprehensive training plan set for all Peer Support Volunteers
Poster and information presented about ALBA at the Scottish Physical Activity Research Connections conference (Nov 17).

32 -Use a rights-based approach in the statutory guidance on the use of mental health legislation /

Interim guidance drawn up in consultation with stakeholders and published on mental health law website.

33 -Commission a review of whether the provisions in the Mental Health (Care and Treatment) (Scotland) Act 2003 Act fulfil the needs of people with learning disability and autism, taking forward new legislative measures if necessary /

Chair of Review group appointed (Nov 17)
Staffing identified for review's independent secretariat
Objectives of the evidence-gathering and analysis published.

35 -Work with key stakeholders to better understand Mental Health Officer capacity and demand, and to consider how pressures might be alleviated /

SSSC Mental Health Officers (Scotland) Report 2016 published (Aug 17)
Social Work Scotland report ‘The Mental Health Officer: capacity, challenges, opportunities and achievements’ published (Oct 2017)

36 -Work with employers on how they can act to protect and improve mental health, and support employees experiencing poor mental health /

28 one day Mentally Healthy Workplaces courses delivered
Information on the scope of workplace training provision across the public sector in Scotland collated and analysed

37 -Explore innovative ways of connecting mental health, disability, and employment support in Scotland /

£2.5 million Employability Innovation and Integration Fund launched (June 18)
Single Gateway Health and Work Service Pilot Project

Integration and alignment advisory group formed

Announcements made on successful Innovation bids.

38 -Develop a quality indicator profile in mental health which will include measures across six quality dimensions – person-centred, safe, effective, efficient, equitable and timely /

Consultation responses collected
Presentation of QI profile to Chief Executives meeting and to Chief Officer Glasgow HSCP
Public Health Registrar started leading on creation of the mental health strategy framework (Sep 17).

Key Deliverables in next 6 months

ACTION / DELIVERABLE
1 - Review Personal and Social Education (PSE), the role of pastoral guidance in local authority schools and services for counselling for children and young people /

Phase 2 of the of the Review is underway and will be completed by March 18.

2 -Roll out improved mental health training for those who support young people in educational settings /

Roundtable discussion to review existing provision, gaps in workforce training and to establish key stakeholders group (Jan18)
Engagement with young people to explore potential of young people's resource (Jan18)
Identify evidence of impact/effectiveness on learning outcomes (March 2018)
Develop a timetabled action plan (March 18)

3- Commission the development of a Matrix of evidence-based interventions to improve the mental health and wellbeing of children and young people /

Design Team and Advisory Group will be established by April18
Processes to guide quality assurance and strong feedback loops will be developed by April18.

4 -Complete the rollout of national implementation support for targeted parenting programmes for parents of 3 and 4 year olds with conduct disorder by 2019-20 /

Support the ongoing implementation of the Psychology of Parenting Project (PoPP) in the 16 Community Planning Partnership areas who are continuing as PoPP sites, and the 4 new PoPP sites

5 -Ensure the care pathway includes mental and emotional health and wellbeing, for young people on the edges of, and in, secure care /

Draft care standards for the Secure Care Strategic Board to consider (April 2018)
Draft care pathway for the Secure Care Strategic Board to consider (April 2018)

6 -Determine and implement the additional support needed for practitioners assessing and managing complex needs among children who present a risk to themselves or others /

National professional development event on mental health and trauma (March 2018)

7 -Support an increase in support for the mental health needs of young offenders, including on issues such as trauma and bereavement /

Publication of CYCJ loss, bereavement and adversity webinar recording (Nov 17)
Publication of CYCJ’s Adverse Childhood Experiences research (Jan 18)
Submission for publication of two CYCJ journal articles on the 'trauma of institutions' (Feb 18).

8 - Work with partners to develop systems and multi-agency pathways that work in a co-ordinated way to support children’s mental health and wellbeing /

Key officials meeting to assess the current landscape and to identify key steps and partners needed to deliver action (Jan 18)
Meeting with CAMHS Lead Clinician’s Group (Jan 18).

9 -Support the further development of "Think Positive" to ensure consistent support for students across Scotland /

Meetings with all 20 participating institutions (Nov 17)
Training and networking event for staff and student officers involved in Student Mental Health Agreements(Jan 18).

10 -Support efforts through a refreshed Justice Strategy to help improve mental health outcomes for those in the justice system /

Appoint Action Owner and develop agreed plan with SG Justice and range of stakeholders (early 18).

11 - Complete an evaluation of the Distress Brief Intervention (DBI) by 2021 and implement the findings from that evaluation /

Incremental delivery of DBI training across the four test sites and key staff groups
Incrementally increase the scale of DBI across all four test sites

12 -Support the further development of the National Rural Mental Health Forum to reflect the unique challenges presented by rural isolation /

Add further partners to the Rural Mental Health Forum and continue to expand their network and reach
Continue to directly inform the Isolation Strategy, the Action Plan implementing the Mental Health Strategy and enable wider funding to be secured.

13 -Ensure unscheduled care takes full account of the needs of people with mental health problems and addresses the longer waits experienced by them /

Test of change to place CPNs in EDs of GRI/QEUH, planned for October 2017, data to be available in Dec/Jan
Narrative description of MH services in all regions across Scotland (Dec 17).

14 -Work with NHS 24 to develop its unscheduled mental health services to complement locally-based services /

Complete internal review of NHS 24’s mental health provision and current capacity - with options appraisal assessment (March 18)
Hold further engagement events with key stakeholders, as part of programme of redesign(Dec 17 - Feb 18)
Scope joint collaboration between Police Scotland, NHS 24 and SAS
Determine how NHS24 might support the wider use of ACPs (Feb 18).

15 - Increase the workforce to give access to dedicated mental health professional to all A&Es, all GP practices, every police custody suite, and to our prisons. Over the next five years increasing additional investment to £35 million for 800 additional mental health workers in those key settings. /

Appointment of Action Owner (Dec 17)
SG Ministerial commissioning letter to Integration Authorities to include delivery of action 15
Publication of part 3 of national workforce plan with MH contribution (Dec 17)
Receive and consider proposal from collaborative working group (Spring 2018)
Agree shape of training GP enhanced psychiatry training project with relevant HSCPs, professional bodies and services (Spring 2018)

16 - Fund the introduction of a Managed Clinical Network to improve the recognition and treatment of perinatal mental health problems /

"Mapping and gapping" visits to all territorial NHS boards has begun, to be completed by Oct 18.
Regional/national half-day events to gather views from professional groups, third sector orgs, women with lived experience and their families (March 18)
Website development as resource for women, families and professionals (March 18).

17 -Fund improved provision of services to treat child and adolescent mental health problems /

Award of year 2 funding to Boards (March 18)
Delivery of a Mental Health Access Improvement Support Programme and review of year 1 of the programme - review completed August, seeking date with Minister (Dec 2017).

18 -Commission an audit of CAMHS rejected referrals, and act upon its findings /

Analyse and publish report with recommendations and qualitative data included(May 2018).

19 - Commission Lead Clinicians in CAMHS to help develop a protocol for admissions to non-specialist wards for young people with mental health /

Meeting with key stakeholders
Report with suggested amendments to RCP standards

20 -Scope the required level of highly specialist mental health inpatient services for young people, and act on its findings /

Report from SLWG to NPF/NSSC re the LD CAMHS inpatient proposals (March 18)
Publication of LD CAMHS Models and Outcomes study (March - May 18)
Formation of Project Board and Steering Group, including relationships with key stakeholders (Feb 18)
Increase user involvement in planning process and regional involvement in developing care pathways (May 18).

Scottish Youth Parliament discussion day event (March 2018)

22 -Support development of a digital tool to support young people with eating disorders /

Pilot launch of the online platform and associated evaluation in Nov 17, national launch in Feb 18
Social media promotion of online peer support launch, via BEAT, SEDIG, NHS Lothian and NHS service promotion nationally (Dec 17).