Mental Health Division 17 March 2010 Geoff Huggins Mental Health Division 17 March 2010

The purpose of the Government I lead is to create a more successful country, with opportunities for all of Scotland to flourish, through increasing sustainable economic growth. Alex Salmond MSP, First Minister

Priorities An approach to health and well-being that ensures all Scots enjoy the right level of physical and mental health to give them the opportunity to maximise their potential (Strategic Priority in GES) Help people to sustain and improve their health, especially in disadvantaged communities, ensuring better, local and faster access to health care (Healthier Objective/Better Health Better Care)

Context Strong evidence base for many therapies Concern about rise in anti-depressants Demand for non-pharmacological treatments for mental illness But: Capacity to deliver limited and growing slowly Measurement systems not in place Referral systems unclear

Early Action 2005 – Delivering for Health – ICP for depression 2006 – Delivering for Mental Health – Target to stop growth in use of anti-depressants Commitment to growing access to psychological therapies 2007 – creation of psychological therapies group and start of work on the Matrix

Further Steps 2008/2009 – Services on the ground NHS 24 – telephone based CBT Living Life pilot, supported self-help Local psychological therapies co-ordinators in place, funded by NES Towards a Mentally Flourishing Scotland – Steps for Stress Development of SIGN guideline on non-pharmacological responses to depression

Commitment for 2010 During 2010/11 the Scottish Government will work with NHS Boards to develop an access target for psychological therapies for inclusion in HEAT 2011/12.

Breaking that down… “During 2010/11” = to October 2010 (when HEAT decisions are made) “will work with NHS Boards” = through sub-group of psychological therapies group, but also with CEs, ISD and others “access target” = from when a decision to treat through a therapy to when treatment begins “for inclusion in HEAT 2011/12” = with monitoring starting from 1 April 2011 and Boards being judged on the basis of their performance

Challenges Information systems (both for monitoring and for locally managing delivery) Referral systems and approaches (making sure people get access to an approach that is appropriate for them quickly) Capacity (both training people and getting the most out of people who have been trained) Supervision (making sure we deliver a quality and safe service)

A Whole System Approach Not just about the ‘face to face’ therapies – the whole system needs to work effectively Not just about psychology, all professions have a part to play Need to work with clinician and public expectations about the system – developing literacy about therapies Applying what we have learnt about change already – tried and tested methods

Assessment for Psychological Therapy Treatment (“face to face”) GPs “Non-face to face” therapies General Assessment Referral from elsewhere e.g. general medicine Referral from elsewhere Volume Time

Next Steps Work continuing throughout the Summer Boards need to be thinking about information systems Decisions to be made in the Autumn Need to respect the context we are in – not about a new workforce Important to demonstrate outcomes, not just activity

Contact Information Geoff Huggins Deputy Director Primary and Community Care | Head of Mental Health Room 3E:02 St. Andrew’s House 2 Regent Road Edinburgh EH1 3DG Web - http://www.scotland.gov.uk E-mail – geoff.huggins@scotland.gsi.gov.uk ++441312443531 (office) ++447795222431 (mobile)