1. Scotland – Mental Health data and metrics
John Mitchell, Principal Medical Officer and Psychiatric Adviser Scottish Government
Fiona MacKenzie, Service Manager, Information Services Division, NHS National Services Scotland

2. Scotland Population of 5.4m 6 cities population of ~1.9m
Towns/villages/remote population ~3.3m
790 islands (~95 populated with 104k people)
Est. That one in three will have mental ill health each year

3. We calculated the burden of disease for 132 disease, condition and injury categories as defined by the international Global Burden of Disease (GBD) study.
Burden of disease is a measure of the health of the population. It aims to quantify the difference between living to old age in good health, and the situation in which healthy life is shortened by illness, injury, disability and early death.
Burden of disease studies use a single measure which combines fatal burden [i.e. years lost because of early death – years of life lost (YLL)] and non-fatal burden [i.e. years lost because they are lived in less than ideal health – years lived with disability (YLD)]. The measure used to describe the overall burden of disease is called the disability-adjusted life year (DALY).

4. Strategic Background Mental Health Strategy 2017-2027
Thematic work on prevention and early intervention, access, physical health, rights, data.
Specific action on creation of a quality indicator profile as well as population MH & wellbeing framework.
How to ensure its vision is delivered? (parity, shifting the balance, MH a priority)
The opportunity and challenge of integration.

5. Data collection and challenges
Scottish Suicide Database
Distress Brief Interventions – Pilot
Drug and Alcohol misuse
Inpatients
Outpatients
Population Coverage
Data – Evidence - Action
Workforce
Urgent and Emergency Care
Finance
Waiting times – CAMHS and Psychological Therapy
CHI – community health index number – unique identification number assigned to each individual. This can be used to link records across various datasets.
Green – established dataset, routinely submitted / analysed
Amber - datasets newly established and completeness not yet 100%
Blue – to be explored further
CHI - linkage
Community
Prescribing
Primary care
Third/Voluntary Sector
Police
Education
Social Care

6. Deaths by Suicide by Health and Social Care Partnership – Scotland 2012-16

7. Number of Defined Daily Doses per 1,000 Population (aged 0-19) per Day – ADHD Drugs – 2009/10 and 2016/17
between 2006/07 and 2016/17. Data on five types of drugs are included: hypnotics and anxiolytics (used to treat insomnia and anxiety), antipsychotics and related drugs, antidepressants, drugs used for attention deficit hyperactivity disorder (ADHD) and drugs for dementia. This data is based on community prescribing and excludes hospital usage.
Among the NHS Boards, the highest recorded rate of DDDs per 1,000 population per day for 2016/17 was in NHS Borders at 24.3 and Western Isles was the lowest at 1.9 DDDs per 1,000 population per day (Figure 21).
Thirteen of the fourteen NHS Boards showed an increase in dispensing of ADHD drugs between 2009/10 and 2016/17. The largest increase was recorded by NHS Borders who dispensed 10.5 DDDs per 1,000 population per day in 2009/10, increasing to 24.3 in 2016/17. Dispensing in NHS Fife and NHS Tayside was also substantially higher than the national average for 2015/16.

9. Linked CAMHS Pathways
Aggregated CAMHS pathways for individuals who use A&E and then subsequently have a CAMHS Outpatient attendance.
Does Outpatient Attendances reduce future unscheduled care activity?

10. MH Quality Indicator profile
Action 38 MHS but work since 2014.
Applies to mental health services – 17 current indicators, 13 new.
MH strategy framework in development will provide data on population mental health and wellbeing from a social and public health perspective, using existing data.
Together will provide data to support commissioning and delivery, quality improvement.
Not performance indicators and set no new targets.

11. Presentation of Indicators

12. Taking forward the work
Move from annual reports to web based real time data with improvement emphasis.
Draft commissioning guidance - illustration of how service delivery can be underpinned and supported by data.
Align with new National Performance Framework and Public Health Priority on Mental health and wellbeing.

13. Scotland Population = 5.5m Urban remote and rural
Population = 5.5m
Urban remote and rural
Mental health prevalence