1. Is Alcohol a Problem? -Setting the Scene
Eunice Reed
Lead Psychologist,
Substance Misuse Directorate,
NHS Lothian

2. “ There is little doubt that alcohol consumption is continuing to increase across Scotland and that the health and social harms associated with this trend are positioning alcohol alongside obesity as the top public health concerns facing Scotland.”
Dr Harry Burns, Scotland’s Chief Medical Officer, 2006

3. Alcohol Related Harm
Scotland is 8th in the world for alcohol consumption per head of population
People in Scotland drink 25% more alcohol per head of population than individuals in England and Wales
There were 2372 alcohol related deaths in Scotland in 2005 – enough to fill 33 double decker buses
Source: Alcohol Information Scotland

4. “Although life expectancy across Scotland as a whole is improving, the significant adverse impact on health of alcohol is now obvious.
Mortality from cirrhosis of the liver amongst males in Scotland has overtaken that in other European countries including France which has had the highest rate for much of the 20th century.”
Dr Harry Burns, Scotland’s Chief Medical Officer, 2006

5. Time trends in age-standardised mortality rates for liver cirrhosis per 100 000 by age-group, sex, and country between 1950 and 2002 (Lancet, 2006)

6. Scotland has a level of alcohol-related mortality much higher than that of the other UK countries, for both men and women.
All the countries experienced a large increase during the 1990s and early 2000s, flattening off into the mid 2000s.
Scotland has had the highest position throughout the period and the absolute differences between Scotland and the other countries have grown for both men and women. The relative difference has grown for men but not for women.
This was a special analysis by the Office of National Statistics in 2007, using a consistent definition of alcohol-related mortality for the four countries.

7. A population approach Reduced alcohol consumption Culture change
Delivery of alcohol brief interventions
Improved treatment

8. What are the Implications of Delivering for Mental Health in Relation to Alcohol Use and Misuse?
Commitment 4: We will increase the availability of
evidence-based psychological therapies for all age groups
in a range of settings and through a range of providers.
Target 1: Reduce the annual rate of increase of defined daily dose
per capita of anti-depressants to zero by 2009/10.
Target 3: We will reduce the number of readmissions (within one year)
for those that have had a hospital admission of over 7 days by 10%
by the end of
Commitment 13: We will translate the principles of Mind the
Gap and A Fuller Life into practical measures and advice on
what action needs to be taken to move the joint agenda
forward and support joined-up local delivery by the end of
2007. .
Commitment 7: Key frontline mental health services,
primary care and accident and emergency staff will be
educated and trained in using suicide assessment tools/
suicide prevention training programmes. 50% of target
staff will be trained by 2010.
Target 2: Reduce Suicides in Scotland by 20% by 2013.
Commitment 8: Ensure that people are managed and cared
for more effectively in the community and avoid inappropriate
admissions by ensuring that the crisis standards are achieved
by 2009.

9. Why should this concern all Psychological Therapists?
65% suicides are linked with excessive drinking
24%clients with a severe mental health problem also use substances problematically
Anxiety can be a cause and effect of heavy drinking
Withdrawal symptoms can be similar to symptoms of depression, anxiety and agitation

10. Changing Scotland’s Relationship with Alcohol – A framework for Action
New strategy for Scotland
published March 2009 (
Recovery Agenda

11. Workshop Aims
To consider training needs of staff in mental health and substance misuse services in relation to psychological therapies
To consider the issues raised by comorbidity both for Substance Misuse Services and also for Mental Health Services
This includes primary care therapists