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

2. 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

3. 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)

4. 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

5. 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

6. 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

7. 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.

8. 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

9. 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)

10. 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

11. 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

12. 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

13. 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 - –
(office) (mobile)