Chamber and committees

Scottish Association for Mental Health submission of 21 October 2021

PE1871/G - Full review of mental health services

Introduction

SAMH is grateful for the opportunity to respond to PE:1871. We would like to pay tribute to Karen McKeown and those involved in the Shining Lights for Change campaign for continuing to push for change following the loss of their loved ones.

1. What progress, if any, has been made in the provision of mental health services since the previous petition was closed in 2019 and the impact of such progress?

The last few years have brought many promises on mental health, and yet, very little has changed in relation to people’s experiences of Scotland’s mental health system. This is reflected in official statistics, which show that almost one in four adults continue to wait longer than four months to be seen by psychological therapies; the number of times people were detained for mental health treatment has risen since 2019; and the five-year average suicide rate increased from 13.4 per 100,000 population in 2015-19 to 13.9 in 2016-2020. (Public Health Scotland, Mental Welfare Commission, Public Health Scotland)

This lack of progress was also conveyed in the Cross Party Group on Mental Health’s review of the Scottish Government’s Mental Health Strategy, which it conducted between 2019 and 2021. The Group, of which SAMH is the Secretariat, heard examples of progress and good practice, however this was not consistent across the country. Overall, the CPG found a disconnect between progress outlined in the Scottish Government’s Mental Health Strategy Progress Reports and people’s experiences of accessing mental health support.

2. The extent to which the Covid-19 pandemic has impacted on the Scottish Government’s ongoing work to address issues identified in the petition?

There is no doubt that the Covid-19 pandemic has disrupted ongoing work on mental health. For example, the recent launch of the National Suicide Prevention Leadership Group’s (NSPLG) suicide bereavement support pilot in North Ayrshire and the Highlands had to be delayed because of the pandemic.

At SAMH, we were particularly frustrated by the delay in the publication of statistics on deaths by suicide in 2020 and again in 2021. As an organisation seeking to be there for people’s mental health, it is important we have up-to-date data to help us do this.

Nevertheless, the coronavirus pandemic has demonstrated that the Scottish Government can act quickly and decisively. In particular, we welcomed the national roll-out of the Distress Brief Intervention (DBI) programme, which rapidly connects people in distress to sustained support in their community. We must see more of this type of quick and ambitious action as we move out of the pandemic.

3. Whether the Covid-19 pandemic has impacted on access to mental health services and ways in which this could be addressed?

In 2020, SAMH commissioned longitudinal research into people’s experiences of mental health treatment during the pandemic. Ultimately, we found that systemic changes to the delivery of this care have resulted in increased feelings of mental ill health while also affecting people’s ability to cope.

In terms of accessing support, of participants who had tried to speak to their GP about their mental health since March 2020, over one in ten (13%) had been unsuccessful. Worryingly, over a quarter (27%) of respondents to our final survey indicated that their specialist treatment and support had stopped altogether because of the pandemic. Where the delivery of people’s care had changed, people described feeling isolated, abandoned and fearful as well as confused about how to access support.

On top of this, over half (54%) of respondents indicated they didn’t want to bother professionals about their mental health because of the pressure on the health service caused by the pandemic. In one survey many people felt that mental health was less of a priority now for the NHS (54%) and the Scottish Government (35%) compared to before March 2020.

We also heard issues concerning crisis support, which many people explained had deteriorated. In particular, participants highlighted a lack of consistency concerning the delivery of this type of support and a reliance on telephone crisis lines. Additionally, people described the crisis support they had received as being short-term and perfunctory. In some cases, people’s withdrawn specialist support had been replaced with a number for a telephone line that was ill-equipped to meet their needs.

Mental health services were struggling before the pandemic. Therefore, recovering and renewing the previous system will not be good enough. Now is the time for radical and ambitious change: we must see greater investment in psychological wellbeing support, accessible help for children and young people, and long-term plans for suicide prevention. While remote support has its benefits, it does not work for everyone. That’s why we are also calling for in-person support to be firmly embedded in the review of the Mental Health Strategy 2017-2027, due to take place in 2022.