Louise Christie on the need to see real and ambitious change in how we design, deliver and access mental health support and services
The Scottish Government is refreshing it’s Mental Health and Wellbeing Strategy and we are delighted to have an opportunity to input at an early stage. We have published ‘A Chance for Change’, a new report that shares feedback specially gathered from people with lived experience of mental health challenges, front-line practitioners and those with an interest in mental health recovery.
The report highlights that people want to see real and ambitious change in how we design, deliver and access mental health support and services. They felt that this refresh should not just about improving access to existing services but about the transformation of Scotland’s mental health system into one that equally values different routes to and types of support.
People are calling for a whole system, cross sector approach. One that truly recognises and invests in the third sector and all the innovative work happening on the ground in communities. There is a strong call for the refreshed Mental Health Strategy to move away from the dominance of the medical model and over-burdened NHS clinical services. People told us they would like to see tailored support with better access to a range of help in the community. Reshaping the mental health system in this way would open up access, help to reduce waiting lists and result in better, more person-centred support.
Previous Scottish Government mental health strategies have, to some extent, acknowledged of the role of third sector and community support. However, this has been within plans focused on the medical model and has often seemed like an ‘add-on'. These plans often overstate the role of clinical services and undervalue the role of other types of support in people’s lives and recovery journeys. We need more balance. This of course would require different thinking, learning from third sector innovation and practice and an openness to change from both services and those seeking support.
It is encouraging to see the announcement of £15 million investment in a second year of the Communities, Mental Health and Wellbeing Fund but we need to go much further. This is about a change to the whole system. It is essential that there is a commitment to shifting resources and to addressing the fragile and short-term funding culture for third sector and community-based initiatives. This culture makes many successful services and supports unsustainable.
But it is not just about the money. People who fed into the report felt that the mental health system would feel more joined up and collaborative if different types of support were equally valued. We live with an out of date view across the general population that when facing mental health challenges that there is only one gateway to support - directing people into the medical system for help via GPs and then secondary mental health services. This is reinforced by messaging and strategies that have an emphasis on mental illness and the medical model.
People shared with us their experiences of support that was there when needed and that worked with them to support their recovery. Much of this was delivered by the third sector and community based. They want this valuable and much needed support given the recognition it deserves and the investment it needs to flourish in our communities. They emphasised that people do not always have to go through a medical route to get help and do not need to get trapped on waiting lists or in clinical pathways and services when other support may be more appropriate.
One person summed this up:
“Most people go straight to their GP because they think that’s what they've to do. But there's so many services they could go to before they go to their GP for anything, and that might reduce people going to their GPs and going on medication”
The people we spoke to welcome the development of new roles such as community links practitioners, community connectors and peer workers. These roles and recovery focused approaches support people to identify what works for them and connects them with the right help to suit their needs. However they wanted more buy-in and investment in these newer non-medicalised roles and for them to be a much more important part of the mental health system. For this to happen there needs to be a much stronger focus on mental health recovery and the central role of the third sector and communities in mental health and wellbeing.
With this refresh we have a real opportunity to make positive change to the mental health and wellbeing of the people of Scotland. Let’s bring people, services and organisations together on an equal footing to create a mental health system that nurtures the third sector, all the good practice happening on the ground in communities and the NHS.
Read the full or summary ‘A Chance for Change’ report
Louise Christie is director, Scottish Recovery Network
