National Programme for Improving Mental Health and Well-Being: Action Plan 2003-2006

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National Programme for Improving Mental Health and Well-Being

1. Introduction

Since its launch in October 2001, the National Programme has been working nationally and locally to raise the profile of, and to support further action in, mental health improvement (promotion and prevention), to address the stigma of mental ill-health and to prevent suicide in Scotland. A National Advisory Group, chaired by the Minister for Health and Community Care, was established in January 2002 and has met on five occasions to advise and steer the work of the Programme. A National Programme Team has been created as part of the work of the Scottish Executive's new Mental Health Division to lead the work of the National Programme and to work in support of the implementation of 'Improving Health in Scotland: the Challenge', launched as part of the White Paper 'Partnerships in Care' in March 2003. The work of the National Programme forms a key part of the Scottish Executive's work on improving health in Scotland and in achieving greater social justice by working to address mental health inequalities and reduce the opportunity gap experienced by people with mental health problems.

To help set a baseline for the work, a national survey of public attitudes to mental health and mental illness was commissioned. The results were published in December 2002 in the report, 'Well? What do you think?'. This survey will be repeated every two years to help monitor and assess any national changes and trends in attitudes towards mental health and mental illness.

The initial work of the Programme during 2001-2003 has focused on two key priorities - eliminating stigma and preventing suicide. Considerable progress has been made in both areas, but much more requires to be achieved. In recognition of the wider and more challenging agenda on mental health improvement, while continuing the work on stigma and suicide prevention, additional funding of 24 million is being provided through the Health Improvement Fund to support new and continuing national and local action and activity over the next three years, 2003-2006.

This action plan sets out the main aims and areas of activity for national work and provides a suggested outline for local areas to follow. The action plan exists as a guide and will evolve and develop further over the three-year period in the light of experience, learning and new evidence.

In addition to the input of the National Advisory Group in developing this action plan, a number of discussions have taken place with national and local agencies including NHS Health Scotland and CoSLA, a range of Scottish Executive Departments, local agencies and organisations, voluntary organisations, community groups, people who have experience of mental health problems, and their carers. Achieving the aims and objectives set out in this action plan will require ownership, collective commitment and action from a wide range of key players. A continuing dialogue will be encouraged and supported over the next three years to help achieve wide ownership, commitment and action.

2. Key Aims and Priority Areas for the National Programme

This action plan sets out the key aims to be achieved and the main priority areas for action nationally and locally during 2003-2006. The National Programme Team will help in taking forward initiatives to implement the key aims of the plan and to monitor their impact. National agencies, Scottish Executive Departments and local areas are also encouraged to take further action on improving mental health and well-being. This will involve developing and adapting their own forward plans for action, taking into account the key aims and priority areas of the National Programme.

The four key aims for National Programme action during 2003-2006 are:

  • Raising awareness and promoting mental health and well-being

  • Eliminating stigma and discrimination

  • Preventing suicide

  • Promoting and supporting recovery.

The National Programme aims to work with and through others to achieve these key aims in the following priority areas:

  • Improving infant mental health (the early years)

  • Improving the mental health of children and young people

  • Improving mental health and well-being in employment and working life

  • Improving mental health and well-being in later life

  • Improving community mental health and well-being

  • Improving the ability of public services to act in support of the promotion of mental health and the prevention of mental illness.

The National Programme will be taking forward a range of actions and initiatives to ensure the above aims and objectives are addressed. These are set out in this action plan. Key relevant agencies, such as NHS Health Scotland and CoSLA, and Scottish Executive Departments are also encouraged to take forward these priority areas in their own local joint health improvement plans and local Community Planning Partnership work. The delivery of these aims, with a focus on the priority areas, involves a wide range of partners. These include:

  • Scottish Executive Departments, NHS Health Scotland, CoSLA, NHSScotland, Scottish Prison Service, Communities Scotland, Job Centre Plus, Scottish Arts Council

  • The full range of local Community Planning Partners (Local Authorities, Health Boards, Enterprise Councils, Police, Voluntary Agencies and others)

  • Local Authorities (especially Social Work, Education, Housing, Social, Leisure and Cultural activities)

  • Health (especially Public Health, Health Promotion, Mental Health, Primary Care)

  • Professionals and practitioners in health, social care, education, housing, social inclusion, community learning and development, employment.

  • Local Community leaders

  • Employers and Trade Unions

  • National and Local Voluntary Organisations

  • Self-help groups, people with experience of mental health problems and their carers.

One of the main tasks of the National Programme is to engage with, and support, this wide group of agencies and interests in taking forward the aims and priorities of the programme.

Annex 1 shows a graphic representation of the Action Plan.

3. National Programme Actions in Support of Key Aims

A number of key initiatives have already been established by the National Programme. These include the 'Breathing Space' telephone advice line, the national survey on attitudes towards mental health and mental illness, the 'see me' national anti-stigma campaign, and the 'Choose Life' suicide prevention strategy and action plan. Efforts have been made through the 'Well?' magazine to communicate the full scope and range of work in improving mental health and well-being. 'Well?' will continue to be produced each March and September.

The National Programme functions as a catalyst and is designed to raise the profile of, and gain commitment, support and action for, improving mental health and well-being; develop improved knowledge; communicate, disseminate and help with implementing evidence-based practice; improve the skills and capacities of the workforce; develop ways of monitoring changes over time; and evaluate progress. In doing this the National Programme will continue to take forward existing initiatives and develop new initiatives to achieve the aims of the programme.

The National Programme will also continue to encourage, develop and commission a range of work that supports achieving its key aims.

Key Aim No. 1 -
Raising Awareness and Promoting Mental Health and Well-Being

Over the next three years we wish to raise awareness about the need for good mental health and well-being amongst the general public. This requires improving the public's understanding of positive mental health, improving understanding of how to promote mental health, and improving awareness of both mental health and mental illness.

This improved awareness and understanding is essential to help enable people to take care of their own mental health, to help others, to prevent mental ill-health and improving awareness of where and how to access support and help.

Key National Supports
NHS Health Scotland
Health Improvement across Scottish Executive Departments
CoSLA
Scottish Arts Council

Key Local Agencies and Practitioners
Community Planning Partners (especially Health Boards and Local Authorities)
Health Promotion Specialists
Local Authority Health Improvement Officers
Local LHCC-based Public Health Officers
Integrated (formerly New) Community Schools Integration Managers

Key Support Action for 2003-2006
Development of National Mental Health Literacy Project

Development of a programme of linked activities to support improving awareness of mental health through increasing mental health literacy in Scotland. This will involve three main components of work:

  • Mental Health awareness training (building on the Mental Health First Aid course developed and validated in Australia)

  • Consumer guides to common mental health problems

  • Development of self-help tools and manuals

A Project Group will be established by autumn 2003 to take this work forward over the next three years.


Key Aim No. 2 - Eliminating Stigma and Discrimination

Promoting and ensuring equality of opportunity, equal rights and the social inclusion of people with mental health problems is fundamental. Eliminating stigma and discrimination is one key element of promoting people's rights and helps to ensure that people are able to access services and supports.

Key National Support Agencies
'see me' Campaign Team
Scottish Executive's Equalities Unit
NHS Health Scotland
National Mental Health Organisations including key professional bodies

Key Local Contacts
Local Mental Health Service User Groups
Carers Groups
Voluntary Groups
Local Anti-Stigma Groups including 'see me'
Mental Health Promotion Specialists
Local Authority Health Improvement Officers
National Programme Support Actions for 2003-2006
a) National Anti-Stigma campaign
The National Programme will continue to fund the 'see me' National anti-stigma campaign over 2003-2006.
'see me' will continue to work at both national and local levels and design and implement an integrated campaign using a variety of media.
The 'see me' Campaign Team are continuing to build a network of local and national contacts to support the local delivery of anti-stigma work.
A three-year work plan has been developed by the 'see me' Campaign Team and its Management Group for implementation.
b) Dementia Awareness
Support has been provided to a Dementia awareness-raising campaign developed by Alzheimer's Scotland - Action on Dementia. The campaign takes place during Dementia Awareness week in June each year. National Programme support in 2003 enabled more intensive work to be carried out in two local areas - Dundee and Dumfries. The impact of this additional campaign work is being evaluated. Results will be available by early 2004 and will inform campaign work for subsequent years.
c) Local Exemplar Programme
The National Programme is providing support to the Highland Community Care Forum to assist in the development of a programme of local anti-stigma work across the Highlands, developed and delivered by the Communications Work of the Highland Users Group. The work has a particular focus on young people and
will provide insights, learning and experience to be shared across the rest of Scotland.
d) Equalities Work
Working with the Scottish Executive's Equalities Unit, work has begun on identifying key issues in relation to mental health/mental illness and inequalities. This will inform the need for the development of a programme of work on equalities and promotion and prevention in mental health over the next three years.


Key Aim No. 3 - Preventing Suicide

Scotland has a rising rate of suicide, particularly amongst young men. The rates of self-harm are also high and give cause for concern, especially amongst teenage girls and younger women.

In common with other national approaches to suicide prevention, Scotland is taking a collective approach to addressing the problems and risk factors which can lead to suicide and to helping cope with the aftermath of a suicide. 'Choose Life', a National Strategy and Action Plan for Preventing Suicide in Scotland, was launched in December 2002 as the overarching policy on suicide prevention in Scotland and as one key component of work in improving mental health and well-being.

Actions taken in support of suicide prevention complement and support the aims of the National Programme.

Key National Support Agencies
CoSLA
Communities Scotland
NHS Health Scotland
Scottish Prison Service
National Mental Health and other Organisations including key professional bodies
National Forum for Lesbian, Gay, Bisexual and Transgender Health
Relevant Voluntary Organisations
Key Local Contacts
Local Community Planning Partners - Local Authorities, Health Boards and Voluntary Organisations and local Community Groups, self-help groups and others

National Programme Support Actions for 2003-2006
a) Implementing 'Choose Life'
The National Programme will establish the National Implementation Support Team (NIST) to take forward the national actions as set out in 'Choose Life'.

Guidance was issued in July 2003 for local Community Planning Partners on their role in local implementation. The Guidance outlines the support funding available for local co-ordination, training and other local community-based initiatives and activities.

b) Breathing Space
The National Programme currently supports the Breathing Space telephone advice line. This service is particularly targeted at young men suffering from low mood and depression and aims to put people in touch with local appropriate services.

The service is currently promoted across Greater Glasgow and Argyll and Clyde only. The initial uptake of the service has been encouraging and a detailed evaluation of the service is planned prior to national rollout.


Key Aim No. 4 - Promoting and Supporting Recovery

Supporting people who have experienced mental ill-health into mainstream life; to have a network of social and personal support; to have access to good housing; to help in ensuring that people with mental health problems can both access and retain employment, significantly aids people's recovery from mental ill-health. To help promote and support the process of recovery for individuals and to gain a wider understanding and awareness of what helps people recover, the National Programme is supporting the development of a National Recovery Network for Scotland.

The proposed aims of the Network are to collect and disseminate people's experiences of recovery and to provide information and advice to a range of local and national agencies to promote and support recovery. The proposed Network will also collect and disseminate relevant national and international evidence and material on recovery. More details will be provided as the plans for the Recovery Network develop.

Key Support Agencies
National and Local Voluntary Organisations
Providers of health and social care services
User and Carer Groups

4. Support to Priority Areas

Through discussions with a wide range of stakeholders, including the National Advisory Group, six priority areas have been identified for action within the National Programme. These range across different life stages and a variety of settings. They complement other work being carried out across the full range of health improvement activities, involving education, employment, social justice and communities, amongst others. The National Programme is funding and supporting actions to be taken by key agencies and players in these priority areas to achieve the integration of mental health and well-being into their policies, strategies and action plans both nationally and locally.

The priority areas are:

  • Improving infant mental health (the early years)

  • Improving mental health of children and young people

  • Improving mental health and well-being in employment and working life

  • Improving mental health and well-being in later life

  • Improving community mental health and well-being

  • Improving the ability of public services to act in support of the promotion of mental health and the prevention of mental illness.

Priority Area A: Early Years

There is ample evidence that risk factors and vulnerabilities in infancy and early childhood are associated with mental health problems in children and young people. These in turn are associated with greatly heightened risk of mental illness in adult life. The ability to improve mental health and well-being in the 'early years' is a vital area for action. Ensuring the best possible start for children in their early years, promoting their mental health and that of their parents, and working to prevent and reduce the impact of mental health problems are key priorities.

The National Programme will work with colleagues in Education, the Health Department, the Women and Children's Unit, NHS Health Scotland and others to ensure the integration of mental health in their work on early years. We are in discussions about providing support on mental health promotion and prevention with the national demonstration project 'Starting Well' in Glasgow. Key areas for action include:

  • Ante-natal care

  • Parenting programmes - educational and community-based parenting support

  • Identification of and early interventions for Post-Natal Depression

  • Home visiting (intensive) - targeted

  • Family Centres - community-led initiatives, children's playgroups.

Priority Area B: Children and Young People

The start of formal school marks a major transition for children and provides a significant opportunity for promoting mental, emotional and social health and well-being and for prevention and early intervention. Entering secondary school, the onset of puberty, an increasing need for independence, peer relationships, and identity and sexual orientation issues influence the development of our young. This period is marked by increased exposure to risks that may predispose young people to poor mental health. This includes the first onset of anxiety, depression, eating disorders, substance misuse, psychosis and deliberate self-harm. Moving into young adulthood is a time for identifying as an adult with personal and social responsibilities, for developing intimate relationships and embarking on career, vocational and education pathways. Here, significant mental health problems and mental illness affect as many as one in ten of our young people.

Developing improved emotional, social and mental health and well-being amongst our children and young people and supporting them through the many transitions they face is vital to their health and development. Promoting mental and emotional health, and preventing and reducing mental health problems among parents, children and young people requires action at home, in schools, colleges, universities, local neighbourhoods and other settings.

The National Programme will encourage and support work which aims to promote greater understanding and awareness of mental, emotional and social health and well-being and mental illness amongst children and young people and those working with them. Emphasis will be given to the prevention of mental health problems in children and young people.

The next three years will see a focus on:

  • The development of mental, emotional and social health and well-being in schools in collaboration with the Scottish Executive Education Department, the Health Promoting Schools Unit, NHS Health Scotland, and others. This will also include work on developing effective front-line responses in schools for children and young people who experience emotional difficulties, mental health problems and mental illness.

  • Support to the Scottish Executive's Child Health Support Group and their work on Children and Young People's Mental Health. This will involve providing support in taking forward a number of the recommendations of the recently published Scottish Needs Assessment Programme (SNAP) on Children and Young People's Mental Health.

  • Building on the SNAP process of engaging with and involving children and young people in ways which help further the development of national and local action on promotion, prevention and care.

  • Working with West Lothian as a local exemplar of practice in the development of an integrated service for children and young people which combines promotion, prevention and care in an integrated local system.

Priority Area C: Improving Mental Health and Well-Being in Employment and Working Life

Improving the promotion of mental health and well-being where people work, reducing the time people are off work with emotional, stress-related and mental health problems are important actions for people of working age. In any one year, at least three out of every ten employees will be off work with a mental health problem, leading to significant financial costs to employers and significant financial, emotional and mental health costs to people and their families. Being able to respond to mental health problems and mental illness in the workplace, working to eliminate employment discrimination on the grounds of mental ill-health, helping to improve the retention of staff who develop mental health problems, being able to support people back to and into employment and to achieving an improved work - life balance are all major mental health improvement goals.

Supporting people to be involved in meaningful activity and to gaining worthwhile employment is fundamental to good mental health and well-being. People who do not have meaningful work can be missing an important support for their mental health and well-being.

Promoting mental health at work, addressing employment discrimination, enabling and supporting people to remain in work and helping to improve the employment opportunities for people with mental health problems are all key aims.

The main areas for support over the next three years include:

  • Supporting NHS Health Scotland's Workplace Programme in publishing three major research projects on mental health and well-being in the workplace and in developing and implementing follow up support work and action.

  • Working with Scotland's Health at Work (SHAW), to implement a complementary programme of activities aimed at promoting mental health and well-being at work.

  • Linking with the work of 'see me' and the Equalities Unit to address stigma and discrimination in employment and the workplace.

  • Working to increase the profile of mental health and employment (getting into work, transitions to work and employability) and to support the mainstreaming of mental health into employment policies and initiatives. This involves working across Scottish Executive Departments, with Scottish Enterprise, the Department of Work and Pensions and others.

  • Encouraging and supporting the development of work on job retention for people who develop mental health problems.

Priority Area D: Improving Mental Health and Well-Being in Later Life

Older adulthood can be a time of considerable change, some positive - more leisure time, travel opportunities, some negative - loss of work, bereavement, lower income, reduced social contacts, increased social isolation, poorer health, ageism, fear of violence, increased risk of depression. Action is needed both in local communities and in residential and nursing home settings to support developments and actions that enable older people to achieve a life that is satisfying and rewarding.

Promoting mental health and well-being, preventing mental ill-health and responding early in dealing with mental health problems in later life is an important area for action. Instead of assuming that older age is inevitably linked with failing health, poverty and dependency, the aim of public, private and voluntary action should be to support older people to make an active contribution for as long as they wish (or are able) and to support their continuing connectedness with their families, friends, neighbourhoods and communities.

The National Programme, along with the Older People's Unit within the Scottish Executive Health Department and NHS Health Scotland's Older People's Programme, have begun a programme of work to address mental health and well-being in later life. Following a two-day seminar in March 2003, a report has been produced. This will be used in the development and implementation of a national three-year collaborative programme on improving mental health and well-being in later life.

The programme for 2003-2006 will take forward:

  • the analysis of Research and Dissemination of the evidence base to policy makers and practitioners

  • the development of Health in Later Life Interest Groups on a regional structure to share information and experiences and to influence policy development at a national and local level

  • a small projects scheme to support local groups or initiatives to support the development of mental health and well-being in later life.

Consideration will also be given to the development of specific resources to support local work.

Priority Area E: Improving Community Mental Health and Well-Being

A whole-community response is required to maximise the mental health potential of all community members. This will involve the development of mentally healthy public policy, creating supportive environments, improving access to services and supports (particularly for marginalised and disadvantaged groups), strengthening community action, supporting community-led mental health initiatives, developing and consolidating local community partnerships and enhancing the role and contribution of community development and community education and learning.

Being able to provide the basic building blocks of a good quality of life in local communities is an essential part of improving mental health and well-being. This involves the provision of good quality housing, quality built environments, environmental policies that have communities' well-being at the core of their actions, good transport infrastructure, safe parks and recreational areas and facilities, cultural activities, play areas, clean streets, responsive policing, tackling speeding and drug dealing. Action also needs to be concentrated on building improved connectedness in local communities, on supporting and encouraging greater involvement of local communities and on supporting and enabling local communities to support themselves. Health and social care services (and other public services) need to be designed with communities at their centre; building community trust and reducing suspicion; tackling discrimination, prejudice and stigma. This will involve developing partnerships, supporting community-based and community-led initiatives, building on local activities, engaging with the social inclusion and regeneration initiatives in local communities and developing greater awareness of mental health and well-being in local health improvement work and in local Community Planning.

The National Programme commissioned work in four communities in Scotland looking at what people understood by mental health and well-being and how it could be improved in local community settings. A report, 'Building Community Well-being', was published in June 2003 based on the work carried out locally. Work in the four chosen areas will continue to be supported by the National Programme and the main lessons learned will be disseminated across Scotland.

In addition to this focused practical local work, the National Programme is supporting work across the Scottish Executive in partnership with Communities Scotland and NHS Health Scotland, to support the mainstreaming of work on improving mental health and well-being within local communities. A programme of work will be jointly developed and implemented.

Priority Area F: Improving the Ability of Public Services to Act in Support of the Promotion of Mental Health and the Prevention of Mental Illness

Mental health services and other health and social care services provided by the NHS, local government, the voluntary sector and the private sector have a role to play in improving mental health and well being. As well as providing support, care and treatment, services need to be able to respond to people's housing, employment, leisure, cultural and wider social needs to help enhance people's own capacity to engage with and sustain the social connections and supports which they value. Supporting people to recover their mental health is an important role for services to perform.

Supporting services to promote mental health, prevent mental ill health and support recovery is a key priority area for the National Programme.

The National Programme will focus on supporting services in undertaking their promotion and prevention role in mental health and well-being. This will build on:

  • work being undertaken by local authorities relating to their power to advance well-being outlined in the recent Local Government in Scotland Act 2003.

  • supporting health and local authorities in undertaking their duties and functions set out in the new Mental Health (Care and Treatment) (Scotland) Act 2003 and more specifically, supporting local authorities to provide services designed to promote the well-being and social development of people with a mental disorder.

  • Additional work in support of the role of services in promotion and prevention includes:

  • Supporting the Scottish Executive Health Department's Centre for Change and Innovation (CCI) in the implementation of the programme 'Doing Well by People with Depression.'

  • Support to the Primary Care Modernisation Group's agenda on mental health promotion and prevention.

5. Support to National and Local Action - National Programme Support Activities

In addition to taking work forward on each of the key aims and to supporting work in the priority areas, the National Programme will also provide support to national and local agencies through:

  • The ongoing collection and dissemination of the evidence base for mental health improvement and the production of helpful guidance and support to assist in the use of the evidence base in local practice.

  • Developing and commissioning a programme of national research in support of improving our knowledge on the improvement of mental health and well-being and disseminating the results.

  • Supporting and commissioning an evaluation of the National Programme and key components of its work.

  • The development of a core set of public mental health (mental health and well-being) indicators to measure and track progress locally and nationally.

  • An effective communications strategy to keep people in touch with work and practice across Scotland on improving mental health and well-being.

  • Establishing and supporting learning networks and other opportunities to foster the exchange of experience, skills and ideas across Scotland through a range of events, seminars, conferences, workshops and other training and development opportunities.

The National Programme Team will work with colleagues in the Scottish Executive Health Department, other Scottish Executive Departments, with NHS Health Scotland and others to commission appropriate work to deliver these key support activities.

a) The evidence base

A briefing paper on the evidence base for mental health improvement was commissioned by the National Programme and published in November 2002 entitled, 'Mental Health Improvement: What Works?'.

In addition to this report (which will be updated on a regular basis), the National Programme is funding 'Evidence into Practice' workshops in every Health Board area in 2003. These are aimed at a variety of local practitioners involved in mental health improvement work. A review of this exercise will be conducted to assess the utility of further workshops and training on the use of the evidence in mental health improvement.

To help in the collection and dissemination of the evidence base, other helpful information, policy updates, useful resources, links and practice information, NHS Health Scotland is being supported by the National Programme to establish an evidence base service for mental health improvement. This service will be developed further over the next three years.

b) National research

A research programme to support the work of the National Programme is in the early stages of development. The programme will also include research in relation to the 'Choose Life' Strategy. This is being led by researchers in the Scottish Executive Health Department's Social Research Unit and will be planned and developed in consultation with key players. As one part of this programme the survey of national public attitudes to mental health will be commissioned on a bi-annual basis; the next survey will take place in 2004.

c) Evaluation

It is intended that the National Programme will be evaluated as part of the broader Health Improvement Programme. This evaluation will be formally commissioned by NHS Health Scotland and the results published.

In addition to this evaluation work, the National Programme will commission evaluations of the key components of the programme itself. This will help to monitor and evaluate their effectiveness and to inform future development. Initial priorities for evaluation include the implementation of the first phase of 'Choose Life', the work of 'Breathing Space'; and the national anti-stigma campaign, 'see me'.

d) Indicators for public mental health/mental health and well-being

NHS Health Scotland, supported by the National Programme, are taking forward work to develop a set of core indicators for public mental health/mental health and well-being. This work will be used to develop national and local indicators for collection and analysis as a way of monitoring the state of public mental health/mental health and well-being across the country. These indicators will be of particular value to the local Community Planning Partnership process and local joint health improvement plans.

e) Communications strategy

Communicating effectively with a wide range of key partners both nationally and locally is an important part of the National Programme's role. The National Programme will continue to produce twice yearly issues of the 'Well?' magazine and a new website will be available from September 2003. The website is aimed at communicating the work of the National Programme to a wide range of professionals and practitioners and will function as an information portal with links to other sites nationally and internationally.

The National Programme is a key part of the Scottish Executive's broader Health Improvement work and is therefore part of the Scottish Executive 'Healthy Living' branding. A logo for mental health and well-being has been developed as part of the healthy living brand and is available for use on all appropriate communications and materials nationally and locally.

f) Learning networks, events, training and development

The National Programme will continue to support and fund a range of learning, training and development opportunities. This includes support and funding to a wide range of local and national events, seminars, workshops and conferences over 2003-2006.

Support is available for events which benefit the key aims and priority areas of the National Programme. These events must be accessible to people with mental health problems and their carers and a report of each event produced.

6. National Programme Organisation, Management and Financial Framework

The National Programme Action Plan will be advanced through the National Programme Team located in the Mental Health Division of the Scottish Executive. The Ministerial-led National Advisory Group (NAG) will provide advice to the work of the National Programme and will monitor and advise on the delivery of the Action Plan. The NAG will meet on an annual basis to consider the progress being made on the Action Plan.

The National Programme Team will continue to be responsible for initiating, supporting, contracting and commissioning work and for the performance and financial management of the work of the programme.

To help with the co-ordination and management of the key components of work a quarterly cycle of meetings of an Implementation Group, to support and guide the detail of the Programme's work, will be developed over 2003-2006. This will enable the key components of work and key delivery and support organisations and agencies to share information, experience and views, to review progress and plan appropriate forward action.

The National Programme Team will produce an annual review of progress.