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6. Delivering for Mental Health
Delivering for Mental Health (2006) sets a vision for mental health services in Scotland and also underpins the Scottish Government's vision for a healthier, more successful Scotland. It reinforced the need to undertake this work and made this one of the 14 commitments -
"we will translate the principles of Mind the Gaps 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".
This commitment is consistent with the Plan for Action on Alcohol Problems' intention to strengthen links between the alcohol and mental health fields, and the commitment to partnership working in the Quality Standards for Substance Misuse Services.
Those with co-occurring mental illness and substance misuse have been consistently found to have more severe problems, higher rates of relapse and adverse health and social consequences (ref CARES report) and should therefore be a priority in Mental Health and Substance Misuse strategic planning.
It is important to achieve a balance and to have clear links between health promotion, illness prevention, care, treatment and rehabilitation/recovery. Each complements and supports the other.
The promotion of good mental health will have direct and indirect benefits on the prevention of mental illness and on substance misuse. With this in mind an emphasis on substance misuse in mental health promotion activities should be supported. It is also important to advance health promotion and illness prevention action aimed at populations and not just at individuals.
As with Delivering for Mental Health this guidance is not prescriptive about the particular structure of services that needs to be in place to deliver good outcomes. Rigid structures can lead to a reduction in innovation and are not always appropriate for the changing population they serve. Instead this paper proposes models of approach designed to inform change, focusing on the key aspects that need to be in place at each point in a journey of care so that agencies, staff, service users and carers can be clear about what needs to be delivered, how it is to be delivered, where, when and by whom.
Many of the Delivering for Mental Health targets will particularly benefit those with co-occurring mental health and substance misuse. An example is the commitment to improving physical health of those with severe and enduring mental health problems by ensuring a physical health assessment every 15 months where possible and appropriate (Commitment 5).
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