Mental health services provide support, assistance and treatment
for those with a mental illness and their informal carers. The
services may be provided by NHS primary care, secondary care, local
authority social services, voluntary organisations and the
independent sector. It is therefore essential that these individual
services co-ordinate their work to meet the individual service
user’s needs and that this work can be shown to be
fit-for-purpose.
In 2004, NHS Quality Improvement Scotland (NHS QIS) published a
national overview of schizophrenia services in Scotland. The key
findings identified that mental health services sometimes lack
co-ordination, do not deliver evidence-based interventions, do not
record outcomes and often do not meet service user assessed needs.
To address these findings, NHS QIS published its 3-year strategic
work programme in 2005, Improving the Quality of Mental Health
Services, 2005-2008. To ensure that mental health services continue
to improve, three key areas were identified: care, often provided
by different organisations, should be co-ordinated by means of
ICPs; the success of a service should be measured by the extent to
which the needs of service users are actually met; and information
systems should be developed to enable assessment of the first two
key areas.
In 2006, the Scottish Executive Health Department (SEHD)
published Delivering for Mental Health (DfMH). DfMH addresses the
need to set targets and commitments for the development of mental
health services in Scotland. It takes forward the Millan
Principles, which underpin Scotland's mental health legislation,
Mental Health (Care and Treatment) (Scotland) Act (2003), and marks
a national commitment to a new style of working for mental health
services. Healthcare Improvement Scotland is taking this work
forward in conjunction with NHSScotland and partner organisations
by developing standards for ICPs, as set out in Commitment 6 of
DfMH:
"NHS QIS will develop the standards for ICPs for schizophrenia,
bipolar disorder, depression, dementia and personality disorder by
the end of 2007. NHS board areas will develop and implement ICPs
and these will be accredited from 2008 onwards."
Commitment 6 is linked to achieving the Health
Improvement, Efficiency and Governance, Access and Treatment (HEAT)
targets for mental health:
- Target 1: Reduce the annual rate of increase of defined daily
dose per capital of antidepressants to zero by 2009/10.
- Target 2: Reduce suicides in Scotland by 20% by 2013.
- Target 3: Reduce the number of re-admissions (within 1 year)
for those that have had a hospital admission of over 7 days, by 10%
by the end of December 2009.