Access To Mental Health Services In Scotland Slow And Complicated

13th September 2023

Accessing adult mental health services in Scotland remains slow and complicated for many people. In particular, ethnic minority groups, people living in rural areas and those in poverty all face additional barriers.

There have been big funding increases for services since 2017, but a lack of data makes it hard for the Scottish Government to see the impact of that spending. Waiting times for psychological therapies have improved. But ministers do not measure the quality of wider mental healthcare services, or whether they are improving people's health.

The mental healthcare system is fragmented. The Scottish Government, NHS boards, councils, Integration Joint Boards, Health and Social Care Partnerships and the third sector are all
involved in funding, planning or providing services. This makes accountability complex. And it causes complications and delays in developing care focused on the needs of individuals.

The Scottish Government plans to increase its Mental Health Directorate budget by 25 per cent and ensure that ten per cent of the front-line NHS budget is spent on mental health by 2026.

They have also committed to giving all GP practices access to community based mental health and wellbeing services. These commitments are essential to improving access to services and
relieving pressure on the mental health workforce. But ministers' plans are not on track.

Stephen Boyle, Auditor General for Scotland, said, "The Scottish Government needs much more information to understand the difference its investment in mental health services is making, from specialist services to community-based support.

"That planning must include moving beyond using waiting times as the sole measure of whether services are improving the lives of those in need. And it needs to include a costed delivery plan for the care that people can expect in their communities."

Ronnie Hinds, Interim Chair of the Accounts Commission, said, "Councils and Integration Joint Boards have a vital role to play in improving the availability and quality of data needed to plan services and get the right levels of staffing in place.

"They also need urgently to develop shared goals and targets to improve how housing, welfare and other services work together in order to address and prevent the root causes of poor mental health."

Notes
1. Over 2,700 people waited more than a year to start psychological therapies in 2022/23.

2. NHS boards spent £1.2 billion on adult mental health in 2021/22, while councils spent £224.7 million.

3. The Scottish Government's Mental Health Directorate budget is £290.2 million in 2023/24.

4. Before accounting for inflation, the Scottish Government's Mental Health Directorate budget would need to reach £342 million by 2026/27 to reach its commitment to increase funding by 25 per cent. But the 2022/23 and 2023/24 budgets are lower than the increases needed to meet this target.

5. The Scottish Government's own projections show that mental health spending will decrease as a proportion of front-line NHS spending by 2026, from 9.8 per cent in 2021/22 to nine per cent in 2026/27. It is not on track to hit its ten per cent target.

6. Audit Scotland has prepared this report for the Auditor General for Scotland and the Accounts Commission. All Audit Scotland reports published since 2000 are available at www.auditscotland.gov.uk

• The Auditor General appoints auditors to Scotland's central government and NHS bodies; examines how public bodies spend public money; helps them to manage their finances to the highest standards; and checks whether they achieve value for money. The Auditor General is independent and is not subject to the control of the Scottish Government or the Scottish Parliament

• The Accounts Commission is the public spending watchdog for local government. It holds councils and various joint boards and committees in Scotland to account and help them improve. It operates impartially and independently of councils and of the Scottish Government and meets and reports in public.

• Audit Scotland is a statutory body set up in April 2000, under the Public Finance and Accountability (Scotland) Act 2000. It provides services to the Auditor General for Scotland and the Accounts Commission for Scotland.

Read the full Audit Scotland report HERE
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