Last year Beat responded to a Scottish government consultation, which had invited individuals and organisations to help influence what would be included in their new 10-year mental health strategy. The Scottish Government recently published the full strategy, which contains 40 ‘actions’ aimed at improving mental health services and support across the country.
We welcome the publication of this strategy and support its broad vision for the future of mental health care in Scotland, but believe clearer and more ambitious promises are needed from the Scottish government to enable a transformation of the care offered to people affected by eating disorders in Scotland.
Following a grant from the Scottish government, Beat is about to begin an exciting collaboration with NHS Lothian to deliver a project to directly address Action 22 of the strategy, which relates specifically to eating disorders: “Support development of a digital tool to support young people with eating disorders.” The strategy document says this is to: “…help ensure that young people with an eating disorder are able to access support in a way that reflects digital lifestyles…”.
We welcome the inclusion of this action – it is crucially important that support is available for people with eating disorders and that they are encouraged to seek help. Beat’s project with NHS Lothian will create an online peer-support forum and a training resource aimed at promoting early intervention and helping parents of a child with an eating disorder to support their child. These resources will be designed in partnership with young people and their parents.
However, this alone is not enough. We also want to see a Scotland where everyone who seeks help for an eating disorder can quickly access evidence-based treatment. Having to join a long waiting list is often a distressing experience, and the chance of making a full recovery from an eating disorder improves significantly when evidence-based treatment is accessed quickly. The current English mental health strategy (the ‘Five Year Forward View for Mental Health’) promises that by 2020/2021 children and young people with an eating disorder will be able to access evidence-based treatment within strict maximum waiting times. It is disappointing that, in this strategy, the Scottish government has not committed to creating an equivalent set of standards for Scotland’s children and young people, as well as establishing such standards for adults. We urge them to address these omissions without delay.
The new Scottish mental health strategy refers to the importance of health professionals following evidence-based clinical guidelines. However, it does not address the fact that the most recent clinical guideline for eating disorders in Scotland needs to be reviewed, as it was published 11 years ago. Staff in Scottish Child and Adolescent Mental Health Services have recently received initial training in how to deliver Family Based Therapy (FBT) for children and young people, but many services feel that further training is necessary to ensure that families are able to access this evidence-based form of treatment wherever they live in Scotland, and for years to come. We would also like to see the creation of a nationwide ‘Managed Clinical Network for eating disorders’ in Scotland. This could improve communication between specialist clinicians and management of transitions.
During the consultation, the Scottish government proposed that the following commitment would be included in the strategy:
“By April 2017 we will have started a review of how deaths of patients in hospital for mental health care and treatment are investigated.”
However, this has not been included as one of the strategy’s 40 actions. When she launched this strategy, the Minister for Mental Health, Maureen Watt MSP described it as a “first step”, and she has promised that it will be monitored, reviewed and added to over time. While a phased approach to implementation of the strategy is to be expected, this review was proposed in the consultation as an ‘early action’ and it is imperative that such a serious topic as this is addressed in the first phase of the new strategy.
Furthermore, in their current form, many of the 40 actions lack the detail required to enable them to be measured. We hope that in the months and years ahead these actions are refined to become clear promises, with timelines and resources allocated to each. We welcome the publication of this strategy, which is an important first step, but Beat calls on the Scottish government to ensure that further steps are taken to improve the treatment and support provided for people affected by eating disorders in Scotland, including the introduction of ambitious access and waiting times standards for evidence-based treatment.