Reply on the 24th May 2016 from The Scottish Ministers

St Andrew’s House, Regent Road, Edinburgh EH1 3DG www.gov.scot abcde abc a Population Health Directorate Mental Health and Protection of Rights Division 24 May 2016 Dear Ms Milligan, Thank you for your email of 23 April 2016 to Scottish Ministers, about your concerns regarding mental health and access to treatment for depression. I am replying on behalf of Ministers. Firstly, I was sorry to read of your experience of depression over a period of years. Anyone who has not been in your position will be unable to understand fully what your experience of depression will have meant for you. Nonetheless, I can understand that the experiences which you describe will have been very challenging and distressing. I fully appreciate your frustration and concern regarding the difficulties you have described accessing care and support. I take this opportunity to explain the role of the Scottish Government and to signpost you to some additional options for out-of-hours support. Firstly, it may help if I explain that the Scottish Government cannot intervene in the healthcare of individuals. NHS Boards are responsible for working with their partners to plan and provide safe, person-centred and effective mental health services which meet the assessed needs of their local populations, in line with clinical guidance and Scottish Government mental health policy and legislation. A patient’s care and best interests should always come first and - whatever the setting – Ministers expect care, services and support to be provided to the highest standards of quality and safety, with the needs of the individual at the centre of all decisions. It is of course important that national policy is translated to improvements on the ground - I do appreciate that you feel this has not been your experience on this occasion. I would want to assure you, though, that with the NHS and other partner agencies we are doing all we can to improve how services respond to people experiencing mental illness. St Andrew’s House, Regent Road, Edinburgh EH1 3DG www.gov.scot abcde abc a You mention the challenges which can be encountered by working age people who experience depression or anxiety. Psychological Therapies have an important role in helping people with mental health problems, who should have access to effective treatment, both physical and psychological. It is generally accepted that these therapies can have demonstrable benefit in reducing distress, symptoms, risk of harm to self or others, health related quality of life and return to work. We have introduced a national target for access to evidence based psychological therapies within 18 weeks of referral, in recognition of the positive contribution such therapies can have in treating mental illness. I acknowledge the concerns around stigma related to mental health and we are actively working to reduce the stigma around mental health and employment, through investment in the See Me programme (seemescotland.org/), Scotland’s national programme to end the stigma and discrimination that can be associated with mental illness, which specifically addresses workplace environment. You do not mention whether you are in touch with your GP. If you are not in touch with your GP, I would urge you to do so - GPs are best placed to advise and guide patients regarding appropriate treatment or management of symptoms. If you feel a need to speak to someone in confidence about your experience of illness and the associated challenges which you have experienced, you can do so with your GP. It may be helpful for you to take along a family member, friend or advocate for support – information about independent advocacy can be obtained from your local NHS Board. Regarding out-of-hours support, I am unsure if you are familiar with the following sources for help. Support can be obtained out of hours from Breathing Space, a telephone and web service which offers free and confidential advice for people experiencing low mood, depression or anxiety, whatever the cause. This service can be contacted on 0800 83 85 87, 6pm to 2am Monday to Thursday; and 6pm Friday through the weekend to 6am Monday. Calls to Breathing Space are free from landlines and from mobile networks. See also www.breathingspace.scot (see especially “Your Mood”) which provides a wide range of useful information and advice about coping with low mood, depression and anxiety. Another source of support which is available out of hours is NHS Living Life, a free telephone service available to anyone over the age of 16 feeling low, anxious or depressed. The service can be accessed either by a referral through your GP, or by phoning the number directly on 0800 328 9655 (Monday to Friday 1pm to 9pm). After a telephone assessment, callers can be assigned to either: Living Life Guided Self-Help – guided support with a selfhelp coach over 6-8 weeks; or Living Life Cognitive Behavioral Therapy (CBT) – specialist support with a therapist over 6-9 telephone sessions. NHS Living Life telephone support is based on a CBT approach to help you understand some of the reasons why you are feeling low, depressed or anxious. The service can help you address negative patterns of thinking and teach new ways of coping. You can find out more about Living Life on the NHS24 website. Finally, another source of support is the Samaritans, who provide confidential nonjudgemental emotional support, 24 hours a day, for people who are experiencing feelings of distress or despair. You can contact Samaritans free on 116 123. You can find more information about Samaritans at www.samaritans.org By way of information, we are currently working on the development of the next Strategy, and over the last few months we have engaged with a wide range of stakeholders including people who use services, service providers and professional bodies. The Strategy as eventually published will be informed by all of the comments and input that we have received, and we anticipate that it will include a continued focus on improving access to St Andrew’s House, Regent Road, Edinburgh EH1 3DG www.gov.scot abcde abc a treatment, as well as a focus on mental health aspects of Primary Care, and on employability and mental health. Thank you again for writing to Scottish Ministers about your concerns over your wellbeing. I very much hope that you experience improved health in the near future. Yours sincerely Karl Zaczek Mental Health and Protection of Rights Division