Publications relating to policy and public affairs in Scotland
This page contains key resources relating to policy and public affairs in Scotland. For further information on these resources, please get in touch with scotland@rcpsych.ac.uk.
RCPsychiS has launched a report examining the impact of health and social care integration on mental health services in Scotland.
More than a decade after the Public Bodies (Joint Working) (Scotland) Act 2014, and ten years after integration arrangements became operational, there has been no comprehensive assessment of what integration has meant for mental health services. Our report seeks to contribute to that discussion by highlighting the experiences of psychiatrists working across Scotland's mental health system.
While integration was intended to create a more joined-up approach to care, members report that mental health services have often experienced increased fragmentation, with responsibility for planning, funding, governance and delivery spread across multiple organisations. The report identifies five key areas of concern:
- Patient safety and governance
- Financial transparency
- Accountability
- Clinical leadership and decision-making
- Duplication, waste and gaps in care
Among the issues raised are concerns about the growing disconnect between those responsible for patient safety and those controlling resources, the difficulty of tracking whether funding intended for mental health reaches frontline services, and the lack of consistent mental health representation within key decision-making structures.
Given the scale and significance of these issues, RCPsychiS is calling for a Scottish Parliament cross-committee inquiry into the impact of health and social care integration on secondary and specialist mental health services. We believe such an inquiry would provide an opportunity to examine whether current arrangements are delivering the transparency, accountability and outcomes that patients, clinicians and policymakers expect.
' Multi-system solutions for meeting the needs of autistic people and people with ADHD in Scotland' is a framework of work streams to guide national policymakers in addressing the crisis in the provision of appropriate pathways and support for people with neurodevelopmental conditions.
This paper has been over two years in development with RCPsychiS members and represents the voice of Scotland’s clinical leaders in mental health care. It offers a high-level, strategic exploration of one of the most urgent and complex challenges facing our health system: the growing unmet need for neurodevelopmental care. The paper sets out a comprehensive framework of multi-sector solutions - spanning health, education, employment, social care, and public understanding.
Staff and Members at RCPsychiS have developed a proposal for a 4-tiered, multi-sector approach to providing appropriate pathways and support for ADHD and autism in Scotland.
In recent years, there has been an unprecedented rise in referrals for neurodevelopmental condition (NDC) assessment and support in Scotland. Referrals for ADHD assessment alone increased by 500%-800% across health boards between 2019 and 2021. This is driven by several factors: increased societal awareness and understanding, unmet historical needs, population growth and social change, and the impact of the COVID-19 pandemic.
However, there is currently no dedicated, national standard NDC referral, treatment or support pathway in Scotland. This is leading to critical issues within the mental health sector. Without a nationally agreed pathway in place for NDCs, the rapidly rising scale of need has had a critical impact on service capacity within secondary care mental health services. This has led to unprecedented pressures in the mental health sector and lengthy waits for assessment and treatment across all health board areas in Scotland - which is posing an existential threat to the mental health system.
The growing demand for NDC services, coupled with insufficient capacity and resources, poses a systemic risk to the sustainability of Scotland's mental health services. Without urgent action to address this, the system risks destabilisation, harming both patients and clinicians.
We envisage a role for national leadership and focus on the delivery of 4 tiers of action, as outlined in our proposal.
Read our proposal here: RCPsychiS - NDC Pathways proposal final - January 2025
The RCPsychiS MSP Guide to Mental Health and Mental Illness is a practical resource designed to help Members of the Scottish Parliament (MSPs) and their staff in supporting constituents affected by mental health issues and mental illness.
This guide provides evidence-based information on recognising and supporting constituents with mental health concerns, provides an overview of mental health conditions and mental illnesses, provides information on how to help constituents affected by mental illness and how to help someone in distress, offers information on signposting individuals to appropriate support services, and gives context to the broader impact of mental illness.
It aims to equip MSPs and their teams with the knowledge and tools needed to offer informed, compassionate assistance to those in need within their communities.
