Scotland's healthcare system 'failing' mental health patients, psychiatrists warn
The Royal College of Psychiatrists in Scotland is now calling for a Holyrood inquiry
Scotland’s integrated health and social care system is “failing patients” accessing mental health services, a report from the professional body for psychiatry has warned.
The Royal College of Psychiatrists in Scotland said the current system is “disjointed and poorly coordinated”, which is having a “damaging impact on patient safety, clinical leadership and financial transparency”.
The college is now calling for a Holyrood inquiry into the system’s flaws.
Dr Pavan Srireddy, vice-chair of the college, said: “The current structure is failing patients.
“Mental health services support some of the most vulnerable people in Scotland, yet responsibility for these services is often spread across multiple organisations, with no clear line of accountability when problems arise.
“More than 10 years after interaction, it’s right to ask whether the current arrangements are delivering the improvements that were intended.
“Too often, psychiatrists are excluded from key decisions about services and resources, limiting their ability to deliver the care patients need.
“Psychiatrists bring a unique understanding of patient need, clinical risk and service demand. Their expertise must be embedded in decision-making alongside policy and finance leaders to ensure that resources are directed where they can have the greatest impact on patient care.”
Health and social care services became integrated back in 2014, creating 31 different bodies responsible for planning and funding services.
However this new report suggests this is leading to “fragmented decision-making and unclear accountability risk reducing the impact of funding intended for mental health services”.
It adds clinicians have “no seat at the decision-making table” and little influence over financial and strategic decisions.
The report also highlights transitioning from child to adult mental health services as a “structural fault line” because the two sit across multiple different systems. Other areas of concern include a lack of accountability and responsibility, and waste and gaps due to duplication.
The college says it is “vital not to lose sight” of how important good mental health services are, as 11.3 per cent of Scots report having a mental health condition.
While NHS Boards remain responsible for workforce, patient safety and clinical governance, the report highlighted that the key decisions affecting funding, service capacity and resource allocation sit elsewhere.
Clinicians report having “no seat at the decision-making table” with little influence over the financial and strategic decisions that shape services.
Dr Srireddy says there must now be an independent inquiry at the Scottish Parliament on integrated health and social care services.
He said: "The inquiry should assess whether the current system is improving patient care, outcomes and the flow of mental health funding to frontline services.
“The beginning of this new parliamentary session presents an opportunity to address these longstanding concerns and put patients at the heart of decision-making.”
Adam Harley MSP, the Lib Dems’ health spokesman, said: “Scotland needs world-class mental health services. The current system is failing far too many, with people stuck waiting for months and years before getting the help they need.
“Ultimately, the Scottish Government needs to change direction and meet the scale of the challenge before them.”
Miles Briggs MSP, the Conservatives’ health spokesman, added: “This is a damning verdict from Scotland’s psychiatrists on the SNP’s mental health system.
“Too many of our most vulnerable young people are being failed, waiting too long for treatment and falling through the cracks.
“These experiences are the result of a system that simply is not working.
“The SNP cannot ignore these warnings and must guarantee people can access the timely mental health support they need, instead of being left to navigate a broken system.”
Mental Wellbeing Minister Maree Todd said the report highlights a number of issues but the government has shown “clear commitment” to improving mental health services.
She said: “The wide range of partners working together demonstrates our commitment to ensuring everyone in Scotland, wherever they live, has 24/7 access to the right mental health and wellbeing support and I expect all organisations to work together across boundaries to achieve that.”
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