Severe and enduring mental illness - community services are working, but more ambition is needed

A new study by the Mental Welfare Commission found many positive aspects of care and support for people with severe and enduring mental ill health in Scotland who were in touch with community mental health services.

Most people interviewed were satisfied with their care and treatment, saw local mental health care teams regularly, and had good arrangements for crisis planning.

The large majority had regular physical health checks, and were satisfied with their housing.

But only three of the 59 people interviewed had jobs, and a significant number experienced some loneliness and isolation.

The study involved interviews with people in every mainland health board in Scotland, and with one island authority. All of those interviewed were identified by local community mental health services. All had been diagnosed with a significant mental health illness for more than a year.

Colin McKay, chief executive of the Mental Welfare Commission, said:

"Most of our visits to people with mental ill health take place in hospital. But we know that many people with severe and enduring mental ill health live in the community, and we wanted to hear their views on their care and treatment, and how they were getting on more generally.

"All of those we visited were connected to community mental health services, and they had positive experiences of that support. This is welcome.

"But while people's lives were safe and stable, there was also a sense of low expectations; of little belief that life might offer more opportunities in the future. We would like to see more ambition from local authorities, the NHS and integrated joint boards in helping those with severe and enduring mental ill health to feel positively about their chances of getting back to work, and engaging more.

"The Scottish Government is consulting now on its next strategy for mental health, which includes a commitment to ensure that employment and welfare programmes are designed to take account of mental health conditions. This is encouraging, and we hope to see real progress in the coming years."

The report includes a range of recommendations, including a call for community mental health services to have a clear focus on recovery.

The report also commits the Commission to discussing with the Care Inspectorate the ways in which their inspections of community services can look at how those services are promoting well being.

A further recommendation asks that the Scottish Government includes a stronger focus on employment support in the next mental health strategy.