OVER THE past 20 years, Scotland’s national health service has increasingly recognised the growing concerns over mental health and has developed its remit to improve delivery and provision of its mental health services.

Speaking at the National Rural Mental Health Forum in March, Belinda Arthur, who works with the NHS 24 Service Development Directorate, explained that a huge amount of work has been carried out to redesign the organisations’ provision of emergency mental health support:

“I’ve been working in mental health for around 20 years. During the last few years there has been a significant change in internal structure of the organisation and a lot of that has taken place around mental health care.

“User experience has become part of the design process – the NHS is constantly seeking feedback from the public on how to constantly improve their services,” said Ms Arthur, who joined NHS 24 last year. “One of the big changes on the cards is the creation of a ‘mental health hub’ which will be incorporated as part of the 111 service,” she continued. “When dialling 111, there will now be an option to speak to someone about your mental health, which has never been done before.

“Research has shown that people calling with mental health concerns were hanging up when they heard there wasn’t a service specific to their need and through this new system, we will have fully trained psychological wellbeing practitioners ready to support and advise the public.”

Ms Arthur made the point that when an individual is in distress and needs to speak to someone quickly, there needs to be an environment in which they feel safe to discuss their concerns and that requires the right person on the other end of the phone.

“We discovered that people were calling and were being asked too many questions in a scripted manner, which served as a deterrent to people accessing help as they didn’t feel comfortable engaging with the call handlers.

“Through this new system, the handlers are all trained psychological wellbeing practitioners who will ensure that they engage with individuals through a person-centred approach, not following a scripted procedure but listening and advising on calls according to the individual’s concerns,” she explained.

NHS 24 haven’t officially launched the new mental health hub as they intend to trial it first to monitor the demand for the service and assess any improvements which can be made.

Unofficially, it goes live at the end of March and will be available between 6pm and 2am on Friday, Saturday and Sunday evenings, for an indefinite period. Ms Arthur added: “We know from existing data that these hours are the times that people are most in need of support and the long-term aim is to fully integrate it in to the service.”

The proposed timings should be welcomed by the agricultural community, given that farmers operate outwith typical office hours and have to cope with the pressures such as the lambing and calving season, and at harvest time.

“There is a culture change going on in Scotland and the NHS needs to know where the problems are. We have user focused groups that people can contribute to and I would urge farmers and others involved in the agricultural industry to feed into these discussions to make sure we are taking in to account the needs of the wider population,” she added.

“NHS 24 is aware of some of the differing challenges between rural and urban areas, but we need to know the main things to look out for – to understand the barriers facing certain groups and we need to know who is going to phone or why they won’t, so we can alter our service accordingly.

“The purpose of this new mental health hub is to make sure that individuals are properly listened to and feel part of the conversation. By the end of the call they need to feel like the right decision has been made,” explained Ms Arthur. “Our wellbeing practitioners will be able to link people to sources of support for issues that may raise and as they are experienced and trained within the mental health field are able to offer direct support and advice.

“We will also have the authority to connect people with clinical support, which may take stress off those individuals, such as farmers, who feel they are unable to speak to the GP directly – as we can, given consent from the individual, pass on their information to their doctor.

“One of the main benefits of this proposed service to the NHS is that it will relieve some of the stress which is being felt by departments like A and E, who are under extreme pressures, particularly during weekend evenings. We have found that some of the individuals calling the emergency service line on a weekend evening may end up being referred to A and E or experiencing an intervention with the Police, which can cause further distress to the individual and may not be the best course of action.

"Although there will be cases which need referral to the emergency services, the hope is that through this service we can focus on getting people the right treatment, at the right time and provide person-centred support during a period of mental distress,” she concluded.

Guidance and support

If you have personally been affected by any of the content in this series and would like to seek further advice, please see the details of specific organisations below: -

Breathing Space – Lines are open Mon – Thu between 6pm - 2am and from Fri 6pm – Mon 6am

RSABI - Helpline open seven days between 7am – 11pm on 0300 111 4166 or rsabi@rsabi.org.uk

SAMH – Call the info service on 0141 530 1000 Mon – Fri between 9-5 or enquire@samh.org.uk.

Samaritans – Helpline open 24/7, on 116 123 or 08457 90 90 90 or jo@samaritans.org

Support in Mind Scotland (NRMHF) Call on 0131 662 4359 Mon – Fri between 9am – 5pm or info@supportinmindscotland.org.uk

You can reach us by phone on 0131 662 4359 Monday to Friday between 9am and 5pm.

If you need urgent medical attention, then please call NHS 24 on 111 or call emergency services on 999.