Give mental health ‘equal priority’ in NHS reforms, psychiatrists urge

Psychiatrists have urged the Scottish Government to give mental health “equal priority” to physical health in its NHS reform agenda, amid an increase in demand for services.

The Royal College of Psychiatrists in Scotland (RCPsychiS) said proposed health and social care reforms are a “once-in-a-generation opportunity” to ensure all Scots have access to good mental health care.

The body, which represents 22,000 psychiatrists, called for a number of changes as part of the reforms, which it said would improve the experience of patients and staff.

The proposals include involving psychiatrists and other frontline clinicians in decision-making about services, staffing and resources.

The body is also calling for measures to improve the recruitment and retention of staff, and for greater financial transparency and accountability.

The call comes as Scotland marks World Mental Health Day on Saturday.

RCPsychiS vice-chairman Dr Pavan Srireddy said: “This programme of reform must make a tangible difference to the experiences of patients, and the staff caring for them.

“This means reducing variation in care, strengthening services, and ensuring people can get the right treatment wherever they live.

“With need for mental health services continuing to grow, mental health must be given equal priority to physical health, not treated as a secondary consideration.

“This includes giving mental health the same weight in strategic planning, resource allocation, performance management and system leadership.

“This World Mental Health Day, our message is simple: mental health cannot be an afterthought in NHS reform.”

A recent report by the body highlighted “serious concerns” about Scotland’s existing health and social care system, which it says has “disproportionate impacts” on mental health services.

It described the existing system as complex and poorly co-ordinated, and said it gives rise to concerns about patient safety, financial transparency and a lack of clinical leadership.

Dr Srireddy added: “Psychiatrists and other frontline clinicians know where the system works, where people are falling through the gaps, and where changes could make the greatest difference.

“From the outset, their expertise needs to be around the table when decisions are made about services, staffing and resources.”

He also called for “honesty” about the pressures facing the workforce.

“Psychiatrists and their colleagues are working incredibly hard to provide high-quality care, but persistent vacancies and pressure on services make that harder,” he said.

“Reform must create the conditions in which we can recruit, retain and support the staff our patients need.”

He added that patients and staff also need to have confidence that money for mental health services is delivering “real improvements in care”.

He said: “Future structures must provide greater financial accountability through transparent spending decisions and clear oversight of how funding is used.

“They must also establish clear lines of accountability for decision-making, so that responsibility is visible, understood and consistently applied across the system.”

He continued: “This is a once-in-a-generation opportunity.

“Success shouldn’t simply be measured by whether structures and organisations have changed, but by whether a person needing mental health care gets better, safer and more joined-up support as a result.

“The Royal College of Psychiatrists in Scotland stands ready to work constructively with the Scottish Government, Parliament and partners to make that happen.”

Minister for Mental Wellbeing Maree Todd said: “Good mental health underpins not just good health outcomes but can make the difference to someone being able to access and keep a job, their ability to focus and do well at school, and shape positive relationships throughout their life.

“Our refreshed Mental Health and Wellbeing Delivery Plan sets out our priorities to improve mental health support and services over the next three years and is aligned to wider health system reform.

“It represents a joint commitment from national and local government to take action to meet different needs across a person’s life, regardless of where they live in Scotland.

“Mental health spending by NHS Scotland has more than doubled since 2006 to £1.6 billion in 2024/25 – reflecting the importance of providing good mental health support.”