Dr Fiona Lang, Mental Health Adviser to the
Clinical Standards Board for Scotland
Dr Fiona Lang
The Board was established at the beginning of March 1999 under the chairmanship
of Lord Patel to develop and run national standards in the five key priority areas,
which include mental health (concentrating in the first instance on schizophrenia).
The task has been particularly difficult because of a lack of hard quantifiable
evidence and benchmarking standards. In addition, schizophrenia is very a very
different experience for different people and involves lots of services and lots of
different people.
In addition, there is a wide range of views as to what standards should be put in
place. This is the first time that standards are being set in mental health.
There is unfortunately no robust clinical evidence base in the mental health sphere.
We need to set standards that are:
- achievable but stretching
- designed to improve current care
- agents of change.
Standards should be concern themselves with:
- needs assessment
- carers and their needs
- treatments and interventions
- all 'stages in the journey' through mental illness
The quality of evidence is generally poor. Existing studies are selective and there is
no long- term follow-up. The Standards Board initiated the gathering of such research
evidence as exists in the literature.
The framework for standards in mental health was based on this process:
- consultation with professionals, carers and users
- focus group meetings
- drawing up April/June draft standards
- Piloting the draft standards
The standards now adopted concentrate on the following:
- needs assessment
- initial diagnosis
- initial assessment and assement a year after diagnosis
- ongoing care
- admission and discharge
- carers
- drugs
- psychological and social interventions
- drugs and alcohol misuse.
The Standards are to be launched in the last week of November in the form of a
number of documents. A key element of the standards will be the audit tool.
The process will be that Trusts send in assessments and the Standards Board will
use a combination of self-assessment and peer review visits, involving carers and
users, who will be offered training for this role. The first Trust review will take place in
February 2000.
There was a discussion after the talk.
Annual General Meeting
The Annual General Meeting approved last year's minutes with one minor correction,
accepted the accounts and reappointed the Auditors. For further details, see the
Annual Report.
Two retirals from the Management Committee – Bill Easton and Gordon Bryce –
were recorded, with thanks to both for their work. Two members were re-elected to
serve for a second term: Marie McKeown and Jacqueline Atkinson.
Two new members were elected.
Mary Weir reported on the last year's work of the Fellowship. For further details see
the
Annual Report.
Lord Campbell of Croy was retiring as Patron and the meeting expressed its gratitude
for his work on behalf of the Fellowship. One new Patron is currently being appointed.
Ian Gilmour described the current financial difficulties of the Fellowship and the need
to adopt strict financial disciplines in the coming months. The problems have been
largely caused by MISG (Mental Illness Specific Grant) funding being frozen for the
last six years, and level funding from other providers.
The Annual membership fee was increased by £5 to £15 by a unanimous vote.
It was also agreed to explore the possibility of increasing user involvement in the
Fellowship.
The meeting closed with a vote of thanks to the Chair.
