Care Standards
We hope these resources will help with navigating mental health services in Scotland and ensure that you are receiving good standards of care
What Should Your Care Look Like?
Health and Social Care Standards
These should be adhered to by all healthcare professionals. They have been developed to make health, social care and social work services better for everyone by ensuring that each person is treated with respect and dignity, and that their human rights are being upheld.
1. I experience high quality care and support that is right for me.
2. I am fully involved in all decisions about my care and support.
3. I have confidence in the people who support and care for me.
4. I have confidence in the organisation providing my care and support.
5. I experience a high quality environment if the organisation provides the premises.
Specific Standards For Healthcare Professionals
Healthcare professionals must all register with regulatory bodies who define specific standards for their profession.
They also provide a searchable register of all members.
Click below to view the standards set by the most common mental heath professional regulators:
All doctors must be registered with them
All health and care staff must register
Professional body for therapists in the UK
Search for practitioners or professional bodies
The National Trauma Framework
What is trauma and Adversity?
'Trauma' is a word we normally associate with veterans of war or other life-threatening events. However, this national policy (and being trauma-informed) also includes those who have experienced many kinds of negative events that are very common in our society. These events can have a lasting impact on our physical, mental and social health.
Trauma and adversities can be single events or prolonged negative circumstances where someone had little or no power to control the outcome or escape. They include enduring physical or emotional harm, serious illness, poverty or discrimination at any time in someone's life. If this happened in childhood they are known as Adverse Childhood Experiences (ACEs).
What Does This Mean For My Care?
Viewing mental health through a trauma-informed lens means taking into account how adverse experiences can shape the brain, nervous system and body. Asking 'what happened to you?' instead of 'what is wrong with you?' is a shift away from services and society viewing problems as being 'all in your head' and only offering individual solutions or little outside support.
This national policy and training programme applies to all public services (from mental health staff to police officers) so that they can recognise external events that generate health problems and distress, and limit the future impact this has on individuals by protecting them from further harm. The overall aim is to create a society where health and wellbeing are accessible to everyone.
Because most people have experienced one or more adverse events this means that this national policy is applied to everyone and it is also a good standard of person-centred care. The simplest way to identify if you are receiving care that meets trauma-informed standards is that you trust your healthcare providers because you are being provided with:
Being trauma-informed means understanding that physical and mental health symptoms are interconnected and highly influenced by our environment. This can be easily explained by thinking about having a 'window of distress tolerance'. Rather than focussing on reducing the separate symptoms of anxiety or depression, this approach aims is to improve wellbeing by increasing the size of the 'window', where people feel calm, safe and stable. Click here for a more detailed infographic about the window of tolerance.
A trauma-informed approach actively resists putting individuals in situations which are re-traumatising.
Traditional mental health treatments (such as CBT and psychodynamic) and services do not automatically do this
and can be harmful if they are not adapted. It is important to ensure that your practitioners are adhering to the National Standards.
If they are not aware of the framework or the training you can direct them to it here:
Trauma-informed professionals and services provide the conditions that allow individuals to stay within their window of tolerance because they are in a safe, stable and reliable environment. Instead of all responsibility being placed on individuals they recognise that the window is shrunk by enduring negative experiences. This approach also highlights the importance of mutual support and community to collaboratively regulate the nervous system (known as 'co-regulation') to improve health and wellbeing. It is not something that can be achieved alone - relationships matter!
If the root cause of your difficulties is directly related to traumatic events you should be offered a phased approach to recovery. This means that you should be provided with care in these three stages (and it's okay to repeat stages):
- Safety and Stabilisation: Helping you to navigate out of a current crisis situation, make sure you are in a safe environment, are receiving appropriate support from professionals, organisations and/or loved ones to feel safe, have assistance to develop coping skills and are living to a good standard (i.e. stable finances and housing).
- Making Sense of Your Difficulties: This is where you begin to explore your difficulties, usually with the help of a trained professional but this could also include peer support or self-help (see our Common Treatments page).
- Re-Connecting and Future Planning: When you are feeling better in yourself its time to start looking to the future, making plans, further building your support network and sense of community.
Addressing the widespread impact of trauma and adversity is not an individual responsibility.
It is a social problem that requires political solutions. View our resources to find out more.
NHS Mental Health Therapies for Adults
The Adult Mental Health Matrix details the different treatment pathways and options that should be available for common mental health conditions. You can use it to ensure that you are receiving care that is appropriate for your needs and make informed decisions.
Click the image to view a pdf copy
A new website is also under development but not yet complete.
The People With Learning Disabilities Matrix outlines mental health treatment pathways and options that should be available for common conditions. However, it is important to remember that therapies must be adapted to suit the needs of individuals and used to benefit their wellbeing, not to change behaviours that pose no risk of harm to themselves or others. These could be a way of communicating, self-soothing or highlighting where there is an unmet need that must be addressed.
Click the image to view a pdf copy
The Neurological Disorders Matrix includes mental health interventions that are recommended for common mental health conditions relating to brain injuries, stroke, epilepsy, Multiple Sclerosis (MS) and Parkinson's Disease.
Click the image to view a pdf copy
The Persistent Physical Symptoms Matrix includes mental health interventions that are recommended for common mental health conditions relating asthma, cancer, cardiovascular disease, chronic fatigue, kidney disease, COPD, chronic pain, diabetes, IBS, arthritis and weight gain. Please remember that mental health treatments should be used to benefit your wellbeing and not to increase your ability to do activities that may lead to further harm to your physical health.
Click the image to view a pdf copy
The Forensic Services Matrix does not include a lot of mental health support options for people in forensic settings, which is a universal problem.
Services are also failing to address other needs of prison populations, such as learning disabilities, autism and ADHD, although they have been found to be highly prevalent. An independent investigation was conducted and they reported that they were:
'confronted by a system that appears to be nearing the edge of crisis [...] it feels like only a matter of time before some parts of the system give way under the pressure or are subject to legal challenge.'
You can read their final report and recommendations here.
NHS Mental Health Therapies for Children and Young People
The Children and Young People Matrix can be used to find out about mental health support that may be available for common health and disabilities. A more up-to-date resource is the Early Intervention Framework for Children and Young People's Mental Health and Wellbeing. It outlines supports that adhere to the United Nations Convention on the Rights of the Child (UNCRC), underpins the Scottish best practice model of Getting It Right For Every Child (GIRFEC) and delivers on The Promise made by the Scottish Government to care experienced children and families.
The Child and Adolescent Mental Health Services: National Service Specifications outlines the care provisions young people and their families can expect from the NHS when using Child and Adolescent Mental Health Services (CAMHS) and how children, adolescents and their families should be involved in care decisions.
Looking For Something?
There's alternatives to traditional therapy at the bottom of our treatments page that might fit better with your needs.
What Do I Do If Things Go Wrong?
If you don't feel that you are being listened to it is your legal right to have an advocate to support you.
Find out more about this on the Mind website.
If you have been harmed by mental health services (including misdiagnosis or waiting far too long for help)
you can raise concerns to the NHS and try to make changes, for yourself and others. Share your experience on the NHS Care Opinions website and follow the formal NHS complaints procedure.
You can also raise concerns to one of the professional or regulatory bodies.
The Patient Advice and Support Service (PASS) by Citizens Advice can support you throughout the
NHS Complaints process, including requesting a copy of your medical records.
Check out our Care Standards and Navigating Services pages for advice.
Do you need help navigating the mental health system?
We believe that everyone should have access to the help they need when they need it, and be able to make informed decisions about their own healthcare.
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