Poor mental health is an important public health challenge and significant mental health inequalities exist in Scotland. Improving the mental health and wellbeing of the population is a national priority because this is recognised as having a positive effect on many different aspects of society.

As our publication Good Mental Health for All alludes to, good mental health is essential in achieving and improving outcomes for individuals, families and communities. As such, it underpins successful delivery of a wide range of national priorities and strategy commitments.

Our Mental Health Inequalities Briefing set outs key messages and actions to address the issue of mental health inequalities.

You can find information below on

• our work on mental health inequalities, including our inequality briefing
• the Good Mental Health for All initiative 
• the Scottish Government’s Mental Health Strategy.

Impact of COVID-19 on public mental health

The COVID-19 outbreak is likely to have an impact on everyone’s daily lives, mental health and wellbeing.

Our rapid review of the impact of COVID-19 on public mental health includes studies from 4 March to 15 May 2020 during the COVID-19 outbreak and aims to answer three research questions

1. What impact is the COVID-19 pandemic having on mental health outcomes (using validated measures) at the population level?
2. What risk and protective factors are associated with mental health outcomes during the COVID-19 pandemic?
3. What are the key learnings and implications for Scotland?

Mental health inequalities

Mental health problems are not equally distributed across the population. Socially disadvantaged people have an increased risk of developing mental health issues to the extent that

• adults living in the most deprived areas are approximately twice as likely to have common mental health problems as those in the least deprived areas (22% versus 11%)
• there were twice as many GP consultations for anxiety in areas of deprivation than in more affluent areas in Scotland (62 versus 28 consultations per 1000 patients in 2010-2011).

The link between social status and mental health problems is thought to result from the level, frequency and duration of stressful experiences and the extent to which social and individual resources and sources of support reduce their impact.

Stressful experiences occur across the life course and include

• poverty
• poor housing
• family conflict
• unemployment
• childhood adversity
• chronic health problems.

These all contribute to a greater risk of mental health problems, particularly if several occur together and there are no protective factors to offset their negative impact.

Our mental health inequality briefing outlines two specific strands relating to social inequalities and mental health

• mental health inequalities as an (often neglected) component of health inequalities
• the social and health inequalities experienced by people with mental health problems.

This briefing sets out actions to address these issues based on evidence of what works and, as such, does not address the detail of inequalities in accessing mental health services.

Impacts of interventions for depression on population health and health inequalities

We know that mental health interventions can have benefits for individuals, but we don’t know the scale of their impacts on population health and health inequalities. So we included three interventions for the treatment of depression in our ‘Informing Interventions to reduce health Inequalities’ (Triple I) project.

The interventions we included were computerised cognitive behavioural therapy, individual guided self-help, and group physical activity.

Using the interactive tool you can alter the number of individuals treated and the targeting strategy (e.g. to deprived areas), in order to estimate results for local areas as well as for Scotland.

We found that interventions for depression could help to reduce health inequalities if targeted where most needed.

National and local actions

Scotland’s Mental Health Strategy

The Scottish Government’s Mental Health Strategy takes a health promoting and preventative approach and sets out a range of commitments around

• more accessible child and adolescent mental health
• improved responses to common mental health problems
• integrated community, inpatient and crisis mental health services.

The ambition is to create the best social circumstances possible and improve the conditions in which people are born, grow, live, work and age. This cannot be achieved solely by the NHS. Community Planning Partnerships, Integrated Joint Boards, third sector organisations, people with lived experience and their families and carers will also play a key role. Such partnerships can assist by working together to take action to reduce mental health inequalities, both as part of prevention and as part of service provision.

The Scottish Government has developed a framework with priorities to transform mental health in Scotland over the next 10 years.

You can read the current mental health strategy on the Scottish Government’s website.

Good Mental Health for All

'Good Mental Health for All' is an initiative developed by us and endorsed by the Scottish Government and the Convention of Scottish Local Authorities which sets out a vision to improve mental health and wellbeing. It links to the Scottish Government’s Mental Health Strategy and encourages action at national, local and community levels.

The document brings together a vision of a mentally flourishing Scotland and sets it in the context of the best evidence of what works and what we need to do to address health inequalities. This is essential if good mental health for all is to be achieved.

Distress Brief Intervention (DBI) programme 

The Distress Brief Intervention (DBI) programme provides a framework for a compassionate and effective response to people in distress, making it more likely that they will engage with and stay connected to services or supports that may benefit them over time.

You can also read our initial evaluability assessment which aims to identify possible evaluation options.

Training and support

We provide

• mentally healthy workplace training (external site) for those at risk of poor mental health such as construction sites and prisons via Healthy Working Lives
• animations raising awareness of mental health and suicide prevention in partnership with NHS Education for Scotland
• training on Scotland’s Mental Health First Aid (external site) for adults as well as Scotland's Mental Health First Aid: Young People (external site)
• information and guidance on social prescribing and self-management 
• breathing and relaxation exercises for stress (external site) via NHS inform
• physical health of those with mental illness (external site)
• mental health indicators. 

Information for the public

If you are looking for information on specific mental health conditions or have concerns about yourself or someone you know, please visit NHS Inform.

Find out more

You can contact us about our work on mental health.