NHS Health Scotland
Outcome Indicators


5.9 There are associations between one or more of the long-term mental health outcomes and each of the intermediate outcomes: mentally healthy schools, increased learning and skills development for all; mentally healthy workplace; and financial security for all.


Mentally healthy schools
Work is currently being undertaken as part of the Children and Young People Mental Health Indicators Programme to establish the evidence base for the association between mentally healthy learning environments and long-term mental health outcomes.

Supportive school environments, including access to healthcare professionals, are important protective factors for suicide among adolescents including those who have experienced sexual abuse, those with learning disabilities and those who identify as lesbian, gay, bisexual and transgender.[1]

Learning and skills development
There is evidence that participating in learning is associated with a range of mental health benefits and contributes to the adoption of healthy behaviours. Recent research has found positive associations between adult learning with optimism and efficacy.[2]

Mentally healthy workplace
Epidemiological evidence from the Whitehall studies shows that the workplace and working environment has an influence on mental health and wellbeing.3 A number of key areas of the organizational culture (such as demand, control, support, relationships, role and change as identified by the Health and Safety Executive) are associated with poor mental health.[2, 4]

Financial security
Financial insecurity is associated with poor mental health outcomes; debt in particular is a risk factor for mental health problems and people with mental health problems are more likely to experience debt. People experiencing financial strain can also take longer to recover from mental health problems.[2, 5] A recent Scottish survey found that higher mental wellbeing was associated with finding it easy to manage financially.[6]


  1. McLean H, Maxwell M, Platt S, Harris F & Jepson R (2008). Risk and Protective Factors for suicide and suicidal behaviour: A literature review. Scottish Government Social Research, Edinburgh.

  2. Parkinson J (2007). Establishing a core set of national, sustainable mental health indicators for adults in Scotland: Final report. NHS Health Scotland: Glasgow.

  3. Ferrie (2004). Work, stress and health: the Whitehall II study. Public and Commercial Services Union: London.

  4. Bond FW, Flaxman PE, & Loivette, S. (2006). The business case for the management standards for stress: Conclusions based upon meta-analyses. UK Health and Safety Executive (HSE).

  5. Jenkins R et al (2008). Debt income and mental disorder in the general population. Psychological Medicine, 38 (10): 1485-1493.

  6. Davidson S et al (2009). Well? What Do You Think? (2008): The Fourth National Scottish Survey of Public Attitudes to Mental Wellbeing and Mental Health Problems. Scottish Government Social Research: Edinburgh.