SRA recently responded to a consultation on improving NHS 24 services in rural communities. The SRA response is part of a larger consultation being facilitated by the Rural Mental Health Forum. The forum consists of nearly 40 organisations from across Scotland that make up the membership. The consultation is a valuable opportunity for SRA to feed back on our 2017 conference workshop on ‘Wellbeing and Inclusiveness’.
How could NHS 24 better support the mental health and well-being of people living and / or working in rural communities across Scotland?
At the SRA Conference In September 2017, one of the key points from the Inclusiveness and Wellbeing Workshop was that NHS 24 provided no mental health support. One delegate corrected this point as inaccurate so the point was changed to ‘lack of awareness of NHS 24 mental health services’. This key point highlights that NHS 24 must do more in rural communities to inform of the valuable services that can be provided. Suggestions of how this could be done include promotion to local rural networks such as Community Councils, Development Trusts, Community Centres and also nationally based organisations that have a rural focus such as those who are members of the Rural Mental Health Forum. As well as targeting community-led organisations, large scale employers could be engaged with to highlight the value of NHS 24 services to staff/members/customers (Forestry Commission Scotland, Marine Harvest etc)
Another key point raised (and similar to above) that people simply did not know where to go to get help. The services that NHS 24 can offer can and do meet the needs of many people that access them, the challenge is how to ensure those services are communicated well to rural communities and the suggestions above could contribute to that. A point raised by an SRA member who resides in Applecross queried how NHS 24 could offer a better service than the GP/Nurse on call service in a remote community. The service works well in Applecross, however, it is dependent on professionals understanding of mental ill-health and this may vary between different areas/provision of service.
Consideration should be given to the issues of poor connectivity, poor mobile signal and an the potential ‘technology fear’ that many people may experience – due to location or age, or both. One SRA member highlighted that anyone with hearing issues and residing in an area with no mobile reception would be at a disadvantage for accessing NHS 24.
2. What else could NHS 24 consider as part of ongoing developments?
Improved access to counselling and reduced waiting times are key themes in improving mental health across Scotland generally. This is even more so in rural areas where public transport is poor (or non existent) and isolation can be felt even more so. A point raised in the workshop was the lack of crisis care close to home, or people not knowing how to handle such a situation. NHS 24 could highlight their step-by-step mental health services in this area in rural areas as an option for people feeling very low.
Improved linkages with third sector services e.g. Locally led peer support groups, drop in centres, self help courses (where available) would improve overall mental health service delivery – this would involve very up to date data and possible mapping of current and regionalised services but could offer a more varied choice for someone seeking support. Many local organisations may offer counselling services for free or at a reduced rate (e.g. Lochaber Hope in Fort William).
Continuing the challenge of stigma should be a priority for NHS 24 as often living rurally can bring it’s own challenges (e.g. small GP practices, no privacy)
Continued work with the Rural Mental Health Forum and regular reviews with this group will be informative and can improve overall inclusion of rural communities within NHS 24 developments. In addition, many areas have a regional mental health partners group (e.g. Lochaber Mental Health Inclusion Group). Regular consultation with such groups can bring invaluable insight in to the challenges that rural areas face in raising awareness of mental health and wellbeing and how individuals can access help/support.
Awareness raising in schools of mental health and wellbeing in general was a key point from the SRA conference – this principal could be applied to increasing knowledge in an educational environment of what NHS 24 can offer – particularly rural schools where main stream media channels may not be so obvious or mental health topic openly discussed.