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Public Audit Committee

HOLYROOD COMMITTEE CALLS FOR BETTER MONITORING OF ANTIDEPRESSANT PRESCRIBING AND RESOURCE ALLOCATION IN MENTAL HEALTH SERVICES

19 May 2010

A Scottish Government target to halt the increasing rate of antidepressant prescribing is too simplistic and needs to be reviewed, according to a Scottish Parliament committee.

In its report – Overview of Mental Health Services – the Public Audit Committee called for a number of improvements to the monitoring and allocation of resources in mental-health services.

Committee members expressed concern that the level of antidepressant prescribing had quadrupled across Scotland in the last 15 years, and that reasons for this increase remained unclear.

There was also concern that prescribing levels across Scottish GP surgeries varied significantly, with evidence to the committee suggesting that the variations could be caused by factors such as the gender and age of the GP.

Committee Convener Hugh Henry MSP said: “The committee is concerned that the Scottish Government does not currently collect information on the number of people taking antidepressants and the data collected does not explain why the level of antidepressant prescribing continues to increase.

"The committee therefore questions whether the Scottish Government target to reduce the increase of antidepressant prescribing can be achieved.”

"The committee also had particular concerns with some of the reasons given for the variations in prescribing including that female GPs are more likely to prescribe antidepressants compared with older doctors.

"In light of evidence that most people are being prescribed appropriately, we urge the Scottish Government to review its target and urgently improve the quality of data available on antidepressant prescribing and the causes of depression.”

The committee report identified issues relating to funding and resource allocation and highlighted concerns that services were targeted at the severe and enduring mental illness, rather than on promoting wellbeing.

Committee members were not convinced by explanations given for variations in the level of funds transferred from NHS boards to local authorities to provide mental health services in the community, and recommended that the Scottish Government centrally monitored funding to ensure it was allocated appropriately.

In the light of evidence received that voluntary mental-health service providers are facing cuts in funding to make efficiency savings, Mr Henry said: “The committee recognises the value of mental-health services provided by voluntary organisations, and recommends that the Scottish Government ensures that local authorities monitor the impact of spending constraints on voluntary-sector organisations in terms of the quality of services provided and their ability to meet demand.”

In its findings the committee also:

• recommended that there should be closer monitoring of the levels of prescribing of drugs for children with Attention Deficit Hyperactivity Disorder
• recommended that the Scottish Government continues to monitor the accessibility of mental-health services
• requested that Audit Scotland consider reporting on the Scottish Government’s dementia strategy as part of its future work programme, in view of the ageing population
• recommended that the Scottish Government Health Directorate monitors and encourages more cross board working.

Background
The report from the Public Audit Committee followed the publication of a report from the Auditor General for Scotland – Overview of Mental Health Services (740KB pdf).