Delivering on the Framework and Commitments

Following publication of the Framework and Commitments in February 2025, the PDG took the opportunity to refresh and refocus. Five workstreams were created to align to the commitments and provide robust oversight of delivery. Scottish Government Police Division and the Authority co-chair the PDG, with NHS 24, Scottish Ambulance Service, SAMH and Voluntary Health Scotland leading workstreams. 

Since the commitments were published in February 2025, commendable progress has been made across all five workstreams. Detail on progress within each workstream is summarised below.

Communications

The first task of the communications workstream was to support the initial publication, launch and cascade of the Framework and Commitments. Members of PDG have ensured that the documents have been cascaded through their own workforce and networks to raise awareness and to build connections into relevant wider interdependent policy areas such as public protection. 

Following publication of the Framework and Commitments, Police Scotland undertook a series of internal communication actions to enhance awareness of the products and promote their value to local policing in responding to mental health distress. This included an internal news article, specific briefings from line managers, and a briefing to all divisional commanders aligned to ongoing internal communications on the work of the Police Scotland Mental Health Taskforce. 

Since publication, the PDG have taken all opportunities to present to stakeholders and partners on the importance of the Framework and Commitments to build multi-agency buy in and extend opportunities for cross sector collaboration. These sessions have also given a platform to explore opportunities for wider agencies, partners and services to collaboratively support delivery of our shared ambitions. 

A multi-agency communications toolkit is being developed to support ongoing information cascade with a focus on consistency of communication around the commitments made. This will support further embedding of the Framework across a growing range of Local Authority and NHS services. 

Improved Transfer of Mental Health Care

Building on the practice examples identified during NHS board workshops, Police Scotland have developed a test of change process with NHS Lothian to analyse and support the efficacy of handover processes in urgent and emergency clinical settings. The test focuses on a shared risk assessment and decision-making process based on multi-agency assessment. Learning and evidence from this test of change will then inform the promotion of consistent use of this good practice example across all local policing divisions. In addition to this, NHS 24, Scottish Ambulance Service and Police Scotland are exploring improvements to their shared pathways.

The mental health index (or community triage guide), developed to support direct local referrals to appropriate local and community-based support services, is being reviewed to confirm if an additional direct referral pathway into NHS 24 would enable direct interaction between ambulance crews, response officers and NHS 24 Mental Health Hub. The index is subject to continuous improvement through the Mental Health Unscheduled Care Network to ensure any evolution aligns to service delivery developments.

From a policing perspective local officers are reporting the positive impact that the index is having on their ability to respond to individuals in distress or crisis and ensure they access the right support at the earliest opportunity. An officer in N division highlights the value of the index in providing timely access to appropriate support, saving time and giving consistent local information and guidance.

Similarly, an officer in G division reports the value of having the index on their digital device as it allows 24/7 information on all local support available for the person in crisis. They stated “having the index to hand provides me with quick and effective communication and provides those in emotional distress with the necessary help in a private and supported environment”.

A review of Psychiatric Emergency Plans has been undertaken which has identified opportunities for increased consistency across areas through standardised templates for local plans. Work is now underway to draft guidance and a standardised template for the plans, which has been informed by recent learning and user experience. NHS boards have been involved and have committed to testing of the approach as it develops. 

An emergency services partners high intensity usage group has been established to enable data sharing, focused on identifying individuals frequently seeking support from multiple services. This will aim to ensure that these individuals are better served by improved coordination and connection to the local services that can collectively best deliver the support they need.  

Building Capacity and Capability

Police Scotland have put in place a Distress Brief Intervention (DBI) lead for every Health and Social Care Partnership (HSCP) across Scotland. This has supported an increase in training uptake across the mental health unscheduled care landscape. 

Police Scotland now have DBI pathways live in 22 of the 31 HSCP areas of Scotland, with Scottish Ambulance Service live in 15. 

Data at paragraph 4.5 below shows that Police Scotland have contributed 1,700 referrals through DBI to local services between July 2024 and June 2025, which accounts for some 9% of local referrals in comparison to 16% from NHS Mental Health Unscheduled Care and 4% from Acute Hospital Emergency Departments (A&E). 

The DBI training provided to officers ensures that they have the insight and skills to identify individuals in crisis who would benefit from a timely intervention. For example, an officer trained in DBI was able to identify that the individual they were engaging with on a different matter was in distress and offer access to appropriate support. 

Testimony from the DBI trained officer describes that during the discussion the individual confirmed they were suffering from low mood and suicidal thoughts and needed someone to talk to. The individual had a referral made by the officer and reported that they felt better after their conversation with the officer. 

Work continues on the Enhanced Mental Health Pathway with a collaborative strategic steering group in place and ongoing development of transfer capabilities between Police Scotland, Scottish Ambulance Service, and NHS 24. 

Since 2018/19 over £18.5m has been invested in the pathway, with a further £1m allocated to NHS 24 to support resilience to meet increasing demand for the service. Funding has also been provided in this financial year to improve access to adult mental health treatment, expanding the NHS 24 Mental Health Hub by December 2025 to provide access to digitally enabled psychological interventions and therapies for people who may benefit from early treatment. 

Police Scotland service advisors are trained to assess the suitability of an individual for support through the mental health pathway during their assessment of each initial call for service. For example, during a call about a neighbour dispute a caller disclosed suicidal and self-harm thoughts. The service advisor used their training to discuss a safety plan with the caller while making a referral through the pathway for support from NHS 24 for the individual. This individual received tailored support from a trained practitioner from the most appropriate service, giving a positive outcome and better care with no police attendance required.

Police Scotland have put in place a series of themed learning sessions to be delivered from August to December 2025. These sessions aim to improve mental health awareness internally and ensure consistency across all local divisions. These learning bytes are short videos available on the Police Scotland intranet, explaining the basics of mental ill health and distress and the roles of key partners in responding to this. 

Additionally, Scottish Ambulance Service and Police Scotland are working to develop joint training initiatives and inputs to raise intra-organisational awareness. This will see Police Scotland provide input on their approach to mental health distress for newly qualified paramedics.

Strengthening Community-Based Provisions

Following publication of the Safe Spaces report work is underway across partners on next steps. Funding has been secured to pursue a Safe Spaces social and economic case, and a tender is in development. This work will help identify the core elements of community-based provision necessary in a safe space model, and provide a template for a national roll out. 

Third sector providers have presented to wider partners through the mental health reference group on their crisis response services, including Penumbra 365, the Neuk, Hope Point and the Beacon, in addition to services focused on preventing crisis such as ‘the Nook’ by SAMH. Inputs have also been provided by NHS Ayrshire and Arran on their local response and treatment model.

Hope Point, a community-based facility in Dundee, reported that in quarter one of 2025/26 they took 13 direct referrals from Police Scotland which resulted in direct one to one support being offered to people in distress or crisis. 

Penumbra365, operating in Aberdeen, offers similar direct referral access to Police Scotland. In quarter one of this year 52 referrals were made by the local police team into the service for support services such as distress brief intervention or safeguarding support as well as mental health support.

SAMH intend to open a series of community-based walk in, mental health hubs over the coming year, known as ‘nooks’, with the first due to launch in Glasgow city centre in the Autumn. To complement this hub model community outreach posts will be established based on user need. This community-based hub model builds on the positive outcomes being delivered through existing community facilities such as the Neuk, Hope Point and others. 

NHS Ayrshire and Arran have also presented on their Mental Health Unscheduled Care Assessment Hub, situated within Woodland View Hospital, which became fully operational in September 2024. It provides a unique service offering assessment and support for up to 72-hours to determine whether people can be best supported within their community environment or if acute admission is required. It is a nurse-led unit for the assessment of people thought to be presenting with mental illness and associated acute risk. This initiative supports the Emergency Services Mental Health Pathway for unscheduled care partners including Police Scotland. 

During 2024, there were 1,239 direct referrals from Police Scotland into this pathway. Through this rapid community response service, the majority of referrals were managed within the person’s home or other community setting, utilising remote and home visit contacts, whilst 110 required to be conveyed for face-face assessment in the safe clinical environment of the Hub.

Data, Evidence, Benchmarking and Improvement 

Work is progressing on the creation of an outcome focused performance framework to underpin the collaborative commitments and evidence the progress being made. The framework will provide an initial baseline for the work being progressed and will evolve over time, working to align data from the range of organisations involved in delivering the whole system response to mental health distress. 

The performance framework will include key metrics from across NHS, Policing, public protection and third sector provision such as call demand, average time spent on mental health related and concern for person incidents, DBI usage, mental health pathway referrals, workforce insights and crucially user experience.

The Mental Health Unscheduled Care Network and Public Health Scotland are working jointly on the collation and reporting of consistent data to underpin improvements to the system. Professor Susan McVie is leading a project focused on linking individual level data across policing and health services. 

Dr Martha Canfield was commissioned to lead a responsive research project on what ‘good’ looks like in the context of transfer of care. The first draft report from this project has been considered by the project advisory group and will be published following review. This research provides insights into models of transfer of care in other systems and jurisdictions to assist in identifying good practice models.