Read standard 9: Mental health and wellbeing

Gender identity healthcare: Adults and young people
Healthcare Improvement Scotland

Standard statement

People have timely, equitable, consistent and person-centred access to mental health and wellbeing support.

Rationale

People should be able to access mental health and wellbeing support as part of ongoing assessment and care, when required. People accessing gender identity healthcare experience a range of challenges that can affect their psychological health and wellbeing.46-49 People accessing gender identity healthcare may also report co-occurring mental health conditions including anxiety and depression.5 Over-medicalisation has been reported as contributing to apprehension and low levels of confidence when accessing general healthcare and gender identity healthcare services.5, 44

A holistic and person-centred approach should be taken regarding any referral for mental health and wellbeing support. Services should be trauma informed and promote wellbeing and psychological safety in line with national standards, training frameworks and policy.15, 35, 48, 50-52

Services that promote wellbeing and psychological safety can reduce health inequalities and improve outcomes.47 Understanding and acknowledging the experiences of people who have experienced trauma can help services improve for everyone.19, 35

For general mental health and wellbeing support, people should be supported at a local level to access appropriate services, including counselling, Children and Adolescent Mental Health Services (CAMHS) or other psychological interventions, within national timeframes.29, 46 A range of services should be provided, including wraparound and peer support to ensure people receive the care and support that is right for them. Services should work in partnership across providers and settings.

Young people, including care-experienced people, may require additional support that is responsive to their needs.46, 50, 52 Support for families and representatives should also be provided, where appropriate.

Who is responsible for meeting this standard?

All organisations and staff in line with their roles, responsibilities and workplace setting.

Criteria

9.1

NHS boards have referral pathways to mental health and emotional wellbeing support services that are person-centred and trauma informed, including third sector and peer support services.

9.2

People, and where appropriate their families/representatives, have access to an initial appointment for their mental health assessment within national referral times.29

9.3

People are informed about options for continuous or ongoing support for their mental health and emotional wellbeing, including unscheduled mental health support.

9.4

Enhanced and tailored support is provided for people with assessed social communication needs, neurodevelopmental conditions, learning disabilities or additional support needs.

9.5

People have access to mental health and wellbeing support from appropriately qualified staff including:

  • counselling
  • clinical psychology
  • community mental health services including CAMHS
  • age and stage appropriate therapeutic support
  • peer support
  • third sector support.
9.6

Families/representatives are offered:

  • access to mental health support from a person with the appropriate skills and knowledge of gender identity healthcare
  • signposting to relevant support organisations
  • support at key stages of a person’s life or care.

What does this standard mean for...

What does the standard mean for people?

  • If you need support for your mental health or emotional wellbeing, you will be supported to access it.
  • Staff understand your experience and the impact it may have had on you.

What does the standard mean for staff?

Staff, in line with roles, responsibilities and workplace setting:

  • undertake assessments for mental health and emotional wellbeing and know who to refer to if someone needs support
  • understand, recognise and respond appropriately to individual needs
  • provided person-centred, trauma informed care which respects the person and is non-judgemental.

What does the standard mean for the organisation?

Organisations:

  • develop referral pathways and arrangements with a broad range of mental health and emotional wellbeing services
  • ensure staff have time to support and care for people and their families/representatives
  • provide mental health and wellbeing support within community and primary care settings where appropriate
  • support timely referral to specialist mental health and psychological services where required
  • ensure mental health support and interventions are evidence based, holistic and person-centred.

Examples of what meeting this standard might look like

  • Evidence of referral pathways for mental health services including CAMHS.
  • Signposting to support group or peer support for the person and their families/representatives, where appropriate.
  • Evidence of timely referrals to services.