The Framework for Mental Health Services in Scotland--a progress report one year on

Progress in implementing the Framework for Mental Health Services in Scotland since its launch in September 1997 is described. Reasons for action being behind the expected timetable are discussed. The success of the joint strategies, due for completion by the end of December 1998, hinges on overcoming the deep systemic factors which mitigate against change. The Framework as a template has the potential to be a powerful change agent to counter these. The development of better services requires a balance of "top down" and "bottom up" approaches, and front line staff must be actively engaged in the process.