Residential rehab in Scotland has changed a great deal since the postcode lottery days, according to a major evaluation published by Public Health Scotland on 15 September 2026. The synthesis report covers five years of the Scottish Government’s Residential Rehabilitation programme. Its headline result is one the sector has waited a long time to see. The government has met its target for publicly funded placements.

Dr David McCartney welcomed the findings in a blog headed “Mission Accomplished? Rehab in Scotland, Five Years On”, posted on 20 September 2026. Twenty years ago he helped set up an NHS based rehab service in Edinburgh, so he remembers how things looked. Reliable access, he writes, depended on living in the right area, having money or being plain lucky.

The Numbers Behind Residential Rehab in Scotland

The programme committed £100 million over five years to March 2026. Its two goals were to raise bed numbers by 50% to 650 and to lift yearly publicly funded places to 1,000.

In 2025/26, 1,125 Scottish residents started a publicly funded placement once evaluators adjusted for repeat admissions. That is a comfortable margin over target. Counting residents from outside Scotland, the figure reaches 1,196. Access to publicly funded rehab has more than doubled since 2019/20. Overall, the number of Scottish residents entering residential rehab in Scotland, publicly or privately funded, has grown by around 60%.

The evaluators also point to a shift in who pays. Fewer people now rely on private funding, and more receive public support. McCartney describes a treatment once reserved for the rich, the insured or the lucky. Now, he says, it is open to anyone for whom it is clinically appropriate.

More Beds, Aimed at the Gaps

Capacity for residential rehab in Scotland rose by 35%, from 425 to 574 beds. That leaves the country short of the 650 bed goal. Even so, the evaluation found that the growth focused on areas of unmet need, particularly women with children and rural areas.

McCartney names several services that did not exist when the programme began. Aberlour’s Discovery Grove in Dundee and the Burrow in Falkirk are two. He also cites Rae House in the North East and Nevis House, which extends reach across the Highlands and Islands. As a result, he notes, mothers can now be treated alongside their children.

Referrers Are Changing Their Minds

Attitudes among the staff who refer people to residential rehab in Scotland have shifted too. In a 2025 survey, 66% of referrers said they would consider sending someone who had been through rehab before, up from 45% in 2023. McCartney welcomes that change. Recovery is rarely a straight line, he argues, and a second or third chance should be routine.

Concern about safety has also eased. The share of referrers who agreed that rehab can increase overdose risk fell from 49% to 36%. Its authors caution that this figure reflects perceived risk rather than surveillance data. Meanwhile, 75% of respondents felt more confident explaining what rehab involves than they did two years earlier.

What the Outcomes Show for Residential Rehab in Scotland

For the first time, Scotland has a national individual level dataset on who goes to rehab and how they fare. McCartney calls it, to his knowledge, unique in Europe. The evaluation could draw on one full calendar year of it, 2023.

In 2023, 55% of the 827 people in the dataset finished with a positive status. That meant substance free, occasionally using or stabilised on opioid substitution therapy. The rate reached 70% for alcohol placements, against 35% for drug placements. However, 40% left with an incomplete status, and most of them disengaged. Longer stays of 61 days or more, and secure housing before admission, both pointed to better results.

Other measures were encouraging. Some 90% of people with Drug and Alcohol Outcomes Star data recorded positive change in at least one of ten areas. The report notes that the availability of this data is slightly skewed. Among 146 people whose records could be linked, one drug related death followed placement in the first six months. Even so, the evaluators warn that the risk after rehab for opiate use may be higher.

Where Progress Still Stalls

Access has improved, but it is not yet easy. Only 30% of the 151 referrers surveyed in 2025 agreed that residential rehab in Scotland is easily accessible. Nearly half (46%) said lack of funding had become a bigger barrier than two years earlier. Meanwhile, 53% of Alcohol and Drug Partnerships still reported funding constraints. The evaluation concludes that demand for publicly funded places exceeds the money available.

Support after rehab is the next weak point. The report lists insecure housing, limited capacity and low awareness of aftercare among the problems. However, 54% of referrers did see more joined up working between providers. McCartney puts it bluntly. Sending people from structured, supportive care back into the challenges that fed their problems, he says, is not recovery.

Not everyone backed the investment. Some stakeholders questioned the £100 million, which was 40% of the £250 million National Mission budget. They doubted that the evidence base justified it. The evaluators stress they assessed the programme itself, not how rehab compares with other treatments.

What Comes Next for Scotland’s Residential Rehabilitation Programme

The report makes four recommendations. First, deliver the commitments in the Drugs and Alcohol Strategic Plan. Second, build a long term monitoring strategy. Third, embed recovery orientated support across the whole pathway. Finally, fund more research on how well residential rehab works across a range of outcomes.

McCartney believes the new national plan, which he says runs from 2026 to 2035, addresses many of these gaps. He also draws on his own service. Almost half its patients were abstinent at four years, he reports. Among those who completed treatment, more than 60% were. His message is to keep the data, keep the funding and keep the bar high for residential rehab in Scotland.

Source: dbrecoveryresources