We have read the paper by El-Ghorr et al. (Int J Care Pathways 2010;14:57-64) on Scotland's national approach to improving mental health services with great interest. The paper described the strategy developed by NHS Quality Improvement Scotland (NHS QIS) in which integrated care pathways were used as tools for redesign and continuous quality improvement. In our opinion, a similar national effort is also necessary in Norway. In particular, pathways would help bridge the ‘gap’ between primary and specialist services. We point to which elements of the Scottish programme it is that would be relevant to implement in Norway in future. Furthermore, we discuss factors that are already present in Norway upon which authorities, health leaders and professionals could build on in a future national-level implementation of pathways in mental health care.