Meeting of the Parliament 06 January 2015
I was nearly ready, Presiding Officer.
I welcome my first opportunity as the minister with responsibility for mental health to debate improving Scotland’s mental health. I know that members will join me in welcoming the opportunity to cover that important matter, particularly at this time of year, when minds turn to doing better and to renewing resolutions. One of my resolutions is to do all that I can to ensure that we see improved mental health in our country.
As the first minister of any Scottish Government to have mental health explicitly referred to in their ministerial title, I hope that that gives some indication of the importance that the Administration places on improving Scotland’s mental health. We shall rightly be judged on our efforts, and I hope to set out some of those in the next 10 minutes or so.
The Government is taking forward the Mental Health (Scotland) Bill to seek to refine and improve the system that we have in place to ensure that people with a mental health disorder can access effective treatment quickly and easily. I hope that that in itself gives some indication of the importance that we place on mental health. That bill will rightly be subject to debate on its own merits at another time, but I thank the Health and Sport Committee for its efforts in scrutinising it thus far, and I look forward to reading its stage 1 report in due course.
In this opening speech, I will aim to cover some key issues relating to illness, recovery and stigma. I will speak about what we have done and how we are doing; set out the progress that we are making across Scotland; and speak about what we will do next to focus on the challenges that are before us. Members may be familiar with those challenges from discussions with constituents.
Mental health is, of course, a subject that touches us all, whether we have a mental health problem, we are a carer for someone who has a mental health problem, or we have family, friends or colleagues who have had a mental health problem. Mental illness is one of the top public health challenges not just in Scotland, but across Europe as a whole, where it is estimated that mental health disorders affect more than a third of the population every year.
Despite mental illness being such a common human experience, people too often do not admit to their closeness to a mental illness. A person might be unwilling to mention a spell of illness, the time that they needed antidepressants or the time that they required therapy. They might be reluctant to mention that they take medication daily to control symptoms. We might shy away from asking a friend who has been down if they are okay and whether they want to talk. That reluctance, reticence or unwillingness can come about because we expect a bad response. That is an issue and one of the challenges that I spoke of earlier.
That is why we must continue to break down the stigma of mental ill health. Debates such as this one are key to doing just that. It is vital that the Parliament—our country’s national legislature—regularly and openly debates topics that are related to mental health.
Our partners in the third sector also have a huge role to play in tackling stigma. I am pleased that the work of organisations such as Alzheimer Scotland, Penumbra and the Scottish Association for Mental Health is being recognised. The Government recognises the importance of the third sector, and in 2013-14 we provided more than £1 million to numerous national mental health organisations.
I welcome the joint Scottish Government and Comic Relief funding for the see me campaign. As members will know, see me is Scotland’s national campaign to end mental health stigma and discrimination, and it is hosted by the Scottish Association for Mental Health. The Scottish social attitudes survey shows that the work of see me is still needed, with a greater emphasis on changing outcomes. People still experience negative attitudes if they have a mental health problem, and people self-stigmatise—they avoid events and do not want to talk about their illness.
The refounded see me programme has a framework of action to take forward over the next three years, with activity areas based around, for example, equality and human rights, the workplace, settings where people experience discrimination, lived experience participation and national campaigning.
There are other ways in which we can start to end mental health discrimination. There has been a debate on parity of mental health and physical health—I see that Mr Hume’s amendment refers to that. I welcome that debate. I want to see the same focus and approach to improving mental health services that we have to improving physical health services.
The National Health Service (Scotland) Act 1978 states that the Scottish ministers have a duty to secure improvements in the physical and mental health of the people of Scotland. It does not distinguish between the two, nor does it place a higher importance on one than on the other. Our Scottish NHS has a duty to promote the improvement of health, and that duty extends equally to physical and mental health.
For too long, mental health lacked targets. People waited for lengthy periods to receive well-recognised, evidence-based treatment. The Government is working to change that. Scotland was the first nation in the UK to introduce a target to ensure faster access to psychological therapies for people of all ages. The target for boards is that patients will get a referral to treatment for psychological therapies within 18 weeks. That is a challenging target, but we should recognise the work that boards have been doing to try to meet it.
The latest data shows that the average adjusted waiting time for psychological therapies is eight weeks and that 81 per cent of people were seen within 18 weeks. Some boards are doing better than that, but we know that others are not. That point is made in Richard Simpson’s amendment, which also mentions our shared concern about stigma. I say at this stage that we will support the Labour amendment this evening.
We have been offering boards support to tackle waiting lists. I want to see the good work being sustained, but let me be clear that I want to see all the boards meeting the target, and that is why the Government has embedded it in NHS Scotland’s local delivery plan guidance for 2015-16.
I want to say a little about recovery. People with mental health problems have been at the forefront of rethinking what is meant by recovery. As the Scottish recovery network emphasises, people can and do recover from even the most serious and long-term mental health problems. The network also stresses that recovery is a personal journey and that it is about living a meaningful and satisfying life with or without symptoms. A meaningful and satisfying life is as important for people with a mental health problem as it is for people with a physical health problem.
One of our challenges now is to address the higher mortality rate of people with a mental health disorder compared with the general population. We have produced guidance on how NHS boards can ensure that there is good work between primary and secondary care to provide good-quality physical health services to people with severe and enduring mental illness. Physical health improvement is built into the Scottish recovery indicator to ensure that practice in mental health services relates to the factors that can help recovery.
The mental health of our children and young people has been a focus of our efforts to improve Scotland’s mental health. We have increased the specialist child and adolescent mental health services workforce by almost 50 per cent since 2008, and we have introduced a waiting time target for accessing child and adolescent mental health services to help to drive improvements. In the two years between September 2012 and September 2014, the number of children and young people who were seen by CAMHS increased by more than 60 per cent. That phenomenal increase reflects more children and young people being referred to services.
It is little wonder, then, that the target has been challenging. We have been transparent in publishing the data. I say again that it is clear that some boards are doing better than others, and again I make the point that I want all the boards to meet the target. This target, too, is embedded in NHS Scotland’s local delivery plan guidance for 2015-16.
Ensuring access to mental health services for children and young people is an absolute priority for this Government. That is why we have not only increased the number of people who are employed in the area—