Meeting of the Parliament 13 June 2018
I am pleased that one of the amendments that have been selected for debate today—the Labour amendment—acknowledges that the prevalence of mental health problems is linked strongly to disadvantage and inequality. I agree that there is now a mental health crisis in Scotland, and that if we want to tackle it in the long term, we must make sure that people have the social and financial security that they need.
Yesterday, the Health and Sport Committee heard from the Mental Health Foundation Scotland that
“the austerity agenda and welfare reform have had a huge impact on people’s mental health, particularly around employment”
and that we need to look at
“in-work poverty and job security”.—[Official Report, Health and Sport Committee, 12 June 2018; c 14.]
That is why my amendment, which was not selected for debate, called on the Scottish Government to improve support for mental health in primary care. We know that the erosion of social security support has placed increasing pressures on people’s health, and on general practices.
Access to primary care in Scotland remains inequitable and, as I have stressed many times during debates on health, general practitioners in the most deprived areas typically have longer patient lists and see many more patients with mental health problems. Supporting GPs in areas of high deprivation is absolutely fundamental to supporting mental health and tackling health inequalities.
The Government has committed to putting 800 additional mental health workers in place, but progress is slow and we still lack clarity on how many staff will be based in primary care settings and what degree of specialty they will have. We know that there are real issues with access to talking therapies. I agree that there should be access to specialist support in every GP practice, hub or cluster and that as well as prioritising early intervention, we need urgent improvement to support people who experience mental health crises. At the moment, that support—especially out of hours—is just not good enough. We heard from Samaritans in Scotland yesterday that many people would not know where to turn if someone close to them was in crisis.
The Scottish Association for Mental Health has pointed out that there is now a crisis care concordat in England, which aims to ensure that there is 24/7 provision of crisis support. We need to know that the specialist mental health staff are liaising effectively with accident and emergency departments and the emergency services. There is good practice in many areas, but there are real concerns. As James Jopling from Samaritans in Scotland said yesterday,
“There is no line of sight from the minister to what is happening locally.”—[Official Report, Health and Sport Committee, 12 June 2018; c 25.]
and in its written submission, Samaritans said,
“There is no longer an effective structure of suicide prevention leadership or delivery in Scotland.”
I have repeatedly raised the lack of leadership on self-harm, too, and the mental health strategy did not set out any action on reducing it. The Government said that it would be part of the suicide prevention action plan, but it was not a priority in that consultation either. We cannot allow people who have self-harmed or who are at risk of self-harming to fall through the gaps in the strategies.
The Scottish Young Greens are campaigning for every pupil to be given high-quality mental health education, and my colleague Ross Greer has made review of personal and social education in schools a priority. It is fundamentally important that young people also have good access to counselling; the Labour and Conservative amendments both reflect that. The Government, however, has cut the bursary for people who wish to study educational psychology. I ask that it review and reverse that decision.
We cannot look away from the fact that children and young people from the most disadvantaged areas are three times more likely to develop mental health problems than are their peers from more affluent areas. A truly preventative approach to mental health has to tackle that inequality at its root.
I welcome the fact that we are debating such an important issue this afternoon, and I will be pleased to support the Liberal Democrat motion and the Conservative amendment. I will also support the Labour amendment—although I point out that I am concerned about ring fencing.
Janice Hewitt from North Lanarkshire health and social care partnership told the committee:
“one thing that we ask is that partnerships are trusted to invest where they think that the greatest need is”.—[Official Report, Health and Sport Committee, 22 May 2018; c 8.]
She went on to say—