Meeting of the Parliament 25 September 2018
Our 10-year mental health strategy, from 2017 to 2027, paints a clear picture of the kind of Scotland in which I want to live: a Scotland where people can get the right help at the right time, expect recovery and fully enjoy their rights, free from discrimination and stigma.
The strategy’s guiding ambition is that we must prevent and treat mental health problems with the same commitment, passion and drive as we do physical health problems. I was honoured in June to be appointed as Minister for Mental Health to build on the work of my predecessor, Maureen Watt. Although I have been in post for only a short time, I know from my experience as a mental health nurse the commitment and dedication of the people who make a difference in mental health care every day across Scotland.
Today sees the publication of “Mental Health Strategy: 2017-2027—1st Progress Report”. In the strategy’s first period, many of its actions have already been implemented: of 40 actions in the strategy, 13 are complete or nearly complete, and 26 are in progress. Only one action remains, which is to carry out a progress review of the strategy in 2022, which for obvious reasons is yet to get under way.
I will single out for attention three actions in the strategy. Under action 16 of the strategy, we invested £175,000 to establish a perinatal mental health managed clinical network. Its expertise and diligent work has directly informed a commitment in our 2018 programme for Government to deliver a stronger network of care and support for the one in five new mothers who experiences mental health problems during and after pregnancy. That equates to 11,000 women per year. We will invest £50 million in perinatal and infant mental health over the next five years.
More than 1,000 people in Aberdeen, Lanarkshire, the Borders and the Highlands have already received distress brief interventions. The intervention programme is funded by £3.4 million from the Scottish Government in order to provide the offer of next-day contact with a trained worker from a third sector background to anyone who presents in distress to accident and emergency departments, police and ambulance services and primary care. We announced in the programme for Government that the initiative will, in 2019, be rolled out to under-18s.
Last month, on 29 August, I had the pleasure of launching our new “Transition Care Planning—Action 21—Principles of Transition”, which will help young people to move more smoothly from child and adolescent mental health services to adult mental health services. The transition care plans have been designed entirely by young people in dialogue with clinicians, and are a shining example of what can happen when we listen to the views of our young people and act accordingly.
Those are just three of the headline achievements that are summarised in the report. They are examples of specific actions in the strategy that are already making real and tangible differences to people’s lives.
It is important to say that the 40 actions in the strategy will not in themselves completely deliver our central vision. They will act as valuable and necessary levers to create the changes that we want to see, but getting to our ultimate vision and achieving our ambitions will require work beyond that set of commitments. I want, therefore, to mention five pieces of work that are all fundamentally important.
Firstly, there is the children and young people’s mental health task force, which is chaired by Dame Denise Coia and supported by £5 million of additional funding. Dame Denise Coia has dedicated her summer to talking with children and young people and their families, services, agencies and practitioners. Earlier this month, she published her initial “Children and Young People’s Mental Health Task Force—Preliminary View and Recommendations from the Chair” on our whole-systems approach to mental health services, and her work will help to implement the recommendations in “Rejected Referrals to Child and Adolescent Mental Health Services (CAMHS): A Qualitative and Quantitative Audit” that was published earlier this year.
Dame Denise Coia has already started work on a blueprint for how services can better meet the rapidly changing need that we see across Scotland. The task force will convene its first meeting next month.
Secondly, there is the youth commission on mental health. Young people are spending 15 months on an in-depth investigation of child and adolescent mental health services. They will do their own research, identify issues that are important to them and speak to experts, policy makers and service providers about the solutions. The youth commissioners have been invited by Dame Denise Coia to be co-chairs of the task force. That is an inspired move that will keep the voices of children and young people at the centre of that work.
Thirdly, there is “Scotland’s Suicide Prevention Action Plan: Every Life Matters”, which we published on 9 August. It sets an ambitious target of reducing suicides by 20 per cent over five years. It contains 10 actions, and is backed by an additional £3 million. We have already established the national suicide prevention leadership group, which is chaired by Rose Fitzpatrick. That group will meet for the first time, tomorrow.
Fourthly, there is the see me national campaign, which was launched on 18 September. It is the biggest conversation that we have ever had with young people in Scotland about what mental wellbeing means to them. It harnesses the power of music to help people across the country to talk about how they feel. I am sure that the results will be especially valuable to Dame Denise Coia’s task force.
Lastly, our 2018 programme for government has mental health at its very heart. It contains a package of measures to support positive mental health and prevent mental ill health. Those new actions will build on the mental health strategy and will be backed by a quarter of a billion pounds of additional investment, which has a clear focus on child and adolescent mental health services, including school counselling.
All that is reflected in the report, which demonstrates progress on the strategy’s 40 actions and towards achieving our central vision. The framework that is set by the strategy has, with the other work that I have mentioned, helped to create the current sense of purpose and momentum on mental health that we see across Scotland.
Across society, we see a constantly evolving understanding of good mental health, mental distress, mental ill health and mental wellbeing. In the past, many people were unwilling or unable to discuss their mental ill health and to seek appropriate support and treatment. I am thankful that that is changing, but I want to go further in working to overcome the stigma that can be associated with poor mental health.
We need to ensure that the public’s understanding and expectation of mental health services are accurate and appropriate. The services that are delivered must also better reflect need. We know that there is a gap between how services are currently configured and some of the overall needs of the population. There is often too great a focus on crisis and specialist services. For adults and children, new models of support are needed that are less specialised, are available for more people, and are delivered across different settings and services.
We know that changing the location and nature of services and support requires development of the skills and capacity of the workforce who will deliver those services. That means giving staff across the health sector and other sectors the skills and confidence to ensure that they are sensitive and responsive to emerging need and ways of delivering services.
We also need to put in place preventative approaches, and to deliver early interventions where we can. That means ensuring that access to mental health professionals is straightforward and easy to navigate for the individual so that the right help is available at the right time.
On a related matter, we know that the workforce must grow. Through action 15 of the strategy, we are committing significant investment to delivering an additional 800 mental health professionals by 2021-22. We are doing that in partnership with integration authorities, health boards, local authorities and other key sectors, recognising the different services and settings in which people can present when they are in distress.
Finally, the role of data and information is another area in which there is significant scope for improvement. We need to move away from the current focus on waiting times and workforce statistics and instead to use evidence to identify areas for improvement—to identify what works and what has not worked. Measuring patient outcomes and experience will also be important. Action 38 of the strategy—the launch of a quality indicator profile and a mental health data framework—will be key to that.
As I said at the start of my statement, we have come a long way since March 2017, when the strategy was published. The report that has been laid before Parliament today summarises that progress, and does so by looking at what is happening across the whole system.
All of what the report describes is contributing to what will be a fundamental change. Ensuring parity of esteem between physical health and mental health, and meeting our vision for the strategy, will require us to work together to reduce stigma around mental health, to develop innovative and new ways of working and, in doing so, to ensure that Scotland’s mental health services are among the best in the world.
I commend the report to members and will be happy to take questions from them.