Meeting of the Parliament 11 December 2025
I, too, thank Daniel Johnson for bringing the debate to the Parliament. I also thank him for his bravery in being so vocal about some of the challenges that he has faced, which is not something that people appreciate enough.
My interest in this issue was triggered by the eminent Dr Premal Shah, who set up the Lothian adult ADHD and ASD clinics. He is a long-term family friend and quite the force in this area.
I agree that the report is excellent. I enjoyed reading it, and I congratulate the Royal College of Psychiatrists in Scotland on its work. I particularly liked the framing of this issue as a “wicked problem”—one that is complex, interconnected and resistant to quick fixes. We need to bear that in mind. It is not just a health issue; it is a systemic challenge that touches every part of society.
We know that neurodevelopmental conditions intersect with education, employment, justice and social care. We also know that people are being referred into mental health pathways that were never designed for them, which—we must not forget—is overwhelming clinicians as well as delaying care for those who have severe mental illness. The number of vacancies in psychiatry is rising, and burnouts are accelerating. The system is fundamentally under strain from every angle.
We have heard waiting list figures for assessments. Some regions are experiencing delays of more than five years, and I have also had a high number of inquiries from my constituents about their own issues.
I want to focus my brief remarks on the financial cost of those problems to our economy. The figures that have been quoted directly reflect a loss of productivity, and we know that there are productivity challenges in Scotland and across the United Kingdom. Higher unemployment rates increase reliance on benefits. Businesses are losing skilled workers who cannot access timely support. Schools struggle to keep pupils engaged, which leads to lower educational attainment and reduced future earnings. The justice system bears additional costs through higher rates of offending linked to untreated conditions. Every delay in diagnosis and intervention translates into lost economic output and increased public spending. That is a cycle that we cannot afford to ignore.
We know that the funding is fragmented and insufficient. Unless there are dedicated funding streams, we cannot establish the specialist pathways that are needed. However, as I have said, the problem is complex, and so are the mechanisms for funding. We need to acknowledge that. I agree with the pragmatic approach that is suggested in the report that there should be, in the interim, a separate funding stream that is dedicated to wider service development.
Much more thought needs to be given to the potential for digital solutions. Coming from an information technology background, I know that that is easy to say, but I absolutely acknowledge the complexity, and I appreciate how difficult it will be to provide those solutions. However, if we could start to unlock the data sources, that would result in some very powerful tools.
I will pick up on some of the points that have been made on data. We cannot solve what we cannot see. I absolutely agree that we need robust data collection, but we need that data to be disaggregated by sex. We know that ADHD and autism present differently in women and girls. We know that women are much better at masking and at using coping strategies to hide distress, but that delays diagnosis. Such girls are underidentified in childhood, and women can often reach a crisis point before receiving—