Chamber
Plenary, 06 Jan 2010
06 Jan 2010 · S3 · Plenary
Item of business
Child and Adolescent Mental Health and Wellbeing
The American declaration of independence declares that people have
"certain unalienable Rights"
and
"that among these are Life, Liberty and the pursuit of Happiness."
Happiness is not attainable by those with poor mental health. We need to tackle that issue to enable children to grow up leading fulfilled and happy lives. We need to ensure that all our citizens have a right to good mental health, to help them with their pursuit of happiness. We need to start at a young age, to help young people to develop resilience and emotional wellbeing; Action for Children highlighted that issue in its submission to the Health and Sport Committee's inquiry.
The report's discussion of the consequences of poor mental health makes stark reading. Having inadequate services in place for children and young people who have mental health problems is inexcusable: the effect on their development and life chances is severe. Malcolm Chisholm talked about the American research that has been done into the issue. Our prison statistics show that the vast majority of prisoners have mental health problems. Our inability to deal with mental health issues at an early age creates problems for the future, as well as a cost to our society. However, the cost to the person who is affected is immeasurable.
Those who gave evidence to the committee made it clear that "The Mental Health of Children and Young People: A Framework for Promotion, Prevention and Care" was the right way forward; the problem was in its implementation. The Government is committed to implementing the framework by 2015. The long lead-in time means that work towards implementation of the framework is often patchy and inconsistent. The committee is keen that interim targets should be put in place to ensure that progress is measured. That would also allow inconsistencies to be identified.
Waiting times are far too long. As we have heard, in Highland some people wait for more than a year for an out-patient appointment. That is unacceptable for an adult, but it is even more unacceptable for a child in its formative years. Each day, week or month that goes by without intervention makes that intervention more difficult and makes treatment longer.
In its report, the committee discussed the lack of research and the need to increase staffing levels to allow research time, as well as to cut waiting times and to increase service provision. Research is fundamental to improving the way in which treatment is offered. It is a false economy to reduce research in order to increase patient care—both are required.
Possibly the most unacceptable wait is for reports to the children's panel. When young people find themselves at a children's panel, they are already at crisis point. The panel needs to be able to react quickly and to intervene to address the situation in which that young person finds themselves. Waiting times of up to five months were quoted in evidence; that is too long for a young person who is already in crisis. Staffing levels directly affect service delivery, research work and the work of the children's panel. We therefore need more investment in the training and recruitment of professionals to increase the workforce.
The committee looked at the transition from CAMHS to adult services. It became obvious that the two services worked very differently and that many young people had difficulties with the transition. There were several aspects to the issue: the handover, the way of dealing with patients in the two services, and the way in which patients could be transferred. As we have already heard, children's services often use a broader definition of mental health that does not fit easily with adult service provision. Action for Children made the point that it is important to keep that wide definition within children's services, to allow for early intervention. It must be possible for professionals from both services to work together to draw up a single pathway that is geared to the needs of the individual.
In our casework, we often hear of families who feel abandoned when a child leaves school and falls into adult service provision. There is a lack of support and advice and a lack of protected workplaces or college places. The committee was frustrated by that issue and recommended the setting up of a transitional service to bridge the gap between young people's services and adult services.
We have been discussing for many years the effect of the stigma that is attached to mental health issues. I agree with Action for Children's statement that work needs to be carried out locally and nationally to deal with the issue. If we do not deal with it, those needing help will be reluctant to ask for it. It is therefore even more crucial to provide an immediate response to those who ask for help, given that they may already have suffered in silence for some time.
School counselling is one way of providing help in familiar settings, which helps to remove stigma. However, the British Association for Counselling and Psychotherapy tells us that Scotland is lagging behind:
"the Governments of Wales and Northern Ireland have in place national strategies for school counselling and its implementation, and provide ring fenced funding for the provision of these services in every secondary school".
We must ensure that we keep pace and provide these services to all children.
There are many other issues that have not been touched on in the report, including services to deaf people and tailored services for those who suffer from anorexia. Both groups need to travel out of Scotland for specialist care, which, at a time when people need the support of their families and friends, can only hamper their recovery. We need those services locally.
The committee's report is sound and well balanced. I therefore appeal to the Government to implement its recommendations.
"certain unalienable Rights"
and
"that among these are Life, Liberty and the pursuit of Happiness."
Happiness is not attainable by those with poor mental health. We need to tackle that issue to enable children to grow up leading fulfilled and happy lives. We need to ensure that all our citizens have a right to good mental health, to help them with their pursuit of happiness. We need to start at a young age, to help young people to develop resilience and emotional wellbeing; Action for Children highlighted that issue in its submission to the Health and Sport Committee's inquiry.
The report's discussion of the consequences of poor mental health makes stark reading. Having inadequate services in place for children and young people who have mental health problems is inexcusable: the effect on their development and life chances is severe. Malcolm Chisholm talked about the American research that has been done into the issue. Our prison statistics show that the vast majority of prisoners have mental health problems. Our inability to deal with mental health issues at an early age creates problems for the future, as well as a cost to our society. However, the cost to the person who is affected is immeasurable.
Those who gave evidence to the committee made it clear that "The Mental Health of Children and Young People: A Framework for Promotion, Prevention and Care" was the right way forward; the problem was in its implementation. The Government is committed to implementing the framework by 2015. The long lead-in time means that work towards implementation of the framework is often patchy and inconsistent. The committee is keen that interim targets should be put in place to ensure that progress is measured. That would also allow inconsistencies to be identified.
Waiting times are far too long. As we have heard, in Highland some people wait for more than a year for an out-patient appointment. That is unacceptable for an adult, but it is even more unacceptable for a child in its formative years. Each day, week or month that goes by without intervention makes that intervention more difficult and makes treatment longer.
In its report, the committee discussed the lack of research and the need to increase staffing levels to allow research time, as well as to cut waiting times and to increase service provision. Research is fundamental to improving the way in which treatment is offered. It is a false economy to reduce research in order to increase patient care—both are required.
Possibly the most unacceptable wait is for reports to the children's panel. When young people find themselves at a children's panel, they are already at crisis point. The panel needs to be able to react quickly and to intervene to address the situation in which that young person finds themselves. Waiting times of up to five months were quoted in evidence; that is too long for a young person who is already in crisis. Staffing levels directly affect service delivery, research work and the work of the children's panel. We therefore need more investment in the training and recruitment of professionals to increase the workforce.
The committee looked at the transition from CAMHS to adult services. It became obvious that the two services worked very differently and that many young people had difficulties with the transition. There were several aspects to the issue: the handover, the way of dealing with patients in the two services, and the way in which patients could be transferred. As we have already heard, children's services often use a broader definition of mental health that does not fit easily with adult service provision. Action for Children made the point that it is important to keep that wide definition within children's services, to allow for early intervention. It must be possible for professionals from both services to work together to draw up a single pathway that is geared to the needs of the individual.
In our casework, we often hear of families who feel abandoned when a child leaves school and falls into adult service provision. There is a lack of support and advice and a lack of protected workplaces or college places. The committee was frustrated by that issue and recommended the setting up of a transitional service to bridge the gap between young people's services and adult services.
We have been discussing for many years the effect of the stigma that is attached to mental health issues. I agree with Action for Children's statement that work needs to be carried out locally and nationally to deal with the issue. If we do not deal with it, those needing help will be reluctant to ask for it. It is therefore even more crucial to provide an immediate response to those who ask for help, given that they may already have suffered in silence for some time.
School counselling is one way of providing help in familiar settings, which helps to remove stigma. However, the British Association for Counselling and Psychotherapy tells us that Scotland is lagging behind:
"the Governments of Wales and Northern Ireland have in place national strategies for school counselling and its implementation, and provide ring fenced funding for the provision of these services in every secondary school".
We must ensure that we keep pace and provide these services to all children.
There are many other issues that have not been touched on in the report, including services to deaf people and tailored services for those who suffer from anorexia. Both groups need to travel out of Scotland for specialist care, which, at a time when people need the support of their families and friends, can only hamper their recovery. We need those services locally.
The committee's report is sound and well balanced. I therefore appeal to the Government to implement its recommendations.
In the same item of business
The Deputy Presiding Officer (Alasdair Morgan):
SNP
The next item of business is a debate on motion S3M-5453, in the name of Christine Grahame, on the Health and Sport Committee's report, "Inquiry into child a...
Christine Grahame (South of Scotland) (SNP):
SNP
Thank you, Deputy Presiding Officer. Your rebuke is noted by me. I was en route and I apologise.First, I take this opportunity to thank all who gave oral and...
That the Parliament notes the conclusions and recommendations contained in the Health and Sport Committee's 7th Report, 2009 (Session 3):
Report on the Inquiry into child and adolescent mental health and well-being (SP Paper 309).
The Minister for Public Health and Sport (Shona Robison):
SNP
Happy new year to all health colleagues.I thank the committee very much for bringing the important issue of child and adolescent mental health services to th...
Dr Richard Simpson (Mid Scotland and Fife) (Lab):
Lab
I want to ask specifically about an issue that Christine Grahame rightly raised: that universal screening appears to end at eight weeks. That is not even the...
Shona Robison:
SNP
A new chief executive letter is about to be issued that will make it clear that there must be flexibility around the guidance. The guidance is simply guidanc...
The Deputy Presiding Officer:
SNP
You have about a minute.
Shona Robison:
SNP
The promotion of mental health among infants, children and young people is one of our six strategic priorities that are set out in "Towards a Mentally Flouri...
Dr Richard Simpson (Mid Scotland and Fife) (Lab):
Lab
I declare an interest as a fellow of the Royal College of Psychiatrists and a member of SAMH.The whole area of children's services has been characterised ove...
Shona Robison:
SNP
Will the member give way?
The Deputy Presiding Officer:
SNP
I am afraid that the member is about to sit down—even though he may not know it.
Dr Simpson:
Lab
Perhaps the minister can address the point that she was going to make when she sums up at the end of the debate.To conclude—
The Deputy Presiding Officer:
SNP
Quickly, please.
Dr Simpson:
Lab
The framework is excellent; the timing is wrong. We need greater urgency on this matter, which must become a higher priority.
Mary Scanlon (Highlands and Islands) (Con):
Con
I am sorry to start the year on a negative note but, having listened carefully to the minister, I must say that I was disappointed in what she said. If there...
Shona Robison:
SNP
Will the member take an intervention?
Mary Scanlon:
Con
I have only 10 seconds left.My granddaughter received the measles, mumps and rubella jab at 15 months and her parents were told to bring her back at the age ...
The Deputy Presiding Officer:
SNP
I am afraid that the member is stretching my patience a little bit.
Mary Scanlon:
Con
The Governments of Wales and Northern Ireland have in place national strategies for school counselling and its implementation, backed by ring-fenced funding ...
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD):
LD
Clearly, not being a member of the committee presents me with a slight difficulty. As members know, I am more used to making a winding-up speech than an open...
Shona Robison:
SNP
Does the member acknowledge that the vast majority of children are referred much more quickly than that? The HEAT target is designed to ensure that there is ...
Jamie Stone:
LD
I note what the minister says.As I said just before the minister intervened, we need to ensure that children have timely access to mental health services no ...
Ian McKee (Lothians) (SNP):
SNP
In the short time available to me I will concentrate on two matters that are covered in the committee's important report, which, sadly, received little publi...
Malcolm Chisholm (Edinburgh North and Leith) (Lab):
Lab
As the committee's excellent report and the accompanying evidence make clear, there is a great deal of continuity in mental health policy from the previous A...
Michael Matheson (Falkirk West) (SNP):
SNP
As a couple of members have said, mental health services are often called the Cinderella of our national health service. During the inquiry, I was struck by ...
Dr Simpson:
Lab
Professor James Law of the Royal College of Speech and Language Therapists said that it was bad not only that the number of referrals from health visitors wa...
Michael Matheson:
SNP
I recall the strong evidence that we received from Professor Law.The visit emphasised for me the real need to ensure not only that adequate services are made...
Rhoda Grant (Highlands and Islands) (Lab):
Lab
The American declaration of independence declares that people have "certain unalienable Rights"and"that among these are Life, Liberty and the pursuit of Happ...
The Deputy Presiding Officer (Trish Godman):
Lab
I can give Cathy Jamieson about four minutes.
Cathy Jamieson (Carrick, Cumnock and Doon Valley) (Lab):
Lab
Thank you, Presiding Officer, for giving me the opportunity to make a brief contribution to the debate. I will focus on adolescents, but first I thank the co...