Hansard

I welcome the Liberal Democrats’ decision to debate Scotland’s mental health, although it is perhaps a little premature, given that the 10 year follow-up to the Grant report of 2003 is due to be published later this year.

However, given that one in four of us will experience a mental health problem at some time in our lives, and that mental ill health now accounts for close to half of all people who are not working because of health problems, it is important that we consider what progress is being made to tackle the unmet needs of those who are affected by mental illness.

There is no doubt that significant efforts are being made to speed up diagnosis and referral of people who experience mental health problems, and to provide the appropriate services to aid their recovery. The HEAT target that has been set by the Government to have a maximum waiting time, by the end of this year, of 18 weeks from referral to accessing psychological treatment, is very welcome, but is some way from being achieved, with just 82 per cent of adults and 85 per cent of children currently being seen within 18 weeks. Those waiting times do not sound very long, but 4 and a half months is quite a long time for people to be suffering mental trauma without access to the services that they need. I therefore hope that the target times, once they are achieved, will be re-set at a more ambitious level.

SAMH has expressed concern about the health inequalities that persist in parts of Scotland and within certain communities, with access to services being affected by geography, deprivation and ethnicity. SAMH found that in the more deprived areas more than a quarter of people did not know where to seek help when they suffered from depression, anxiety or other mental health problems, and that of those who did seek help, 77 per cent went initially to their general practitioner.

That certainly ties in with what the Health and Sport Committee heard yesterday from GPs who work in deprived communities, who said that many of their patients suffer from multiple comorbidities, and that mental health issues are closely associated with the physical ill health and social problems that affect many people in those areas. Those GPs are under severe and increasing pressure in dealing with their workload, and find that they do not have adequate time to spend with their patients. In those communities there are many people from ethnic minority backgrounds, who also have cultural barriers to seeking help.

Moreover, a recent survey of GPs by SAMH showed that GPs often do not make referrals to services including psychological therapies and social prescribing, because waiting times are too long, referral criteria are unclear, or there is no access to such services in their area. The resultant delays in supporting people who experience mental health problems mean that by the time people come to treatment, their situation is likely to be more complicated and their recovery may be compromised.

Similar delays in engaging with psychiatric services are quite common in remote and rural areas, and for farmers in particular, who used to have the support of colleagues and family on the farm, but who now lead fairly isolated lives and bottle up their problems. That has led to a significant increase in suicide among farmers in recent years, which is cause for concern. However, it is encouraging that overall rates of suicide have come down, but we cannot be complacent about that.

Two commitments in the Government’s mental health strategy particularly interest me. Commitment 21 is:

“We will identify particular challenges and opportunities linked to the mental health of older people and will develop outcome measures related to older people’s mental health as part of the work to take forward the integration process.”

Commitment 22 is:

“We will work with the Royal College of GPs and other partners to increase the number of people with long term conditions with a co-morbidity of depression or anxiety who are receiving appropriate care and treatment for their mental illness.”

Both groups of people are increasing in number as the population of Scotland ages, and the first will certainly contribute to a rise in psychological problems associated with dementia. Given that, I ask the minister to give us an update on those two commitments.

Finally, I want to touch on a success story for children and young people in Fife who have severe mental health conditions. The Royal College of Nursing brought it to my attention just this morning, and I suspect that the minister might have been talking about the same thing in his speech. The NHS Fife child and adolescent mental health intensive therapy service, which is run as a partnership involving nurses, psychiatrists, psychologists and therapists, provides personalised community-focused care for eight-year-olds to 18-year-olds. Under the leadership of a nurse consultant, the service offers high intensity home-based support and therapy that are tailored to meet the individual needs of young people and their families and carers. It offers effective—and cost-effective—therapeutic management of young people who are suffering from severe mental health problems who, as a result, need minimal, if any, hospitalisation. The project sounds very worth while, and other health boards would do well to consider it—especially given the 27 per cent rise in the number of children who were, as Labour’s amendment points out, admitted to adult wards last year.

I am conscious that I have rambled a bit around different aspects of mental health. However, I think that the debate gives us the opportunity to look at service provision from all angles. I commend Jim Hume for leading the debate.