Meeting of the Parliament 02 April 2014
We should always begin health debates with positive stories, and it is very easy to find them because we have that wonderful organisation Patient Opinion here this week. Earlier today, I asked it for feedback from patients on mental health services. It had received many excellent stories about good services from the health service in relation to mental health. It is clear that we should learn from those stories and that everyone should seek to emulate that example.
However, it is always our duty to highlight problems, as well. Psychological therapies are a good example in that context. There has been some general progress on waiting times, but we know that there are problems. That is captured in the motion by the figure of 13,986 people waiting, but it is crystallised for me by two constituency examples that I have heard of this month, which involve people who have had problems that relate to that area of the service. An adult woman with anxiety was desperate to get psychological therapy of some kind, but all she was offered was medication, which she would not take because she knew that it would have adverse side effects on her. The other example involves a parent of a teenage daughter who has profound anxiety and self-harms. It took several years for her to be accepted as a patient by specialist services. Now that she has been accepted as suitable, she has a further wait for treatment.
For me, that raises three questions about psychological therapies. The first is on the waiting time issue. Things have certainly got a lot better, but is the waiting time for assessment or treatment? They may not always be the same thing.
The second question is this: What are the criteria for acceptance by specialist services? There must be fear of a trade-off between the eligibility criteria and the waiting time. I do not know whether that happens, but it is clear that one way of coping with waiting time pressures would be to take only people who are more seriously ill. The forthcoming SAMH research, which Jim Hume referred to, is related to that. We are told by SAMH that GPs are uncertain about the assessment criteria.
Thirdly, what is the range of available psychological services? At a meeting of the cross-party group on mental health about a year ago, we dealt with psychological therapies, and Donnie Lyons pointed out that the Mental Welfare Commission for Scotland was concerned that psychological treatment in the NHS may extend only to cognitive behavioural therapy—not that there is anything wrong with that—and that patients may not get a real choice of therapies. That was reinforced by a letter that I received from the minister a couple of weeks ago that said that only five child psychotherapy trainees started in October. Do we have a sufficient range of psychological therapies?
I have mentioned Donnie Lyons, so it is appropriate to pay tribute to all his work as director of the Mental Welfare Commission for Scotland, from which he retired two days ago. As I am talking about people who retired two days ago, I should also pay tribute to Sir Harry Burns, who is the most outstanding chief medical officer we have ever had. He is, of course, relevant to this debate, because one of his many passions was prevention of mental ill health through development of early years services. That is a very important dimension of Scottish Government policy in which there has been a lot of good work—in particular, targeted work on the early years.