Hansard

I am delighted that we have had the debate and I am proud of the fact that Scottish Liberal Democrats have enabled it to happen. It has certainly been all too brief but, nonetheless, it has provided an opportunity to reflect on an issue that, despite the various debates that we have had, often still struggles to gain the attention that it deserves.

The conclusion that I draw is that it is now time for mental health to enjoy parity of esteem in legislation with physical health. The minister argued entirely justifiably that progress has been made and that measures are in place to go further on targets, data and service improvement. Nevertheless, that still falls short of putting mental health on an equal legislative footing with physical health, and we need to go further.

As Jackson Carlaw said, it has been a good debate. It has rightly and helpfully drawn on the personal experiences of a number of members. Nanette Milne reminded us of the practice in Fife that is delivering real benefits to children and adolescents. Aileen McLeod talked of an initiative in the south of Scotland that is reducing patient dependence on medicines. Malcolm Chisholm was building up to give us a raft of good examples of excellent practice. We need to bear that in mind as we advance the debate about where we want improvements to be made.

That personal approach should surprise no one. One in four of us will suffer poor mental health at some point in our lives, while three quarters of us know someone with a mental health problem. I am among that 75 per cent. A couple of years ago, I attended the funeral of a good friend—a former colleague and flatmate—who tragically took his own life after a long battle with depression.

I first met Andy in the House of Commons, where we started working around the same time following university. It was immediately clear that he was a class act. He was a passionate advocate for the causes that he cared about, notably the environment—and that was at a time when environmental issues were still dismissed as the obsession of a loony fringe. Andy combined that passion with a real political insight, a wicked sense of humour and a generosity of spirit that made him brilliant company and a privilege to know. However, there was always a sense that he was keeping something back—aspects of his life that he was reluctant to share.

It emerged only later that he suffered serious and utterly debilitating bouts of depression. During those times, he would retreat completely from the world, cutting himself off from family, friends and anyone else who might have been able to help. I am not sure what any of us could have done for Andy in the latter stages, but I cannot escape the feeling that, had he been able to open up earlier about the mental health problems that he was clearly suffering, it might have been possible to support him better and enable him to cope with the condition that, eventually, killed him at a wastefully young age. In the early 1990s, the stigma that surrounds mental health was more oppressive than it is today. It is not hard to see why opening up about a mental health problem was the last thing that a young bloke from Yorkshire who was intent on proving himself in the big city would want to do.

We have come a long way in the past two decades and more. Like Colin Keir and others, I record my admiration for the work that those involved in the see me campaign have done in recent years and I welcome the refounding of that initiative for the next three years. However, I firmly believe—I think that it has been acknowledged across the chamber—that we have not come far enough.

As Jim Hume and Nanette Milne reminded us, mental illness remains the dominant health problem for people of working age. It continues to damage careers, relationships and lives. The financial costs—let alone the human costs—are colossal.

Like others, I record again my support for the Scottish Government’s mental health strategy, which has been a welcome and important step forward. Among other things, it recognises that it is critical to provide effective treatment in a timely fashion. Such treatment can safeguard the individual’s welfare in the first instance and, without offering any guarantees, it increases the chances of a person enjoying good mental health subsequently.

That is why the waiting time target to which the minister’s amendment refers is particularly welcome. However, as Jim Hume said, after encouraging early signs of progress towards meeting the target, recent figures suggest that we are moving in the wrong direction in some cases.

There are regional variations between health boards, which open up the prospect of a postcode lottery—Malcolm Chisholm gave us an illustration of that from his constituency. Additional experts have been recruited, but there is evidence of variations in the per capita ratio of psychologists in different parts of the country. That concerns the only element of the Government’s amendment with which we perhaps have a problem. I have no doubt that the situation partly reflects increased public awareness, which is very welcome. However, I presume that a rise in referrals was expected when targets were set and resources were allocated.

Variability is also a feature of the conclusions from SAMH’s know where to go campaign. It found that people who live in remote and rural areas, people from black and ethnic minority communities and people who live in deprived areas face additional barriers to accessing information, help and support. Multiple health and social problems, reduced expectations and lower health literacy have all been found by SAMH to contribute to poorer outcomes in more deprived areas. Ken Macintosh, Neil Findlay and others reasonably made that point.

As Jackson Carlaw suggested, the only discordant note was in Kevin Stewart’s speech. That speech would have carried more weight if the white paper contained evidence about where the additional resources would come from or about a different approach being mapped out for welfare reform.

Rural areas suffer from specific problems. Orkney minds and Orkney Blide Trust do phenomenal work in the islands that I represent, but a culture of self-reliance and stoicism can work against efforts to get people with health issues, including poor mental health, to engage early with medical professionals. Even when the wider community is a source of support, that can almost make things more difficult and increase the fear of stigma for not just the individual but their wider family. SAMH makes similar points about ethnic minority communities. In both instances, the result is delays in people seeking help for mental health problems. That matters because, as SAMH explains,

“The later individuals engage with health services, the more complex their treatment and recovery”

will be.

As I said, we very much support the Government’s strategy on waiting time targets and on the data to inform future decisions. The 10-year follow-up to the Grant report is welcome and I hope that it will address some of the concerns that Richard Simpson raised about children spending time on adult wards, whether through the provision of additional beds or through a service redesign. That issue needs to be addressed.

Despite the Government’s strategy and the efforts of see me and other excellent initiatives in recent years, it is clear that mental ill health is still taboo for too many people. As Nick Clegg pointed out when launching a UK Government action plan on mental health recently, the treatment of those who suffer from mental ill health is

“outdated; stuck in the dark ages; full of stigma and stereotypes.”

He is right.

One speaker at the see me event in Parliament that Fiona McLeod hosted recently defined stigma as making someone go from feeling whole and usual to feeling tainted and deficient. That is simply not right. It is also one of the strongest reasons why putting mental health and physical health on an equal footing in law makes sense. Discrimination that we would not see against those who have a physical disability or condition is still all too common against those who have a mental health problem.

The issue is not whose strategy is best but how one can learn from others in the interests of meeting the needs of those who suffer poor mental health. In all parties across the chamber, there is an appetite for the issue to be discussed more openly, taken more seriously and addressed more effectively. Mental ill health is not a second-class condition. Ultimately, there is no good health without good mental health. I support the motion in Jim Hume’s name.