Hansard

I, too, welcome the publication of the Scottish Government’s new “Suicide Prevention Strategy 2013-2016”, and I commend the minister for providing us with this opportunity to debate its contents.

Suicide is an incredibly sensitive issue and one that must be treated as such by all of us across society. As Willie Coffey has already said, I dare say that most of us in the chamber will know of someone who has either committed or attempted suicide. I know of more than one, unfortunately, and Kenny Gibson mentioned a few of his family members. It is hard to articulate just how much the friends and relatives of those concerned can suffer in the aftermath. It is important that we drive down the number of suicides in Scotland and that any framework that is put in place to achieve that aim is fit for purpose.

The latest strategy follows on from “Choose Life: A National Strategy and Action Plan to Prevent Suicide in Scotland”, which was published in 2002, and it certainly builds on some of the successes of its predecessor. The 18 per cent reduction in suicides in Scotland and the fact that all probationer police officers and 50 per cent of front-line NHS staff are now trained in suicide prevention techniques provide a good platform on which to build.

I have highlighted in previous debates on mental health that it is vital that we end the spectre of patients being condemned to long-term repeat prescriptions for antidepressants without regular reviews of their response to the treatment. The strategy highlights how important it is that we make a concerted effort to change that, as it notes that,

“at the time of death, many people are receiving some form of medication used in the treatment of mental illness.”

Perhaps something as simple as a review of their medication with a change to the dosage or the drug may have made a difference to their mood.

The minister will be well aware of the successful pilot that was held in Glasgow in which participating practices reviewed those who were on antidepressants for more than two years. It led to 28 per cent of patients having a change in their therapy and an 8 per cent reduction in prescribing costs. Reviews can make a difference, but I appreciate that the use of antidepressants is essential in many cases.

I was delighted to come across commitment 7 in the strategy, which reads:

“We will work with the Royal College of General Practitioners and other relevant stakeholders to develop approaches to ensure more regular review of those on long-term drug treatment for mental illness, to ensure that patients receive the safest and most appropriate treatment.”

I welcome the inclusion of that important commitment in the strategy and I would be grateful if the minister provided in his summing-up a timeframe for engaging with stakeholders on working towards those much-needed reviews.

In 2008, the Scottish Government published “Equally Well: Report of the Ministerial Task Force on Inequalities”, which makes recommendations on tackling health inequalities. It said that one of the challenges that faced the ministerial task force was that

“Those living in the most deprived”

10 per cent of

“areas of Scotland have a suicide risk double that of the Scottish average.”

I appreciate the mention of farmers and vets by Nanette Milne and Kenny Gibson. It is without doubt that the incidence of suicide among such people is high because they have access to the means of committing suicide.

I was disappointed that health inequalities merited only one fleeting mention in the suicide prevention strategy. The link between inequalities and greater rates of suicide is acknowledged in “Equally Well”, and it merits greater inclusion in the overall discussion on preventing suicide.

Timely access to psychological therapies has a role to play in treating those with mental illness more effectively, and I hope that it would have the knock-on effect of reducing the number of suicides further. I therefore welcomed the target of access to psychological therapies within 18 weeks of referral as a positive step. However, I caution that, for someone who is suffering from mental anguish, 18 weeks is a long time to wait. Many such patients have of course suffered for some time before their referral. The minister should not limit his ambitions to 18 weeks.

The target is due for delivery by December, so this is not the time to move backwards. In September, there was a 3 per cent drop in the number who are being treated on time. One fifth have to wait more than 18 weeks for treatment, so the Scottish Government cannot rest on its laurels yet.

The head of psychological services in one health board told me that, alongside its counterparts in other areas, that board is constantly making the case for greater investment in mental health services. Yesterday, I visited Midpark hospital in Dumfries, which I know that the minister visited in 2012—I saw his signature in the visitors book. NHS boards are experiencing increasing demand for such services because of the economic downturn and—perhaps more positively—because the public are becoming much more aware of the services’ availability.

I hope that we might be beginning to see some erosion of the stigma that has plagued mental health. The Scottish Government needs to continue to address that. It will also have to address the clear disparity that exists across Scotland in access to clinical and other applied psychologists. It cannot be right that, per head of population, NHS Greater Glasgow and Clyde and NHS Fife have twice the number of psychologists that NHS Forth Valley has. If the health improvement, efficiency and governance, access and treatment—HEAT—target is to be met later this year, access must be addressed urgently.

Suicide is difficult for those who are left to comprehend. I am glad that we are making progress with a decrease in suicides, and I look forward to much more progress in the near future.