Hansard

It is a privilege to speak in a debate on such an important issue. The debate has stimulated many thoughtful contributions. Speaker after speaker has rightly highlighted that behind each of the more than 6,000 deaths from suicide in Scotland since 2009 are individuals and their families and friends who have suffered a devastating, unimaginable loss. Although the motion highlights the positive fact that there has been a 17 per cent reduction in suicides in the past decade, Annie Wells and Alex Cole-Hamilton rightly referred to the fact that, last year, there was a rise of 8 per cent in the number of people taking their own life—the first increase for six years.

Annie Wells also rightly highlighted that, because the Scottish Government’s current suicide prevention strategy expires in 2016, it is crucial that the Government consults and brings forward plans for a new strategy. As Johann Lamont highlighted so powerfully, a critical part of that new strategy needs to be the availability of and accessibility to the right mental health treatment. It is just not acceptable that a quarter of adults who require mental health treatment have to wait more than 18 weeks for that treatment. In many areas, the treatment options are limited. Staff are under increasing pressure, and many areas are struggling to recruit for key posts. There are vacancies in 9 per cent of psychiatric consultant posts, 8 per cent of clinical psychology posts and 4.4 per cent of mental health nursing posts.

Johann Lamont was right to stress that the forthcoming budget must ensure that our mental health services have the resources and staff that they require in order to meet demand and deliver the treatment that people need. Several members highlighted the broader issue that those working in health and social care services must be provided with the necessary training on suicide and mental health. I echo the Scottish Association for Mental Health’s calls for allied health professionals to receive suicide prevention training.

There is also a need for improvements in communication and co-operation between healthcare sectors and I support calls by SAMH to introduce a national Scottish crisis care agreement between statutory, emergency and non-statutory sectors to develop clear pathways.

However, we must look beyond healthcare services and expand other organisations’ ability to intervene effectively to help those people who are at risk of suicide. I welcome the work that has been done by the Scottish Government to promote applied suicide intervention skills training, known as ASIST. The Government’s review found ASIST to be

“effective on a number of levels”.

Training of that kind should be made more widely available, and it should be provided, in particular, for those people who work across our education system. Indeed, the role of education in suicide prevention is fundamental, as Fulton MacGregor highlighted in his contribution. Research has shown that half of all adults with mental health conditions say that their condition started before the age of 14. Early intervention and the promotion of lifelong mental health must, therefore, be at the heart of any truly preventative approach. People who work in all levels of education should have a strong understanding of mental health and suicide, and we must guarantee access to a qualified counsellor in every high school in Scotland.

Although suicide hits all of Scotland’s communities—Maureen Watt was correct when she said that there is rarely any single cause—we know that it impacts on certain groups disproportionately. Clare Haughey, Brian Whittle and others have highlighted that the suicide rate among men is more than two and a half times that for females. Between 2009 and 2015, 73 per cent of people who took their own lives were men, and they were found to be less likely to have had prior contact with healthcare services than women by a 21 percentage point gap. Serious barriers prevent men from accessing the mental healthcare that they urgently need. Bringing forward the cultural and structural changes that are needed to address that inequality must be part of any new strategy. James Dornan’s very personal contribution highlighted the fact that efforts to destigmatise mental ill-health must recognise the key role that is played by gender and must tackle the harmful gender stereotypes that prevent men from seeking help. Likewise, healthcare services must do more to ensure that men who are at risk of suicide receive the treatment and support that they need. I support SAMH’s calls for integration joint boards to commission evidence-based, gender-sensitive services to tackle the inequalities that are faced by men and people in areas of deprivation.

We cannot discuss suicide prevention without discussing the need to tackle poverty and inequality. As Monica Lennon said, the recent Scottish suicide information database report highlighted that suicide deaths are three times more likely among people who live in the most deprived areas compared with those people who live in the least deprived areas. Those figures reflect—in the clearest and most devastating terms—the human cost of inequality. The recent Samaritans report “Dying from Inequality” stated that there is

“overwhelming evidence of a strong link between socioeconomic disadvantage and suicidal behaviour”.

It highlighted that low incomes, job insecurity, zero-hours contracts, unmanageable debt and poor housing increase the risk of suicide. The forthcoming suicide prevention strategy must put it at its heart that, if we are to tackle this health inequality, we need to tackle wealth inequality.

Finlay Carson highlighted another inequality. He spoke about the personal case of the Stewartry rugby player Scott Carson and rightly talked about a lack of connectivity and isolation as factors in suicide. The recent Scottish suicide information database report highlighted that, although rural areas have a higher than average rate of suicide, “very remote small towns” had the highest rate of any area, and accessible small towns and rural areas both had lower rates than their remote or very remote counterparts.

On an individual level, isolation appears to play a role, with 71 per cent of people who have died from suicide reported as being single, widowed or divorced at the time of their death. I hope that we will soon see the publication of the Government’s promised strategy on loneliness, which I hope will include such options as social prescribing. Today’s debate has highlighted how complex suicide is. Self-harm has been highlighted in the very personal cases that Willie Coffey and Alison Johnstone set out, and the impact of deprivation was highlighted by Monica Lennon and others. The chamber has united behind the need for the Government’s new strategy to have clear priorities and clear objectives. I am sure that everyone will get behind that strategy.