Hansard

I am really pleased to have brought this debate to Parliament, as it is on such an important topic to me.

As many members know, almost two years ago, my mum died a week after having a stroke. My grandpa had a stroke that left him with aphasia, and my gran had a stroke and transient ischaemic attacks. I thought that, as a family, we knew stroke well, but I am always in awe of how every stroke survivor I have met shares their story and their honesty about how it has affected their lives and the lives of their families. The mechanism with which they have come to their condition is the same, but no two strokes have the same aftermath. I thank the Stroke Association and everyone who has shared their story with me for their hard work and commitment. Some of those people are joining us in the gallery this evening.

Stroke is the leading cause of disability in Scotland. Around 10,000 people have a stroke every year, and around 128,000 people across the country are currently living with the effects of their stroke. In my Central Scotland region, there are around 15,000 stroke survivors. Everyone who survives a stroke has the risk of experiencing a physical disability, cognitive problems or emotional and psychological effects—or, more often than not, a combination of all three. Two out of every three stroke patients leave hospital with a physical disability and/or problems with speech, communication and thinking and, of course, their emotions and mental health.

Stroke survivors often say that people will tell them, “Ah, you don’t look like you’ve had a stroke.” That is a result of a lack of awareness of the hidden effects of stroke. Those are not all physical; the psychological effects can often be as or more debilitating to the individual.

Last month, the Stroke Association published a report, “Keeping Stroke Recoveries in Mind”, that looked specifically at the hidden effects of stroke, focusing on the psychological and emotional impact on a person after their stroke. The findings mirror those of a similar report that was published 10 years ago. The main message was that psychological and emotional recovery is not viewed on equal terms as physical recovery post-stroke. The Stroke Association spoke to more than 100 stroke survivors; 87 per cent of them want equal access to physical and psychological care in their rehabilitation. However, only 25 per cent report receiving enough psychological and mental health support. Ten years has passed, and the research continues to tell us the same thing, but everyone’s experiences are not improving.

The Scottish stroke psychology forum has supported the Stroke Association with that, and it has provided a tiered model that allows everyone involved in stroke care to be trained and supported to deliver psychological care for stroke patients. We all know about the tight financial constraints on the health budget, so that tiered approach to delivering psychological care will help to alleviate future pressures. By ensuring that people get the emotional and psychological help that they need at the beginning, the long-term health and social care costs will be reduced as they start to rebuild their lives earlier.

There is a strong evidence base to support that. A lot of research that has looked at the economic benefit of providing early intervention has been carried out. All of that has found a strong financial saving in the long term. That is a solution to current problems that stroke patients face and also for the overall health and social care budget.

I was also grateful to hear from Paula, from Glasgow, on that topic at one of our cross-party group meetings. She spoke openly and honestly about the psychological and emotional impact that she faced after her stroke, which she had a year ago. She explained how, overnight, everything changed for her and she went from being a wife, working full time and enjoying many outdoor activities to not being able to do everything that she used to get such enjoyment from. She started to lose control of her emotions and her stroke added a heightened sense of anxiety like nothing she had experienced before. After some time, she spoke to her consultant, who informed her that people are often affected in that way after a stroke, but that there are inadequate resources to cope with the number of people who need support.

With support from her family and empathy from health and social care staff, Paula has made a good recovery. Unfortunately, that is not the story for everyone. We all have a role to play in changing the narrative from stroke being a condition that affects people only physically to one that affects the whole person.

I encourage all members to speak to stroke survivors and their families in their constituencies and regions about the mental impact that stroke has had on them, as it will absolutely open their eyes to the way in which people’s worlds have changed. Grief is a way of describing the feeling that several stroke survivors have described to me. It is not confined only to people who have lost someone to stroke; it extends to those who have lost what their previous life was through any condition, from paralysis to aphasia. The survivors and their families often have to pick up the emotional pieces, muddle through and try to make the best of it. I hope that, through this debate and other work, we can put a focus on the mental health support that many survivors need.

I am keen to support the Scottish Government to drive forward improvements in this area, and I was pleased by the publication, earlier this year, of “A Progressive Stroke Pathway”. Although that document is vast and wide ranging, it includes a focus on psychological care for stroke survivors, which is encouraging. However, we must act now to ensure that that translates to changes for patients. Through early intervention, we can give people the chance to rebuild their lives and save health and social care services a significant amount of money over the long term.

I hope that the cabinet secretary will be able to update us on when the revised stroke improvement plan will be published, and that the Government will give appropriate resource to the plan. I hope that the cabinet secretary will also ensure that stroke care across the 14 health boards is consistent, so that everyone receives the same level of care.

I repeat my thanks to the Stroke Association and all those stroke survivors who have given their time and their effort to the cross-party group, and I look forward to hearing everyone’s contributions.