Hansard

I thank Gillian Mackay for bringing the debate to the chamber. I know that the subject is very emotive for her—we talked about that yesterday—and I pay tribute to the work that she has done in this area. My thoughts are with you, Gillian. I also thank Katie MacGregor from the Stroke Association for her briefing for tonight’s debate, which is comprehensive, extensive and as informative as ever.

I, too, am a member of the cross-party group on stroke. My dad died from vascular dementia about four years ago, after a series of TIAs. When he lost his ability to speak about three years ago, that impacted on his mental health and on my mental health and that of the rest of the family.

There are 2,000 stroke survivors in East Lothian—that is about one in 50 adults; 12,500 people have been diagnosed with high blood pressure—that is one in eight adults; and around 1,800 people have atrial fibrillation, which is a heart condition that causes an irregular heartbeat and raises the risk of having a serious stroke.

As Gillian Mackay mentioned, in March 2022, the Scottish Government published “A Progressive Stroke Pathway”, which was produced by the national advisory committee for stroke. That document sets out a vision of what stroke care in Scotland should be. Early next year, the Scottish Government is due to publish a revised stroke improvement plan, which will be based on recommendations that are made in the progressive pathway report.

“A Progressive Stroke Pathway” states:

“Psychological care should be available to all patients in line with local delivery plans.”

I will touch on that later.

The Stroke Association report “Keeping Stroke Recoveries in Mind” found that stroke survivors are still not receiving the psychological support that they need. The report calls for the model that has been developed by the Scottish stroke psychology forum to be included in the upcoming stroke improvement plan and given appropriate financial and workforce resource.

The report found that 87 per cent of stroke survivors want equal access to physical and psychological care in their rehabilitation but that, at the moment, only 25 per cent think that they are receiving enough mental health support. Ninety-four per cent of people said that they experienced a mild impact on their psychological and emotional wellbeing after their stroke; 75 per cent of respondents reported that they did not get enough support in hospital; and 68 per cent of people did not feel that they got enough support once home from hospital.

Why is it so important to give greater emphasis to emotional care? Stroke is the biggest single cause of adult disability in Scotland. Two out of every three stroke patients leave hospital with a physical disability, and people need support to come to terms with this huge change in their life. People carry the impacts of their stroke with them for the rest of their lives. Even for people with mild disability or those who make a complete physical recovery after a stroke, fatigue and psychological issues can hugely affect their quality of life.

Emotional impact has been included in the two previous stroke improvement plans but, as I said, issues persist. In the 2022 Scottish stroke care audit, the category relating to psychological support was the lowest performing of all the stroke improvement priority categories. The Stroke Association 2019 report “Lived Experience of Stroke”, which remains the largest-ever UK-wide survey, found that nine out of 10 stroke survivors reported experiencing at least one cognitive effect, which was the same figure as for those who reported experiencing at least one physical effect.

Three quarters of stroke survivors experienced a change in their mental health—they might develop depression, anxiety or suicidal thoughts. By 2035 the incidence of stroke in Scotland is expected to double compared with 2015 figures. When a physical illness such as stroke is accompanied by mental illness, that worsens outcomes such as life expectancy.

I again thank Gillian Mackay for bringing the debate to the Parliament. I also thank the Stroke Association for all the work that it is doing and for its briefing. The key point is that we all need to work with health boards to ensure that we keep stroke recoveries in mind. I know that the delivery of the service varies in different parts of the country. I have been trying to speak to my local health board on the issue and I am struggling to raise issues in that regard. We need to ensure that stroke survivors receive the psychological support that they need, as Gillian Mackay has highlighted.