Meeting of the Parliament 28 May 2025
I, too, thank the Liberal Democrats for bringing forward this important debate, and I express my gratitude to staff across health, education and the third sector who work with dedication to support people with neurodevelopmental conditions. There is little doubt that, across Scotland, there is a fundamental gap in how we identify, assess and support those with neurodevelopmental conditions, particularly autism and ADHD, which is causing real harm. Constituents have contacted me and my colleagues, seeking support and direction. We have heard from Alex Cole-Hamilton that that is the case for him, too.
There is a lot to cover in this debate and, although I will try not to repeat what others have said, I wish to highlight a few key points that are essential. Demand for assessments is rising, and existing systems are unable to cope. The result is years-long waits for diagnosis. Without a diagnosis, many cannot access the basic support that they need to participate fully and confidently in education, work and community life. Long waits and unclear pathways are standing in the way of effective treatment. That is particularly true for ADHD, for which treatment can be highly effective and truly transformative.
I hope that this debate can serve as the starting point for a constructive conversation about what needs to change. We need clear action and strong commitments from the Scottish Government to begin fixing a system that is currently failing too many people. I welcome the call for the Government to convene a cross-party summit that would focus on reducing waits for neurodevelopmental support and increasing mental health capacity. That is an important first step in initiating the conversation. I hope that the minister will commit to ensuring that people with lived experience are not only heard but play a central role in shaping solutions and decisions going forward.
Another critical issue is the lack of accurate data. We do not know how many people are waiting for assessment or how long they have to wait. Without transformation in that area, we cannot accurately measure progress.
Significant action can and should be taken to address those issues. The Royal College of Psychiatrists in Scotland calls for strong national leadership and a clear focus on delivering support across four key levels of care. It has devised a model with practical solutions to many of the immediate and medium-term challenges, and it is clear that that must be paired with a long-term strategy.
We need to move away from a single-condition model. Many people experience multiple overlapping challenges. For example, a person with autism may have not just autism but several other conditions. We need integrated neurodevelopmental pathways in all 14 health board areas and to replace siloed systems with co-ordinated whole-person approaches. The national autism implementation team’s “Adult Neurodevelopmental Pathways” report makes that clear. It calls for consistent national standards, early access to support and proper accountability.
We need to stop treating neurodevelopmental support as an optional extra. National leadership is essential, as is long-term investment. Third sector organisations have long echoed that. Promising work is under way. The proposals for new care models and the inclusion of neurodevelopmental conditions in the mental health and wellbeing strategy are all steps forward.
The NAIT report gives us a direction, but efforts should be stepped up. So far, the pace has been too slow. Community-based models show promise but, at present, many people still access GPs or secondary care referrals. Monitoring and on-going support in the community are patchy and inconsistent.
This is the moment to be ambitious. The Scottish Government needs to expand and create adult neurodevelopmental pathways and stepped care models. They have been recommended by the NAIT and by the Royal College of Psychiatrists in the 2021 “National clinical ADHD Pathway Feasibility Study”. That has to be backed by leadership, funding and accountability. We must start the conversation to build a system that works for everyone, and we must back it up with urgent action.