Meeting of the Parliament 28 May 2025
The motion sets out clearly the lack of provision for neurodevelopmental conditions and the impact that that is having. The significant waiting times for diagnosis and support are leaving far too many without the support that they need. The 2021 report by the national autism implementation team was clear on the need for neurodevelopmental pathways and stepped care, but the lack of delivery alongside the growing demand is putting huge pressures on our mental health services.
In my region, NHS Fife has publicly recognised the impact that demand for neurodevelopmental services is having on mental health teams. Fife was one of the pathfinder sites that were identified for adult neurodevelopmental pathways following the 2021 feasibility study. An audit that was undertaken in 2023-24 showed that there was significant unmet need and high demand for adult neurodevelopmental services. Like all boards, NHS Fife is in dire need of additional resources and solutions from the Scottish Government. However, within existing resources, it is starting to pilot some approaches.
A digital neurodevelopmental hub has been created alongside self-help platforms such as moodcafe.co.uk, which is designed to give families and individuals better access to guidance, screening tools and signposting to support. NHS Fife is also trialling group-based interventions such as I CAN, which is delivered by psychology teams, and SPARKS, which was developed by occupational therapists. Those initiatives are aimed at helping people to build resilience and coping strategies while waiting for formal assessment or treatment, but although they are pragmatic and forward-thinking interventions, they are not a replacement for properly resourced and delivered care models and pathways.
We know that, where statutory services struggle to meet demand, the voluntary and community sector steps up. In Mid Scotland and Fife, there are great organisations that are working hard to provide support. In Glenrothes, Autism Rocks (Fife) has been a lifeline for many families. Run by parents for parents, it offers advice, peer support, playgroups and events for children and young people. For many local families, it is the first port of call when diagnosis is delayed or support is absent. In Lochgelly, Hyperclub provides a safe, inclusive place for children and young people with additional needs, many of whom are neurodivergent.
As well as offering respite to parents, those clubs offer a sense of belonging and understanding that formal systems often fail to provide. Although the support that such groups are able to offer is invaluable, it should be delivered alongside NHS services. The Scottish Government must act with the urgency that is required to ensure that support is available, without extensive waits, and in all communities.
The Scottish Government promised to allocate 10 per cent of NHS spending to mental health and 1 per cent to CAMHS, but it has not yet met either target. It promised to recruit people into additional roles to support community health resilience. It promised a learning disability, autism and neurodiversity bill to give voice and rights to people who are too often overlooked. It promised action on CAMHS waiting times. Instead, it has been quietly removing patients with neurodevelopmental diagnoses from those waiting lists altogether—skewing the data to mask the truth. If we are to make progress, it is essential that we have transparency on those figures.
The economic impact of undiagnosed neurodevelopmental conditions often makes a compelling argument. The Mental Health Foundation has estimated the lifetime cost of untreated ADHD to be more than £100,000 per person. The wider cost to the economy runs into the billions when we factor in lost productivity, increased health service use and social impacts.
However, at the core of the debate is the human impact. We know that, if they do not have the proper support in place, people with neurodevelopmental conditions can experience significant mental and physical health inequalities. They are more likely to experience depression and anxiety, more likely to struggle with employment and more likely to come into contact with the justice system or to have substance misuse issues. The right diagnosis and the right support can transform lives. That support can unlock talent and allow people to thrive, rather than simply manage their symptoms. That is what we all have to deliver.