Hansard

Thank you, Presiding Officer, for the opportunity to update the Parliament on the Scottish Government’s work to improve access to the right support for young people’s neurodivergence, mental health and wellbeing.

I know that people are waiting too long to get the support that they need. I want to be clear from the outset that we are committed to making improvements in those areas. Last week, the Royal College of Psychiatrists in Scotland published its manifesto for next year’s Scottish Parliament election, in which it noted a significant increase in people across all ages who are seeking support for their neurodivergence. It also highlighted the importance of a needs-based, stepped care approach to support for neurodivergent people. That echoes our thinking.

Although I recognise that significant work is needed in the area and will go on to say more about our plans for that, I highlight the national neurodevelopmental specification for children and young people. Published in 2021, the specification sets out standards for all children’s services to follow, to ensure that children and young people can access the support that they need for their neurodivergence. The specification takes a needs-based approach to providing neurodevelopmental support, is underpinned by the principles of getting it right for every child and is intended to be delivered by all children’s services partners through a multi-agency approach. I welcome the recommendations from both the royal college and the child heads of psychology services in that regard, because that is what we are working towards through the implementation of the neurodevelopmental specification.

Since the specification was published, the scale and pace of the increase in demand for neurodevelopmental support and services, particularly for diagnosis, have been unprecedented. That growing demand is placing significant pressure on services and is making the implementation of the specification challenging. We know that children and families who are seeking support can be left feeling worried or uncertain about what support is available to them and how to access it, fearing that they will be left stranded if they do not have a formal diagnosis.

I take the opportunity to reassure parents and carers who may be worried that that is not the case. I recognise that a formal diagnosis can be important to an individual’s identity and to their understanding of themselves or of their child. However, support should be provided on the basis of need, not diagnosis. That is particularly important for children and young people, whose needs will change over time as they continue to grow and develop, and for those who have support needs but do not meet diagnostic criteria.

I understand that medication can be important for some who have attention deficit hyperactivity disorder and that a diagnosis of ADHD is needed to access that, but non-pharmacological support can also be helpful and is recommended in the first instance by the National Institute for Health and Care Excellence. It is also important that children and families are able to choose whether medication is right for them.

Much of the conversation in this chamber around neurodivergence has focused on diagnosis and treatment and on the relationship between neurodivergence and child and adolescent mental health services. Those conversations have included incorrect assertions that young people are being moved off waiting lists to meet the CAMHS waiting times target. I make it crystal clear that that is categorically not the case. CAMHS is a specialist mental health service for children and young people who are experiencing significant mental health problems. Neurodivergence is not a mental health condition and CAMHS is not the appropriate service for children seeking a neurodevelopmental diagnosis.

The improvements in CAMHS waiting times are the result of significant and sustained investment by this Government in mental health services and of hard work by our CAMHS workforce. I put on record my gratitude to them for the work that they do every day to support children and young people who have acute mental health needs. The 18-week CAMHS waiting time standard has been met for the second quarter in a row, with 91.6 per cent of children and young people starting treatment within 18 weeks of referral, but we cannot be complacent. Performance still varies across health boards and some children are waiting too long to receive the support that they need. We continue to provide enhanced support to boards that are not on track to meet the standard through providing access to professional advice and ensuring that they have robust improvement plans in place.

We also know that early intervention and prevention are key to supporting good mental health and that not all children who seek support will need a specialist service such as CAMHS. In fact, the majority will find more suitable support in their local community, and we are providing support to local authorities to ensure that that is quickly and easily accessible. Indeed, we have provided local authorities with more than £65 million since 2020 to fund community-based mental health and wellbeing supports for children, young people and their families. Those supports are available in every local authority area, and councils report that they were used by nearly 83,000 people between July 2023 and March 2024. That £15 million per-year funding is continuing through the local government finance settlement from 2025-26, alongside £16 million for school counselling.

Returning to focus on neurodivergence, I acknowledge the concerns raised by families, and in this chamber, about neurodevelopmental diagnostic waiting times. I recognise that that data is not nationally reported or published. Our primary focus—quite rightly, I think—is on timely provision of appropriate support. However, I certainly recognise that further work is needed to improve the quality of the data that we have on neurodevelopmental requirements and support. We will continue to work with health boards and local authorities to improve our understanding of the quality of the data that is available and how it can be used to improve support and services.

Last year, we provided nearly £250,000 to fund a range of individual projects aimed at improving assessment and support for children and young people, including family support and testing of digital assessment tools. That built on a previous £1 million investment to fund five pilots that focused on various aspects of the national neurodevelopmental specification, including implementing GIRFEC and multi-agency working.

In partnership with the Convention of Scottish Local Authorities, we have undertaken a review of the implementation of the specification, which sought views from education authorities, health boards, young people and their families, clinicians and third sector partners, along with others. The review highlighted areas of challenge and further work to support children’s services partners to implement the specification. A report that sets out our findings has been published today and it outlines the specific short, medium and long-term actions that we will take forward. They include providing greater clarity on the roles and responsibilities of partners in delivering the specification; opportunities to promote training; the sharing of good practice, including in the use of new digital assessment tools; work on data availability; and work to improve support to families. I extend my thanks to everyone who contributed to the review.

I am also pleased to announce that, to support us in driving forward this vital work, we will set up a cross-sector task force that will be jointly chaired by Fiona Davies, chief executive of NHS Highland, and Dr Lynne Binnie, chair of the Association of Directors of Education in Scotland’s additional support needs network and the City of Edinburgh Council’s head of education for inclusion.

Further, I am pleased to announce that, to support this work, we will provide half a million pounds in additional funding this year to deliver improvements to the support and services that are available to children, young people and families who are seeking support for their neurodivergence. That funding will be available across children’s services partners in recognition of the multi-agency and needs-based approach that is required. Further details will be set out in due course.

I do not underestimate how much work is needed to ensure that neurodivergent young people are able to access the support that they need when they need it. That will not happen overnight. It will require collaboration and a range of partners working together, including within Government—for example, between my officials and officials in the education and skills portfolio.

Neurodivergence reflects the rich, varied and complex ways in which our brains work. Neurodivergent children and young people bring unique strengths, perspectives and ways of thinking that enrich all our communities, but I recognise that they can face significant barriers in education and daily life that often continue into adulthood when entering further or higher education and the workplace. Those difficulties can be made even harder by the increased risk of mental health struggles that many neurodivergent individuals experience, alongside the need to navigate a world that is not always built for them.

We have made positive progress in ensuring that children and young people are able to access support for their mental health and wellbeing, and we will continue to deliver further improvements. We are in the early stages of an improvement journey on neurodevelopmental support and I look forward to further detailed conversation at the upcoming cross-party summit on neurodivergence.

I end by emphasising the Government’s continued commitment to ensuring that all children and young people who grow up in Scotland receive the right support in the right place at the right time.