The final item of business today is a members’ business debate on motion S4M-13077, in the name of Liam McArthur, on supporting the see me in work programme.
Motion debated,
That the Parliament notes that Mental Health Awareness Week 2015 runs from 11 to 17 May; supports all efforts during that week, and throughout the rest of the year, to stamp out stigma and discrimination regarding mental health issues of whatever kind; welcomes in particular the campaign, See Me in Work, which aims to end stigma and discrimination surrounding mental health issues in the workplace; understands that, while many businesses and organisations understand the impact of mental health in the workplace, it can be challenging to develop a mentally-healthy working environment; believes that See Me in Work, which has a programme that is designed to support staff and improve working environments, can make a positive contribution to improving conditions for people with mental health issues; understands that one in four will experience a mental health illness at some point in their lives; considers that such initiatives have the potential to be of real benefit to a great many people when they need it, and notes the calls for employers in Orkney and across Scotland to get involved with the programme.
17:05
With mental health awareness week running from 11 to 17 May, I am delighted to be leading this latest debate on the issue of mental health. I thank all those members who signed my motion, particularly those who did so with unseemly haste, allowing it to secure the requisite cross-party support by the allotted deadline. I am grateful to those who have stayed on to participate this evening, and I look forward to hearing their contributions.
The issue of how we improve services to, and the quality of life of, those who suffer poor mental health is one that I know commands broad and heartfelt support among members across the chamber. That is very much to be welcomed as we continue our collective efforts to ensure that mental health is better understood and more effectively treated, and that the stigma surrounding it is tackled head-on.
Without wishing to detract from this cross-party consensus, which I know is highly valued by those working in the sector as well as by those campaigning for improvements on behalf of sufferers, I take particular satisfaction from the priority that Liberal Democrats have attached to the issue over a number of years. As the minister is aware, we have consistently called for equal treatment of mental and physical health to be put on a statutory footing in Scotland, as is the case south of the border. In conjunction with the measures that have already been set out in the Government’s mental health strategy, we believe that that would send a powerful message. In practical terms, it would also ensure that the needs of those suffering poor mental health are reflected more fully when decisions about the allocation of funding are taken.
Of course, given the enormous pressure under which the health service in Scotland is currently operating, simply drawing funds away from the treatment of physical health would only compound the problems. That is why I was so proud of the specific commitment made by the Liberal Democrats to invest £350 million more in mental health services in Scotland—£3.5 billion across the United Kingdom—as part of an £8 billion real-terms increase in funding for our national health service.
Sadly, the focus of the recent election campaign appeared to be rather more on who was willing to do deals with whom than on the niceties of specific policy positions. Nevertheless, I think that the commitment was and remains absolutely the right thing. Distressingly, given the outcome of the election last Thursday, the chances of it actually now happening seem vanishingly small.
Although there are many aspects of the debate around mental health that I could have chosen to focus on, I felt that the efforts that are being made to stamp out stigma and discrimination in the workplace deserved our attention this time round. Colleagues will not need reminding, I am sure, that, as well as affecting one in four of the overall population at some stage in their life, mental illness remains the dominant health problem for people of working age. It damages careers, relationships and lives. The financial costs—let alone the human costs—are colossal. In Scotland alone, the cost to employers is estimated to be around £2 billion.
I therefore welcome the current programme that is being undertaken by the Scottish Association for Mental Health and the Mental Health Foundation under the banner of see me in work.
As an aside, I was a little surprised that those at see me appeared to be slightly less than enthusiastic about the prospect of me lodging the motion and allowing Parliament an opportunity to debate these issues today. See me has always enjoyed strong cross-party support and has been very open to working with colleagues from all parties. I know from previous debates that we have all benefited greatly from the expertise and advice that has been available from within the organisation. That approach has been one of see me’s real strengths. I sincerely hope that, as it moves from its campaign to its programme phase, see me will not make the mistake of seeing itself—or being treated by ministers—as somehow a creature of government.
As part of the current programme, see me has helpfully taken soundings on workers’ attitudes to mental health in the workplace. Some of the findings are fascinating, if alarming. Just under half of people think that someone in their workplace would be unlikely to disclose their mental health problem for fear of losing their job. More than half of people thought that fear of missing out on promotion would encourage a work colleague to conceal any mental health issue.
Those findings echo comments that I have heard at a local level in Orkney. The Orkney Blide Trust has suggested that its members are often reluctant to declare a mental health problem in applications, as they fear that it will lead to an immediate knock-back. That is perhaps unsurprising, as research indicates that one in four employers would not employ someone with a mental health problem, particularly in a role that involves contact with the public or customers.
The case study cited in see me’s briefing illustrates that point perfectly as it is about Gemma Patterson, who was denied her dream job in the navy despite passing the entrance exam and fitness test. Gemma’s history of mental ill health was used to fail her on medical grounds, despite her doctor, counsellor and psychiatrist all testifying that she had come out of her mental health problems stronger and more able to cope. The figures that I have quoted might be out of date, but I would hope that see me in work can help address the sort of damaging misconceptions that held back Gemma and discourage others from being open about their own mental health.
Certainly, the local mental health strategy being developed in Orkney is looking to place a heavy emphasis on working with local employers and educating them about mental health. I hope that that work can draw on some of the resources, training materials and positive case studies being developed by see me to back up its four-stage engagement strategy with employers. That staged approach seems very sensible, getting buy-in first of all and providing basic information about how employers can support their workforce in terms of mental health. Through a process of finding out more about staff attitudes to, and understanding and experience of, mental health, employers can then develop plans for improvement, the success of which can be tracked over time and continuously improved.
At this point, I wish to put in a brief word on behalf of the independent advocacy sector and the role that it can play in helping deliver the sort of changes that we wish to see in the workplace. Very often in employment welfare matters an individual will be advised that they can be supported by a colleague or a trade union representative. That is absolutely appropriate in many instances, but under the Mental Health (Care and Treatment) (Scotland) Act 2003 anyone with a mental health diagnosis has a statutory right to an independent advocate.
Advocacy Orkney’s Andy Spence-Jones explained to me recently that
“early intervention of advocacy can stop an employment matter progressing, culminating in disciplinary procedures or suspensions.”
Andy talks of using Advocacy’s expertise in mental health to work with employers, helping them to recognise that employees with a mental health condition
“need support to process their options and clearly articulate their thoughts.”
She argues that that can help an individual remain in employment, benefiting both the employee and the employer.
Other good work taking place that deserves a mention in this context is the clubhouse service run through the Orkney Blide Trust. Since the service started four years ago, 26 clubhouse members out of a total membership of 90 have moved into employment, both full and part time. Although transition into employment is not the primary purpose of the clubhouse, it demonstrates that where appropriate support is available, both to individuals with a mental health problem and to potential employers, real advances can be made.
We have made important progress in raising awareness and understanding of mental health over recent years. I am convinced that that has helped reduce stigma, but there is so much more to do. See me estimates that just less than a quarter of people think that their workplace has a good understanding of employee mental health. More encouragingly, almost nine out of 10 surveyed by see me want a better understanding of the issues so that they can behave appropriately.
I look forward to hearing what others, including the minister, have to say, and I hope that we can all play our part in encouraging as many employers and businesses as possible across Scotland to make a firm and long-term commitment to engaging with a programme that can make a real difference to the lives of the very many people who suffer poor mental health.
17:13
I thank Liam McArthur for bringing this very important debate to the chamber, but I was a bit disappointed that he decided to bring politics into it. I will not rise to that bait, though, because I think that what we are debating is too important an issue.
I remember that, as a responsible employer—I believe and hope that I still am—in social work, one of the things that I was very keen to do and which we did do was to bring in external organisations to equip the employees with mental health awareness so that they could identify that stress, anxiety and early signs of depression were maybe more common than people realised. We also wanted to equip them with the skills and confidence to come to their line managers and discuss what could be, or might be perceived as, a mental health issue.
It is important that such training is brought into workplaces so that line managers fully understand and comprehend that, if someone comes to them with a perceived mental health problem, they must be listened to and understood and the appropriate support must be given at that time. When we give that support and ensure that it is confidential, the person will generally come back.
When we looked at the issue through staff analysis and we worked things through, we noted that those who had come with issues early were more empowered later and they spoke openly to their peer group in the staffrooms. They openly said, “I had a problem and I spoke to someone.” That gives others confidence to do the same. It is not always easy to do that. Liam McArthur was right to say that there is still a stigma around mental health and mental illness. We need to move away from that. There is nothing wrong with having an illness, and there is nothing wrong if that illness happens to be a mental health issue.
I lived for many years through mental health issues. One of the examples from see me was someone with an eating disorder, and that reminded me so much of my daughter. Her employer, at the time when she was going to work, had no idea and no recognition of her specific or special needs. It is very important that, when an employer recognises such things, they are able to be more flexible. A person with a long-term condition—it could be someone who requires dialysis—may be a fantastic employee, but for the fear of losing their job they may develop a mental health problem on top of the physical problem. That might be due to uncertainty that is created by their peers or by line management.
It is important to raise awareness and equip employers to deal with the issues of mental health at work, but we also need to ensure that we equip employees to be able to trust their employer and to be able to go to them without fear that they could lose their job just because they say, “I have an illness.”
17:17
I join Liam McArthur in welcoming this year’s mental health awareness week, which offers us a chance to challenge the stigma that still surrounds mental health issues and to focus on the particular issue of the effect of stigma in the workplace. I am glad that we also have an opportunity today to highlight the efforts of see me over many years to tackle the lack of understanding surrounding mental health issues.
The see me campaign was launched in October 2002, and over the past 13 years it has worked tirelessly to protect the rights of those who live with mental ill health and to bring an end to the discrimination that so often excludes them from the everyday activities that we take for granted. Work is such an activity. The ability to contribute and feel included and, more important, accepted as an individual is a fundamental human need. This starts with tackling ignorance towards mental health conditions and encouraging a more tolerant workplace where employees feel able to discuss any emotional issues with colleagues.
As the UK charity Mind points out,
“employment is more than just a way of earning a living: it provides identity, contact and friendship with other people, a way of putting structure in your life, and an opportunity to meet goals and to contribute.”
See me’s most recent campaign, see me in work, aims to ensure that workers have more positive experiences when relating problems to their employer, thus changing the internal culture of the workplace to one of compassion and support. The programme will support organisations to improve practice on mental health and provide an environment in which staff are able to talk openly rather than living with their problem in silence, which not only leads to a decreased quality of life for the person but impacts negatively on the wider workplace.
In a YouGov survey of Scottish workers that was commissioned by see me, 48 per cent of Scottish workers stated that people do not tell their employers about mental health problems for fear of losing their job, and the same poll found that 55 per cent thought that employees would be unlikely to disclose a mental illness for fear of being passed over for promotion or moved to another post. The research makes a persuasive case for encouraging a compassionate workplace where feelings of isolation caused by poor mental health are discussed as part of establishing a resilient workforce. From the first job interview to promotion and training, employers must be given the necessary information to ensure that all their employees reach their full potential.
There is also the economic case. SAMH figures from 2011 suggest that mental illness costs Scottish employers over £2 billion every year. Figures from studies that were published by the UK Faculty of Public Health estimate that sickness absence due to mental ill health costs around £8 billion per year and that there are 70 million working days missed each year—an average of 2.8 days a year per UK employee.
The see me in work programme works because it puts the necessary information in the hands of employers and makes a convincing case for a better, more compassionate workplace. A number of employers are already working with see me to develop new programmes, including Network Rail, the City of Edinburgh Council and the Edinburgh agency LEWIS Creative Consultants. I hope that anybody who is watching today will look into the benefits of working with the programme and visit the see me in work website for links to the four steps that they can take towards a better, more mentally aware workplace. See me will support organisations through that process and provide updates, resources and essential reports that actively include staff in building a more understanding culture. That is a practical, proactive step that I know we will all welcome, as it will have many beneficial wider impacts.
There is no space for discrimination in an economy that must work for everyone. I support the motion and congratulate Liam McArthur on securing the debate.
17:21
I, too, thank Liam McArthur for giving us the opportunity to debate mental health. I will not rise to the bait of political debate, but I offer a wee bit of advice as someone who has more grey hair than Liam McArthur has: he should wait a little bit longer than a week before he passes judgment on the Conservative Government at Westminster.
The debate gives us another opportunity to acknowledge the excellent work that is done by the mental health charities in Scotland, which contribute a powerful and well-informed voice on behalf of patients. Scotland is rightly given the accolade of being LGBT friendly, but in mental health we see the raw statistics that 48 per cent of Scottish workers think that telling a manager about a mental health problem could result in their losing their jobs and that only 22 per cent think that their co-workers have a good understanding of the importance of mental health. I think that we all need to take responsibility for those statistics.
I acknowledge the journey of Gemma Patterson and thank Liam McArthur for raising that matter.
The Parliament has gained an excellent reputation for equality and anti-discrimination in employment, last week receiving an award for supporting the needs of deaf people in the Parliament, whether they are visitors or staff. I call on the Scottish Parliamentary Corporate Body, of which I was a member, to sign up to the see me in work programme, to undertake an online mental health check of its staff and to take action based on the results under commitment 2 of the programme.
Did the Parliament not undergo a programme with its staff similar to the see me in work programme two years ago, when Mary Scanlon was a member of the SPCB?
I do not remember there being an online mental health check, but Liam McArthur, who is currently an SPCB member, may be able to answer that question.
Dennis Robertson’s point agrees with my recollection, but I undertake to follow up the matter with the SPCB and confirm that.
I certainly do not think that there was an online mental health check.
I was delighted to be part of the Scottish Parliament delegation, led by our Presiding Officer, that attended Scotland week in New York and visited Chicago. I chose to have meetings on mental health with the health commissioner for New York state, as well as a meeting with Alderman George Cardenas, the chairman of the Committee on Health and Environmental Protection in Chicago.
If we can strip away the finances and the insurance companies that back US healthcare and Obamacare, we can learn from the American approach to mental health. Healthy Chicago focuses on mental health. Every City of Chicago employee completes a questionnaire on their mental health at least once a year. That has led to a higher demand for services, because Obamacare has identified mental health as an issue. The questionnaire is also used as an incentive for people to address lifestyle issues.
A similar process is in place in New York. We often think about physical health or mental health, but I learned in New York that it has been discovered that if people have good mental health, they can cope much better with physical ill health and long-term chronic conditions.
Work is being done in New York to look at support for childhood trauma, with support for the whole family. I was impressed by the priority work in Chicago to provide services to the prisoners in the county jail prior to release, which continues on release. There is also a mental health programme that helps families to stop the repetition of violence.
If we put to one side all the finances behind American healthcare, we can learn from how mental health issues are tackled there.
Presiding Officer, I am probably going over time so I will say one more thing and leave my remaining two pages of speech for another day. We still work in silos in mental health. Dennis Robertson made a very good point on that. Indeed, many general practitioners do not have any training in mental health—some GPs have had some training, some have had significant training and some have had no training. If they are lucky, a person who goes to their GP may be referred after a few visits to a specialist, which may mean a 26-week wait. In America—I am not saying that its healthcare is all good—the psychiatrists and the psychologists work with primary care. We need to do more to break down barriers and ensure that, as Dennis Robertson said, we have early diagnosis and intervention. With that would come much more respect for the patient and the issues.
17:27
Good afternoon, Presiding Officer. I thank Liam McArthur for securing the debate.
Most people find it difficult enough if they have one problem at work, but if they suffer from mental health issues they have so much more to deal with. One in four people experiences mental ill health, so we all need to change how we think about people with mental health problems.
At some point, most people will suffer from mental health challenges and will struggle to cope. Mental health awareness week, which is in its 15th year, aims to encourage the conversation around mental health in order to fight discrimination and stigma and to promote good mental wellbeing.
Last year alone, more than 11 million working days were lost due to stress, anxiety or depression. The economic cost of poor mental health in the UK has been estimated at £100 billion. Businesses and organisations know the impact of mental health in the workplace but struggle to develop a mentally healthy working environment.
On attitudes to mental health in the workplace, it concerns me that only 22 per cent of people think that their workplace has a good understanding of employee mental health, while 88 per cent want to have a better understanding of their colleagues with mental health problems so that they can behave or support them appropriately. Therefore, the see me in work programme is definitely needed.
The see me in work programme works with employers to develop resources, training and materials and effective case studies, and provides other support to employers. The programme also works with people with experience of mental health issues to further understand what activities can support the changes that are needed in workplaces to transform culture and make work safe for people with mental health problems.
The overall aim of the see me in work campaign is to support employers in making changes to their work practices to improve the working lives of employees with mental health problems. I encourage organisations to help with the development of this important new initiative, and I join Liam McArthur in supporting see me in work and wish it every success in encouraging employers to foster better awareness in the workplace and to help support people with mental health issues.
Mental health issues do not affect only one group of people—they affect people with disabilities, people from minority communities and those from disadvantaged backgrounds; I could go on. They affect at least one in four people. If those people have an additional mental health burden to deal with, the effect is quadrupled. They have so much to deal with that they break down, which affects their family and the environment that they live in, and they find it extremely difficult to cope.
The point that Hanzala Malik makes is underscored by recent research by SAMH, which identified that in the case of people with mental health illnesses from ethnic minority communities, and those in rural communities, the social structures worked against them being open about their illnesses, with the result that the chances of them seeking the support that they needed were even more limited. I strongly echo what Hanzala Malik says.
Liam McArthur has summed up the point that I was trying to make better than I was managing to do.
I am over my time, Presiding Officer—
That is all right—I will give you extra time for the intervention.
That is so kind of you; thank you very much.
Mental ill health is a concept that is very poorly understood, and people do not understand the implications of it. People sometimes feel that they do not need support, but that could not be further from the truth. They do need support. Therefore, it is crucial that initiatives such as see me in work are supported so that they can help our communities.
17:32
I join other members in thanking Liam McArthur for bringing his motion to Parliament for debate. As others have mentioned, this is mental health awareness week, so it is right that we are holding a debate on the see me campaign on work and mental health.
The debate continues the attention that our Parliament has paid to mental health—I think that I am right in saying that this is the fifth debate that we have had on mental health so far this calendar year. I am proud that we have had so many debates on mental health. Given that it is estimated that a quarter to a third of the population are affected by mental health disorders every year, it is right that it is a topic that occupies us. We need to be as comfortable talking about mental ill health as we are talking about physical ill health. It is important that we ensure that the Parliament—which is, of course, the focus of political life in Scotland—is engaged in debating mental health issues.
However, it is not just talk that is needed. The Scottish social attitudes survey shows that mental health awareness activities are still necessary. The interest in mental health that is shown in the Parliament and elsewhere demonstrates to me that there is a thirst for such activities, and I welcome that.
Sadly, people still experience negative attitudes because of their mental health problem. See me’s survey on attitudes in the workplace shows that fear is an issue. People fear that they might lose their job or not get promoted, and they fear that they will struggle to get a job if their mental health problems are known about.
That said, there are some bright signs. Nearly three quarters of the people who took part in see me’s survey thought that someone at their work with a mental health problem would be supported by colleagues asking what they could do to help, and more than half thought that someone at their work with a mental health problem would be supported by the workplace to make adjustments to their workload to allow them to remain in work. People are keen to understand mental health issues. Many people want to do the right thing, and there are workplaces, colleagues and friends who are keen to learn.
Members have mentioned the YouGov poll—I have just alluded to it. Mary Scanlon was absolutely right to highlight that 48 per cent of people thought that someone at work would be unlikely to disclose their mental health problem for fear of losing their job and that 55 per cent thought that people would be unlikely to disclose for fear of being passed over for promotion or moved to another job. More has to be done in that regard.
However, it is also important that we report the survey’s more positive aspects. For example, 88 per cent wanted a better understanding of colleagues’ mental health problems so that they could behave and respond appropriately. I think that that shows a willingness among the workforce to help tackle and reduce stigma.
People can be helped by the see me campaign’s activities, which rightly focus on changing behaviours. As Malcolm Chisholm pointed out, the campaign was launched in 2002 with funding from the then Scottish Executive, and we still contribute £1 million per annum to it. It quickly established a reputation as internationally groundbreaking in its scope, ambition and delivery, and it has put the issue of mental health stigma firmly in the public arena.
The see me in work programme aims to help employers develop a mentally healthy working environment, which is important for those who are in work and the families whom they support as well as for people who are looking for work. Being in the right work is good for people’s health; remaining in work aids recovery from a mental or, indeed, a physical health condition; and returning to work after illness improves health. On the other hand, long-term unemployment is associated with poorer health in general and, as we know, more psychological distress.
Does the minister agree that a mental illness is sometimes caused by the workplace itself and that, in some cases, an adjustment needs to be made to enable the person in question to move on?
Yes. As well as articulating that being in work is good for a person’s physical and mental health, I observe that, if things are not done properly and if there is too much stress in the workplace, there can be a negative effect. Nevertheless, the overall pattern shows that those in employment have better mental health than those in long-term unemployment.
Improving the working lives of people with mental health problems is the right thing to do, both on an individual basis and on a national basis, and developing mentally healthy working environments can support people into work and help them stay there. It makes sense to tackle the issue in a range of ways. Indeed, going back to Mr Robertson’s intervention, I point out that tackling the issue is important for workplaces that might not be doing so well in that regard, and the see me in work toolkit contains a set of steps for employers to work through. Moreover, the see me campaign has resources, training materials and case studies to support employers. I emphasise that, as the Scottish recovery network has made clear,
“people can and do recover from even the most serious and long-term mental health problems”,
Employment and support in the work environment can play a role in recovery.
Structural changes in workplace attitudes help, but individual attitudes also need to change. Tackling stigma and discrimination should make people feel more comfortable seeking treatment for a mental health problem. The issue requires a structural response. Scotland was the first nation in the United Kingdom to introduce a target for access to psychological therapies for all ages, and the target for health boards is that patients must get a referral to treatment for psychological therapies within 18 weeks. Between October and December 2014, more than 30,000 referrals were made to psychological therapies compared with more than 25,000 in the previous quarter. More people are coming forward for treatment, and NHS boards are responding. Indeed, according to the latest data, the average adjusted waiting time for psychological therapies is eight weeks, and 81.4 per cent of people were seen within 18 weeks. That is some progress. I know that some boards are doing better than others, but I thank all the staff in all the boards who are working to help people get access to the treatment that they need. That said, I recognise that we need to go further still.
We are investing an additional £15 million over the next three years to improve—
Will the minister give way?
Do I have time, Presiding Officer?
Yes, indeed.
How can a general practitioner refer someone for psychological therapy without being able to make a 100 per cent accurate diagnosis of the mental health issue in question? Psychological therapies do not work for several mental health conditions.
A range of options is available and a GP would not necessarily refer a person for psychological therapies. However, it is an appropriate option.
I want to pick on a point relating to primary care that Mary Scanlon made in her speech; she also mentioned it in that intervention and in the chamber last week. I recently had a meeting with the Royal College of General Practitioners in which we discussed the issue. GPs are, of course, trained in mental health; that is part of their core training. They must constantly upskill and continue that training, and there is support for that.
We are investing an additional £15 million over the next three years to improve mental health services. The money will be targeted at a mental health innovation fund and used to boost staff numbers to address the mental health needs of children and adolescents. That spending is part of NHS expenditure on mental health, which was nearly £900 million in 2013-14.
Mental illness is one of the top public health challenges in Europe, and our work in Scotland across the sectors is key in meeting that challenge. We need the support of the NHS and the third sector. I am pleased to support the role of the see me in work programme in that regard.
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