The final item of business today is a members’ business debate on motion S4M-11065, in the name of Linda Fabiani, on world mental health day. The debate will be concluded without any question being put.
Motion debated,
That the Parliament notes that 10 October 2014 is World Mental Health Day; welcomes this day of global mental health education, awareness and advocacy; understands that World Mental Health Day 2014 shines the spotlight on schizophrenia and that one in 100 people have schizophrenia; welcomes the work of Support in Mind Scotland, which celebrates its 30th anniversary this year, and its upcoming 1 in 100 campaign, which is to be launched in October; understands that this work takes place 10 years on from the first Scottish review of schizophrenia care and treatment; is concerned that nine out of 10 people with schizophrenia cannot get employment and experience discrimination and stigma; is further concerned that people with schizophrenia face shorter life expectancies by 15 to 20 years on average compared with the general population; understands that early intervention boosts the life chances of people with schizophrenia and welcomes the work of charities and other stakeholders right across Scotland in supporting the one in 100 Scots living with schizophrenia, including Support in Mind Scotland, and congratulates the volunteers in its East Kilbride support group, which has been working locally for 36 years.
17:32
This is an important debate on something that matters every day of our lives, but the motion mentions 10 October because that was world mental health day. It is an important day to reflect on—a day of global mental health education, awareness and advocacy.
We all have physical health and mental health to some degree. Just like physical health, mental health does not discriminate when it sends problems. Much is linked to someone’s mental health and sense of wellbeing.
I welcome what the Parliament has achieved over recent years. In 2005, the Mental Health (Care and Treatment) (Scotland) Act 2003 came into practice. It was set in motion by the previous Labour and Lib Dem Government and its implementation was carried through by the Scottish National Party minority Government. However, the act was backed by absolutely everyone in the Parliament. It was regarded as one of the most progressive pieces of mental health legislation in the world.
Under the current Government, there has been a big focus on mental health, with the mental health strategy for 2012 to 2015 setting out key commitments on improving the nation’s mental health and wellbeing.
Like good physical health, good mental health cannot be assumed. Anyone at all can be diagnosed with a mental illness but, unlike those with many forms of physical illness and problems, those with mental health problems clearly suffer from discrimination and stigma. Prejudice and misguided stereotyping about mental illness must be tackled, which is why charities such as those behind the see me campaign are important. They tackle the stigma and all the disadvantages that are put on people who suffer poor mental health.
Of course, sensationalist media stories do not help, either. We have all seen those, and I will not dignify them by repeating any of the terrible headlines that we have seen over the years. If we are honest, we must all admit that there are times when our language is not as good as it could be. I know that I am guilty of that now and then. However, times move on and terminology that was normal and accepted years ago is no longer perceived in that way. That is a way of moving on.
That subject raises the issue of common misconceptions around mental health. World mental health day 2014 shone the spotlight on schizophrenia. Around one in 100 Scots experience schizophrenia at some point in their lives. It is reckoned that 26 million people worldwide have that illness. Major symptoms include hallucinations, delusions and fatigue. Of course, the word “schizophrenia” does not mean that someone has a split personality or multiple personalities, although that is how the condition has been depicted over the years in real life and on television, in novels and in films. It is an important illness to raise awareness of. It is widely misunderstood.
Sensational stories in the media exacerbate the problem of discrimination against people with schizophrenia. For example, there is a common misunderstanding that people with schizophrenia are violent. However, the reality is that people with mental illness are much more likely to be the victim of a crime.
Health inequalities for people with schizophrenia are alarming—[Interruption.]
Sorry, Sandra. I heard a wee voice in my ear, and it was you.
The member quite rightly raises some issues. Does she agree that one of the most important aspects of the mental health strategy is raising awareness of mental health issues with professionals in the legal profession—the police and people in other areas associated with justice—and doctors?
That is right. There is institutional bias against people who have mental health issues. That has to be tackled. It feeds into the inequalities that exist. The health inequalities mean that someone with schizophrenia is expected to die 20 years younger than the average life expectancy, and poor physical health is a major issue facing people with schizophrenia and associated mental health problems. There is also an issue around employment. Nine in 10 people with schizophrenia are not employed, despite the fact that most are able to work. That is because of direct discrimination and misconceptions in institutions and on the part of the general public.
Another issue is the fact that, sometimes, people with schizophrenia are reluctant to seek help. Over the years, I have dealt with constituents who have been diagnosed with schizophrenia and are suffering the institutional discrimination that we are talking about but, because of the terrible stigma that attaches to the condition, they do not want to say the word or talk to professionals who could help them. There are big issues there.
There is an issue around early diagnosis. The minister can tell us more about the waiting times for child and young adult mental health referrals. I have concerns about that in relation to early diagnosis.
In my motion, I mention the charity Support in Mind Scotland, which focuses on supporting people with severe mental illness and their supporters. In my constituency, East Kilbride, there has been a support group for more than 35 years; I give a big shout-out for Sheila McLeod and Elinor Gardiner, who have headed the East Kilbride branch of the organisation for all those years. I have attended many of its events in the years for which I have represented that area. As I said, often people do not want to speak to professionals. That is where the voluntary sector comes into its own, because it can gain the trust of people who really need a bit of help.
I want to mention another constituency organisation, Theatre Nemo, and the importance of the confidence and relationship building that can come from drama, culture and the arts.
Let us celebrate Support in Mind Scotland’s 30th anniversary and support its one in 100 campaign, which has just launched. Let us make yet another pledge here in this chamber that wherever we come across stigma and discrimination on mental health issues, we will stand against it.
17:41
I congratulate Linda Fabiani on bringing the subject of mental health to the chamber, in recognition of world mental health day earlier this month. The motion points out that there is a particular focus this year on schizophrenia and the impact that that mental illness has on the lives of individuals and families across Scotland and the wider world. I will stick to that aspect of the debate, although I agree with what Linda Fabiani said at the beginning of her speech about the Mental Health (Care and Treatment) (Scotland) Act 2003, the see me campaign and other initiatives. There has been a great deal of continuity between the previous Government and this one on those developments.
As Linda Fabiani points out, Support in Mind Scotland has been running for 30 years and doing exceptional work in bringing the issues faced by sufferers into the public consciousness, challenging stigma and raising awareness. The first stage of its one in 100 campaign was launched earlier this month with a broad inquiry into people’s experience of living with schizophrenia and the obstacles that they face in navigating everyday life. Its efforts to reach communities in Scotland who have experience of coping with mental illness is commendable. Support in Mind reaches out to share best practice and to learn from the experiences of others.
I notice that it has a particular interest in a report from the Schizophrenia Commission on schizophrenia in England called “The Abandoned Illness”. Some of the findings in that report are interesting. Perhaps the minister can comment on whether there are similar features in Scotland. For example, on premature mortality rates, the report says that people with schizophrenia die 15 to 20 years earlier than their fellow citizens.
The report also talks about issues such as poor employment outcomes, the absence of support for families and the significant fear about speaking up because of stigma. I imagine many of those features are also present in relation to schizophrenia in Scotland.
On the basis of those findings, which present ample evidence for taking a more targeted approach to mental health services, Support in Mind Scotland is keen to emphasise the mutual experiences of service users in Scotland and England. What is interesting is that it proposes to carry out a review of the report and the findings to consider what applies here in Scotland and what the response of policy makers should be. To carry out that analysis, a small steering group of academics and professionals has been convened from across the national health service and other mental health networks. That will be another interesting report when it appears.
The Mental Health Foundation has also taken a great deal of interest in schizophrenia. It points out that, around the world, 26 million people live with schizophrenia. It is keen to highlight that perceptions of mental ill health and schizophrenia are slowly changing. Many who are asked state that in fact people with schizophrenia are not the danger to others once believed. That is certainly progress, although there is still further to go, not least in the media.
Moreover, the foundation says that if someone is diagnosed with schizophrenia, while it is a cause of concern, it should not mean that they lose the capacity to have a full and productive life. That can be helped by the more efficient co-ordination of services, which is one of the areas highlighted as an issue in the report on England that I mentioned. There needs to be a joined-up approach to treatment and support. That starts with early intervention and accurate signposting. Most important, the treatment of conditions such as schizophrenia should be seen as being as important as the treatment of physical conditions. Just because an illness is not visible does not mean that it is any less critical. Without vital early diagnosis, a mental illness can very quickly lead to physical symptoms and self-harm.
One of the worrying features is that people with schizophrenia and, indeed, other mental illnesses are often not looked after effectively in comparison with the treatment of other, more straightforward physical illnesses. The motion speaks of the one in every 100 people who have a life expectancy that is 15 to 20 years lower because of their mental illness. That enormous disparity tells us all that we need to know about the serious challenges faced in improving outcomes for those with schizophrenia. The worsening mental health of each affected individual should not come at the cost of deteriorating physical health.
A paper published last year in the British Medical Journal by the University of Glasgow’s Dr Daniel Smith concluded:
“People with schizophrenia have a wide range of comorbid and multiple physical health conditions but are less likely than people without schizophrenia to have a primary care record of cardiovascular disease. This suggests a systematic under-recognition and under treatment of cardiovascular disease in people with schizophrenia, which might contribute to substantial premature mortality observed within this patient group.”
In short, that suggests that people are dying earlier because of delayed diagnosis. Now is the time to recognise that kind of link and to make a pointed attempt to achieve the more preventive approach that the mental health strategy sets out.
I support the motion and welcome world mental health day’s focus on this much-misunderstood condition.
17:45
I thank Linda Fabiani for bringing up this subject. When I saw the title of the debate I was very keen to speak in it, as it has become increasingly clear to me that mental health is a major issue that needs more attention.
Recently in my constituency a care home was proposed. Assuming it was for elderly or similar residents, folk were broadly happy. When it turned out that it was for folk with mental health issues, there was a fair degree of reaction in the community. There were concerns about the residents being a danger and a lot of misinformation was spread around. Since then, the company building the home has given us a lot more information and most constituents have been reassured by that, but there has been a hard core in the area who have not been willing to listen.
Routinely, constituents come into the office about housing or other problems to which my staff and I believe that there may be a mental health angle. I am particularly grateful to the Glasgow Association for Mental Health, the Scottish Association for Mental Health and the see me campaign for their advice, information, and support.
However, the issue was underlined for me last week when three issues in my constituency, all of which had a mental health angle, made it into the media. First, I am dealing with a family in which the 19-year-old daughter has anorexia. Relations between national health service staff and the family have become somewhat fraught. I am convinced that all involved want what is best for this young woman, but we are struggling to get a meeting of minds on how to move forward. Sadly, one person involved in the case was arrested last week.
I was glad to see that the Evening Times today has a spread on anorexia, which mentioned the see me campaign. The headline is “Anorexia had wrecked my body ... but even worse was the stigma”. The story has a positive outcome: brave Leanne has battled to a normal weight and is now backing the mental health campaign, which is encouraging.
The second case, which has also had a fair amount of coverage, involves a well-known female writer and her ex-partner, who is a musician and one of my constituents. I most certainly agree that we should have adequate laws in place to protect actual and potential victims of stalking and I am happy if the law is to be reviewed. However, we have to balance that with our responsibilities to the other party, in this and other such cases, who might have a mental health issue. Often that person is not acting out of malice. One suggestion that I do not accept is that anyone charged with stalking could say that they have a mental health problem. That in itself plays down mental health issues as if they did not have an objective reality.
I very much hope that there will be no rush to change legislation without all angles on this issue being taken into account.
Is John Mason suggesting that someone should have to suffer appalling behaviour from someone who could be excused on the ground of having mental health problems?
There is a debate there on how appalling behaviour is—there is a whole range. There is stalking that is malicious and there is stalking that is just stupid and unwise, and is a result of mental health issues, which is slightly more what we had in my constituency.
The third case involves the Bellgrove hotel in my constituency, which some members may be aware of. It is really a hostel for homeless men rather than a hotel and is one of the last large homeless hostels in Glasgow. It is run by a private company and so avoids the Care Inspectorate and most other regulation. Last week, it received a new house in multiple occupation licence for 160 residents—generally, it has around 140 residents. My understanding is that a number of those men have mental health issues and are regularly in contact with the local mental health team in Parkhead. I cannot believe that the Bellgrove is the right place for them to be, and I cannot accept that the only regulation that it needs is an HMO licence. That again says to me that we are not taking mental health seriously enough. Indeed, all those examples say to me that we are not taking mental health seriously enough.
One point in the motion that particularly struck me, which Malcolm Chisholm also mentioned, was about people with schizophrenia having
“shorter life expectancies by 15 to 20 years”.
Nobody should say to us, please, that the matter is not a real and serious health issue.
17:50
I, too, thank Linda Fabiani for securing this debate on world mental health day and for giving us the opportunity to debate the critical issue of mental health.
In response to Sandra White’s question, Linda Fabiani mentioned early diagnosis and institutional issues. For many people, the issue is not only early diagnosis but a lack of diagnosis.
Although the motion shines the spotlight on schizophrenia, many issues that relate to that condition—including difficulties with getting employment, discrimination, stigma and shortened life expectancy, which other members have mentioned—also apply to most other mental health conditions.
The motion highlights the work of the East Kilbride support group. I also acknowledge the work of the Highland users group on mental health—HUG—which is very competently managed by Graham Morgan.
As a member of the Health and Community Care Committee, which scrutinised what became the Mental Health (Care and Treatment) (Scotland) Act 2003—to which nearly 3,000 amendments were lodged at stage 2—I hoped that there would be significant improvements in early diagnosis, early intervention, appropriate treatment and support, with people not parked on anti-depressants, and that there would be access to cognitive behavioural therapy and other therapies, psychology and psychiatry specialists and advocacy and treatment with dignity and respect. I hoped and trusted that all the issues that we discussed in the first session of the Parliament would be significantly improved more than 10 years later.
However, I have looked at a recent briefing paper from the Royal College of Psychiatrists, and I doubt the progress and success of the previous legislation. I will quote directly from that paper without my glasses. It said:
“Despite its longstanding position as a priority within health policy it remains the case that mental health services do not receive the same degree of focus (or funding) as other disease areas ... Mental health is responsible for”
23 per cent
“of the disease burden”,
but it gets 11 per cent of the budget, and
“The life expectancy of those with severe mental illness is on average 20 years less for men and 15 years less for women”.
It said:
“depression is associated with ... a 50% increased mortality ... a three-fold increased risk of death”
in subsequent years in respect of coronary heart disease, and
“There is a disparity in research spending”,
which particularly applies to schizophrenia. One of the United Kingdom health research funders showed that mental health got 6.5 per cent of total funding, despite 23 per cent of patients suffering from such conditions.
The recent Health and Social Care Act 2012 for England sets parity for mental health and physical health. I would be thrilled to bits if that were the case in the Scottish Parliament. I hope that it will be.
We—especially Richard Simpson and others—have often spoken about dual diagnosis. We have spoken about people with mental health and drug and alcohol addiction issues. We know that many people use alcohol and drugs as self-medication to mask and cope with mental health issues. That is in the paper from the Royal College of Psychiatrists.
The paper talks about services for older people and dementia. It says:
“Access to psychological”
and other services
“is much poorer for older people”.
The RCP makes plenty more points in its briefing. It is still
“concerned at the lack of Adolescent Intensive Psychiatric Care Units in Scotland. Young people with a need for this are required to be admitted to an adult ICPU.”
It also mentions the consultant vacancies in psychiatry, although I appreciate that psychiatrists are not the only specialists. It is disappointing to read about all the issues that are raised in the royal college’s paper given that they were also raised 11 years ago when the Parliament passed mental health legislation.
Other members have mentioned their experiences of trying to help constituents to find support, particularly in relation to personality disorders. The time taken to diagnose such conditions and the transition from child to adult services, which needs to be looked at, are poor.
You must close.
I have overstepped my time, so I will leave it there. I am pleased to have had the opportunity to speak and I thank Linda Fabiani for securing the debate.
17:55
I, too, thank Linda Fabiani. Let us make the debate personal: statistically, every one of us here has a 50:50 chance that at some time in their life someone with whom they have a direct one-to-one familial relationship will suffer mental ill health. That relates to two parents, a partner and a single offspring, which is statistically what we have as relationships, so the issues will be close to home.
I have discovered only in the past year, for example, that one of my mother’s aunts lived most of her life locked away in the asylum in Lochgilphead. She was never spoken about; I never knew that she existed until I did family research. That was the past and that was the stigma—it happened and it simply was not talked about.
In 1964, as a 17-year-old and before going to university, I very much enjoyed working for six or seven months as a nurse in a psychiatric hospital. That was a time when the treatment of one who was seriously mentally ill was to be locked in a ward and forgotten about. Staffing levels were appallingly poor. The world today is very different; let us hope that that is a good thing.
I will talk about a few matters. The first is awareness. What does mental illness mean for the sufferer? Not all people who suffer from mental ill health are self-aware that they have a problem. We cannot do much about that, but what we—the family and everyone else—can do by being aware of that person’s needs is be there to support them when they need that, catch them when they fall and lift them back up.
We need health treatment for people with mental ill health. We are increasing investment in mental health, which is welcome, albeit—as Mary Scanlon correctly highlighted—that it is the poor relation financially and, more critically, as a chosen specialism for people with medical training. That is more critical than money because, if we do not have the people with the skills, we cannot spend the money to help the people who need help.
We all have to be careful about the social interactions that we have with people who have different degrees of mental ill health. However, let us put a positive spin on the issue. Having a different mental approach, although it creates a huge burden for people, can deliver benefit. I will highlight the careers of three famous schizophrenics. Vincent van Gogh died at the age of 37. It is thought that he died because he shot himself. This is not the time to explore why there is doubt about that, but he produced the most wonderful impressionistic art. There is little doubt that how his brain and mind worked contributed to that. He paid a huge price for that, but he delivered a great deal for us, which we remember to this day.
Clara Bow—the it girl and one of the first stars in the silent cinema, who continued into the era of the talkies—suffered from schizophrenia for her entire life but contributed enormously to the experience and enjoyment of others. Nijinsky, the great dancer, was schizophrenic and, as with Clara Bow, he died relatively early at the age of 60. Many of those famous sufferers were in the artistic rather than the scientific or other domains, but one could speak about many others. Let us remember that people with mental illness can make a huge contribution, which is sometimes aided by the fact of their illness.
We talk about stress in modern society. Stress is good in pushing us forward, as long as we can deal with it but, in the complex world in which we live, too many people are overloaded, so that stress becomes distress and leads to mental ill health. Each and every one of us should be watching for that to happen.
An outcome of mental ill health for some people is suicide. Unfortunately, I have been close to three people who committed suicide. One did so—at the age of 18, I may say—because of a chemical imbalance arising from a physical condition. Another threw herself off a high building while suffering from post-natal depression. As for the third person, to this day we do not know why the suicide took place. There was no sign of it coming—it is a mystery, wrapped in an enigma.
As individuals, we all have a duty to help people with mental ill health and guide them to treatment. As parliamentarians, we must ensure that we provide the resources to help them.
18:01
I congratulate my good friend Linda Fabiani on giving us this opportunity to mark—rather belatedly—world mental health day, which this year focuses on schizophrenia, as members said. I also take this opportunity to commend Support in Mind Scotland for its excellent one in 100 campaign.
This is just the latest debate in the Parliament on mental health. I was fortunate to be able to take part in the debate that my Liberal Democrat colleague Jim Hume led in April. I might return to one or two of the points that I made then. During the debate, it struck me that many if not all the members who spoke were drawing on some element of personal experience. Stewart Stevenson rightly drew us back to such an approach in this debate.
It came as no surprise that members should draw on personal experience. The figures from SAMH and others suggest that one in four people suffers from a mental illness at some point in their lives and three out of four of us will know someone, fairly directly, who suffers from poor mental health. Mental illness remains the dominant health problem for people of working age, and it continues to damage careers, relationships and lives, coming at a colossal financial and human cost.
As Linda Fabiani fairly observed, there has been a succession of initiatives over many years, in successive Administrations. I congratulate the current Government on its mental health strategy, which has waiting times targets and emphasises data collection, both of which are fundamental to ensuring timely diagnosis and delivery of effective treatment. Treatment can safeguard the individual’s welfare in the first instance, and—without offering any guarantees—it can increase the chances of the person subsequently enjoying good mental health.
However encouraging the early signs of progress towards meeting targets have been, recent figures suggest that there is cause for concern. Mary Scanlon pointed to issues at a regional level. We are seeing variations between health boards, which SAMH suggested earlier this year are giving rise to a postcode lottery. For example, although additional experts have been recruited, there is evidence of significant variation in the per capita ratio of psychologists in different parts of the country, which is cause for concern.
There is particular concern in rural areas. As I said in the debate in April, SAMH, in its know where to go campaign, showed how people who live in remote and rural areas face additional barriers to accessing information, help and support. A culture of self-reliance and stoicism in places such as Orkney can work against efforts to get people with health issues, including poor mental health, to engage early with medical professionals. Although the wider community can be a source of support, that can make things more difficult and increase the fear of stigma, for not just individuals but their wider families. The result is delays in getting people to seek help for mental health problems, and, as SAMH explains,
“the later individuals engage with health services, the more complex their treatment and recovery will be”.
In the islands that I represent, there are additional practical difficulties as well. Orkney Blide Trust and Orkney Minds, which do fantastic work, highlight a lack of transfer beds at the Balfour hospital for those who may require a spell in hospital on the mainland and instances of poor discharge planning affecting patients who return to Orkney. Although those who are involved in the mental health team in Orkney carry out phenomenally good work, there is an opportunity, with the move to the new Balfour hospital and the further integration of health and care services in the islands, to look at how the needs of mental health patients can be addressed more timeously and effectively. I am sure that that will be the focus of an event that the Blide Trust is organising next month, which I am looking forward to taking part in.
The stakes are high. SAMH highlights suicide rates that are twice as high for those with mental health issues. As Stewart Stevenson observed, each of us probably has some experience of a close friend—in my case, it was a guy called Andrew Harrison whom I worked with at Westminster back in the early 1990s—committing suicide almost out of the blue. Such mortality rates are not unusual. As Linda Fabiani’s motion says, the mortality rates are far higher for those with mental health issues. A report in the British Journal of Psychiatry on a Nordic study states that, even given improvements, we are still seeing far higher rates of mortality among those with mental health issues. It is just one of the reasons why mental health needs to be put on a similar footing to physical health.
As I said in April, the issue needs to be discussed openly, taken seriously and addressed effectively. It is not a second-class condition and, ultimately, there is no good health without good mental health. I welcome the fact that Linda Fabiani has secured the debate and look forward to the minister’s response.
18:06
It has been an interesting debate. I take on board the point that Stewart Stevenson made. Someone who has been a strong influence on my interest in mental health issues is a former council colleague, Councillor Jim Kiddie, who is the representative for Torry and Ferryhill on Aberdeen City Council. Jim has spoken openly, in the council chamber and at SNP conferences, about his own mental health problems. He has been a fantastic champion of issues related to mental health and has inspired those of us who take an interest in such issues. I also recognise Stewart Stevenson’s point that one in four of us will likely experience a mental health problem at some stage in our life, which emphasises further his point about those in our social and family networks.
I am always struck by the stigma issue—the fact that, to this day, nine out of 10 people report that they feel that there is a stigma attached to their revealing a mental health condition, whether in work, in education, among healthcare professionals or in their home life. A cartoon that is shared on social media compares how things would be if we treated physical health as we treat mental health in society. Someone is asked, “Have you tried not having a broken arm?” or is told, “Maybe you should try cheering up a bit, and that will stop the bleeding.” Those are the realms that we would be in if we spoke about physical health as we often speak about mental health.
It is worth noting that Halloween is just around the corner. Halloween is one of those times when, it is fair to say, mental ill health is at its most misrepresented. Who could forget the controversy that was created just the other year when some major supermarket chains had to withdraw very inappropriate “mental patient” costumes that were designed to perpetuate, in some ways, the stigma that people with mental health conditions are dangerous? It is almost without foundation, but the idea continues to be perpetuated by some elements of the media that if people have a mental health condition they somehow become dangerous.
As well as focusing on treating mental health by recognising the needs of the individual, we need to look beyond that to future treatments that could be realised. While flicking through the news earlier in the year, I discovered that research undertaken at the University of Aberdeen has identified a potential genetic mutation of the ULK4 gene that could be linked to schizophrenia. The academics behind that at the university’s medical sciences department have said that, although more work needs to be done, they are encouraged by the work that they have done, which could enhance understanding of how schizophrenia takes form in those individuals who are affected by it. The identification of genetic mutations and genetic markers offers the potential to inform future treatments for the condition.
It is important that we recognise the work that is being done by many organisations across Scotland to raise awareness of mental health and to tackle stigma, but we must also recognise the work that is being done across the country by our dedicated medical professionals and researchers to get to the bottom of how conditions such as schizophrenia take form and to work on future treatments that can help to tackle those conditions at a much earlier stage.
18:11
As others have done, I begin by congratulating Linda Fabiani on securing time for tonight’s debate to recognise world mental health day, which was a few weeks ago.
I welcome the fact that we are having a debate on mental health. Several members, including Liam McArthur, mentioned that we have had regular debates on mental health issues. Although there is often a lot of focus on the services that are provided by the statutory sector, and our health service in particular, a tremendous amount of work to support individuals with mental illness is undertaken by third sector organisations, including Support in Mind Scotland and the volunteers in its East Kilbride support group, to whom Linda Fabiani referred. Part of the work that the Government does is to support organisations such as Support in Mind. At present, we are providing it with financial support over three years to 2017 to help it to deliver our shared objective of improving the wellbeing and quality of life of people who are affected by mental illness.
The challenge is clear. Mental illness is one of the top public health challenges in Europe. It is estimated that mental health disorders affect more than a third of the population every year, and people with mental disorders have a much higher mortality rate than the general population—on average, they die more than 10 years earlier, as Malcolm Chisholm said. That is why mental health is one of the Scottish Government’s clinical priorities. Our priorities in this area are being taken forward as part of our mental health strategy, which sets out 36 commitments. Within the sector, there is broad consensus that the approach that is set out in the mental health strategy is the right one, which will help to deliver the further improvements in services that we all want to be made consistently.
I am keen for further progress to be made on reducing the variation in availability of services and on increasing the pace of change in the delivery of quality mental health services for those who need them. It might be helpful if I outline to members some of the progress that is being made in delivering the commitments that are set out in the mental health strategy.
As I said in my earlier remarks, I very much welcome the approach that is being taken by the strategy. However, the minister will recall the exchange that we had in the debate in April about the legal status or priority that is attached to mental health, as compared with that for physical health. Does he believe that a signal about parity in law in that regard might address some of the issues that Stewart Stevenson recognised in terms of the pointer that it would give to people regarding the disciplines that they could pursue through higher education and, indeed, the research funding and so on that would go into research into those sorts of conditions?
Let me come to that point slightly later on when I address some other issues, because I want to go through a couple of the issues around the policy that has been set out in the mental health strategy.
The Mental Health (Care and Treatment) (Scotland) Act 2003 is probably not the right basis on which to measure the progress that has been made, because the legislation is not there for on-going operational policy purposes. It might be helpful if I set out some of the progress that has been made and turn to some of the points that Mr MacArthur has raised, which I intend to do.
Seven commitments have already been completed and the remainder are well under way or scheduled for work in 2015. Although there is not enough time to cover all the areas, I will go into a few of them. One of them is the issue of tackling stigma and discrimination, which a number of members have made reference to, and the see me campaign, which is Scotland’s anti-stigma and anti-discrimination programme. The programme is hosted on behalf of the Scottish Government by the Scottish Association for Mental Health and the Mental Health Foundation. It was principally focused on stigma, and has been refounded and extended to deal also with discrimination.
In a partnership that we forged with Comic Relief, funding has gone from £1 million a year to £1.5 million a year, which is a significant increase in funding. A key part of refounding the programme is around looking at areas where people have particular experience of stigma and discrimination, including in the workplace and in accessing health and social care services. That is why we are ensuring that the new campaign focuses particularly on those areas.
Linda Fabiani and others raised the issue of the challenge that individuals with mental ill health can experience in being able to gain access to employment. Again, a key commitment on that was set out in the mental health strategy. We have a stakeholders group that is made up of the Scottish Government, the health service, local authorities, the Department for Work and Pensions, the third sector and specialist employment providers. The group is drawing together a report with recommendations for the Scottish Government—“What works for mental health in employability”—in order to look at what further measures we can take to improve employment opportunities for those with mental illness.
I turn to a point that was raised by Linda Fabiani around children and adolescent mental health services and pick up on a particular point that Mary Scanlon made about what she feels is a lack of improvement in CAMH services. She was on the Health and Sport Committee with me in the previous parliamentary session when we investigated access to CAMH services. At that point, we found that there were significant deficiencies in accessing those services.
So, what has happened since 2008? We have set the health improvement, efficiency and access to treatment target for faster access to CAMH services at 18 weeks, which will apply as of December this year. We have seen over the past couple of years a significant increase in referrals and in the numbers of individuals who are being treated. We see average waiting times for CAMH services across the country being between eight and 10 weeks, which is a significant improvement since the inquiry that the Health and Sport Committee undertook. We have also seen significant financial investment: since 2009 an additional £13.5 million has been invested in CAMH services. That has also resulted in a 45 per cent increase in the CAMH services workforce. One of the things that the Health and Sport Committee identified was a lack of staff in CAMH services.
That is not to say that everything is right and that we do not have in some areas waiting times that are still far too long. However, what we are seeing is a general improvement. We want to make sure that we build on that level of improvement and take it further.
We have also applied the 18-week waiting time to access to psychological therapies. The reason why we have set that waiting time target for psychological therapies, which comes into force this December, is to create parity with physical services in a way that has not been done anywhere else in the UK. Having something in a bit of legislation does not result in parity; parity is achieved by the policy that is delivered on the ground, and Scotland is the only part of the UK so far that has set a target for accessing mental health services that is equal to the target for accessing physical health services.
I remember the days on the Health and Sport Committee when Mr Matheson was not a minister.
I said that progress is disappointing, but it would be absolutely wrong to say that there has been no progress. I can remember the days when waiting times were years, rather than months and weeks. However, everything that I mentioned today about the lack of progress came from the Royal College of Psychiatrists, which has been very vocal on the issue during consideration of new mental health legislation.
I did not have time to mention the fact that, although a person can see a mental health specialist within a certain time, the RCP also said that, at June this year, 5,300 children were still waiting to access treatment in the service. That causes concern.
As I said, I do not want to give the impression that everything is as good as we wish it to be, but we are involved in a process of improving services. We want to maintain that, and that is what the mental health strategy sets out. However, it would be wrong to give the impression that no improvement has taken place and that we are not making progress.
I do not wish to rush you, minister, but I would be grateful if you would draw to a close.
I turn to the points that Malcolm Chisholm made on life expectancy and poor employment opportunities. I mentioned the commitment in the mental health strategy to try to improve employability and opportunities, and the work that we are doing on that. The mental health strategy also addresses that second point on life expectancy, and we are doing work on that.
I will finish on a point that I think members will find useful. We are going to publish a 10-year review report, which will provide a national picture of mental health services in Scotland from 2003 to 2013, so that we can see where the challenges remain and where progress has been made. We should have that report by the end of this year and will, I hope, publish it early in the new year. I have no doubt that it will help to inform members about the areas where further work needs to be undertaken. I assure members that the issue continues to be a priority for the Scottish Government and that we will continue to build on the progress that we have made in recent years. I welcome the particular interest that so many members show in mental health.
I thank all members for that excellent debate.
Meeting closed at 18:23.Previous
Decision Time