Chamber and committees

It is good to hear you mention multidisciplinary teams, and it is great that they are expanding to include physios, pharmacists, occupational therapists, mental health nurses, dentists, optometrists, psychiatrists and paramedics. The teams are getting bigger and bigger all the time; it is important that they do so.

However, concerns have been raised in previous evidence on workforce planning that we will end up just moving people around instead of creating the new capacity that we need. We have also heard about the importance of investing in and integrating workforce planning across primary care and other services. How will the Scottish Government create new capacity in implementing workforce planning in primary care and services across the board?

I have a final question. It is nice and short, but I am not sure that the answer will be nice and short. What might the implications of the national care service be on capacity and workforce planning?

Thank you; that is very helpful.

I thank Gillian Martin and others for their contributions so far, but my biggest thanks must go to the women who shared personal stories with committee members during our inquiry. They were very clear about why good access to mental healthcare matters.

As has been noted, perinatal mental health issues affect up to one in five Scottish women. Those issues range from anxiety and depression to mood disorders and psychosis. Some women are facing mental health challenges for the first time, while others have experienced them before. The women we listened to made it clear that their families come in different shapes and sizes, which is why the committee report highlighted the need to put mums and families at the heart of care and support.

Given that our convener has already touched on the plethora of challenges and the important recommendations of the inquiry, I will use my time to reflect on the things that stood out to me personally. I will say more on the holistic, family-centred approach that I have already mentioned and touch on Covid-19, inequality and the need to listen to and respect women’s voices.

The Covid-19 crisis intensified perinatal mental health issues and increased demands for services. Studies from across the world show that clearly. We know that the pandemic posed additional challenges for women, particularly those from minority ethnic and socially disadvantaged groups, and placed additional strain on services and their staff. Unsurprisingly, it exacerbated the challenges and the future development of perinatal mental health services must take account of the social detriments of maternal and infant mental ill health, reduce stigma and ensure equality of outcomes for all mums and their babies.

It is also vital that we take a more holistic approach that involves whole families and focuses on improving overall family wellbeing. That approach would also benefit our public services. The inquiry evidence repeatedly highlighted the importance and the benefits of a preventative and community-based approach that avoids mothers reaching the point of crisis.

Like any effective system that prevents mental ill health and promotes good mental health, perinatal mental health support must work at three levels: it must be universal for the whole population, selected for high-risk groups and indicated for people with signs or symptoms of mental health problems. Key to that is increasing the circulation of the information that is available to women and their families. Although there is high prevalence of perinatal mental health problems, rates of detection and appropriate interventions are still low.

I was quite shocked that postnatal depression and depression during pregnancy are thought to go undetected in as many as one in two women and that women with pre-existing mental health issues are not being identified at that first point of contact. The provision of better information can help stop women falling through the cracks.

It is also important that, when women bravely ask for help, or raise concerns about their wellbeing or that of their child—this is difficult to say—they are too often dismissed or disbelieved at that critical stage. Women must be respected and listened to. We must get to a place in which we accept no excuses for not doing that.

Third sector services are often excellent, but women told us that support sometimes comes too late and too far down the line. Health professionals can lack awareness of those services, and an integrated approach to investing in third sector expertise is key.

On that note, I really welcome the Scottish Government’s significant funding of £16 million in perinatal and infant mental health since March 2019, and the funding for all NHS boards towards specialist community perinatal mental health services. More than £4 million has been invested in that in 2021-22, which is especially welcome.

Detection and prevention are key to supporting women during that critical stage of their lives. We need to equality proof the delivery of perinatal services. Quick and easy access to perinatal mental health support must be available to every woman in need. We must stand with them and we must keep on listening.

I agree that the retail strategy represents an opportunity to advance Scotland’s wellbeing economy. How will the strategy feed into Scotland’s broader vision of an economic system that is based on wellbeing, fair work and community empowerment?

I appreciate the minister’s answers so far. Can he comment more widely on any Scottish Government plans to strengthen the partnership working between secondary schools, businesses and colleges, particularly on trade apprenticeships, to ensure that young people have a chance to get a taster of trades and make fully informed career choices?

That is helpful. I have a short final question for both of you. What is your top ask of us if we are to facilitate the positive changes that our young people want and deserve?

Fantastic. I hope that our committee can get that positive message out there.

I should declare an interest in that I am a councillor on South Lanarkshire Council. You would say that there are good examples of collaboration that we could build on.

That brings me to my next question. You have spoken about the need for the national agency to be responsive and reactive. Looking again at the role of the regional improvement collaboratives, I am interested in what you see as the priorities for creating that on-going collaborative environment. How can we ensure that the local authorities, the teachers, the parents and, most important, the young people—including our young people with additional support needs, who make up quite a big proportion of pupils—can be involved in that? How can we maximise their influence and ensure that wellbeing and rights are a central focus?