Chamber and committees

Among the recommendations of the review are that NHS-linked charities should put in place induction training for all charity trustees and that the need for on-going training and support should be considered. Such training and support will be an important step towards widening access and ensuring a more diverse membership of NHS-linked charity boards. I appreciate the cabinet secretary’s earlier answers to Paul O’Kane and Douglas Lumsden, but what measures, such as paying trustees and implementing training, will the cabinet secretary employ to ensure that our boards are more representative of lower socioeconomic backgrounds, ethnic minority backgrounds and disabled people?

NHS Lothian’s chief executive has said that the board has requested mutual aid, but I am concerned about the capacity of other health boards to fulfil that request. As we know, the issues facing NHS Lothian are impacting health boards across the country. Just a few days ago, NHS Lanarkshire moved to its highest risk level. What assurance can the cabinet secretary provide that requests for mutual aid can be met, and that health boards that are struggling will be provided with the assistance that they need?

I have one more question on that before we move on to talk about the bill.

If a woman who has had mesh inserted that has caused problems is nervous about the surgeon who put the mesh into their body also being the surgeon who might remove it, is that taken into account and respected?

I am interested in how we can support women’s mental health and in whether consideration was given in the bill to reimbursing private medical costs related to that. In our private round-table session this morning, we heard that some of the women had lost confidence in the centre in Glasgow, and some will probably have lost confidence in the Scottish NHS as a whole. They might want to be seen privately for what has been for many of them a traumatising event. Has consideration been given to paying for or reimbursing women for private counselling and other services, aside from mesh removal itself, that might help them to recover?

I extend my party’s condolences to everyone who has lost a loved one.

I have expressed concern about the changes to travel restrictions and the impact that they will have on our ability to prevent variants from entering the country. The First Minister said in her statement that travellers who receive a positive lateral flow test result will have to book a PCR test. Will she say how that will be enforced and how the approach will affect our ability to monitor for new variants entering the country?

Will the member take an intervention?

Does the member recognise that it was his party’s position that was criticised by the prominent drug campaigner Peter Krykant, for the language that was used over the weekend, not Lorna Slater’s position?

Mental ill health is intertwined with drug use. Trauma and adverse childhood experiences can lead people to use drugs, and the stigma and shame of drug use can prevent them from seeking treatment and help, so we have to tackle the situation from both ends.

I am pleased that the debate crosses portfolios and that the motion recognises that we must do more to support people who use drugs. That includes housing and income and how they join up with the support that comes from the NHS. Ensuring that people who require residential treatment can keep their tenancies and homes will help to reduce anxiety about what will happen after their treatment.

It is essential that we ensure that we provide person-centred wraparound care. I am sure that we all agree that services cannot work in silos if we are to tackle the drugs death crisis. We need joined-up whole-system thinking that addresses the many ways in which people who use drugs are marginalised. We must promote good mental health by providing support to families to reduce adverse childhood experiences.

We also need better mental health support for care-experienced children and young people. I thank all those at the Who Cares? Scotland event yesterday who spoke to the Minister for Children and Young People, and to Anas Sarwar and me, about their experiences. I extend my particular thanks to Nicole, who spoke to me about her experience of drugs and mental health. When I asked her what she would like to say to the Parliament, she told me that she wanted politicians to listen to what people need and to act on that. All participants were also very keen to see trauma-informed care, and for clinicians to be aware of care experience.

Stigma kills. For people who currently use drugs, stigma is one of the biggest factors preventing them from seeking not only help for their drug misuse but any health support, including support for mental health. If people feel that they will be judged for accessing healthcare for their drug use, or that their health conditions will be blamed on their substance use, they are less likely to seek help.

According to the Mental Health Foundation, some people with a dual diagnosis of a mental health problem and drug use find it hard to get the help that they need. Some are turned away from mental health services because they use drugs. That clearly shows the cultural and institutional change that must happen before people who use drugs can access mental health services without fear of stigma.

We need a system of harm reduction, including safe consumption rooms and testing of drugs. It is awful that we cannot test drugs to ensure that they are not cut with poisons, cement dust or many other substances, or to ensure that people are informed about the strength of the drugs that they are taking. That would undoubtedly save lives, but we cannot do it under our current powers. We need those powers in order to prevent deaths. That is a public health measure; the powers should be devolved as soon as possible. That first contact would also allow us to build trust and to help people into mental health support or drug treatment.

One of the most powerful things that we can do, whether we agree with each other or not, is change how substance abuse is spoken about, both in the chamber and more widely, when we make comments to the media. Taking drugs is very risky because of the lack of safe consumption facilities. It is risky because we cannot test drugs, because of the entrenched stigma in our media, because of the dangers of illicit supply and because people feel that they cannot come forward for treatment because they will be judged.

Drug use is not a moral failing, but much of the language that we use expresses judgment. By examining the language that we use to talk about drug use in the chamber and in the media, we can help to set the tone. I hope that we all feel the weight of that responsibility.

I welcome this debate in advance of world mental health day and thank Paul McLennan for securing it.

As the motion states, the pandemic has

“exacerbated pre-existing inequalities in mental health”.

We need to understand what is driving those inequalities, or attempts to address poor mental health will be immediately undermined.

Health and income are inextricably linked. According to the Mental Health Foundation, poverty is both a cause and a consequence of mental ill health. Its report, “Coronavirus Scotland: The divergence of mental health experiences during the pandemic”, states that

“already, before the pandemic, those at the lower end of the economic ladder were more likely to be experiencing a mental health problem.”

We must acknowledge the impact that poverty and income inequality has had on mental health during the pandemic. We know that Covid-19 has not affected everyone equally, and the Tories’ cut to universal credit will seriously worsen matters. Indeed, the British Psychological Society has warned of “devastating consequences” for people’s mental health. There will be an immeasurable impact on individuals and families, who will struggle to pay their bills and be forced to make the awful choice between heating their home and buying food, at a time when they are already dealing with rising living costs and the continued uncertainty of the pandemic.

Services will always struggle to meet demand while the Tories continue to enact policies that decimate people’s mental health and income. A truly preventive approach would seek to tackle the link between poverty and poor mental health. The Mental Health Foundation is calling for a universal basic income pilot to be carried out in Scotland. The Scottish Greens have long supported the introduction of UBI in Scotland, and I have no doubt that it would be an important tool in our efforts to tackle Scotland’s poor mental health. The Scottish Government has committed to introducing a minimum income guarantee in the absence of powers to implement UBI. I look forward to those proposals.

However, we must recognise that many interlinking factors affect mental health, including racial inequality, gender, disability, age and sexuality, as well as economic status.

Absolutely. Loneliness is a particular concern for older people, who may have become isolated from friends and family during the pandemic because of people wanting to keep them safe.

The Mental Health Foundation report identified a need for better recording and reporting of information on ethnicity. It is clear that there is much work to be done on that. Wave 4 of the Scottish Government’s Covid-19 mental health tracker survey revealed that only 20 people from an ethnic minority background took part, which is only 16.5 per cent of those who engaged in wave 1. That is a particular cause for concern, given that the wave 1 report revealed that respondents who identified as black, Asian and minority ethnic frequently reported worse mental health indicators.

Quality data is vital if we are to understand and address the specific mental health challenges that people from ethnic minority backgrounds face. I look forward to hearing from the Scottish Government on how it will improve data collection.

Finally, I want to focus on the mental health of health and social care staff. They have been going at more than 100mph for almost 19 months. Many are exhausted, demoralised and at increased risk of burn-out. Yesterday, the NHS Lanarkshire branch of Unison published a letter detailing how the current pressures on our NHS are affecting the mental and physical health of those on the front line in my region and more widely across the country.

I welcome the Cabinet Secretary for Health and Social Care’s announcement earlier this week of an additional package of £4 million to support front-line workers. When staff cannot access basic necessities such as food and water or restrooms during a shift, it will undoubtedly have an impact on their mental health. Staff have been under enormous pressure and have worked tirelessly in extremely difficult conditions to keep us safe. Now is not the time to turn our backs on them and demand that they get on with the job. I look forward to working with members across Parliament to ensure that those front-line staff get the support that they need and deserve.