Chamber and committees

Thank you. Do any other witnesses want to come in?

No, thank you. I am all good.

Thank you.

As well as preventing more migrant workers from coming here, the announcement this week will undoubtedly make those who are already here worry about the anti-migrant rhetoric that is rising across the UK. What work is the Government undertaking to prevent those staff from moving away from Scotland and to support them at a time when the toxic narrative around migration appears to be growing?

Good morning to the witnesses. Does the bill adequately promote collaborative working among health, addiction and broader support services to ensure the holistic approach that it seeks to achieve?

Notwithstanding what the witnesses have already said about what the bill does and does not do, is there a way to amend it in order to reflect some of what has just been said? Could the bill enhance some of the services that we already have, or do we need to put more effort into enhancing and promoting them?

Several organisations have warned that the bill’s requirement for in-person appointments could exclude some vulnerable individuals or those who have barriers to being able to attend appointments for whatever reason, including those with mental health issues, who may find attending appointments difficult. Would the panel support changes to the bill, to allow for greater flexibility and greater use of telehealth and outreach models, for example, to reduce those barriers and make recovery within the bill more accessible and inclusive?

Sorry, convener—I was waiting for my microphone to come on.

Good morning. I want to follow up, in particular, on what Graeme Callander, who is in the room, just said about the potentially limited flexibility in treatment options. We heard from a few stakeholders that, while there is a person-centred approach in the bill, it may inadvertently create standardised or overly medicalised treatment pathways. In your opinion, how could the bill be amended to ensure that treatment remains genuinely personalised, especially for people who may need a longer-term psychosocial approach or who may require support before they are available or able to take up some of those clinical interventions?

I, too, extend my gratitude to Roz McCall for securing the debate.

Since 2001, mental health awareness week has marked a time to challenge stigma and push for action. The week’s events, which this year run from 12 to 18 May, are led by the Mental Health Foundation and aim to raise awareness and to advocate meaningful change.

As the members who spoke prior to me have pointed out, this year’s theme is community. That should serve as an important reminder of how connection, belonging and mutual support can strengthen mental wellbeing. Community is not just about where we live; it is also about our feeling supported and valued by others around us, which reminds us that we are not alone.

There is some way to go to improve mental health support in Scotland. As SAMH points out, although the Scottish Government’s mental health and wellbeing strategy rightly emphasises early intervention and prevention, the reality on the ground is that access to local services remains inconsistent.

Too many people can access help only once they have reached crisis point, and statutory services that are designed to support the most complex needs are overwhelmed. The number of people who report a mental health problem has more than doubled since 2011, and 11.3 per cent of people who responded to the 2022 census said that they had a mental health problem, compared with 4.4 per cent in 2011. In a way, that should absolutely be welcomed. Enabling people to recognise that they are struggling is a hugely important part of raising awareness and tackling stigma.

Primary care remains a crucial route for accessing mental health support. SAMH welcomes the increase in the primary care mental health workforce, with 356 new full-time equivalent posts being funded through action 15 of the Scottish Government’s mental health strategy. However, community link workers are meant to be a core part of those services. They play an essential role in helping people to access wider community support and to address the underlying causes of their distress. Important work continues to be needed, such as committing to long-term multiyear funding for community link worker provision across the country, with continued work with partners to standardise the community link worker role.

The Scottish Government must act urgently to work with IJBs, local authorities and health boards to ensure that community mental health provision is maintained and sustainably funded to meet the needs of our communities.

I want to turn members’ attention to the challenges that the system faces in meeting diverse needs across the population. Services that were designed for people with severe mental illnesses such as schizophrenia and bipolar disorder are now also expected to handle rising demand for neurodevelopmental condition assessments, such as those for autism and attention deficit hyperactivity disorder, which now affect about one in 10 people. Around the country, we are seeing the removal of some of those pathways for people with autism or ADHD diagnosis needs. During the debate on the programme for government, I mentioned that, although we should encourage workplaces and education settings to put support in place, regardless of people’s diagnoses, we cannot rely on those settings to do the right thing, and nor can we underestimate the positive impact that a diagnosis can have for some people. We need the pathways that we have lost to be reinstated.

Initiatives such as See Me Scotland highlight that their research clearly demonstrates the need for on-going investment and a sustained focus on addressing stigma and discrimination in Scotland, especially on how those factors affect the experiences and outcomes of people who live with mental illness. They also underline the scale of the challenge that lies ahead and the transformative change that will be required if we are to meaningfully reduce such stigma and discrimination.

The importance of community extends to recognising the impact on carers and families. The Scottish Huntington’s Association has, I am sure, shared powerful examples with many members. The condition affects physical, cognitive and mental health, and it places enormous strain on family members who provide care.

For 35 years, families in Scotland have been supported by Huntington’s disease specialists from the Scottish Huntington’s Association. That proactive and community-based support has been shown to prevent crises and reduce the number of hospital admissions. It is precisely the kind of service that we should be protecting. Despite that, services are potentially being cut, so the Government needs to work with IJBs in that regard.

I echo Roz McCall’s comments on psychological support for people who have had a stroke. At the cross-party group on stroke, we have heard people describe how, following their stroke, some survivors find themselves coming to terms with their new life while disliking pastimes and even food that they used to like. Families find themselves coming to terms with a new person who has come home following their stroke. The Stroke Association has a brilliant report on that, if anybody wants to see it.

Awareness matters, but it is only the starting point. To build a fairer system, we must listen to those who are directly affected and commit to creating services that are properly resourced, responsive and equitable.

My question relates in particular to age verification and the supplementary LCM. There are new forms of identification coming on board—we have challenge 25 at the moment—so how quickly does the Government envisage us being able to skill up the workforce that is selling the affected products to make sure that we do not inadvertently have young people accessing things that they should not, or people who are trying to use products for cessation being unnecessarily refused?