Chamber and committees

The Scottish Greens believe that everyone who needs mental health support should have quick and easy access to it. To ensure that it has parity with physical health, we must place mental health at the heart of our healthcare system, and part of that is ensuring that people can get support and treatment when they need it.

Too many people are waiting too long for treatment. The numbers of referrals to psychological therapies are now back to pre-pandemic levels, and services are struggling to meet demand. If we are committed to prevention and early intervention, we need to make it as easy as possible for people to access mental health support. We need to provide an alternative to acute treatment, so that people not only receive the most appropriate support but do not sit on a waiting list while their mental health worsens.

We know that the pandemic has had a devastating impact on mental health. People have struggled financially, they have lost loved ones and they have been isolated while in lockdown or shielding. We should not underestimate the effect of that collective trauma, which will continue to take its toll for many years to come.

For most people, making an appointment with their GP is the first step towards getting help for mental health problems. Like Monica Lennon, I am concerned with the issues that face NHS Lanarkshire at the moment. According to the Royal College of General Practitioners, approximately one third of all consultations in GP practices have a mental health component. General practice teams have already been providing mental health support to a large portion of the population and, as health professionals embedded within the community, they are well placed to do so, particularly to individuals who might not require acute or specialist treatment. According to a recent RCGP Scotland survey, 94 per cent of GPs who responded agreed that, since the beginning of the pandemic, the number of patients who present with mental health problems has increased.

The GP workforce is under pressure like never before, and that is impacting GPs’ ability to help patients who seek mental health support. A report that was produced by SAMH found that, although there have been very positive examples of participants receiving support from GPs, the pressures of the pandemic have negatively affected some people’s experiences of accessing mental health support, with many describing difficulty in accessing appointments, due to high demand.

We cannot leave people struggling without the help that they need, but neither can we expect existing services to meet the surge in demand. We need to expand the number of mental health professionals who work within communities. That is why the Scottish Greens and Scottish Government have committed to ensure that, by the end of this parliamentary session, every GP practice will have a link worker and access to an assigned, community-based mental health clinician. That will help to ensure that patients can access mental health support as quickly as possible and that they see the most appropriate person.

If treatment is truly to be person centred, we also need a diverse mix of mental health professionals in primary care, so that people can see the right person at the right time, whether that is for cognitive behavioural therapy or talking therapies. That will, in turn, improve the support that is provided to people who seek help for their mental health and reduce GPs’ workload.

Increasing the number of community link workers in general practice will—we hope—improve engagement with social prescribing, the mental health benefits of which are well known. In Lanarkshire, the well-connected social prescribing programme has been shown to help people by improving self-confidence and self-esteem, reducing low mood and feelings of stress, and helping people to develop positive ways of coping with the challenges of life, among other benefits.

In a recent scheme, which was run over five months, GPs at five practices in Edinburgh prescribed nature as part of a collaboration between RSPB Scotland and Edinburgh and Lothians Health Foundation. The scheme aimed to establish the effectiveness of using nature as a health tool in an urban setting, with a view to rolling it out to other practices. Given that many peer support groups were cancelled because they were not able to meet in person during lockdown, outdoor social prescribing must be in the mix going forward.

Great work is being done on social prescribing, and the benefits are being felt. However, we know that clinicians might struggle to find the time to engage with social prescribing and to develop relationships with local organisations. Community link workers will be vital in that regard, as they are able to spend extended time with patients. Link workers can build relationships of trust and signpost patients to appropriate, local, non-NHS services. However, due to the pressures of the pandemic, many non-NHS organisations might be providing limited or reduced support, so it is essential that we support those organisations during their recovery from the pandemic, and ensure that there is equal access to social prescribing across the country.

Given that many of the women who travelled did not expect to be reimbursed, do you believe that there is sufficient flexibility to address the many different situations that may arise, to ensure that anyone who claims under the scheme will be covered?

That is great—thank you.

Can the witnesses provide more detail on the exceptional circumstances provision at paragraph 16? Can you provide an example of circumstances that may require that provision to be used?

The importance of complying with public health guidance to safeguard the most vulnerable in society and to protect our public services has been paramount for the past two years. In that time, so many of us have made sacrifices, not seeing loved ones and not visiting those in crisis, but the level of solidarity shown by the public in following guidance and laws has been impressive. It is, therefore, sickening that it appears once again that the Prime Minister and his inner circle have ignored the rules and tried to cover it up. That is undermining public confidence in following health advice. The public feel betrayed and the Prime Minister must go. Does the First Minister agree, and what can we do to retain public confidence in current measures?

I thank Rachael Hamilton for securing this important debate. As we have already heard, around one in 10 women suffers with endometriosis. It can affect fertility, cause chronic pain, depression, fatigue and severely impact the quality of life of those who suffer with the condition.

The actual cause of endometriosis is unknown. There are several potential risk factors or triggers, but none of them fully explains why some and not others develop the condition. It can last between puberty and menopause or for much longer.

It is estimated that endometriosis costs the UK economy £8.2 billion a year. Many will feel the financial impact through lost days of work, or not being able to work at all. For many who have endometriosis, the quality of life impacts will be severe. The mental health impact of endometriosis needs more recognition and better support. The current average time to diagnosis is eight years, which, as we have all recognised, is too long. I welcome the commitment in the women’s health plan to reduce it to less than 12 months.

There are many gynaecological conditions that have similar symptoms and lengthy waits before diagnosis. To ensure that we get everyone the correct help and treatment, we need to reduce diagnosis times across the board, and raise awareness of the specific conditions. In previous women’s health debates, many of the MSPs who spoke noted that, at some point, they felt that their symptoms were not taken seriously. We need to address why that is happening, otherwise those who are suffering will continue to not come forward to raise their symptoms.

I take the opportunity to thank the MSPs and campaigners who worked to bring the condition to the forefront in the previous session. As a result, we have seen wider recognition, and I am sure that many people are now seeking support for their symptoms after seeing that others are also experiencing them. It is important that we continue to talk about our experiences and break the stigma around talking about gynaecological issues and the symptoms that they cause.

Rachael Hamilton mentioned menstrual health, but she did not have time to elaborate further, so I hope that members will indulge me for briefly covering another gynaecological issue. Previously, I have asked about ensuring that polycystic ovarian syndrome is appropriately recognised in the women’s health plan. On average, it takes three years for a diagnosis, and those seeking help will see three doctors before being diagnosed. Similar to endometriosis, without interventions, symptoms can deteriorate and serve as a risk factor for other conditions, such as heart disease. Symptoms can include irregular periods, fertility issues, weight gain or issues losing weight, and hirsutism, which is excessive body hair growth that is usually dark and coarse. In a world in which appearance is routinely judged, that can severely impact women’s confidence and their mental health.

Often, those seeking help are simply told that losing weight will resolve their symptoms, with no recognition of the increased insulin resistance that can come with PCOS. One of the many tests for diagnosis is the test for different hormone ranges. For someone who suffers those symptoms to be told that they cannot be given a diagnosis because their hormones are borderline okay can leave them feeling adrift and helpless. I am one of those who is seeking a potential PCOS diagnosis, and alongside those who are raising awareness of treatment standards of endometriosis, I want to do more.

To those who are struggling with symptoms of endometriosis, PCOS or any other gynaecological condition, I say that you are not alone. Your weight or your body hair does not define you. Choose to embrace it and choose to deal with it. Do not let society shame your body—it is the one that gets you around during the day. Whether you have hair on your arms or face, or whether you have a period, it does not reduce your worth.

We need to break down the societal stigma as we work to ensure that our health services are able to diagnose and treat appropriately in a timely manner. We need to allow GPs time to do the research and update their knowledge. The entire health service is under extreme pressure, and it would be negligent not to acknowledge the impact that the pandemic will have on our ambitions for treatment times. That does not mean that we should not be striving for quicker diagnosis now, but it is important to be realistic.

I thank Rachael Hamilton for securing the debate, and I thank all colleagues who have shared their stories this evening.

Eleven local authority areas returned to school today and school staff, pupils and parents are understandably anxious about what effects the omicron surge will have. Many teachers will be opening windows to ensure adequate ventilation, but with temperatures close to freezing, that creates other problems. Will the First Minister consider deploying some of the money that is currently allocated to economic support to instead assist local councils to purchase air filtration units for classrooms that require them?

In some schools, multiple classes are sharing CO₂ monitors. With case numbers still rising and the return from school holidays just over a week away, will the First Minister set out what measures are being considered to ensure that the return to school is safe for pupils and staff and minimises disruption to learning? Has she received an update from the Joint Committee on Vaccination and Immunisation following the Medicines and Healthcare products Regulatory Agency’s approval of the Pfizer vaccine for five to 11-year-olds?

Given the emergence of the omicron variant, the impact that it will have on the recovery of the health service and the uncertainty around that, how do you see that spending around recovery being allocated?

Thank you.