Chamber and committees

Many mental health practitioners will say that long periods of isolation and a lack of social contact have inevitably had an effect on many people’s mental health. That is what practitioners hear in their sessions, and the situation is stark when it comes to children and young people. The pandemic and repeated lockdowns have been traumatic for children, with months away from school, separation from friends and anxiety about the virus, as well as concerns about their future job prospects. The period between the ages of 19 and 25 is considered to be the most critical period in a person’s life, as it is when they make life choices. We have to factor that into the services that we provide.

We are already starting to talk about a lockdown generation, so we need to prepare our support services for that reality. Sadly, we know that the mental health crisis was with us before the pandemic. Craig Hoy gave an example of that earlier when he mentioned the experience of young girls on social media, and a recent survey showed that three out of five girls had complained of some form of sexual harassment.

There is an urgency about setting out a comprehensive response in the creation of a mental health system that is fit for purpose, with longer-term thinking, funding and support. The pandemic has also highlighted the deep inequalities in our society, and we must be mindful of that in our support for children and families.

All children must be given the same chance to reach their individual potential, but, in order for that to happen, we need to do more to level up opportunities so that our ambitions for them in school and education are accompanied by strong action such as one-to-one help on skills and support in education. Many studies have shown that children and young people who live in poverty experience a greater impact on their mental health and educational attainment. Catherine Seymour, the head of research at the Mental Health Foundation, said:

“our evidence indicates that teenagers from less advantaged homes are having the hardest emotional struggle of all. They are much more likely to report frequent symptoms of anxiety and depression than their peers with parents in jobs that are typically better-paid.”

How do we know that young people are getting the support that they need? How easy is it for them to access the support that they need? How easy is it for them to access the right type of support? I suggest that it is not always easy and that there are quite serious issues of young people struggling to get the support that they need. I have previously raised in the chamber the worrying case of many young people whom I have dealt with being bumped off the referral system for reasons that seem to be very thin. I wonder whether that is due to pressures on the service, but surely such a system must factor in that a person might not be able to respond to a letter or a call because they need a mental health service. Surely bumping them off the list for not responding is fundamentally the opposite of what the service should be doing.

I have also raised previously the fact that, in Glasgow, there is an opt-in service but, if a patient does not reply to a letter within five days, they can be removed from the referral system. I do not really understand that model of care. I have now spoken three times in this debate about mental health, and I want the ministers to address the question of the structure and quality of our mental health service.

In many other areas, we differentiate between young people up to the age of 25 and adults. However, for some reason, we have not done that in our health service, although we have striven to get a transitional service, which is really important when it comes to mental health. The shift from childhood to adulthood is sharp, so we need a service that is designed to recognise that. I therefore welcome the Government’s commitment to extending the CAMHS programme up to the age of 25, but I am concerned about the high rate of referrals being rejected. A figure that I found today suggested that 27 per cent are rejected. I do not really know what that figure means, but we should interrogate it a bit more closely.

I also believe that we need to make sure that we are keeping up with the most recent treatments and that our system is not only a medical model. Many practitioners do not label patients with a specific diagnosis, so that they get the specific help that they need, and I wonder whether that is the approach that we need. Has the service modernised enough? A one-size-fits-all approach is certainly not what we need. We need to offer options that suit the patients. SAMH says that 46 per cent of respondents support having options for dealing with their depression, which suggests that people should have some form of choice. I think that Gillian Mackay spoke about that earlier.

I was concerned to find that a case that I raised during last year’s debate, which involved a young woman who had made a suicide attempt, was not a priority in the system for reasons that I could not understand. After several interventions by her GP and me, as her MSP, she finally got an appointment with a psychiatrist. She required dialectical behaviour therapy as opposed to cognitive behavioural therapy, but she was told that that is not available through NHS mental health services. That has led me to question whether we are too focused on CBT and other singular therapies. I am clear in my own mind that it is common sense that we should incorporate treatments that would widen the options.

I cannot see the clock, Presiding Officer. Am I past my six minutes?

Thank you, Presiding Officer. I will need to sit a bit closer to the clock next time.

I would really like the minister to address the question of the modernisation of our service. Have we done enough research to satisfy ourselves on that front? The issue is about more than waiting lists and resources. We must make sure that, as a nation, we are modernising our service to make it fit for purpose. If we do not do that, all the discussion and critique around waiting lists will be less significant. That question needs to be addressed.

The chief executive of Barnardo’s, Javed Khan, put it very well when he said that

“the negative effects of the pandemic could last a lifetime if children and young people don’t have the right support ... children must be front and centre of the Government’s plans for the post-Covid period.”

I hope that some of my points will be addressed in the summing up.

Will the cabinet secretary address investment, which was the theme of my speech? The Government says that it is a priority, which it clearly is. How does the cabinet secretary satisfy himself that Scotland’s system is not only comparable with the UK’s but is comparable internationally in terms of how we provide services, make sure that people have optimum treatments and that a variety of treatments are available? How do ministers satisfy themselves that investment results in an internationally brilliant service?

There are many examples of the impact of Covid restrictions on the events industry. For one agency, only seven Hogmanay shows out of 60 that were planned went ahead. For many in the sector, a loss of income due to Covid restrictions is catastrophic. I welcome the additional support that the First Minister announced last week, but can she ensure that everyone in the events industry chain who needs support, including agencies, will be eligible to apply for financial support?

As the First Minister knows, the hospitality sector is absolutely terrified of the impact that the recent substantial restrictions will have, especially on smaller venues that cannot apply 1m distancing. Given that she said earlier that support could be tailored to those who need it most, should a business rapid response team be set up to ensure that the £42 million of funding that has been announced today is targeted where it is really needed, in order to ensure the survival of those businesses?

Thank you very much.

I imagine that one of the key issues with prerecorded evidence—forgive me if I have not understood the process—concerns the cross-examination of the complainer in court. How is that done? I imagine that the lawyer for the person who is standing trial would want to put questions to the complainer. Is that done beforehand or in court? It would be helpful to know that.

Would you be concerned about that? It is certainly a concern that I have, and I would like to hear any answers that you have in that regard.

I am interested in the line of questioning that Colette Stevenson started regarding independent legal representation, and in the Lord Advocate’s answer. It is a critical area for the committee to consider.

I note that the Lord Advocate said that there is already a right to be heard on a section 274 and 275 application where the application relates to medical records. Should that right apply more widely than medical records? I would have thought that, if an application is made to use evidence of sexual history at a preliminary diet, the complainer should have an interest in the whole application, not just medical records.

Those are helpful answers. It is clear that, if we want to pursue the issue, there is quite a bit of work to be done to strengthen the right to be heard, on which I agree with the Lord Advocate. The question is how we can make that happen through legislation. Also, I note what the Lord Advocate said about women being “turned away” by the legal profession, so there is a lot to be done in that respect.

I have one remaining question, given the shortage of time. If we legislated and created the right for the complainer to be fully represented at a preliminary trial where sexual history evidence is asked for, albeit that there are issues with the timescale, I take it that the Crown would have no objection to dealing with what is in effect a third party representing the complainer? Mr Harvie, as the Crown Agent, would you be happy to deal with a third party on this matter?

Thank you.