Chamber and committees

Over the past number of years, even pre-Covid, there has been a rise in the number of people coming forward with mental health conditions. A lot of that is down to the fact that we are changing how folk think about their mental health. Much of the destigmatisation is down to a lot of hard work on the part of many stakeholders, but it is also due to the amount of investment that the Government has made through the see me campaign. Just the other week, in order to ensure that the campaign continues to thrive, the Government—this is also down to the Parliament, through the budget process—agreed to provide the campaign with £5 million over the next five years so that it has the comfort of knowing what it will be able to do over the piece.

It is a really good thing that we are destigmatising mental ill health, but we still have a long way to go. Let us be honest: there are still a lot of folk who will not discuss mental health issues or their own mental health. There are aspects that folk are still wary of discussing. The best example is probably the unwillingness on the part of many folk to talk about suicide and suicide prevention. The work that has been done here in Scotland by the national suicide prevention leadership group has been recognised by the World Health Organization. We need to go further, however, so we have said that we will double the suicide prevention budget during the course of this parliamentary session. We need to get folk to start speaking about the issues, which are often still taboo.

I will continue, if I may; I know that I have rabbited on for a fair while. A number of organisations and groups have major parts to play in helping us. The other week, I went to an event at St Mirren Football Club—which George Adam would, of course, say is at the centre of the universe, although I do not know that I could agree with that. For—if I remember rightly—the seventh year, St Mirren ran a conference day. It was initiated by a local lad who had seen some of his mates die by suicide and thought “Enough is enough.” That event was immense. It was heart rending and difficult, but it made people think about what is going on, what some folk are going through and what we need to do to help folk in their time of greatest need. That community-based approach is the best way, in some respects. The event brought a lot of footballers together for a very good competition, but that message was at the heart of it. We need to do more such things.

As I think that Mr Gulhane knows, those are not mental health link workers but community link workers. I do not have the detail of all that in front of me. As he said, 218 link workers are in post, and I will get colleagues to write to the committee around about other aspects of that. However, those are community link workers and not mental health workers.

There has been a huge difference through some of the things that we have done in recent times. Again, it would be worth the committee’s while to talk to other organisations about what different interventions have meant in different places.

To give the committee an example, distress brief intervention work is happening in a number of parts of Scotland. It has been expanded and we will no doubt also roll that out further. If you talk to the folks working in that area, you can tell the difference that it can make. Let us take the police, for example. Pressure comes off them if they can get others in to help folk at time of need, rather than officers being tied up, often for long periods of time and often without having the skill set to deal with the difficulty that the person is facing at that point—although, let us be honest, most of our officers are pretty immense. Those things therefore make a huge difference.

Another example, although not quite so recent, is work that went on at the Victoria hospital in Fife as part of a joint partnership between Shelter, NHS Fife and the Scottish Government, which focused mainly on housing but also on dealing with mental health. Getting folk housed and getting them support took pressure off the accident and emergency department.

There are a lot of things going on and a lot of learning is happening. We have to consider what is working, what is working well and how we can export that elsewhere. The co-operation that exists in many places is beneficial for all those organisations, but the outcomes can be immense for individuals who are vulnerable and in a lot of distress.

There was a huge amount in that question. Ms Webber said that it is all buzzing about in her head, and I think that it is probably all buzzing about in our heads at the moment, as well.

I explained to the committee earlier the level of engagement that we have with partners around getting all of this right as we move forward. At the moment, we have a significant number of folk in hospital who should not be there, and it is best that they are not there. Some of the solutions will be interim ones, but the ambition is to get folk back to living independently, with support, if that is possible and as soon as we can.

Rather than going on about all of the possibilities, we will write to the committee about what we are doing. We do not have some of the information that Ms Webber is asking for regarding people in interim situations. I will write back to the committee in more depth to explain how we are handling that.

I have a figure for the number of autistic people in Scotland; I do not have a figure for the number who are diagnosed each year, but I can see whether we can provide that for the committee.

According to the Scottish Government-funded microsegmentation of the autism spectrum research project, whose report was published on 26 March 2018, there are approximately 44,133 autistic people in Scotland, with a national Scottish autism prevalence rate of 1.035 per cent. Around 32.7 per cent of autistic people also have a learning disability. As I have said, I do not have figures for diagnoses per annum to hand, but we will see what we can do to provide the committee with that information.

I will ask Ms Campbell to respond and then come back in, convener.

I will be a bit controversial and say that I agree with most of what Mr Sweeney said. However, we must also recognise that services deemed good in the minds of some folk might be deemed not so great by others.

When I was in my previous role as Minister for Local Government, Housing and Planning, vast changes, some of which are still on-going, were made in homelessness policy, regulation and legislation, and the voices of folk with lived experience of homelessness were at the very heart of what we did. I am not saying that that was absolutely perfect—it never is—but we are on a good journey and in a good place, because we listened to people and their experiences. I fully intend to do the same in this role. Whether it be in relation to autism services, social care or mental health services, I will continue to listen to the voices of lived experience.

In some of the conversations that I have had thus far in coming into this new role, I have noted that some of the assumptions that we all make, rightly or wrongly, about what we think needs to be improved first and what our priorities should be are not necessarily shared by folks with lived experience. I have talked to folk about mental health services in general, and something that has cropped up again and again and that I think is one of the top priorities for the groups that I spoke to—I know that some folk will disagree with me—is the fact that the complaints system does not work for people. We need to look at that very closely in this area and in others.

Beyond that, in those areas where there is very good practice, you will usually find that service users have helped to shape the service in question. Again, that is something that we need to push further. Some local authorities and health and social care partnerships are very good at listening to the voices of lived experience and shaping services and while others are not quite so good. We need to continue on this journey to ensure that everyone is doing that. I would also point out that one of the proposals in the national care service consultation is for community health and social care boards to have the voices of lived experience at the table, which I think is essential.

The programme for government, which was published in September, committed the Government to carrying out scoping work on the remit of and powers in the learning disability, autism and neurodiversity bill in this parliamentary session. It will take time to scope all that and get it right, and we need to continue some of the conversations that we have been having. For example, there are polarised views on the proposals for a commissioner, and we have to listen to all sides if we are to get that right. That scoping work will happen and we will move on with the matter in this parliamentary session.

Concurrently with that, the Scottish mental health law review is due to report next September. As the committee will likely be aware, the review will make recommendations to give effect to the rights, will and preferences of the individual by ensuring that mental health, incapacity and adult support and protection legislation reflects people’s social, economic and cultural rights, including the requirements of the United Nations Convention on the Rights of Persons with Disabilities and the European convention on human rights. That said, I think that today’s Supreme Court ruling has put some difficulty in our way with regard to embedding certain UN convention rights in legislation, but that is probably a discussion for another day. You will be glad to hear, convener, that I will not go into a rant about that, but it is fair to say that, like many others, I am quite irate about it.

The Scottish mental health law review is extremely important in all this, but we need to listen to people and ensure that we embed rights in any legislative change, whether that be in the learning disability, autism and neurodiversity bill or in anything that comes from the review itself.

It is fair to say that when you take on a new ministerial role you have to do a wee bit of stocktaking to see what is going on out there. In my new role, I have been talking to lots and lots of folk about the various issues that I am responsible for, and the committee can be assured that that general stocktake applies right across the board.

As I said, I know of a number of health and social care partnerships and local authorities that are doing very well in this area, and I know of a number of others that are not doing as well as they should be to meet their people’s needs. I will continue having the very detailed conversations that need to be had, to do that stocktake and to ascertain what is going on out there that is right and what is not going quite so well.

Mr Stewart knows me from numerous other committee appearances—we seem to cross each other’s path on a regular basis—so I will probably bore him by saying something that he has heard me say many times before. We have had some success in other areas with this approach, but I am one of those folks who get very frustrated when we do not export best practice across the board. We are a small country, but sometimes people are afraid to blow their own trumpets and say what they are doing well, which means that others do not have the opportunity to pick up that good practice. Convener, I assure you, Mr Stewart and the rest of the committee that my ethos with regard to the exporting of best practice remains in place. That is what we will aspire to do.

I will make some general comments about the provision of one-stop shops, which I think are important. I think that the point being driven at is that provision varies from local authority to local authority, and local authorities are responsible for commissioning and delivering those local services. We have examples of really positive provision in some local authorities such as South Lanarkshire, which operates an autism resources co-ordination hub, and Edinburgh, with its Lothian one-stop shop. There is also a one-stop shop that is supported by Perth and Kinross. However, there is still work to do to ensure that other parts of the country have the right provision, because it is fair to say that some parts have very few services to meet the needs of autistic people.

The Government works with national and local autism charities, which also operate a number of services. Indeed, I was having a discussion about that very issue yesterday. Scottish Autism and the National Autistic Society have national coverage, but we also have close links with Inspiring Scotland and with effective and valued local organisations, such as the Aberdeen one-stop shop and Autism Rights Group Highland.

As I said—and I think that we have to be honest about this—provision is excellent in some places but not in others, and we need to encourage, cajole and perhaps even take further action through regulation to ensure that, in the short term, provision across the board gets better. Beyond that, we have the opportunity with the changes that we are making through the national care service and other actions around that to put in place a framework of high-quality standards that all can expect.