Chamber and committees

The alcohol industry is a big part of Scotland’s economy. How do we support that business in Scotland while supporting the industry to take responsibility for the issue and helping it to do what it can to support alcohol-harm reduction?

I have a quick question on the families and women issue. I know that the Scottish Government has a framework that has been created for families who are affected by drug and alcohol use in Scotland. That is a framework for a whole-family, holistic approach that is inclusive for families. Women might need to be supported because they might have families to support and they might be carers for family members. I would be interested to hear your thoughts on that framework, which has been implemented, and on progress on its delivery.

I thank Oliver Mundell for mentioning the cross-party group on mental health which, as he said, we co-convene, as I forgot to mention it.

I welcome the opportunity to lead the debate on eating disorders awareness week 2022, which takes place from 28 February to 6 March. I thank colleagues on all sides of the chamber who have supported my motion, allowing the debate to go ahead.

For many years, this debate was brought to the chamber by the former MSP Dennis Robertson, who lost his daughter Caroline to anorexia nervosa in 2011. In speaking about his members’ business debate in February 2012, he said:

“I want people to be aware of the symptoms and get help as soon as they can. I’m trying to ensure GPs and other medics become more aware of the dangers.”

I agree with Dennis, and I know that the Scottish Government has taken action in that regard—I will expand on that in a wee bit.

Dennis Robertson now chairs the Scottish Government’s lived experience panel on eating disorders, and he has undoubtedly played a part in putting the subject on the political agenda. I thank the eating disorders charity Beat for the excellent work that it continues to do to support those who are at risk of, and those who are living with, an eating disorder. That includes supporting families and friends.

It is great to have folk in the gallery again, Presiding Officer—that is a sign that we are emerging from the pandemic. [Applause.] I welcome the staff and the ambassadors from Beat. I invite members to join us for a photograph at the bottom of the stairs to the public gallery after the debate—everybody is welcome.

Around 1.25 million people across the United Kingdom, and one in 50 people in Scotland, currently live with an eating disorder, and the numbers have increased during the Covid-19 pandemic. The pandemic has exacerbated the situation, with a reported increase of 86 per cent in referrals to specialists between 2019 and 2020.

Types of eating disorders include binge eating disorder; bulimia; anorexia; other specified feeding or eating disorder, or OSFED; and avoidant/restrictive food intake disorder, or ARFID. A very dangerous eating disorder is diabulimia, which occurs when people with type 1 diabetes deliberately omit their insulin in order to control their weight. It is extremely dangerous to do that.

Eating disorders have high mortality rates. Anorexia has the highest mortality rate of any mental illness, and one in six people with binge eating disorder have tried to end their life. People with eating disorders typically develop severe physical health problems, and their overall quality of life has been estimated to be as low as it is for those with symptomatic coronary heart disease or severe depression. Without early intervention, many people become unable to participate in education or employment, but recovery is possible. Access to the right treatment and support is life changing, and early intervention provides the best chance of recovery.

The key symptoms of eating disorders include excessively worrying about weight or body shape; avoiding social situations where food may be involved; frequently visiting the toilet after meals for prolonged periods; and not being up front about the food that you are consuming. It is important for family members, friends and colleagues to be aware of those signs. There is some speculation around what causes eating disorders, but research has shown that there is a link between eating disorders and depression, low confidence and low self-esteem.

One of Beat’s key asks is to ensure that healthcare practitioners are fully aware of eating disorders, and for eating disorder education to be improved across Scotland. I welcome the fact that Beat has had positive engagement with almost all medical schools in Scotland, including those at the universities of Dundee, Glasgow and Aberdeen. Beat continues to engage with the other medical schools; I urge all medical schools to work with it so that our next generation of doctors and healthcare professionals are able to identify eating disorders at an early stage and properly direct people to specialist services.

Another of Beat’s key asks concerns social media, which we know can be a factor that contributes to eating disorders. We need to ensure that people use social media safely, and there are great tips on Beat’s website.

In March 2021, the Scottish Government completed a national eating disorder services review. The “Scottish Eating Disorder Services Review—Summary Recommendations” document includes a total of 15 ambitious recommendations that are focused on ensuring that all those who are affected by eating disorders receive timely and appropriate care and support. The recommendations include better co-ordination of national activity and data collection; national availability of self-help resources, which should be available to everyone in Scotland at any stage of life; and a focus on early diagnosis, with the aim of prevention.

It is welcome that an implementation group has been set up to review timescales for, and the cost of, implementing the recommendations. Three sub-groups—a training group, a standards group and a data group—have been created within that group, although the data group has not yet met. I would be grateful if the Minister for Mental Wellbeing and Social Care could outline when the implementation group is likely to report and when the lived experience panel that is chaired by Dennis Robertson will meet.

This week, I contacted the dietetic team in NHS Dumfries and Galloway. The team has a dietician who works specifically with those who are living with, or are at risk of developing, an eating disorder. I heard from the team that, because of the rurality of Dumfries and Galloway, some people who are at risk of developing an eating disorder may not be picked up as easily, or they may be reluctant to access support because of the travel that is involved in attending appointments. Although the situation has improved with the move to virtual appointments, there is still an issue for people in rural areas who want to access eating disorder support services. That is especially true for face-to-face services, which are required as part of the specialty. Again, I ask the minister to ensure that rural areas are included in the Government’s approach.

I welcome the Scottish Government’s commitment of £120 million for a mental health recovery and renewal fund, with a focus on improving support for mental health in primary care settings and enhanced community support. I also welcome the Scottish Government’s increased investment in Beat.

This Saturday, I will be delivering the keynote address at PosiFest in Edinburgh. PosiFest is a positive psychology festival that aims to support positive health and wellbeing through providing a safe space to explore issues around mental health. There will be performances, music, comedy and a message tree, and everything will be centred on positive approaches to mental health. The event will have a resource hub, with two therapists and information on Beat and eating disorders that can be shared. It will also be live streamed, so people do not have to come to Edinburgh to participate. I congratulate Shalhavit-Simcha Cohen and all the other organisers on putting the event together, and I encourage anyone who is struggling with mental health issues to go along.

In conclusion, I welcome the debate and the work that the Scottish Government has undertaken to improve the outcomes of people who are living with eating disorders in Scotland. I look forward to hearing from my colleagues this evening.

The training does not have to be complicated. It does not aim to make people specialists. Does Jackie Dunbar agree that we want the simplest approach to raising awareness of trigger signs that would lead to further referral pathways, for instance?

Veterans, service personnel and their families contribute a huge amount to our society. I welcome the great strides that the Scottish Government has made towards ensuring that our veterans and armed forces community receives the best possible support and care, including as we emerge from the pandemic.

While they served, veterans might well have been involved in operations that were integral to our safety, security and wellbeing. Their duties might have placed them in dangerous situations, which could have had a significant impact on their physical and psychological health. The current situation in Ukraine demonstrates that. We see the turmoil as people flee and families are split up as civilians stay behind and put themselves in harm’s way. All of that will have consequences for wellbeing.

From the outset, I note the role of the third sector in promoting the importance of our veterans’ health and wellbeing. I welcome the Scottish Government’s commitment to supporting the third sector as we move forward on Scotland’s journey to becoming a wellbeing economy.

The Scottish Government accepted the recommendations in the Scottish Veterans Commissioner’s paper, “Veterans’ Health and Wellbeing: a Distinctive Scottish Approach”, and commissioned the Scottish Veterans Care Network to draw up a veterans mental health and action plan.

The action plan’s 38 recommendations are based on three key principles, which are worth repeating. Principle 1 is:

“Veterans will have equal access to mental health and wellbeing services, regardless of where they live”—

that includes veterans in rural areas, which is an important issue in my region of South Scotland. Principle 2 is:

“Veterans should be able to access the right help at the right time”,

and principle 3 is:

“NHS Boards, Health and Social Care Partnerships, Local Authorities and the Third Sector should be appropriately supported to meet the needs of veterans”.

To meet those principles, the Scottish Government has made available £1 million to create a fund that will provide direct financial relief to third sector organisations and projects, including the veterans garden at the Crichton campus in Dumfries and Galloway, which I will talk about a wee bit later. The Scottish Government has been able to continue to fund the unforgotten forces consortium, which is a partnership of 16 civilian and ex-services charities, and it has contributed £500,000 over the next two years to support those organisations’ work to improve the health, wellbeing and quality of life of older veterans in Scotland.

I welcome the fact that the Scottish Government is working to ensure that all veterans and armed forces personnel have access to suitable and safe housing and do not end up homeless. Following consultations with the housing sector, including the Veterans Scotland housing group, the Scottish Government published “Housing to 2040”, which is Scotland’s first long-term housing strategy. It is welcome that, since 2012, more than £6 million has been made available to deliver more than 100 homes for veterans in Scotland. In the context of that work, I pay particular tribute to Dumfries and Galloway Housing Partnership, which has undertaken veterans awareness training and has been part of the veterans housing allocation scheme in Scotland.

Across my South Scotland region, fantastic individuals and organisations are committed to supporting our veterans and former armed forces personnel. At the Crichton campus in Dumfries, Mark Harper and his dedicated group of volunteers and local veterans run and maintain the Dumfries veterans garden. Their focus is on supporting ex-service personnel by giving them a safe space in which to socialise, learn, garden and access confidential advice and support services, with a focus on PTSD. The Veterans Garden Dumfries runs a monthly breakfast club and drop-in centre, which provides participants with access to relevant information and advice, with support from NHS Dumfries and Galloway and the Crichton Trust.

In 2021, I was able to support and work with The Veterans Garden Dumfries and NHS Dumfries and Galloway to secure endowment funding for the garden. It meant that a relationship could be solidified between NHS mental health services and the Veterans Garden—a relationship that has proven to be massively beneficial. That funding has also allowed Alcohol & Drugs Support South West Scotland to work with the Veterans Garden and to have a drop-in service for everyone. I thank the chief executive of NHS Dumfries and Galloway, Jeff Ace, and Mark Harper, the veteran who runs the garden, for their work. Mark Harper won the volunteer of the year award at the Scottish veterans awards. I ask the cabinet secretary to join me in congratulating Mark on the success of Dumfries veterans garden and invite him to visit it when his diary allows.

I also pay tribute to Robin Hood, who is a former veteran in Dumfries who has been instrumental in supporting SWS RnR and Nithcree heavy goods vehicle training. Graeme Dey will know what I am talking about, because he visited a couple of years ago, when he was the veterans minister. Nithcree Training, with funding from the Scottish Government, supports veterans to train to obtain their HGV licence and security licences. The charity has supported and funded more than 187 veterans not only to achieve their HGV licence but to enter into further employment. It is a great example of how local initiatives can be hugely successful in supporting our local veterans.

I welcome the steps that the Scottish Government is taking to support our veterans, especially in addressing stigma. It seems that, in every mental health debate, we discuss the need to tackle stigma. I realise how important the issue is and have raised it in a number of debates.

I encourage the Government to continue to support the third sector, and I support the Government’s motion.

I have a quick question about self-directed support. A couple of panel members have mentioned that and we raised it in the Health and Sport Committee in a previous parliamentary session. There is a document from 2011 that talks about barriers to self-directed support and things that help it. Do any panellists—perhaps Annie Gunner Logan or Fiona Collie—have a feeling about how well we are doing with self-directed support? In my case work, I have people who are not really aware of it or what it does. How are we doing with it now?

I will be short and will focus my comments on the Audit Scotland briefing. One of the key messages says:

“Regardless of what happens with reform, some things cannot wait. A clear plan is needed now to address the significant challenges facing social care in Scotland”.

There are things that we can do without legislation. Setting aside longer-term challenges, what can be done with the social care sector to address immediate short-term issues? What specific actions could be taken to address the short-term challenges?

Thank you, convener. I was just waiting for my camera to come on.

Cabinet secretary, I will pick up on your comments about working with the Secretary of State for Health and Social Care. Obviously, a lot of work has taken place between the civil servants in both Governments. In your opening statement, you outlined that, originally, the bill was encroaching on devolved areas. Will you tell us a little bit about the work that has taken place between the two Governments to achieve legislative consent, and can you confirm that work will continue to ensure that Scotland’s devolution settlement is always considered in future legislation?

As someone who is interested in child poverty and public health, I wonder whether you can tell us to what extent child poverty is viewed as a public health issue.