Meeting date: Thursday, March 5, 2020
Meeting of the Parliament 05 March 2020
Agenda: General Question Time, First Minister’s Question Time, Whitburn Academy Be Herd Group, Scottish Parliamentary Corporate Body Question Time, Portfolio Question Time, Budget (Scotland) (No 4) Bill: Stage 3, Parliamentary Bureau Motion, Decision Time
- General Question Time
- First Minister’s Question Time
- Whitburn Academy Be Herd Group
- Scottish Parliamentary Corporate Body Question Time
- Portfolio Question Time
- Budget (Scotland) (No 4) Bill: Stage 3
- Parliamentary Bureau Motion
- Decision Time
Whitburn Academy Be Herd Group
The next item of business is a members’ business debate on motion S5M-20457, in the name of Neil Findlay, on Whitburn academy’s be herd group, shattering mental health stigma. The debate will be concluded without any question being put.
That the Parliament acknowledges the success of Whitburn Academy’s pupil-led Be Herd group, which aims to raise awareness of, and remove, stigma regarding mental health issues; understands that it was launched after the opening of the Mental Health and Wellbeing Hub in the school library, which can be used as a quiet safe place to relax or a place to talk to a mental health ambassador; notes that its work includes presentations at school assemblies, at which pupils, staff and parents can tell their personal stories, support sessions for anyone from the school community affected by mental health problems and events promoting the project; acknowledges that, in September 2019, it was awarded a West Lothian Council Stellar Award, which was followed in October by a COSLA Gold Award for tackling inequalities and improving health; recognises that SAMH has said that 25% of the population will experience a mental health problem; notes the view that it is paramount that early intervention programmes are in place to tackle mental ill health among young people and that schools play a major role in this, and commends the Be Herd group as an excellent initiative by Whitburn Academy's pupils and staff with an ambitious aim to shatter the stigma of mental ill health and offer help and support to their peers and the wider community.12:55
I thank the members who signed the motion, allowing it to be debated, and I welcome the members of Whitburn academy’s be herd group to the gallery. They are very welcome.
To put the debate in context, in December, almost 11,000 young people were waiting to start treatment with child and adolescent mental health services. That treatment is supposed to start within 18 weeks of referral, but in the last three months of last year only three national health service boards in Scotland met that standard. My health board, NHS Lothian, saw less than half of young people within the 18-week timeframe, with one in three young people waiting for more than a year. There are now more than 30,000 open cases in the CAMHS system. However, if a child is in mental health crisis they need help now—not in a year, 18 months or even longer.
We hear a lot from the First Minister and others about health services in England and Wales and elsewhere. I urge people in the chamber to listen to this. In 2016-17, the rate of mental health admissions for young people under the age of 18 was 61 per 100,000 in Scotland, 33 per 100,000 in England and 13 per 100,000 in Wales and the suicide rate for young people aged between 15 and 24 was 15.1 per 100,000 in Scotland, 9.7 per 100,000 in Wales and 8.1 per 100,000 in England.
Those are shocking and completely unacceptable statistics, because delays in diagnosis and treatment can have a devastating impact on young people and their families, which can have a long-term effect well into adulthood and, for some people, for their entire life, with a greater likelihood of unemployment, homelessness, addiction, imprisonment and even early death. That is true particularly in areas where there is widespread material poverty and where the impact of deindustrialisation is still all too evident.
It is those issues and the inadequacy or absence of services that prompted pupils, teachers and families at Whitburn academy to fight back. The pupils and their inspirational teachers, led by Heather Forbes, refused to sit back and accept the status quo. They saw a desperate need and so they established the be herd group—a pupil-led health and wellbeing project. It aims to remove the stigma associated with mental health issues and encourages pupils, staff, parents and members of the wider community to be heard and to talk about their mental health.
The project’s mascot, Ellis the Elephant, represents the notion of mental health being the elephant in the room. With £6,000 of funding, the group set up a health and wellbeing hub, which is a quiet and relaxing area where people can go for help, support and information. It established a network of peer supporters called the Elefriends, who listen to worries and concerns and signpost people to help and advice. Whitburn academy has 50 mental health first aiders, more than 20 staff and pupils trained in safe talk suicide prevention techniques and 17 lesbian, gay, bisexual and transgender plus ambassadors. The group regularly addresses assemblies at which pupils and staff are encouraged to open up and talk. All that is in a bid to destigmatise mental ill health.
I first came across the group at a concert that it held in 2019. It was one of the most moving and powerful events that I have attended in my 17 years as an elected representative. In front of their peers, teachers, support staff, parents and carers, the pupils told their stories and performed music relaying their experience and struggles with anxiety and depression, suicidal thoughts, living with an eating disorder, coping with issues around sexuality and identity, losing a parent or close family friend, or living in a situation where there may be drug or alcohol dependency or violence. It was moving and hugely inspiring.
Since then, the be herd group has been awarded a Convention of Scottish Local Authorities gold award and a West Lothian Council stellar award. However, more important than all that, the feedback from the school community is very positive, with many people saying that mental health first aid helped them to deal with stress in their lives including at exam time, and 2018-19 saw the school achieve its best ever exam results.
I am in awe of not just the young people and their teachers but the parents and support staff who have shared their problems and helped to build resilience and support. The Scottish Government can learn from the work that is being done at Whitburn academy, and it should refocus its work on prevention, early intervention and promoting wellbeing across Scotland.
A recent freedom of information request by Tes Scotland showed that there was no clear delivery plan for rolling out school-based counselling, so I have an idea for the Government. Why does it not consult the people in the gallery from Whitburn academy and listen to the parents, the carers, the teachers and, most important, the young people who are telling this Parliament loud and clear that the system is failing young people across Scotland and that the services that they need are simply not there? Pointing the finger at integration joint boards, councils, Westminster or anyone else does not help a single child, does not take the pressure off a single family who are at their wits’ end and does not address the inadequacy of services now.
The reality is that CAMHS across Scotland are at breaking point. Too often, children and young people are seen only when they are in crisis. The service urgently needs investment to ensure that children and young people are diagnosed and treated quickly, when they need to be. No one should be left to fall through the net but, sadly, we know that all too many are. I am advised that there are only 48 specialist mental health beds across Scotland for under-18s, and that there are none north of Dundee, which is shocking. That leaves children and young people at home when they are at crisis point, and it leaves families struggling to cope. Others are admitted to non-specialist paediatric wards or adult mental health wards, which are completely inappropriate for their needs.
Audit Scotland has said that young people’s mental health services are “complex and fragmented” and focused largely on specialist care and responding to crisis, with less action being taken on early intervention and prevention. Its report called for a long-term financial plan; a task force to work alongside COSLA on children and young people’s mental health; assurances that data on mental health services is up to date so that effective scrutiny can be applied; and joined-up working, to ensure that gaps can be filled.
We have all heard glib statements being made—indeed, we have probably made such statements ourselves—about parity of esteem between physical and mental health. It does not exist. The waiting time for a physical ailment is 12 weeks, yet the equivalent period for a mental health issue is 18 weeks. There is no parity of esteem, so let us not pretend that there is.
I note that I have gone over my time. I wanted to mention a number of people—most of all, all the pupils involved and the local agencies that they are involved with—but I do not have time. I will simply congratulate the staff, the pupils, the parents and the members of the wider school community who have worked on the be herd project. I wish them well for the future and urge them to continue to provide support and solidarity to one another and the wider school community. I also make a plea to them to continue campaigning and not to give up, because it is only by putting pressure on decision makers such as those in this Parliament that we will be able to bring about the change that we so desperately need. [Interruption.]
I am going to have a word with everybody in the public gallery. I would prefer it if you did not clap. The reason for that is that, if people clap all the time or if they boo or hiss because they disagree with something, it all becomes a bit silly. Therefore, please do not show any appreciation or otherwise. When we get to the end of the debate, perhaps you will get that opportunity.13:04
I very much appreciate Neil Findlay securing the debate. Although Whitburn academy is not in the Almond Valley constituency—it is in the constituency of Fiona Hyslop, who is sitting next to the Minister for Mental Health—there are young people from my constituency who attend the school, who are mainly from the villages of Fauldhouse, Longridge and Stoneyburn.
One of the purposes of members’ business debates is to recognise, celebrate, and thank those who are doing great things to strengthen the bonds within their communities. In this instance, people are doing that within and beyond the school community. We always need to find space in our busy parliamentary schedules to appreciate those who give freely of their time and talents, often with no fanfare and for no reward, but simply through the desire to make life better or to right a wrong.
I am therefore glad to have the opportunity to place on the record my appreciation of Whitburn academy’s be herd group, and everything that it is doing to shatter the myths and stigma around mental ill health. As a former mental health officer, I am well aware of the important links between myth busting and early intervention.
Much has changed since I was at a West Lothian school 30-plus years ago or, indeed, 20-plus years ago when I started my mental health social work career, when mental health issues in young people were either not believed, hidden, or downplayed. Today, although the journey is yet to be complete, we have travelled part of the road, in that mental health issues are treated far more seriously.
It is a good suggestion—I have touched on it with the minister—that public policy and services in Scotland should always be informed first and foremost by those with lived experience. I am sure that, along with Mr Findlay, the constituency MSP would want to encourage direct engagement between the be herd group and the Scottish Government.
We have already heard from Mr Findlay that the be herd group has rightly been recognised with a West Lothian Council stellar award—which is no mean feat, although we have great schools in West Lothian—and it has achieved the COSLA gold award for tackling inequalities and improving health. Many congratulations and well done on that.
What has impressed me about the project is that it is pupil led. The role of mental health ambassadors is important. The work that the project has done in reaching out to primary 7 pupils during their transition times means that it is now a benchmark for other schools in West Lothian and, I hope, elsewhere in Scotland.
As I said, we have good schools in West Lothian. I want to touch on some of the activities in the schools in my constituency. Inveralmond community high school and James Young high school were active during mental health week with time to talk events and workshops on celebrating uniqueness. The counselling service in Inveralmond community high school is well used and appreciated. It is, of course, welcome that funding for school counsellors has increased from £4 million to £16 million, but I refer back to my earlier comments about the development of services having those who use those services at its heart.
I also want to mention the Neil’s Hugs Foundation, which is a great local suicide prevention charity led by the marvellous Donna Paterson, who does amazing work with students at West Lothian College. Neil’s Hugs also often visits West Calder high school and St Margaret’s academy. My old high school, West Calder, has done interesting work on reaching out to men and boys to offer mental health support.
On the more formal services and mental health support systems, it is fair to say that their journey is yet to be completed to deliver on the ask once, get help principle. We know that there are issues in the Lothians, and NHS Lothian is woefully behind the 18-week CAMHS target at 48 per cent, which is well below the 90 per cent target. Having long waits for CAMHS is unacceptable. I would never demur from the importance of resources and capacity.
Since 2006, spending on CAMHS has increased by 182 per cent, and during the current parliamentary session, £5 billion will be spent on mental health, so the problems seem to be as much about the systems are they are about the resources. We need to get the systems working far better.
I call Jamie Greene. It will have to be a generous four minutes.13:09
You are always generous, Presiding Officer.
I thank Neil Findlay not only for his motion, but for the speech that he delivered. I know that the chamber emptied after the theatre of First Minister’s question time, but this is, arguably, the most important debate that we will hear in Parliament this week.
Since being elected to Parliament a few years ago, I have been encouraged by members’ approach to the stigma around mental health. There has often been consensus among members on the issue, and the fact that we are having the debate and talking about the issue in the public domain is encouraging.
However, the statistics that Neil Findlay shared with us are far from encouraging. This morning, I learned that 56 per cent of Scots with mental health problems face discrimination not only at work, but from friends and family members. We know that record high numbers of young people in Scotland—11,000—are waiting for CAMHS treatments. That is a shocking statistic. We know that a quarter of Scots do not even feel comfortable talking about mental health. We talk about shattering the stigma and tackling mental health, but we have far more work to do. Angela Constance said that we are still on a journey. I agree, but why is the journey taking so long?
I raised this point when we debated drugs. When we have consensus, it feels all fuzzy and warm. When we all agree, it is very nice, but there are some things on which we need to break the consensus and have a right old argument. Pressure is what will make things change. A cosy consensus on such issues is what I believe has got us to a state of complacency. As Angela Constance mentioned, only 48 per cent of young people are being treated.
I agree. Please let me finish my speech, because there is nothing cosy about what I will say in the next couple of minutes.
I pay tribute to the work that Whitburn academy is doing with the be herd project. The forum that has been created allows people to share their personal stories of what is affecting them—stories of what is going on at home, including domestic abuse, alcohol or drug abuse, anxiety, illness and even bereavement or loss of a parent. As an only child who grew up in a household that had its fair share of some of those issues, I know only too well what it feels like to have to deal alone with one’s domestic situation. There was nothing like be herd when I was at school.
No young person should have to deal with those issues, so it brings utter shame on us as politicians and as a Parliament that there are still young people who rely on projects such as be herd. Top-down action from the Government is welcome; I will be pleased to hear what the Government has to say. I am sure that we will hear some positive numbers and big figures in relation to the money that is going in at the top, but it seems to me that some of the work should be done at the grass roots.
The be herd project is a perfect example of the bottom-up and community-led efforts that will tackle mental health issues. We could establish more such pupil and school-led environments. We should have a proper look at the role that schools play in tackling mental health issues in young people, because I know that those projects make a difference. I am sure that the people in the gallery are testament to that.
Last night, I chaired a meeting of the LGBTI+ cross-party group, which Mary Fee was also at. We discussed the mental health of young people a lot. At the meeting, I was presented with statistics on young LGBT people in Scotland who have thought about suicide; a third of them have actually tried to kill themselves. As things stand, two lives in Scotland are claimed by suicide every day. That is two lives too many.
Children’s mental health waiting times have doubled since 2017—there is nothing cosy about that statistic. We know that women remain significantly more likely to develop mental health problems, and that there is a higher prevalence of suicide among young men. Staggeringly, more than five children every day phone suicide hotlines—five young people in our country.
Yes—let us celebrate initiatives and good work, and let us celebrate and welcome the work of the teachers, pupils and staff of the schools that come to Parliament. For Neil Findlay, I say that the “fuzzy” thing of which he spoke is a good thing. However, the issue is the saddest that we have to face.
I commend Whitburn academy for its work. We could see more such work, but what we really need to hear in the next few minutes is what the Government has to say about those sad and shocking statistics.13:15
I, too, thank Neil Findlay for lodging the motion and securing the support to debate an important topic. The success of Whitburn academy’s be herd group has rightly been recognised in Parliament, and by awards that the group has won from the Convention of Scottish Local Authorities and West Lothian Council. The young people who are behind the campaign to raise awareness and remove the stigma around mental health should be very proud of themselves for their success, and for developing a crucial initiative to support their peers and their classmates. I am particularly pleased to see them in the gallery.
Mental health has rightly become a more mainstream health and social issue. We need more initiatives like the be herd group in order that we can tackle the stigma around mental health. Peer support is a key factor in supporting good mental health in schools, because many young people feel that they cannot speak freely or openly with professionals or adults.
We know that there are significant problems with mental health support from the NHS. Recent figures show that more than 5,000 children and young people waited more than 18 weeks for mental health support. That is simply unacceptable. The statistics are shocking, so action needs to be taken now. Neil Findlay is right to say that we need to stop talking and do something—and we need to do it now.
Statutory services including the NHS and the whole education system must make an effort to improve the mental health of children and young people. It cannot be left to children and young people, as well as the third sector, to fill the gaps when public services fail. Such initiatives and organisations should supplement, not replace, statutory services. As admirable as the be herd group is, it should not be left to young people to take the lead on supporting each other’s mental health.
Research suggests that one in four adults suffers from poor mental health at some point in their life. Improving mental health services for children and young people is preventative spend for the future, just as it is a current priority for children and young people today. I hope that we can, by supporting and encouraging more children and young people, along with better provision of mental health support through schools and the NHS, tackle the pressures that many face. I also hope that more schools can follow the lead of Whitburn academy and encourage pupils to take the lead on peer support of the kind that is provided by the be herd group.
I thank Neil Findlay once again for securing the debate, and I congratulate all the staff and pupils of Whitburn academy on their award-winning success and the fantastic work that they do in breaking down the barriers and stigma of mental health.13:18
I am pleased to respond to the debate on behalf of the Scottish Government. It is imperative that we have such conversations and that we aim to break down the stigma associated with mental health. That is why debates like this one are important.
I want to thank a few people for bringing the debate to the chamber. First, I thank Neil Findlay for lodging the motion and for his continuing support for the be herd initiative. Schools across the country are doing fantastic work to support our young people’s mental health and tackle the issue of stigma. I thank Mr Findlay for bringing the be herd group to my attention. I was particularly pleased to be able to speak with Fiona Hyslop, whose constituency Whitburn academy is in, and to hear how impressed she has been by the work that is being done there.
Secondly, I thank and praise the pupils and teachers of Whitburn academy who are involved in the be herd group. It has been inspiring to hear how they have changed the culture of the school, so that pupils, staff, parents and the wider community can access support and a safe space in the school in which to talk. I was impressed when I heard about the recognition that the initiative recently received through both a West Lothian Council stellar award and a COSLA gold award for tackling inequalities and improving health.
Supporting good mental health is a priority for the Government. Mental ill health is a significant challenge that requires us to respond in an ambitious and systematic manner. Breaking down barriers to enable our young people to access appropriate services is crucial, along with removal of the stigma that is associated with mental health. That is why we are taking forward approaches that focus on prevention, early intervention and clinical services. We know that young people often face barriers in reaching out for mental health support, and initiatives such as Whitburn academy’s be herd group are helping to reduce the stigma that surrounds mental ill health. Breaking down stigma and discrimination is essential if our policy ambitions in the mental health strategy, the national suicide prevention action plan and the programme for government are to be achieved.
As stigma reduces, more children and young people are feeling comfortable in coming forward for mental health treatment, which shows that attitudes towards stigma are decreasing.
I do not disagree with anything that the minister has said. However, that is part of the issue. We see more young people and their families coming forward, but, in Lothian, a third are waiting more than a year. That is the nub of the issue. Yes, people are coming forward, but the treatment and the services are simply not there.
Further on in my speech, I will speak about the actions that we are taking as a Government—and that I am taking as a minister—in conjunction with other agencies and with input from children and young people and their families, which is key to ensuring that those services deliver for them.
We want to make sure that anyone who needs help can access services that are appropriate to their needs. Therefore, we are making significant changes to meet the increasing demand for services and to ensure that everyone gets the right treatment at the right time and in the right place. In 2019, 21 per cent more patients were seen than in 2013. It is really positive to see more young people coming forward for help, but increasing demand puts pressure on services. Therefore, we are rolling out a package of measures to support positive mental health for all and workforce development, as well as to improve access to the high-quality services in CAMHS and psychological therapies.
We all agree that long waits for mental health treatment are unacceptable. That is why, in this year’s programme for government, we set out plans to work with NHS boards to improve their performance against waiting times and to reduce long waits. Boards will develop trajectories that will be set out in their annual operating plans, ensuring that performance is tied to funding.
Will the minister take an intervention?
I will in a second.
My officials are already in regular contact with boards to support them to produce local improvement plans and robust trajectories that are based on detailed modelling of capacity and demand. The audit of rejected referrals that was published in 2018—which Mr Findlay referenced—contained a range of recommendations to improve the effectiveness of CAMHS, and we accepted all 29 of those recommendations.
As a direct result of the audit’s findings, we announced the establishment of the children and young people’s mental health task force, which produced its final recommendations on improving CAMHS in July last year. The children and young people’s mental health and wellbeing programme board is currently considering the delivery of those recommendations through nine key deliverables, which include the development of a CAMHS service specification, which was published last month.
Some young people are waiting a year, which is surely unacceptable to all of us, including—I appreciate it—the minister. If NHS boards are not delivering, why has nobody in the chamber yet answered the question of why people are waiting so long? Is it a lack of resource, is it a lack of people, or is it a lack of trained nurses? What are we doing to get under the skin of the problem? Why are the waiting times so long, and what will the Government do with those NHS boards that have the longest waiting times? How will we get those down promptly?
The member raises a valid point. As the Minister for Mental Health, I want to understand exactly why some boards are underperforming whereas others can meet their waiting time targets and provide services more timeously.
We have committed to developing a community mental wellbeing service for five to 24-year-olds that will offer immediate access to counselling, self-care advice and family and peer support. That will ensure that support is available more quickly and, where possible, will prevent issues that require specialist services. The service will also help to reduce demand and will allow young people and families who need specialist services to receive them more quickly.
I hope that that reassures members that we are continually increasing our investment in CAMHS. In fact, the overall spend on CAMHS in Scotland has increased year on year since 2011 and has increased by 182.7 per cent since 2006. We have come a long way since the 2018 Audit Scotland report on the issue. As colleagues are aware, in our most recent programme for government, we announced a package of measures to strengthen support for children and young people’s mental health and wellbeing.
Again, that goes right to the heart of the issue. If we are increasing funding but a growing number of people are not being treated, there is a fundamental problem, which might be because of the problems that Angela Constance referred to. If we continue to put money in, as the Government claims that it is doing, but the results are worse, we have a major problem.
As I said, there is increasing demand for CAMHS year on year, which is why we are developing early intervention and medium-term care packages and options to enable people to access services that are of lower intensity than CAMHS and that are probably much more appropriate for those individuals.
Provision of access to a counsellor is one part of the support that we are putting in place. Through our investment in pupil equity funding and Scottish attainment challenge funding, local authorities and schools are putting in place wider mental health supports that promote positive and nurturing learning environments. We are also commencing work to design and develop a new mental health training resource for all school staff, which will provide our valued school practitioners with the skills and confidence that are required to support and assist young people.
We recognise that schools play an integral part in supporting young people’s mental health, but schools cannot do it alone. It is important that all professionals who are involved in a young person’s life are able to support and promote positive mental health, to be connected and to collaboratively engage to ensure that the best possible outcomes for children and young people are achieved. That is why we are taking forward essential and crucial work to strengthen wider community services.
I am determined that on-going dialogue with young people will be at the heart of how we develop our policy on mental health. We must provide young people with opportunities to get their views across directly to the Government. We must also work hard to remove stigma. I am committed to acting on what I hear and to providing the advice and support that young people feel they need. The process is on-going, and the partnership working to develop the be herd initiative at Whitburn academy is an important part of it.
I thank all members who have spoken in the debate, and I again thank Neil Findlay for bringing this important issue to the chamber.13:28 Meeting suspended.
14:30 On resuming—