Meeting date: Tuesday, December 1, 2020
Meeting of the Parliament (Hybrid) 01 December 2020
Agenda: Time for Reflection, Business Motion, Topical Question Time, Covid-19, Valuing the Third Sector, Mental Health Support for Young People, Decision Time, Carers (Support After Bereavement)
- Time for Reflection
- Business Motion
- Topical Question Time
- Valuing the Third Sector
- Mental Health Support for Young People
- Decision Time
- Carers (Support After Bereavement)
Mental Health Support for Young People
The next item of business is a debate on motion S5M-23498, in the name of Johann Lamont, on an inquiry into mental health support for young people in Scotland. I ask members who wish to speak in the debate to press their request-to-speak button.16:47
I am grateful for the opportunity to speak on behalf of the Public Petitions Committee about its inquiry into mental health support for young people in Scotland and its report, which we published in July. Before I talk about our inquiry in more detail, I will start by reflecting on the catalyst for that important piece of committee work.
In December 2016, a public petition was lodged by Annette McKenzie calling for consultation with, and consent from, a parent or guardian before medication is prescribed to treat mental ill health if the patient is under 18. Ms McKenzie lodged her petition following the tragic death of her daughter, Britney, from an overdose of prescription medication. Annette McKenzie has shown such courage in highlighting her concerns, doing so in circumstances that no parent should ever have to face, and we know that she continues to raise alarm about the scale of distress among our young people and the desperate need for action.
The committee took written and oral evidence on the petition from a wide range of individuals and organisations, including the Scottish Government and representatives from the medical profession and organisations that have a role in promoting and protecting children and young people. From that evidence, it was clear that there was strong support among key stakeholders for young people under the age of 18 being able to give consent to treatment for themselves and for the principle of patient confidentiality being protected.
Although some people will hold a different view, as a committee we respect the position that young people have a right to confidentiality when accessing medical advice and support. However, we noted the importance of medical professionals highlighting to young people, when prescribing for their distress, the importance of them seeking support from someone whom they trust.
The evidence that the committee gathered raised serious concerns about young people’s experiences of seeking help for their mental health, in particular when they were doing so for the first time. The evidence was compelling, and it was clear to the committee that we needed to explore the issue in greater detail. We therefore agreed to establish an inquiry to enable us to understand the issues and suggest improvements for how young people who are feeling low and/or anxious, in particular for the first time, can get the advice and support that they need.
The committee is grateful to all those who engaged with our inquiry and met with us. We are especially proud that our work has been heavily influenced by the views of young people who were prepared to share their experiences of accessing mental health support services. I thank them all for their bravery and their honesty; the evidence that they gave was critical to our understanding and, ultimately, to our report recommendations.
Throughout our report, we acknowledge that good work is being done across the country. We recognise the desire and the energy in government at all levels, and among educational, healthcare and third sector organisations, to actively improve the support that is available for young people. The committee was fortunate enough to see some of that work at first hand.
However, it was evident from our engagement that, notwithstanding that desire and energy, many young people are struggling to find the help that they need. We heard examples of successful approaches, such as the whole-system approach that is being applied in the Scottish Borders and North Ayrshire. Partnership working was highlighted throughout as key to providing good-quality support to young people. However, such a co-ordinated approach is not the experience of young people in all parts of the country. We therefore believe that it is imperative that integration authorities and the Convention of Scottish Local Authorities work together to identify areas of good practice and opportunities for agencies to work more closely together to develop specialist services.
It was clear from our evidence that there is a lack of information—or at least accessible information—for many young people and their families, and even for those professionals who are seeking to support them, about the services that are available. We therefore stress the need for a comprehensive mapping of the range of services that are being offered in communities. That would ensure a more effective network of services, while creating an opportunity for gaps in support to be identified and addressed. It is crucial that the information is available and accessible and is actively promoted to young people and relevant professionals. To achieve that, we urge the Scottish Government to set out the minimum level of tier 1 service provision that should be available locally and to work with integration authorities to provide clear pathways to support services.
We recommend that integration authorities take an inventory of all the services that are supporting young people’s mental health in order to build an accurate picture of the provision that is available locally. That information then needs to be shared widely. Although we recognise that some integration authorities have already done that, it is clear that not all of them have.
Parents and carers, in sharing their experience and knowledge with us, have expressed how desperately they have tried to support their children as best they can. However, in many cases, they too are struggling. Alongside information and advice to help them to identify the signs and know who to turn to when mental health issues arise, we recognise that parents may also need support themselves. As a result, we recommend that the Scottish Government commission work to identify how best to support parents and carers to access information about their children’s mental health and signpost them to access the right services.
There has been much scrutiny across the Parliament of the Scottish Government’s commitment to ensure that every secondary school has access to counselling services. Although the committee welcomes that commitment, we note that counselling alone will not address the needs of young people and can therefore only ever be one part of a package of measures. We recognise the successes that a number of local authorities have achieved using programmes that focus on early intervention and resilience. It is imperative that consideration is given to how counselling services can complement those approaches.
Given the limitations of the policy in isolation and the considerable costs that are involved, we believe that the Scottish Government should be ready to reallocate the spending if it appears that schools counselling is not delivering the desired outcomes, and if there are other interventions that may be effective instead. We therefore recommend that the Scottish Government work with COSLA to review the extent to which the policy is delivering on its intended objectives while achieving best value with the resources available. The results of such a review should be reported to Parliament by early 2022.
We began our work prior to the coronavirus, but we considered our final report during lockdown, when it was already becoming clear how much of an impact the Covid-19 pandemic was having on the lives of everyone, and none more so than young people. The impacts of home schooling and cancelled exams and the effects on training and employment prospects have been clear, and the wider impact on mental health remains to be seen. We can only look into the future and dread. We acknowledge that the Scottish Government has allocated additional resources for mental health services, but we do not yet know the full consequences of the pandemic. More work will be required in the longer term to monitor, identify and address the significant challenges facing young people.
We highlight the clear role that exists for all employers in Scotland. Although many employers recognise their duty of care to their employees, there is more to do to ensure that good practice is shared among all employers. We therefore advocate that employers ensure that there is suitable mental health training for members of staff with line management and/or human resources responsibilities.
Another key theme in our report is the need to properly equip those who work with children and young people with skills and knowledge so that they can identify and support children who are struggling. We firmly believe that a young person should be able to choose in whom they wish to confide. Whether that is a teacher or member of school staff, a general practitioner or a youth worker, there should be training available to ensure that people in those roles can support young people. As a consequence, we recommend that the Scottish Government work with relevant partners to develop an online mental health first aid training course for all people who work with children and young people. Although the committee does not consider that that training should be mandatory, it suggests that the Scottish Government take steps to ensure that the course is easily accessible to all those who want it.
Given the amount of time that children and young people spend in school, we recognise that, for many young people, a teacher would be their chosen trusted adult. We therefore believe that it is essential that teachers are equipped with the confidence to identify and support young people with their mental health. To achieve that, we recommend that Education Scotland ensure that mental health first aid training is included in initial teacher education by the start of the academic year 2021-22. We also recommend that regional improvement collaboratives identify the availability of continuing professional development for teachers in relation to supporting young people’s mental health.
The committee again acknowledges the hard work of all those who are supporting young people and who are seeking to improve the services that they can access. The people we met were passionate about helping young people, and they are eager that they and the young people they work with have the support that they require.
I thank all committee members, past and present, the clerks and others for their work throughout the inquiry and during consideration of our report.
Finally, to Annette McKenzie I say that, although I recognise that she has not got the change that she asked for, she has prompted a very important conversation and consideration in Parliament of the support that is available to young people for their mental health, which I hope she will see during our debate today.
That the Parliament notes the conclusions and recommendations contained in the Public Petitions Committee’s 3rd Report 2020 (Session 5), Inquiry into mental health support for young people in Scotland (SP Paper 776).16:57
I thank the Public Petitions Committee for looking into this important issue. I am pleased to respond on behalf of the Scottish Government.
The issues that the Public Petitions Committee has raised are critical. Following the committee’s final report on its inquiry, I wrote to it with the Scottish Government’s response to key recommendations that were made. I wish to take some time to summarise that response.
The report made recommendations relating to local mental health support and service availability and the need to ensure that appropriate guidance and pathways are in place for children and young people. We are working closely with local authorities, supporting them to develop new community mental health and wellbeing services. Last month, we announced a further £15 million to respond to children and young people’s mental health and wellbeing issues, building on our previous investment. That funding has been allocated to local authorities to support local responses for five to 24-year-olds, their families and carers.
In addition, in March, we provided local authorities with a framework for how community mental health support and services should be provided. That framework aims to set out a clear, broad approach for the support that should be available to children and young people within their communities; to assist local children’s services and community planning partnerships with the commissioning and establishment of new services or support or with the development of existing services and support; and to facilitate the enhancement or creation of services that can deliver support that is additional and innovative, wherever those services are best placed.
One of the report’s recommendations focuses on support for the parents and carers of those experiencing mental health issues. We are working across sectors to ensure that a wide range of information and support is available to families who need it—for example, through our Parent Club website, which offers guidance on children’s mental health. Solihull Online parenting support can also be accessed through that site. We are investing £240,000 in Solihull Online to provide additional support during pandemic restrictions and into the next phase of recovering from, and exiting, restrictions.
The committee also raised the issue of increasing public awareness. As members will know, Clear Your Head is the national campaign that was launched on 21 April to support people to cope during the pandemic. The campaign and associated website highlight the practical things that people, including young people, can do to help themselves to feel better and cope with the restrictions during the pandemic. We have worked with Young Scot to develop aye feel, which is a resource that encourages young people to look after their emotional wellbeing and provides key advice and signposting.
On the committee’s recommendation regarding support in employment, we have committed to delivering the young person’s guarantee, so that every person aged between 16 and 24 will have the opportunity to study, take up an apprenticeship, job or work experience, or participate in formal volunteering. We have also committed to working with employer groups and trade unions to promote mentally healthy workplaces.
The report recommended further work to review the provision of school counsellors. We are on course to invest more than £60 million so that every high school has access to counselling. As part of the joint agreement with the Convention of Scottish Local Authorities and local authorities on that commitment, the Scottish Government has agreed a reporting form to understand progress and measure outcomes for those who access a counsellor via their secondary school.
The committee recommended that online mental health first aid training for people who work with children and young people be developed. I am pleased to say that we are developing an online, open-access professional learning resource in mental health and wellbeing for all school staff across primary and secondary education in Scotland, and it is expected that the training will be available by spring 2021. That is in addition to previous mental health first aid training and the mental health in schools working group resources to support mental wellbeing, which have been available since June 2020.
With a focus on the Covid-19 pandemic, on 8 October, I set out the Government’s response to the mental health challenges of Covid-19 through our new transition and recovery plan. In the plan, we laid out a range of actions to respond to the needs of our young citizens, including emotional wellbeing, support that is available in education settings, and pathways into specialist mental health services.
Alongside the plan, and further to the measures that I have already mentioned, we have put in place additional support measures, such as enhanced digital resources on mental health and wellbeing, and expansion of the Distress Brief Intervention programme, which supports people who present to front-line services in distress, and is now available nationally to those over the age of 16. In particular, on 6 November, we announced £1.32 million of additional funding to support students with the mental health impacts of the pandemic. I extend my thanks to the students of Scotland, who have dealt with substantial challenges over the past three months.
Despite such positive developments, as today’s published child and adolescent mental health services waiting times statistics show, there is still work to be done. It is encouraging to see more children and young people starting their mental health treatment sooner, but as demand continues to increase, we know that some people are still having to wait too long for treatment. We recognise that long waits are unacceptable, and we remain committed to meeting the standard that 90 per cent of patients are seen within 18 weeks.
A number of boards have focused on the children and young people who have been waiting the longest. That concerted effort to address backlogs has pushed down the proportion of people who have been waiting for less than 18 weeks, and who are being seen. Notably, NHS Greater Glasgow and Clyde has more than doubled its capacity to see new patients over that period, and has reduced the CAMHS waiting list by more than 1,000 since the end of March 2020. Several other boards, including NHS Grampian and NHS Tayside, also made significant progress in meeting demand for CAMHS and are now in a good position to meet the standard in the future.
Although those initiatives to reduce long waiting times necessarily impact on the performance standard, I welcome that increasing numbers of children and young people who had been waiting are now receiving treatment under CAMHS care, despite the obvious operational difficulties caused by Covid-19. However, in a number of board areas, the proportion of people who are waiting longer than 18 weeks has gone up over that time. That is why the Scottish Government is directing enhanced improvement support to the boards that are not on track to meet the standard.
In our transition and recovery plan, which was published on 8 October, we set out a number of actions to progress improvement in access to CAMHS. They include the implementation of our CAMHS service specification and a tailored programme of support for national health service boards to improve their waiting times performance and address unacceptably long waits. We will work with mental health leads in those boards to develop and implement recovery plans by the end of March 2021.
Despite the constraints that have been caused by the pandemic, health boards have responded creatively, and many have made significant progress. We have been working closely with all boards to plan the recovery of CAMHS across Scotland and to help individual NHS boards to respond effectively to the anticipated increase in demand in the months ahead.
Members will also be aware that, on 24 November, annual suicide statistics for Scotland were published. We continue to prioritise our work on suicide prevention through our suicide prevention action plan and the national suicide prevention leadership group. Every one of those lives lost is a tragedy. My heartfelt sympathies go out to those who have been bereaved by suicide.
I would also like to recognise the efforts of our mental health workforce through the pandemic. Mental health workers have worked tirelessly throughout, supporting children, young people and families. Without those workers, many people would not be receiving the support that they require. I thank them for everything that they do to ensure that mental health is seen as a top priority across Scotland.
The adversities that have been faced because of Covid-19 have shone a critical light on the importance of good mental health. Although it has been a very difficult time for everyone, I am grateful that mental health is now being spoken about far more openly and is at the forefront of everyone’s mind—exactly where it should be.
Thank you. I still have a little time in hand, so if our opening speakers go slightly over, as the minister did, that is okay by me, but do not overegg it. I call Brian Whittle to open for the Conservatives.17:06
As if I would overegg it, Presiding Officer.
I start by declaring that I have a daughter who is the head of guidance in a secondary school.
I am glad to have the opportunity to open the debate on behalf of the Scottish Conservatives, because my time in this place is done. One of the biggest memories that will go with me is the first time that Annette McKenzie appeared in front of the Public Petitions Committee and, with incredible bravery and a quiet dignity, spoke about the tragic death of her 16-year-old daughter. I remember her being terrified just to be sitting in front of parliamentarians and the cameras. She was driven by a sense of need to try to prevent what happened to her from ever happening again.
As the committee convener said, Ms McKenzie’s daughter presented at her GP’s surgery with anxiety symptoms. She was prescribed a full month’s worth of medication, and she died after taking an overdose of that prescription medicine.
Ms McKenzie’s simple ask was that a parent or a guardian should know of such a diagnosis and prescription. She said that had she known, she would have been able to ensure that her daughter took the prescription medication in the required doses.
Under the Age of Legal Capacity (Scotland) Act 1991, a person under the age of 16 has the legal capacity to consent to any medical
“procedure or treatment where, in the opinion of a qualified medical practitioner”
the person understands
“the nature and possible consequences of the procedure or treatment.”
That got me thinking about the capacity of a young person—or of anyone, for that matter—presenting to a GP with poor mental health to make rational decisions. As the convener can tell anyone, I pushed that point throughout the inquiry. Surely the very nature of poor mental health must bring that into question. I cannot accept the blanket answer that there is patient-doctor confidentiality—to me, that is a cop-out. I am asking whether we have the balance wrong. I say that we have, and I think that the medical profession must take—
Although I understand exactly what the member is saying, and I do not rebut it, does he accept that being in mental ill health does not prevent someone from being able to engage positively with what happens to them?
I was going to come on to say that it is a complicated issue and it is not straightforward. I am not suggesting that I have an answer. What I want to see on the back of the inquiry is the medical profession taking another look at the issue and for us to see whether we can change, or massage, the legislation that was first brought in, in order to help people like Annette McKenzie.
The debate is related directly to last week’s debate on the Health and Sport Committee’s medicines inquiry. In that debate, I said that there was an overprescription of drugs to tackle anxiety, more often than not because of medical practitioners’ limited treatment options and lack of the time to spend with a patient in order to make a full assessment of need. In my opinion, that should be linked in turn to other inquiries, such as the Health and Sport Committee’s social prescribing inquiry, because I do not think that the current plan is working particularly well.
The inquiry into children and mental health support gathered a worrying level of evidence that highlighted serious concerns about the experiences of young people who seek help for their mental health. We know how much pressure CAMHS were under prior to the Covid crisis, with thousands of children—more than a third of cases, according to the latest figures from Public Health Scotland—waiting for longer than the 18-week waiting time target that was set by the Government. More than 1,000 children and young people have now waited for longer than a year for mental health treatment, yet we know that early intervention is key.
During the Covid crisis, referrals for young people have dropped by more than half, at a time when we know that mental health issues are rising steeply. That should set alarm bells ringing. Recently released statistics show a sharp increase in suicides in the year prior to Covid, and we have a continued rise in the number of drug-related deaths—at three times the rate of the rest of the UK—which are often associated with childhood trauma. We should all be concerned about what is coming when this year’s figures are announced. I would like the Scottish Government to have a plan now to look at that.
The roles of the third sector and the school environment are crucial, because they offer options in a non-medical environment to those who are suffering. It is somewhat ironic that this debate follows the one on valuing the third sector, which is grossly underappreciated and underfunded. There has to be better integration of mental health services in the NHS and the third sector. There are examples of where such integration works well and is very effective. We need to replicate that across the country.
Recently, Johann Lamont and I had an impromptu discussion—her reputation is now destroyed—about the importance of keeping sport accessible to our children and young people. That was hugely important before Covid; now, it is absolutely essential. Any parent—me included—of children who participate in sport but had that option taken away during Covid will know exactly what I am talking about. Prevention is better than cure.
I will finish where I started. Given Ms McKenzie’s long campaign—it is now a four-year one—the support that she has galvanised over that time for her petition, and the hugely important issues that she has raised, the Parliament owes her, and all those who have children who suffer from poor mental health, full consideration of the issues that the petition raised. What has really changed in all that time? The answer is very little. The most damning thing about this Parliament is that, after a full term and with everyone gearing up for an upcoming election, such issues, which really matter, are still not being properly addressed.
The Public Petitions Committee has done its job, and I thank all the clerks and staff, as well as my colleagues, for taking on a huge issue and delivering such a comprehensive report. The Scottish Government has talked long but has come up really short on definitive action. It now has a committee report to galvanise it into taking action.
The matter is beyond petty politics. Despite all the political manoeuvring, and attempts to get one over on each other, surely there has to be room for the issue to be properly addressed; otherwise, what are we doing here? I urge the Scottish Government to take a breath, take stock of the committee’s report and work with members of all parties to develop a strategy and plan in order to support our children and young people into good mental health. In these times, more than ever, that is crucial.17:13
On behalf of Scottish Labour, I welcome the committee’s report. We agree that mental health provision for young people in Scotland is complex and fragmented, and for that reason I welcome the conclusions and recommendations that have been offered by the Public Petitions Committee.
I thank the many organisations and young people who voiced their concerns and spoke of their experiences of mental health services for young people. I also thank Annette McKenzie for lodging the petition that led to the inquiry. It will have been incredibly difficult for Ms McKenzie to talk about her experience and the tragic loss of her daughter. As other members have done, I praise her for the incredible strength and commitment that she has shown in raising the extremely personal and important issue that led to this debate.
I also thank committee members and the clerks for their work in recent months to produce the report.
Any investment in mental health services for children and young people is welcome, but it is crucial that investment is adequate, and the Government has not achieved that. The Government has invested in mental health services across the population in the months since the report was published. The committee welcomed the additional funding in response to the pandemic; it also rightly pointed out that there were calls for the expansion of services before the Covid-19 public health emergency. The pandemic has exposed further the mental health crisis that already existed. Many young people, particularly students, will be feeling even more isolated.
In the first wave of the virus, we witnessed a sharp drop in referrals to CAMHS. The continuing high rate of rejected referrals shows that hundreds of young people remain without the support that they urgently need. Today’s CAMHS statistics for June to September 2020 show that referrals have increased again while rejected referrals remain at a steady level. Of the 9,699 children and young people who were left waiting at the month end, it is shocking that more than half have waited longer than 18 weeks and almost 1,000 have been waiting for more than a year.
What is required is more connected work on mental health services for young people, along with effective throughcare in the transition from CAMHS to adult services. The expansion in mental health counsellor numbers is welcome—Labour members called for that—but it is not a single solution and must be part of a collection of services that work alongside one another. There is a stark difference between what is on offer and what must be on offer.
Recruitment and training play a part in the challenge of supporting young people’s mental health. In relation to the commitment to have counsellors in all secondary schools by September this year, Stuart Valentine, the chief executive of Relationships Scotland, said:
“there are not enough qualified children and young people’s counsellors to fulfil the commitment.”—[Official Report, Education and Skills Committee, 5 February 2020; c 10.]
Obviously, the pandemic will have played its part in the Government’s ability to achieve its ambition this year. I would be grateful if the Minister for Mental Health could update the Parliament on success in meeting the deadline.
Schools have a strong part to play in supporting young people’s mental health. A further tool at our disposal is mental health first aid training for all school staff and senior pupils, a key aspect of which must be about identifying and signposting pupils to services. A crucial theme of the committee’s report is the lack of signposting. People do not know where to seek further support.
Parents and carers raised that issue with the committee. Parents and carers need support if they are to be able to support young people. A parent who contributed to the digital consultation said:
“if there was common knowledge and education available for parents then I feel we as parents could help more and make a start on the healing process.”
The inquiry stemmed from a petition that raised concerns about the prescription of medication to young people. In certain cases, medication has a role to play in dealing with the poor mental health of anyone at any given time, but medication should be only the start of recovery. It is rarely a long-term solution, and it should be given alongside other services. We agree that early interventions and better training and resources are key to helping teachers to support young people.
Finally, I hope that the Government takes on board the conclusions and recommendations in the committee’s report. It is more important than ever that mental health services are properly funded and signposted. Schools have an important role in the mix of mental health support and throughcare in the transition to adult services, but they should not be the cliff edge that many young people face or have faced in the past. The pandemic has worsened mental health across the population, and we cannot leave a generation of young people behind as we rebuild.17:21
Mental health is a subject that should be a permanent fixture for debate in the chamber. As Scottish Liberal Democrats pointed out in our Opposition debate a year ago, there is a mental health crisis in Scotland. I am grateful to the Public Petitions Committee for producing the report. I am grateful, too, to the petitioner, Annette McKenzie, and pay tribute to her for submitting the petition in 2016 that inspired this body of work.
This latest report adds to the mountain of evidence that already exists to show that Scotland has its work cut out to put together an effective system that is capable of looking after the mental health and wellbeing of children and young people.
That has only become more obvious during the pandemic. As the committee points out, it has been reported that 9 per cent of 18 to 24-year-olds across the UK have lost their jobs altogether, which is the highest figure for all age groups. As a member of the Education and Skills Committee, I have seen the challenges to mental health and wellbeing that have been created by the waves of disruption to young people’s education. School closures, cancelled exams and all the uncertainties around higher and further education restarts have created a perfect storm for anxiety and isolation. In evidence to the Education and Skills Committee earlier this year, Educational Institute of Scotland general secretary Larry Flanagan said that an increasing number of children will have been “severely traumatised” as a result of the coronavirus crisis.
It is blatantly clear that, with the current workforce levels, the system cannot cope. Too many young people are waiting too long for mental health treatment. Once again, Scottish Government figures released today show that well over 1,000 are waiting for more than a year. It is heartbreaking to see that many more children are now struggling at the back of one of the longest queues in the health service. That figure is just the tip of the iceberg. As the Scottish Association for Mental Health points out in its briefing, some children and young people are rejected from CAMHS after a paper-based referral without any in-person contact. Problems that may start as something small become worse and, too often, as a consequence of that wait, comes tragedy. Waiting times are not just numbers that do not add up; they are evidence of individuals who have reached out, only to find that the support that they need is just not there. For someone who is at their most vulnerable, that realisation must be crushing.
In my remaining time, I will speak about another issue that has had the attention of the Education and Skills Committee in recent months—school counsellors. Issues that were highlighted in evidence to the Public Petitions Committee chimed with my own reflections. One contributor to a round-table evidence session held by the committee stated:
“school based counselling services are essential to ensure this help is available at the earliest opportunity.”
I agree. That is why I was troubled by evidence that the Education and Skills Committee heard in the autumn, which showed a fragmented system. There was no quality assurance, no co-ordination and no profile of demand. When asked for details, those giving evidence reverted to CAMHS figures
As SAMH has pointed out, people
“feel like they need to be in crisis”
to access CAMHS, but there are large numbers of people who need support and do not fall into that category. If the Scottish Government does not take immediate and material action, the situation will only get worse. It requires more boots on the ground, and a coherent and accountable system in place to back them up. That means building the workforce and making sure that those who work in front-line roles such as teaching are given the training that they need to process and understand the issues that children and young people face.
SAMH research found that 66 per cent of teachers feel that they have not had enough mental health training to do their job properly. Worryingly, that is more likely to be the case for those who qualified in the past five years. SAMHS has called on the Scottish Government and Education Scotland to take measures to protect time for mental health training for all school staff.
The Scottish mental health first aid programme has paused its face-to-face training because of the pandemic. Since May, Scottish Liberal Democrats have called on the Scottish Government to restart that work, because by failing to provide those basic interventions, we make everything much worse. Too often, Government spending focuses money on reactive policies that only try to fix problems when they have already reached the point where interventions are needed.
On that basis, I support the committee’s findings.17:26
I thank the clerks and the Scottish Parliament information centre, as well as my fellow committee members, for their hard work in contributing to the report on the inquiry into mental health support for young people in Scotland.
I also thank everyone who gave written and oral evidence to the committee. We were fortunate to hear from a wide range of charities and stakeholders, including Penumbra, SAMH, Children in Scotland, representatives of the medical profession and many other organisations.
It is important that we also heard from individuals about their personal experiences and the mental health support that they had received. I thank them for sharing their stories with us.
As others have done, I begin by noting my thanks and appreciation to Annette McKenzie. In December 2016, Ms McKenzie lodged a public petition calling for consultation of and consent from a parent or guardian before prescribing medication to treat mental ill health in patients under 18 years of age. Ms McKenzie lodged the petition following the tragic death of her daughter, Britney, from an overdose of prescription medication. I am grateful to Ms McKenzie for her courage in highlighting concerns to the committee, which has brought the issue to where it is today.
Mental health influences how we think and feel about ourselves and others, and how we interpret events. It affects our capacity to learn and communicate, and our capacity to form, sustain and end relationships. It also influences our ability to cope with change, transitions and life events. Good mental health allows children and young people to develop the resilience to cope with whatever life throws at them, and to grow into well-rounded and healthy adults.
The central purpose of CAMHS is to develop and deliver services for children and young people—and their parents and carers—who are experiencing the most serious mental health problems. It also has an important role in supporting mental health capabilities in a wider network of children’s services.
Delivery of good-quality child and adolescent mental health services is vital, and relies on adequate numbers of well-trained staff being recruited and retained across NHS Scotland. Over the past decade, the number of people working in child and adolescent mental health services has increased by more than 50 per cent, and investment of £58 million over four years is helping health boards to improve access to CAMHS and psychological therapies through workforce development, recruitment and retention, and service improvement support.
Timely access to healthcare is a key measure of quality that applies equally in relation to access to mental health services. Early action is more likely to result in full recovery and, in the case of children and young people, it will also minimise the impact on aspects of their development such as their education, which will improve their wider social development outcomes. Figures show that three children in every classroom will, by the time they are 16, have experienced a mental health problem and that a worrying 74 per cent of young people do not know what mental health information, support and services are available in their local area.
When we have a physical health problem, we all know where to turn and what we need to do, but when we become mentally unwell it is often hard to know where to turn. It is vital that our young people know what support is available and how they can access it. Similarly, people who have roles in supporting young people must be aware of the services and support that exist.
During our evidence sessions, it became clear that there can be a confusing and cluttered landscape for young people who are seeking help for their mental health, and for people who are trying to help them. Although a range of services is available in the public, private and third sectors to support young people who are seeking help for their mental health, we must continue to improve how we distribute not only the message, but information about the avenues of support that are available for young people, their families and friends, and the professionals who are supporting them.
I very much welcome the Government’s actions to ensure that children and young people receive the support that they need at the earliest possible stage. Support includes the £60 million that is guaranteeing that every high school has access to school counselling services, and which is guaranteeing delivery of 80 additional counsellors in further and higher education.
During the committee’s engagement events with young people, several young people highlighted how helpful it is to have access to a counsellor or mental health professional in their school. The benefits of school counsellors were similarly highlighted to the committee by several teachers. It was hugely encouraging to hear at first hand feedback from pupils and teachers about the services and the role that they play as part of a wider range of measures.
The establishment of a mental health in schools working group is also a welcome step forward in the Government’s on-going commitment to supporting positive mental health in children and young people in schools. The group’s remit includes supporting the development of professional learning resources for all school staff. That will provide the essential learning that is required to support children and young people’s mental health and wellbeing.
It is accepted that mental health support for young people was a challenging area for public policy even before the considerable impact of Covid-19. It has therefore never been more important for young people to be aware of their mental health, the steps that they can take to protect it and the services that are available for those who need them. It is expected that school closures, cancelled exams and general uncertainty regarding the future, on top of what is often already a stressful time in a young person’s life, are likely to lead to increased anxiety in young people.
Given the scale of the impact of the Covid-19 pandemic, good practice must exist across all local levels, and focus must be put on intervention and prevention. The Scottish Government’s 10-year mental health strategy sets out a commitment to
“create a Scotland where all stigma and discrimination related to mental health is challenged, and our collective understanding of how to prevent and treat mental health problems is increased. We want to see a nation where mental healthcare is person-centred and recognises the life-changing benefits of fast, effective treatment. We want a Scotland where we can act on the knowledge that failing to recognise, prioritise and treat mental health problems costs not only our economy, but harms individuals and communities.”
We have certainly made progress, with the 2019 annual report showing that progress has been made on all 29 recommendations of the audit of rejected referrals to CAMHS, and that there has been development on 19 of the 40 actions in the mental health strategy.
Mental health is an integral part of public health. It is as important as physical health to the overall wellbeing of individuals, communities and societies. The events of recent months have shown how important it is that children and young people have the emotional resilience to adapt to social pressures, challenges and changes in circumstances.
I welcome the report’s recommendations and the response from the Scottish Government, and I look forward to the progress of our mental health strategy, as we continue to advance the development of services and information to ensure that no child or young person is left behind.17:33
The debate and the report that underpins it come at a vital inflection point, as we look at ways to improve access to mental health care for young people. I joined the committee at the end of its work on the report, which might have been helpful because I was able to provide a fresh look at some of the issues.
The latest data suggest that there have been decreases in the number of children and young people starting treatment. Nearly 40 per cent are not being seen within the 18-week target. We have some of the longest mental health waiting times on record and an extensive backlog of cases to be taken forward. That is the backdrop. We have to improve the care that is provided to young people.
Those declines have, of course, taken place during extraordinary circumstances. I do not doubt the will of all the people involved to make things better, but the issues with CAMHS waiting times predate the pandemic, so there is a need to look beyond the events of this year in order to understand the changes that are needed.
The committee’s work has raised a number of issues. In particular, it has identified challenges in improving early intervention and prevention. That is the key, and the recommendations that minimum levels of service provision in local areas should be set out, and that clear pathways to support for young people should be published will be vital in ensuring that the available support is at a high enough level to treat all those who need such support.
In her response to the committee, the minister set out the actions that the Scottish Government is taking to meet those challenges. In particular, she referred to the £2 million of new funding and the framework for local authorities that was issued in March this year.
However, a lot has happened in the intervening period. With that in mind, could the minister set out whether she believes that that that is sufficient to deal with the problems that have arisen since and, if not, what further support the Scottish Government will put in place to ensure that its commitment to the committee is kept?
Mr Mason will be aware of the fact that, last month, we increased funding to local authorities so that they could provide a direct response to the effects of the mental health challenges that children and young people face. I mentioned that in my speech. I take it that Mr Mason welcomes that commitment.
I am sure that people understand that.
The committee also identified issues with the provision of school counsellors, and questioned whether the current level was sufficient for the performance that is needed. School counsellors are a vital part of any mental health strategy for children, as they can be the first to witness potential problems; they can do so long before a young person might discuss issues with a doctor or seek referral for treatment.
I am conscious that many different pressures affect our young people, including pressures on their physical welfare, such as those to do with the perception of body image and dietary problems. We should recognise that those pressures have become more apparent in recent years, and may have developed alongside declining family stability and the growth of social media. We must recognise the impact that both those issues can have on a young person’s wellbeing, and that addressing them should, therefore, be part of the solution.
The committee has asked the Government to work with COSLA to fully review provision of counsellors. Although the minister has said that she is working with COSLA on mental health support, a commitment to reporting to Parliament on that specific issue by early 2022 would be very reassuring.
The availability of mental health support to children and young people is vital at the best of times, never mind during the current pandemic, when the focus has understandably been drawn to other areas. It is my hope that the committee’s report and the recommendations that it contains will help the Government to improve the quality of care for young people, so that if someone is struggling with their mental health, support is available to them, regardless of where they live or how old they are.17:38
I thank Johann Lamont and the Public Petitions Committee for bringing this crucial debate to Parliament. Young adults have been especially badly hit during the pandemic—they have been hit by a triple whammy of curtailed education, diminished job prospects and reduced social contact with peers. In many ways, it is quite heartbreaking.
Young people who have been shielding during the pandemic have had an especially tough time, as it has impacted on their jobs. For many, it has affected their ability to socialise with people after lockdown. The Office for National Statistics tells us that young people who reported that their wellbeing was being affected were much more likely than people over the age of 30 to report that the lockdown was making their mental health worse. The period between the ages of 18 and 24 is a time of especially high risk of experiencing mental health problems: three quarters of mental health problems arise before a person reaches their mid-20s.
I recognise Clare Haughey’s dedication to provision of mental health support, but I also have a plea to make, because the current system is not fit for purpose. What I see on paper looks fine, but the reality is not, as I know from bitter experience.
A young woman whom I know recently made an attempt on her life following two failed requests to her general practitioner for support. After several weeks, no action had been taken. There seemed to be an argument between the Rossdale mental health resource centre in Glasgow and wellbeing services with regard to which was the right service for her.
After six weeks, she was sent a letter, the wording of which I found astonishing. It said that, if she would like to opt in to the service, she had five days to do so, after which she would be removed from the list. She was, of course, removed from the list, because she was unable to cope with life, but she was angry at that letter.
That young woman is underweight and fragile, not because of an eating disorder but because of other health issues. She has difficulty holding down a job, and her issues are affecting her relationships. What she needed was to talk to someone swiftly, as soon as she left hospital, and to feel that the service was there for her. I can assure members that she thinks that it was not there. The delays and lack of serious treatment have only added to her problems. She wonders why no one seems to care.
A week ago, after three months, she made an attempt on her own life, which is a clear cry for help, in my opinion. She has had one phone call and now has to wait for a further two months to be told whether any action will be taken or, indeed, whether there will be a diagnosis.
In contrast, another young woman in Glasgow, in the same health board, was referred two weeks ago and has already had a video appointment and has been referred to Rossdale mental health resource centre, following a request to her GP.
I have some questions. Why is video not standard across the board? Why is the follow-up so slow? What is the service opt-in all about? Does that really help struggling young people? Why is it that someone who has made an attempt on her own life is still waiting for help, while someone else in the same health board area has accessed help through their GP? That disparity is not acceptable. How many more young people will suffer because the service is under so much strain that there is a month between the first assessment and the outcome? Why is there such a lottery in one health board?
The mental illness situation is only going to get more acute. There have been some great speeches about that this afternoon, including those from David Torrance and Mary Fee. We have to get the system right, and that has to be done swiftly.
In the Government’s latest wellbeing survey of young people, which was done before the pandemic, 38 per cent of young people reported that they had poor mental wellbeing—the highest level on record. Obviously, the pandemic has made that worse. The drop in referrals to CAMHS over the first lockdown was deeply concerning.
The most common reason for a referral being rejected was that the condition was not deemed to be severe enough, even when children were self-harming. I find that quite astonishing.
The Mental Health Foundation said that there is an urgent need to put in place measures to support the mental health and wellbeing of people aged between 18 and 24. We need to be prepared to make design changes in the light of the pandemic. We need to focus on that critical age group. If we do not, the consequences will be bleak.17:42
I thank the committee for its report and I welcome the opportunity to speak in the debate. I know that the process has been difficult for the petitioner and that it has taken four years, but I welcome the report and I thank the petitioner for the work that she has done to bring this critical issue to the Parliament.
Everyone agrees that good mental health is as important as good physical health. I believe that it is right, therefore, to assert that there should be the same access to support and services for mental health as there is for physical health. However, as some of the speeches that we have heard today have demonstrated, that it is not always the case and, tragically, in the most extreme cases, young lives are lost.
The effects of the pandemic have touched everyone, but none more than our young people. I have been in dialogue and have had Zoom meetings with Samaritans and the Scottish Association for Mental Health to discuss the impact of the pandemic on young people’s mental health. The particular demographic of my constituency has made me aware of and concerned about students’ mental health and how they have coped with the restrictions. Early indications have shown that there has been a worsening of mental health issues in that younger age group.
The evidence is overwhelming that good mental health and wellbeing contributes to students’ ability to participate effectively, grow in confidence and thrive in their studies. Poor mental health can negatively affect the learning of students and others, their progress and their ultimate outcomes.
Before 2020, a first-year college or university student would have had a really different experience when starting their studies: they would move away from home, make new friendships, go to a new city, be financially independent or just be independent. All that has been taken away by the pandemic. The measures that have been put in place are necessary, but they have had an effect on students’ mental health.
Unfortunately, it is no surprise that the number of young people who are looking for support has risen. Through its helpline, Samaritans has identified increased levels of anxiety and concerns about mental health, finances and employment—that has been mentioned—as well as feelings of loneliness and isolation. Samaritans has answered almost 1 million calls for help, and about one in four contacts have focused on concerns about coronavirus. In a recent survey of call handlers, one said that young people
“seem to have little hope for the future, what will happen about their”
university course or their job.
A few weeks ago, I raised the issue of mental health in the chamber and sought assurances that students will have access to support. I acknowledge the Minister for Mental Health’s response and welcome the action that the Scottish Government has taken to provide an additional £3.6 million for 80 additional counsellors, which David Torrance mentioned, in colleges and universities over the next four years, as well as the funding of NUS Scotland to host Think Positive, the student mental health project, which supports students who are experiencing mental ill health.
I asked whether the applied suicide intervention skills training would continue to be accessible—I think that Beatrice Wishart mentioned that. It is a vital component of the services that are offered to provide support. The evidence shows that it is an effective training programme that provides people with the skills and confidence to intervene. The minister said that ASIST was not being delivered because of the pandemic, which I understand, as the training is delivered face to face in normal circumstances. However, a number of organisations have had to adapt—as the Parliament has adapted its meetings—so I ask the minister whether the decision to stop the delivery of ASIST could be looked at again. The training could be provided virtually, as we in the chamber and in committees participate virtually. That could be a useful and effective way to bolster our mental health services.
I acknowledge that the Scottish Government is taking action and working with professionals and organisations. We see that in the work that is being carried out with the NUS, Samaritans and SAMH, to name but a few. Yesterday, I had the opportunity to meet SAMH, when I discussed today’s debate and said that I would speak. SAMH has engaged with the Public Petitions Committee’s inquiry, and it has a number of asks of the Scottish Government. Perhaps the Scottish Government could explore what SAMH has raised with the committee and me and incorporate that into the work that it is already doing.17:48
I, too, am pleased to take part in the debate as a member of the Public Petitions Committee. Along with my colleagues, I have found exploring the impact of mental health on young people to be truly eye opening. I am grateful to Annette McKenzie for submitting the petition and for her strong persistence. I also thank the clerks for their hard work.
Through the committee’s work, I had the privilege of listening to many people around Scotland—particularly young people—who were amazingly open in sharing their experiences of mental health and what they feel must improve for young people. I am sure that the report goes some way to highlighting the ways in which the complexities of mental health support can be better addressed without any more delay.
Young people can face several pressures: school work, exams, family-related issues and bereavement. The impact of Covid-19 has increased those burdens to a dangerous extent. Uncertainties about health, exams and future work opportunities, as well as the potential for bereavement, have heightened feelings of stress and anxiety.
However, those are far from being new problems. Covid-19 has served to worsen the on-going mental health crisis that was already plain to see before the pandemic. With a rising number of suicides, increasing waiting times for mental health treatment and concerning vacancy numbers in psychiatric services for children, the gaps in mental health support are in dire need of fixing. The necessity of establishing mental health support pathways that are widely available and easily accessible has never been more pronounced.
The committee noted a clear need for much greater emphasis to be placed on early and proactive intervention. Guidance at the point of need would help to target mental ill health before it escalates and worsens.
On the basis of the points that he has made, I take it that Maurice Corry will welcome the establishment of the community wellbeing centres for five to 24-year-olds that are being rolled out across the country by local authorities. They will provide a lot of the early intervention and lower-level therapeutic interventions that he has spoken about.
I thank the minister for that very valuable intervention. Yes, I totally support that. I also have an interest on behalf of veterans—our early service leavers, who fall into the higher end of the age group—and I very much welcome those centres.
Hand in hand with early intervention, there must be a more co-ordinated, partnered approach to mental health support provision. A major concern for many young people—often shared by their teachers, pupil support assistants and, on occasion, GPs—is knowing which way to turn and how best to navigate mental health support services. Each local area differs in the pathways of support that are available, with varying degrees of signposting.
The committee learned of the benefits recognised by organisations across the public, private and third sector in working together—a prime example being Place2Be, in Ayrshire, which is in my region. That charity works with schools and the local council to build resilience by encouraging more open dialogue and developing coping strategies for young people.
That joined-up approach needs to be more consistently available across the whole of Scotland. I certainly agree that there is a need to build up a network of services, which will be furthered by greater information sharing and integration across local authorities, so that those services are as transparent and accessible as possible for young people and their families. That was highlighted in the minister’s intervention, and I agree with the points that she made.
Families, teachers and GPs play a key role in supporting young people through mental health issues, and that is not without its own pressures. The limits on teachers’ and GPs’ time to spend with young people has caused concern. Indeed, having the time and space to simply listen cannot be underestimated. Moreover, the committee recognised the obligation to ensure that parents can receive training and counselling in how best to support their children through mental ill health.
Young people’s mental health and the impact of Covid-19 must be taken seriously. I hope that the Scottish Government will act on those concerns without delay. Young people and their families are deserving of the best possible access to support. If they are to be able to get that, there must be a greater focus on co-ordination and early intervention, as is exemplified by the process that is being followed.17:53
I express my gratitude to the Public Petitions Committee and everyone who contributed to the inquiry and report. It has been an excellent debate, and I welcome the contributions from colleagues across the chamber.
It was heartening to hear from committee convener Johann Lamont’s opening remarks that the committee found evidence of good mental health services and strong examples of partnership working across the country. That is important. It is also positive that, as a country, we are speaking much more openly about mental health; that must be welcomed.
However, it is clear from the evidence that there are gaps in the support and that those must be filled. Urgent action is needed to ensure that every child and young person receives the right support when they need it, and that there is support for parents and carers too. That came across strongly in the comments from Johann Lamont and others.
Annette McKenzie has shown great courage in the face of the worst possible adversity. The tragic death of her daughter Britney clearly made a mark on the committee members and on those who have supported Annette and her family. It was right that the convener recognised that Annette’s petition has been the catalyst for the committee’s comprehensive enquiry.
The mental health of young people in Scotland has been a prominent issue during my time in the Parliament. Before Covid, youth campaigners in Scotland described the growing mental health crisis as their generation’s epidemic. Long waiting times for mental health treatment are intolerable and urgent action is required to prevent our children and young people falling deeper into mental health crisis.
As we have heard, life in lockdown is affecting the mental health of people of all ages and from all backgrounds. But, for children and young people, who may not understand the magnitude of what has been happening, and for those who have experienced direct trauma, it is particularly difficult. The minister for mental health has acknowledged today, and previously, that the Scottish Government anticipates an increase in demand for mental health services.
We have heard from members, including Beatrice Wishart, about the important role played by schools in supporting young people in these difficult times. Adequate funding is required now more than ever, for not just the NHS but the vital third sector organisations that provide lifeline support.
We have heard about the importance of proper pathways. Signposting is important too. We all know of examples of excellent services in our communities, but how many of our constituents know how to access those at—or, more importantly, before—the point of crisis?
Covid-19 has affected not only businesses; it has hit the voluntary sector hard. Many charities have been unable to fundraise.
I join the minister in paying tribute to the mental health workforce, who have had to adapt enormously during the pandemic. I welcome her commitment to addressing unacceptably long waits for CAMHS, which have been highlighted again by today’s figures.
There is an area where we are beginning to make some progress. I thank the minister for her work in bringing opposition spokespeople together with experts from charities and young people with lived experience to address the issue of self-harm. I do not think that the Parliament has addressed that enough, but there is a cross-party commitment to do better.
I was shocked to learn that one in six young people in Scotland between the ages of 16 and 24 has self-harmed at some point in life. We know that the prevalence of self-harm increases with deprivation. People who live in the most deprived areas are more than twice as likely to self-harm as those in wealthier areas—that economic factors affect mental health is true in general. Self-harm is mentioned in almost one in four contacts that under-18-year-olds make with Samaritans’ helpline service. I am grateful to the minister for bringing people together on that issue. It is clear that there is a lot of passion in the Parliament to get that right for all young people.
SAMH is asking for each local authority to have a central mental health hub that children and young people are referred to if they need support that is not readily available in their community and where they can be quickly assessed by a multi-disciplinary team and connected to the support that they need without the threat of rejection. That is important. SAMH is also asking for the professionalisation of personal and social education, with mental health education as a core part of PSE. That is just one example that shows that it is not the job of one minister to get this right: all parts of Government must work together.
To pick up on a local example, the minister will be familiar with the work of FAMS—Families Affected by Murder and Suicide—a Lanarkshire-based charity founded seven years ago to support families affected by murder or suicide. The charity has recently been in touch to say that it is financially vulnerable because it is not able to fundraise, but that demand for its service is overwhelming. It says that the cost to the NHS and emergency services of FAMS closing could be thousands of pounds in terms of visits to accident and emergency, general practitioners and so on, and that the cost in human terms would be immeasurable.
We need to act, because we cannot leave a generation of children and young people behind. I was struck by the words of Annette McKenzie, whose daughter Britney has inspired much of today’s debate. Annette said:
“Britney’s beautiful smile hid a world of pain, her smile could brighten up the darkest of days, just not her own.”
As we think about building back better, we need to think about building back kinder, so I will finish with Annette’s words. She said:
“reach out to all your friends tonight let them know you love them and are glad for them in your life and you’re here for them.”18:00
The debate has been really interesting. I am pleased that all members have taken part constructively, although we have made some punchy points, which I will reflect on in summing up.
I thank the Equalities and Human Rights Committee for its work in producing the report. I also thank Annette McKenzie, who has become a strong and courageous campaigner on young people’s mental health issues and who was the catalyst for the report. I was struck by the mantra on her social media that
“It’s easier to build strong children than broken adults.”
How right she is. However, in working on the Parliament’s Redress for Survivors (Historical Child Abuse in Care) (Scotland) Bill, I have heard at first hand about the experience of survivors who were broken children and who have become strong adults. There is hope.
In the context of Covid, the report is timely and much needed. We have a virus on our hands that is harmful to our physical health—particularly among older and more vulnerable people—but that is equally harmful to the mental health of young people, who have been disproportionately affected by the secondary impacts of the lockdown. They have lost social interaction and jobs. They have been cooped up in the house, often with their parents, and have been unable to see their friends. There has been a tragic rise in online bullying and in the stress of social media. There has been a lack of sports and hobbies and a lack of access to support and much-needed medical care. Support has often moved online or on to the telephone, and, for too many, it has simply been about prescribed medication on repeat, with no face-to-face catch-up or counselling. We know that that is now the norm for far too many young people.
That is not because GPs do not want to help; it is because they have only 15 minutes. There are waiting lists of months for cognitive behavioural therapy, talking therapies and other forms of intervention. Many things that young people used to do to self-help, such as hobbies, having coffee with a friend, volunteering, working and education have all gone now, too.
The issue goes far beyond anecdotal evidence; the data speaks for itself. According to Samaritans, the suicide rate among young people is the highest that it has been since 2007. Another report tells us that one in nine young people in Scotland has attempted suicide. Members should think about that when they visit schools and colleges. In any group of young people there, one in nine will have attempted suicide, and one in six will have self-harmed, which Monica Lennon referred to.
Among the lesbian, gay, bisexual, transgender and intersex community, the numbers are even higher. I have lost two friends in my network in just the past three months. I know that because they popped up on Facebook—it is another month and another loss. Both of those people were still surrounded by so much stigma and taboo.
That is why we all need to take the committee’s report seriously. I do not say this lightly, but I believe that the current physical health emergency, which we are now nine months into, will lead to a mental health emergency that will last for years—a mental health emergency that we have not seen the likes of and for which, sadly, we are woefully underprepared. It is simply too early to work out how the emergency will manifest itself but, just as we equip our nurses with personal protective equipment, we need to equip teachers with the skills to spot the signs and to support those who need help.
As the committee report recommends, and as many members have said in the debate, that work must start now. It should have already started, because those sad statistics speak for themselves. The report mentions the “confusing and ... cluttered landscape” for accessing support. That gets to the heart of the matter. The pathways to get support are not only unclear; they are often not there at all.
We know that the NUS Scotland study found that a third of students had nowhere to go for support. When they go for support, what happens? They face lengthy and unacceptable waits, even for that first vital assessment, never mind for on-going treatment. I do not mean that they are waiting for weeks—in many cases, they are waiting for months, and, in some cases, for more than a year. How can waiting a year just to see someone be acceptable to any of us?
I know that the minister takes the issue seriously, but we talk the talk in this place about mental health. We say that it has equity of importance with physical health, but does it really? There would be outrage in the Parliament if someone who had been diagnosed with a severe physical disease had to wait nine months before they saw a consultant. Indeed, in some cases, we do see that. Where is the same outrage over mental health support?
Let this debate serve as a stark warning to us all. It must be the catalyst for a renewed overhaul of our approach to supporting young people’s mental health. There must be a support mechanism and a focus on community-led, bottom-up approaches, with mental health first aid training for our teachers and opportunities for their professional development. We know that school counsellors will play a vital role, so we must meet the target of having them in every school; every school must have access to one.
We know that there is a workforce crisis in providing mental health support, because the Royal College of Psychiatrists warned us of that. We know that there are many vacancies in consultancy posts. We must ask why that is and what is being done about it. I hope that the minister will reflect on the recruitment issue in her summing up.
I am happy to respond now.
I am in my final minute, but I would like the minister to address the issue in closing.
I cannot take part in the debate without addressing the substance of the petition, because it raises an important and grave issue. I do not have the answer to the complex issue of whether parents or guardians should be informed about a mental health diagnosis or about the prescription of medication. I do not have teenage children with depression who are taking medication or self-harming, but would I want to know whether they had been prescribed medication? I probably would—if nothing else, to ensure consistent adherence to their treatment plan.
Do I also think that young adults should have the right to privacy? I would not interfere in their contraception or in their sexual or other personal health issues, but if someone is vulnerable and their general practitioner says so, the moral question is whether their guardian should be informed.
That conundrum has yet to be resolved, but we know that we cannot let down those young people a day longer. If we can prevent every loss of life, every act of self-harm and every day of darkness, we must. If we do not, that will be a shameful legacy of our shared time in this Parliament. We can do better. We have to do better.
I give Clare Haughey an equally generous six minutes.18:08
Thank you, Presiding Officer. I thank members for this thoughtful and constructive debate, which has addressed many important issues this evening, and I again thank the committee for its work and its report.
As the Minister for Mental Health, I am reassured that there is clear consensus that the mental health of our young people is of paramount importance and that we, as a country, must continue to do more to ensure that children and young people have the support that they need. We must work together to ensure that our mental health is cared for and talked about as equally and openly as our physical health is. That is true from perinatal and infant mental health all the way through to mental health for older people.
As I mentioned at the start of the debate, Covid-19 has brought new and significant challenges into everyone’s day-to-day life. It has changed life as we know it. It has taken away many comforts that we rely on so heavily—the usual things that we might do to improve our mental wellbeing, such as visiting friends or going to the gym—and alternatives must be found.
The pandemic will undoubtedly have a substantial impact on the mental health and wellbeing of our population for some time to come. However, we continue to strive to provide the best possible mental health care and support for Scotland’s children and young people, including those who support them, particularly their families and carers.
The actions in our transition and recovery plan set out how we will do that as we continue to live with the impact of the Covid-19 pandemic and, I hope, as we move towards the successful development and distribution of a vaccine.
The experiences that members from across the chamber and beyond have shared today have been honest and telling. I am sure that we have all, as constituency MSPs and members of communities, heard personal accounts of the mental health challenges that are faced by children and young people throughout Scotland. It is those stories and experiences that drive me to keep working to improve services—to improve access to CAMHS, to develop alternative services for those who would benefit from support in the community and to ensure that every young person in Scotland can access high-quality information to support their mental health and wellbeing.
Before the debate closes, I will take a moment to thank all our key partners, some of whom have been mentioned in the debate, particularly third sector organisations across Scotland. They have shown absolute resilience through the most trying of times to ensure that local services and support are still available to our children and young people. I am sure that members will join me in recognising their hard work and commending them for all their support over the past nine months and beyond.
Similarly, I say thank you again to our young people of Scotland. I hope that future generations never have to experience challenges like those that our young people have had to face through the pandemic. I am aware that the repercussions of Covid-19 will be felt for years to come and it is extremely important that we remember that. When the virus itself is no longer with us, the indirect effects of it will remain for some time.
During the debate, we have heard many interesting and thought-provoking points. I will address a few of them. Mary Fee asked for an update on school counsellors. We are on course to invest £60 million so that every high school has access to counselling. Our local authority partners made excellent progress during the school closures and plans indicated that they were on course to deliver by the end of October. My officials are currently confirming that position with the authorities, and we will report on that in due course.
Jamie Greene raised the issue of workforce. The Scottish Government is supporting the Royal College of Psychiatry’s choose psychiatry programme, which aims to encourage medical graduates to work in the field of mental health, and we will continue to do that.
Johann Lamont raised the issue of mental health training. We have a range of training materials, including online resources that are provided by NHS Education Scotland, which are available to all staff who are currently working with children and young people.
Sandra White and Beatrice Wishart both raised the issue of ASIST—applied suicide intervention skills training—and I know that I have answered a question from Sandra White about that in the chamber. It is quite complex, so I commit to writing to both members to give a full explanation of why it cannot currently be delivered online.
Pauline McNeill raised concerning issues about constituency cases and the issue of CAMHS using Near Me. CAMHS is one of the highest mental health users of Near Me. Mental health services across the country have been using Near Me and have adapted to using it remarkably well over recent months. In the case of CAMHS, video consultations are not always appropriate, for reasons that include digital exclusion and safeguarding. However, we will continue to work with our CAMHS colleagues and try to address digital issues where that is appropriate.
I thank the Public Petitions Committee again for its dedication to the inquiry into mental health support for young people in Scotland and for requesting the debate, and I thank the petitioner, Annette McKenzie, for her drive and determination, which was so evident when I met her. As someone who has also lost a child, I can only express my admiration for the work that she has done.
As we near the end of 2020, it is fair to say that this year mental health has been discussed more than ever before. We have routinely checked in with friends, family and colleagues to ensure that they are feeling and coping okay, and we have been putting the mental health of others and ourselves first. I am thankful for that—it is something that I hope will continue far beyond this year.
I call Gail Ross to wind up the debate on behalf of the Public Petitions Committee.18:14
I, too, thank everyone who has been involved in the inquiry and the production of the report, especially our committee clerks. It is a strong report with recommendations that have to be taken seriously.
I thank the minister for her consideration and that of the Scottish Government; I note that other members have put on record their thanks to her for listening and engaging across the parties on the issue. I have no doubt that she cares deeply about the subject and will continue to commit herself and her team to the young people of Scotland. I also thank all those members who have spoken today in what has been a particularly challenging, and sometimes emotional, discussion. I am glad to hear that everyone agrees with our report’s recommendations.
As the convener said in her opening remarks, and as many other members mentioned, we are here for this debate because of the courage of Annette McKenzie. Despite her grief and pain, she has campaigned for change, aiming to help other young people and their families. While the committee recognises the concerns that have been raised and the specific action for which she originally called, we really hope that Annette feels proud that today’s debate has taken place in no small part because of what she started with her petition.
With regard to the petition, Brian Whittle spoke about the capacity of young people to make decisions about their own treatment, especially given the petitioner’s situation. Jamie Greene also addressed that issue. Both members agreed that there is no easy solution, and the committee really struggled with that aspect, too. Many members highlighted the need for better access to mental health support, especially—and importantly—at the point when young people need it the most. However, we know that starting a conversation about mental health is sometimes not easy, and we need to try to change that.
As we recognise in our report, there is no question but that the impact of Covid-19, given how it is likely to impact on mental wellbeing, will lead to an increase in demand for mental health services over and above what we have already seen. A few members, including Mary Fee, Brian Whittle, Tom Mason, Maurice Corry, Monica Lennon and others, spoke about the need for joined-up services and a more streamlined approach, and the committee agreed on that, too.
To inform our report, we undertook extensive external engagement, and we are grateful to all those who met us. The experiences of the young people, their families and friends and the professionals who are doing all that they can to support them were critical to our understanding of how young people are currently able to access support for their mental health.
As many members said, the committee is grateful, in particular, to the young people who took the time to meet us and share their—sometimes painful—experiences. Their voices have been central in shaping the recommendations in our report—and, by extension, shaping the debate—to increase the support that is available and access to it, and to tackle the stigma of mental health. Monica Lennon spoke about stigma and how we need to get through that in order to give people the support that they need. She is absolutely correct—we have come far, but we still have a long way to go.
We want to empower young people so that they can have more awareness and, ultimately more agency, in respect of their own mental health. Around this time last year, I—along with Brian Whittle, who was my committee colleague at the time—had the privilege of meeting a group of young people in Parliament. They were honest and frank about their experiences and the support that they had received from teachers and school staff, and from third sector organisations working with the schools. A number of members highlighted the relevance of our debate earlier today, on the importance of the third sector.
I was struck by how important it is for young people—as they told us—that they are able to access the right support at the right time. It is also important that young people know how to express themselves and make themselves understood, so that they can ask for help more effectively.
The committee has seen at first hand the good intentions and commitment of all those working in healthcare and educational settings, in third sector organisations, in national Government and in local government to support people with their mental health. Our evidence shows, however, that, where things are working well, that could be shared more widely, and that those who work with young people could be equipped with better resources and training. Discussions about mental health and about possible avenues for support need to be more open and accessible. We recognised that, although much is being done, it is often not enough.
We heard about early intervention programmes such as let’s introduce anxiety management—LIAM—in NHS Greater Glasgow and Clyde, but its success depends on being used at the earliest stages of anxiety. It is therefore concerning that there are waiting lists for that programme in many areas. In Highland, there are challenges with recruitment, which results in similar situations: there are long waiting lists, and young people are struggling to be heard.
Many members—if not everyone who spoke in the debate—highlighted the need for training, especially in specialist services such as CAMHS, noting the huge waiting lists that some areas face. I thank the minister for recognising that in her remarks, and I welcome the actions to help boards that have particularly long waiting times.
Like Maurice Corry, I welcome the creation of the wellbeing centres by local authorities across the country, and I echo the minister’s thanks to every single person who is working in mental health at the moment. We owe you a huge debt of gratitude for all that you are doing.
David Torrance’s speech was powerful, pointing out how important it is for young people to have good mental health in so many aspects of life. He also spoke about challenging stigma and living in a Scotland where we prioritise mental health, and I agree with that whole-heartedly.
Tom Mason noted the rise in mental health issues and the increased use of social media. That is something that other members have discussed in other debates.
Sandra White mentioned the Samaritans, SAMH and all the good work that they do, highlighting the asks that both those organisations have, and she asked that those be incorporated into the current Scottish Government’s work programme.
Maurice Corry noted the pressures that young people face, mentioning the worrying rise in the incidence of suicide among young people, which I know is something that worries us all.
Jamie Greene reminded us of GPs being under immense pressure, with only 15 minutes per appointment. He painted a bleak picture of the statistics of self-harm and suicide, particularly in the lesbian, gay, bisexual, transgender and intersex community. He told us how he has personally lost friends. I cannot imagine how difficult that must be, so I thank him for telling us about that.
The likely impact of the Covid-19 public health emergency on our mental health as well as our physical health has been recognised by all members who have spoken. Beatrice Wishart noted the challenges to health and wellbeing due to the interruption to education and the inability of the current mental health system to cope. She also spoke about the importance of training and access to help, and about the big role that education plays in that.
Pauline McNeill spoke about the impact of lockdown and how it is affecting our young people. She recounted a distressing situation involving someone who was let down by services and attempted to take their own life. She pointed out that there are discrepancies between some areas in the services that can be accessed.
Mary Fee and Sandra White spoke about students and their feelings of loneliness and isolation. As was pointed out, that issue has been around since long before Covid-19, albeit that Covid has exacerbated and will exacerbate the situation. We do not yet know the full extent of the longer-term impact of this crisis, but we know that the challenges that many young people face, such as disruption to their education and to the employment opportunities that are available to their age group, have been significant.
The committee acknowledges that meaningful work and commitment to improve mental health support for young people was already being undertaken by the Scottish Government before our report was published. Our report shows, however, that more needs to be done. The impact of Covid-19 will only compound the situation. As a Parliament, it is our duty to ensure that our young people have the best possible support for their mental health.
In conclusion, I echo Monica Lennon’s words: get in touch with somebody, phone them, ask them how they are doing and tell them that you love them.
I support the motion in Johann Lamont’s name.