Chamber and committees

Can I add to that because—

The project that Ms Harper has talked about is not one that I am aware of. If she furnishes me with further detail, I will have a look and see what work it is doing. I am sure that it is very good work. I have said to the committee previously that there is good work in destigmatising mental health going on in communities across Scotland. Nationally, we have provided £5 million over five years for See Me to give it the comfort of knowing that that resource is available over a longer period of time. It has done some immense work, but we still have a way to go.

There are some areas of mental health that we have to destigmatise further, such as self-harm, which it is much more difficult for folk to talk about. I have met representatives from the Labour Party and the Green Party about our ambition to create what is I think the world’s first self-harm strategy. We will have to get folk to open up in order to be able to do that right and we will have to destigmatise. I am due to meet Conservative and Liberal Democrat representatives about this, too, in the near future. I hope that we can work cross-party collaboratively to help destigmatise that area, because there is a lot of work to do there. I hope that we will see collaboration and co-operation right across the Parliament on an issue that we have not done enough to tackle.

No, I think that we have to ensure that community-based services are as good as they can be in order to stop folk reaching acute services. That is the ambition here. As we move forward, we want to invest more in that preventative approach. That is why we have invested in school counsellors, that is why we are investing in primary care and that is why we are investing in community resources.

I would agree that we have a lot of work to do to reduce CAMHS waiting times and waiting lists. We get fixated about the statistics, but all of this is about people and their families, and I recognise that this is a particularly stressful time for folk who are waiting. I want to ensure that we have a service whereby we reduce those times and those lists.

There are lessons that have been learned pre-pandemic that have led to the modernisation of services in certain places, and we need to ensure that that happens everywhere. That is why we have put the standard in place to make sure that everybody follows that way. I will give Ms Webber an example—I may have given it before, so my apologies if I have. If we look at CAMHS waiting times and lists, we see that Grampian has done fairly well even during the pandemic. A decade ago it was not in a good place, but it has modernised the service. It is much more community focused, with much more emphasis on helping folk in communities, and that has made a real difference. We need to export that best practice and those models across the country. That will reduce lists and reduce waiting times.

Somebody mentioned data earlier. In some regards I get frustrated when we are comparing apples with oranges. We have to get the data right in all of this to ensure that we have all the knowledge at our fingertips to show what investment we will require in the future.

Finally, to show how seriously we take all this, I note that we have invested £40 million of the £120 million mental health recovery and renewal fund in CAMHS. That is how important we feel it is. This is a priority.

Ms Webber made an excellent point about team activity. I know that, during the first lockdown, which was very difficult for young folks, some teams coped by being able to gather online. At an event that I was at at St Mirren Football Club, which I have talked to the committee about before, I had a discussion with Paul McNeill, who is the excellent head of community development at the Scottish Football Association. He said that the kids in one of the teams that he coached were getting on grand online, but there was a much more difficult experience mentally for folks who could not get online, because they were not able to connect with their team-mates. It was very important that we made the investment in getting digital devices out there to folks who were digitally excluded because the team aspect has seen a lot of folk through.

We cannot overstate the value of team sport and the camaraderie that there has been, even though many people could not take part in activities in the first lockdown.

Can I just say one thing here? I have said this regularly, and it is not just me—a lot of the mental health professionals out there will say the same thing. Poverty is the main driver of mental ill health, and it is very difficult for some folk to engage in programmes if they have real concerns about how they will pay their bills, whether they will be able to feed their kids, or whether they will be able to buy that pair of shoes for wee Johnny or Jenny going to school. We cannot get over the fact that many of the powers here still rest with the UK Government.

As Maree Todd has said, we have a situation in which we are doing our level best to mitigate some of the policy decisions from down south, but as we increase the Scottish child payment, which is the right thing to do, the UK Government takes away all of that through a universal credit cut. Although we have mitigated the likes of the bedroom tax, the UK Government still has the welfare cap. We have to recognise that, although we will do everything that we possibly can on such issues, it would be much more helpful if those welfare policies, which have been enacted by the UK Government, were got rid of, because they are having a major impact on the physical and mental wellbeing of so many folk in our country.

May I say one thing before you bring in Ms Harper, convener?

It is important to put on record our thanks to the staff who work in mental health services, but particularly in CAMHS. I should say to the committee—we will provide more detail as always, because I know that you will ask for it after the session anyway—that the last quarter saw a record number of new patients starting treatment in CAMHS, as our NHS continues to remobilise and as demand has increased. That is a record number of new patients entering CAMHS, and that is down to the efforts of the workforce, who have increased in number, although we know that we have more to do there The staff have been amazing in rising to the challenge. I hope and know that they will continue to do that. We will send you more details because I know that the committee is always interested in the numbers.

Yes. I think that many folks who have thought about this for a long while acknowledge that, if you are in a rural area, particularly in a remote rural area or an island community, not everything will necessarily be on your doorstep. That is right. However, there are other ways of delivering services within those communities. Let us take, for example, rural Aberdeenshire—let us go with your constituency, convener, which contains many remote rural places, although some folk might find that hard to believe. There are different ways of delivering services there that ensure that those communities can still flourish and benefit from those services.

During the course of the pandemic, we have seen a rise in the use of telemedicine, but Grampian was a trailblazer in telemedicine long before the pandemic period. We can deliver a lot of services to remote rural communities online. We have to think about what is required. I have to say that I was sceptical around some of the online provision in relation to mental health services, but it works for people—it works well. Again, in your neck of the woods, convener, over the course of the pandemic period, the Grampian resilience hub did extremely well in bringing services into folks’ own houses at a point where they could not get out or could not get from Newmachar, Insch or wherever to services in Aberdeen.

There are ways of doing what we are talking about, and it is not just about the physical aspect of that 20 minutes; it is about what we can do in terms of the online world to bring those services to communities that are more remote and rural and to island communities? I am sorry if I have gone on too long but I am quite passionate about this.

I agree with the points that Ms Mackay has made. We have a job of work to do to ensure that we have the right mental health workforce for the future. That includes looking at the entry into the profession. It also includes getting the educational elements of this right and allowing folks to follow the career pathways that they may wish. We have some work to do there, but if we are truly serious about getting mental health services right and fit for the future—which I am—we need to recognise that we need more diverse folk in the profession.

Again, we have to be flexible in terms of the workforce. We have talked about school counselling. One of the next big moves, of course, is around folks in the primary care setting, which is extremely important. I have had conversations with a number of colleagues around the table about how we can get that right, because it cannae be the same old. We need folk from diverse backgrounds but, beyond that, we need workers to be multidisciplinary in what they do.

I will be honest with you and say that I am willing to steal good ideas from elsewhere. I met Dr Gulhane a couple of weeks ago about children’s wellbeing practitioners south of the border. I am quite happy to nick good ideas if they fit in. That is grand.

One of the main things that we need to do is to make sure that there is a diverse workforce that caters for the needs of all of society—not just the LGBT+ community but, as Ms Todd mentioned earlier, our minority ethnic communities, which are often not brought into play enough in this regard. In particular, folk will know that I have had an interest in what more we need to do to support our Gypsy Traveller community. We have to get this right for all.

The evidence has been clear since before the pandemic that girls and young women appear to experience poorer mental health and wellbeing than boys. We undertook research on the reported worsening of the mental wellbeing of young women and girls, which was published in 2019. That research highlighted several interrelated drivers that may have contributed to that trend, which included things such as body image concerns. To further explore some of the causes of the trend, we established the Scottish Government national advisory group on healthy body image for children and young people, which published its recommendations in March 2020. We are currently working on meeting those recommendations. That is one area where we need to move further forward.

I know that there has been discussion at the committee and evidence given about the impact that screen time and social media use can have on young folk, so body image is not the only aspect, although it is way up there. We are looking to resource work on that and to work with Young Scot to bring forward a national conversation on body image, screen time and mental wellbeing. We want to hear the voices of young folk about this directly, so that we shape our future work absolutely right.

We have touched on eating disorders today. Young girls are disproportionately impacted by eating disorders, which was again exacerbated during the course of the pandemic. I have already outlined some of the work that we are undertaking there.

We also need to better understand the mental health needs of women and girls who are affected by gender-based violence. Having recently funded and published an Improvement Service report on that important subject, we are now considering how best to take forward its recommendations. We will link all that work to a refresh of the Scottish Government’s equally safe delivery plan.

I would like to touch on another area where we need to do more: autism in young women. I have heard—and I am looking at members’ faces because I think that others have probably heard the same thing—that it is much more difficult for a young girl or a young woman to be diagnosed as autistic, and often they are left in limbo for a long while and diagnosis comes far too late. We have to ensure that we work on that. It will take a fair amount of graft to get it right for the future.

I hope that that gives you a flavour of some of the work that I see as being a priority, but there are many other things that we are doing also.