Chamber and committees

I will add to what Ms Todd has said, as there are a number of other things that we need to do. We need to raise awareness of adverse childhood experiences in our communities and across the nation. We have to recognise the impact that trauma can have on people. That is why we are investing in our national trauma training programme and providing some £4 million to support the development of trauma-informed workforces and services.

In some parts of the country, trailblazing work is going on. I had the pleasure of talking to folks from South Ayrshire and Dundee recently. I was very impressed with the huge amount of work that South Ayrshire Council has done with its workforce and with elected members on trauma-informed practice. We have to ensure that such work is exported across the board.

Ms Harper asked about eating disorders. Eating disorder services are extremely important to me because, as folk know, I know people who have been impacted by family members having eating disorders. During the pandemic, the number of eating disorder cases has risen, and we have to continue to monitor and react to that.

As folks know, we conducted a national review of eating disorder services. The review group is jointly chaired by Dennis Robertson, a former MSP, who has campaigned vociferously for improved services, and Dr Charlotte Oakley, who was previously the clinical lead of the connect-ED—eating disorders—service at NHS Greater Glasgow and Clyde. The group’s aim is to ensure that stakeholders are empowered, through collaboration and engagement, to provide their input, experience and expertise and to play a leading role in delivering the recommendations and improving services.

I am sure that the committee is well aware that, in June, we announced an additional £5 million to respond to the review’s recommendations. We have also provided further investment in third sector organisations—for example, we gave £400,000 to Beat, the UK’s eating disorder charity—to provide a wider range of options and support for those affected by eating disorders, including families and carers.

I do not think that we should underplay the issue. There has been an increase in the number of folk presenting with eating disorders, so we have a fair amount of work to do to get it right for folk.

I do not want anyone to have to go elsewhere for treatment. I want folk to remain as near to their home as possible, because one of the key things in all of this is family support. We have some very good practice in supporting families when there is a distance to travel, but we probably have to do more on that front.

The key thing for me—I am sure it is the same for Dr Gulhane—is that we get to a situation in which folk do not have to go into acute services. That is why an amount of our investment has gone to the likes of Beat. We need to build on the community support that is available. I have visited the unit here, in Edinburgh, and a huge amount of its work is in the community rather than on the ward. We are in a situation in which we will have to keep a very close eye on beds. It may well mean more investment and an increase in the number of beds, but I think that it is preferable—I am sure that Dr Gulhane would agree—if we can keep folk out of hospital and provide them with the right support community. That would be the best way forward.

As Ms Baillie well knows, we have gone through a global pandemic, and are now getting back to some kind of normality. I have outlined what we have done around CRWIAs. We know that we have more to do and we will do it.

You might get it from a mental health perspective and perhaps a bit of a history perspective and a planning perspective as well.

Ms Callaghan has asked an important question. It is one of the reasons why 20-minute neighbourhoods featured in the SNP manifesto and in the manifestos of the Scottish Greens as well, if I remember rightly—Ms Mackay may correct me there. It is important that, as we plan our neighbourhoods we get it right. In terms of our net zero ambitions and our ambitions for vibrant communities, that is the right way forward.

I know that, in some local authorities, there is much more advancement in this kind of work. There should be more of it, as far as I am concerned. I know from my own experience in local government that initiatives such as planning for real exercises, which involve communities and individuals, are a good way of getting that balance right. Not everybody gets what they want—that is the reality—but, if you set down the parameters, that is helpful in shaping the future of communities.

This is an important issue. I think that we now have the right planning regime in place to allow that to go forward, including the opportunity for neighbourhoods and communities to be involved in local place planning. In order to do that—I apologise to those folks who have heard me say this before, because it is a point that I make all the time—we need to bring community planning and spatial planning together and not see them as separate. We know that achieving that will bring about results that can be good for folks’ physical health and their mental wellbeing.

There is a lot of work to be done. Many areas are embarking on it, and some are further on in that journey. However, this is good stuff as far as I am concerned and it is the right thing to do as we move forward.

I think that, in many places, they are. Again, I think that we do very well in those places where services listen to young folks with lived experience, where there is that communication, collaboration and co-operation. That does not work so well for others, I have to say. That is one of the reasons why we have put in place the child and adolescent mental health service standards that we have. There is work to do there, without a doubt, and we need to have young folk at the very heart of shaping those services in the future.

I have talked to a lot of young folk over the past number of months and I will be honest with the committee and say that some of the issues that have been raised with me are ones that I would not necessarily have thought of. I think that we need to make sure that we are capturing all of the difficulties that young folk face.

Let me give some examples. The school counselling service is an important move forward in terms of mental health service delivery. We are beginning to get data from those counselling services on what the main challenges are that young people are coming to those counsellors about, and LGBT+ issues are up there. We have to take cognisance of that and ensure that we are shaping the right services for the future to do right by folk.

We only have to look at news reports from yesterday to see the impact that it can have on young women. Day and daily, this is difficult for young women, so we have to get this right as we move forward and we are committed to doing that.

I will not stray into talking about education and early years, although it is tempting, because I know that the committee will hear from Shona Robison and Clare Haughey next week.

The investment that we have made in perinatal and infant mental health support can also make a big difference. I know that the committee has been discussing that subject and that you will report on it very soon. The four-year investment makes a substantial contribution to improving and supporting the mental health and wellbeing of women and infants, which can have a huge long-term impact. We await your report and recommendations with anticipation.

We are still analysing the responses to the consultation, and we know that we have more work to do to consult with stakeholders about our proposals before final decisions are taken by the Cabinet.

In all of the work that we do on the national care service, and whether services are in or out of it, we have to take a joined-up approach. We know all too well from stakeholders that transition periods can sometimes be some of the most difficult times for people, and that there does not seem to be the link that should be there when people move from one service to another. Legislation on that has changed recently, but there is a question about when is the right time for change and whether that change is the right thing to do. More joined-up approaches are required.

I can give an example—it is the starkest one that I have—of where we sometimes do not get it right and can confuse people and do too much rather than have a systematic right approach for folks. The other week, one of my officials was talking to a young person, who has a lot of things going on in their life and is involved with 15 different agencies. The question that that young person asked was, “Who do I listen to in all of this?” Often, what that person was being told was contradictory, according to them. I think that we can all agree that that is not the right approach for a young person, so we have to ensure that, in the future, we do not have those kinds of examples and that everything that we do is person centred.

The message that I get from a lot of young folk is, “I want somebody I can trust to deal with me.” There is absolutely no reason why the good practice of having a lead person, which is happening in many places, cannot be followed across the board.

Whether children’s services are in or out of the national care service—the initial responses to the consultation show that the majority are in favour of them being in it—we have to make sure that the linkages are right and that we take a person-centred approach, as opposed to the current situation in which, in some cases, we have a bit of a postcode lottery. No matter what, we want a national quality standard so that folks know the service that they can expect.

Beyond that, again no matter what, we have to listen to the voices of lived experience. The places where services are working well are the ones where young folk are at the heart of helping to shape services and where there is the maximum amount of communication, collaboration and co-operation. No matter what, that is what we need to see across the board.

We will write to the committee about that, too.

Holistic whole-family support and the whole family wellbeing fund are absolutely vital in getting this right as we move forward. You will hear from our other colleagues that, in terms of the work that needs to be done, along with the multidisciplinary and multi-agency approach that is being taken, we are taking a cross-cutting approach in Government in order to get this absolutely right for families across the country.

We have real ambition on this issue. The work is largely being led by other ministerial colleagues, but we are all involved in the overview of the matter in the group that is chaired by the Deputy First Minister. This is an important issue. This is one of the main policy planks that will help us to move beyond just getting it right for every child to getting it right for everyone.