I am afraid that I will struggle to give way. I am sorry.
As my colleague Jim Hume highlighted in opening the debate, only half of health boards are meeting the new 18-week target for treatment, and five are failing to meet the old 26-week target. Meanwhile, the availability of educational psychologists is below what is needed and, again, adult psychological services are falling short of the targets that have been set.
In practice, that means that interventions for those who need help—that might involve putting in place support, identifying coping strategies or whatever—are delayed, potentially with serious consequences. As SAMH warns,
“the later individuals engage with health services, the more complex their treatment and recovery will be”.
Let me be clear: this is not a criticism of the people who are on the front line in our healthcare and third sectors. Without the contribution that they make, which invariably goes above and beyond anything that we have a right to expect—as Jim Hume and the minister emphasised—the situation for people who have poor mental health would be profoundly worse. That is why the Scottish Liberal Democrats prioritised mental health in our recent budget negotiations with ministers and why in 2013 we called for additional support to boost underresourced psychological therapies.
It is little wonder that pressures exist, given the number of people who are affected. The range of conditions may be wide, and some people move in and out of ill health, but it is not a niche. As Nanette Milne pointed out, the latest social attitudes survey confirms that one person in 4 has personal experience of mental ill health in their life.
The impact, though, stretches far wider. In this and previous debates, members have spoken passionately from direct personal experience, either of themselves, a family member or a close friend. I can think of few other debates in this chamber in which similar insight and empathy have been brought to bear. That impact is one—although only one—of the reasons why we must elevate the importance that we attach to tackling poor mental health and encouraging good mental health. Scottish Liberal Democrats firmly believe it is now time for Scotland to follow the lead that has been taken south of the border, and to legislate to afford equal treatment to mental and physical health. Progress has been made here and measures are in place to go further, but they fall short of putting mental health on an equal footing with physical health, which matters. As the head of the Orkney Blide Trust, Frazer Campbell, explained to me recently:
“too often mental health services are way down the list in terms of budget allocation and other resources (for example, hospital space and room design etc).”
That is why Frazer wants to see equality in service provision.
In passing, I briefly record my gratitude to those who helped raise about £12,500 for the Blide Trust at the “Strictly Come Dancing” show last Friday night—particularly the dozen souls who risked life, limb and reputation on the dance floor. As well as raising money, I hope that the event brought the work of the Blide Trust, and the needs of people in Orkney who suffer poor mental health, to a wider audience. The issues of stigma and a reluctance to seek help are known to be more prevalent in smaller communities, especially rural ones.
Whatever other steps we take, I agree with Rod Campbell that we in this country need to be more open and honest about mental health. However, if mental health is something that people find hard to talk about openly, it is as nothing compared to the taboo surrounding suicide. Obviously not everyone with a mental health issue considers taking their own life, but the numbers who do and who succeed remain high, despite a reducing trend in recent years. In 2013, 795 people died by suicide in Scotland. Male suicides run at three times the rate for females, and according to the Samaritans suicide is now the leading cause of death of under-35s in Scotland. That last statistic is truly shocking. That people who have most of their life ahead of them and who have so much still to experience and to contribute conclude that they cannot bear to continue living is truly appalling and demands recognition of depression for what it really is.
When I spoke in the last debate on mental health, I talked about Andy Harrison, who was a friend, work colleague and flatmate from my days working in Westminster. Andy took his own life four years ago after a long battle with depression. To this day, I find it hard to accept or understand such a tragic loss of talent, vitality and decency. Andy’s wicked sense of humour and generosity of spirit, which made him such a privilege to know, masked a deep-rooted despair that ultimately killed him.
Since then, I have learned of others who have found themselves wrestling with many of the same demons as Andy. In my Orkney constituency, there has been a spate of suicides over the past six months or so. Although apparently those deaths are not out of keeping with statistical averages, nevertheless in a community of the size and character of Orkney they have touched people profoundly. I learned recently that someone whom I was at school with took their own life last year—I can still remember the shock at being told.
Even though we know that each suicide involves an individual, with their own personality and their own circumstances, and that their suicide represents that person’s own tragedy, we are guilty of seeing the statistic rather than the person. In truth, very often, even those who are closest to them do not realise the full extent of the risk until it is too late. Again, that is why we must create the conditions whereby issues of mental health, including depression, can be talked about without fear of stigma and judgment.
I firmly believe that one way of helping to achieve that is through setting an ambition of zero suicides. To John Mason I say that that is not the same as setting a target, nor is it inconsistent with the objectives underlying the Assisted Suicide (Scotland) Bill. It is about setting an aspiration and changing the mindset about how people with mental health issues are cared for. Evidence from elsewhere shows that it can have dramatic and positive effects. Mersey Care NHS Trust, in Liverpool, has a programme involving improved training for staff who work with parents, patients and families to develop a personalised safety plan. It also has a dedicated safe from suicide team that provides advice, support and monitoring, and works closely with partners including the Samaritans. In Detroit, which is signed up to such a commitment, the area that is covered by the programme has reported no suicides in more than two years.
Again, this is not a criticism of existing schemes, such as choose life, but a plea to go further—to aspire to something even more ambitious. If we fall short in that ambition, let us at least get closer than we currently are.
As I said in closing the debate last year, this is an issue that needs to be discussed openly, taken seriously and addressed effectively. It is not a second-class condition, and ultimately there is no good health without good mental health. One year on, it is truer now than ever. I urge colleagues across the chamber to support the motion.