 The next item of business is members' business debate on motion 10464, in the name of Clare Haughey, on the everyone's business campaign. The debate will be concluded without any questions being put. May I ask those who wish to speak in the debate to please press a request to speak buttons? I call on Clare Haughey to open the debate for around seven minutes, please. Thank you very much, Presiding Officer. Firstly, I would like to thank the members who signed my motion welcoming the everyone's business campaign to Scotland. The campaign is one that is incredibly personal to me, having been a mental health nurse for over 30 years and for the last 15 years specialising in perinatal mental health care itself. On that note, I must refer members to my entry in the register of interests in that I currently hold a registered mental health nurse and hold an honorary contract with NHS Greater Glasgow and Clyde. I will be delighted to welcome a number of people to the gallery this afternoon. We will be joined by a number of the change agents as well as some of Scotland's most talented mental health professionals, from lead nurses to consultant perinatal psychiatrists and consultant clinical psychologists, and I sincerely hope that they enjoy their visit to Parliament. Among them is an individual without whom perinatal mental health services in Scotland would not be where they are today, and for that we all owe him a huge debt of gratitude, Dr Rock Cantwell. Dr Cantwell's passion in this area has ensured that many mothers, their infants and their families have received the specialist care that they need and deserve. Finally, I would like to pay tribute to the everyone's business campaign co-ordinated for Scotland, Joanne Smith, for her work and drive in ensuring that the campaign is raised in Parliament. Our debate this afternoon could not be more timely. We are in the middle of this year's mental health awareness week and at a time when mental health is at the forefront of the public's thoughts. Although most will be aware of the shocking statistic that suicide is the biggest killer of men aged under 45, it is probably a lesser-known fact that it is also the leading cause of direct maternal deaths within a year of childbirth. Perinatal mental health problems are sadly all too common, with estimates ranging from between 10 and 20 per cent of women developing an illness in the first postnatal year, and one in seven of those hiding or underplaying its severity. Across the UK, mental illness in pregnant and postnatal women often goes unrecognised, undiagnosed and untreated, with many mothers suffering in silence. The everyone's business campaign is therefore calling for all women across the UK who experience perinatal mental health problems to receive the care that they and their families crucially need, wherever and whenever they need it. The campaign is built on three main themes. Accountability for perinatal mental health care should be clearly set nationally and complied with. Community specialist mental health teams meeting national quality standards should be available for women in every area of the UK, and training in perinatal mental health care should be delivered to all professionals involved in the care of women during pregnancy and the first year after birth. The campaign recently published a UK-wide map that categorised the different levels of specialist perinatal mental health community teams. Those included so-called red areas where no specialist team exists, pink areas where some extremely basic level of provision exists, amber areas where basic level of provision exists but currently falls short of the national standards and needs expanding, and finally green areas where women and families can access treatment that meets nationally agreed standards. Although that might not be a comprehensive community care across the country that is reflected in the map, that is not to say that there are no services available at all. There are dedicated professionals across many services throughout Scotland ensuring that mothers, their children and their families can access help. Every health board in Scotland, bar 2, has direct access to one of the two mother and baby units in Scotland, while the two exceptions can access this care when it is required. A service that I am very proud to have worked in prior to my election is the perinatal mental health provision in Greater Glasgow and Clyde, which is categorised as the highest level in the everyone's business map. However, the report and I acknowledge that we can do more across Scotland. In 2017, the Scottish Government, with the UK's first ever minister for mental health, sought to address those disparities by launching the new Scottish managed clinical care network for perinatal mental health to identify gaps in provision of care and promote improvements in local services. The new network is an excellent start to ensuring that every woman and her family who requires help with perinatal mental health problems receive prompt effective care from professionals who are skilled to meet their needs. Although not fully there yet, as an RMN of over 30 years, I cannot overstate how far our mental health services have come in that time. When I started nursing, mental health hospitals were on the periphery of our society, quite literally, on the outskirts of towns and cities, and there were few community services available. Now community mental health services are the norm. There are leases on psychiatry in our acute hospitals, and crisis and home treatment teams can be found in most areas of the country. As clinical nurse manager of the perinatal mental health service, I was part of the team who helped to set up the mother and baby unit in Glasgow in 2004, the first of its kind in Scotland. All that and the continual work to end stigma has ensured our services, our treatment and the prevention of mental illness is constantly improving. Presiding Officer, I have cared for so many women over the years suffering from a range of illnesses, including depression and anxiety after having a baby, many of whom had lost all confidence in their self and their ability to be a good enough parent. After some treatment and support, they have got back to health. I often reflect on the words of one particular mum who gave me a card after her care and treatment came to her clothes and it read, I've spent weeks looking for a gift that shows my appreciation for all you've done for me. Nothing I could find seemed good enough, so I'm trying to find the words in this card to repay you. You've given me back my life, you've knitted my family back together again and I can now go on with being a mum, the mum I want to be to my children. I believe that those words show exactly why those services are so important. As a perinatal nurse, I feel very privileged to have worked with mums, their infants and their families at a very special time in their life, the time when their baby has been born. It's a very special area of mental health care and one that I'm very passionate about and I'm sure other health and social care professionals who work in the field feel likewise. It shows why perinatal mental health care is so important. Perinatal mental health care is everyone's business and until the time that those mums who experience mental health problems receive the care that they and their families need, wherever and whenever they need it, we still have work to do. Thank you, Ms Hawking. We move to the open debate. Speeches of up to four minutes, please. I call Annie Wells to be followed by Ruth McGuire. Thank you, Deputy Presiding Officer. I want to thank Claire Hawking for bringing us the debate forward today, especially during mental health awareness week and to offer my support to the everyone's business campaign. I would also like to welcome those in the gallery today. With more than one in 10 women developing a mental health problem during pregnancy or within the first year of having a baby, I strongly believe that this is still a topic not nearly spoken about enough. We all know people who have struggled after the birth of a child. After having my son 24 years ago, I, like many young mothers, found myself in a situation where I felt alone, isolated and wasn't sure if I was doing the right thing. I continually questioned my actions and felt that everyone else seemed to know better. No matter how much I beat myself up or questioned myself, I didn't want to say to anyone that I wasn't coping. However, having spoken to friends and family in looking back, it seems that this is how a lot of people feel, and I am pleased to see that it is now being discussed more openly. That is exactly why I, too, welcome the introduction of the maternal mental health alliances campaign here in Scotland, one that seeks to improve access to specialist perinatal mental health services so that women can receive the care that they and their families need, wherever and whenever they need it. We know services are falling short of the standards that are required, and only last month's data analysed by the MMHA from 2017 showed that women had no specialist care in seven out of the 14 health boards, warning that women were facing a postcode lottery in accessing life-saving care. We know what the costs are when adequate support is not provided. Suicide remains the leading cause of death for women in the perinatal period, and the impact of undiagnosed or untreated illnesses can be devastating for families. Although I welcome the commitment to introduce a managed clinical network, I want there to be a view to expand and improve antenatal and postnatal mental health services so that we get it right for every mother. When we know that seven in 10 women will hide or underplay the severity of their perinatal mental health problem, it is also important that, on top of improving service provision, we break down barriers when it comes to talking about mental health. Last month, I was lucky enough to visit quarriers in the heart of Glasgow's East End to see the perinatal mental health support that it provides in its purpose-built family resource centre. Based in the community, the facility created a comfortable space in which mothers could talk openly about issues that they were having and know that they were not alone. I was encouraged to hear from staff in the centre that the resource is well utilised, and it is also great to see those services being delivered locally and within the heart of the community. That is something that I would like to see replicated across the city and indeed Scotland, showing that perinatal mental health is something that we can all speak about without any stigma or feelings of self-doubt. On that point, it was positive to hear that NHS Greater Glasgow and Clyde have met national guidelines on service provision set out by the Royal College of Psychiatrists. With them being clearly focused on delivering for service users, that gives us a greater chance of succeeding in assisting every mother. All stakeholders locally and nationally need to play their part, and the NHS are right at the heart of the strategy going forward. I hope that they continue to hit those guidelines, and we have a duty to ensure that those guidelines are monitored regularly. To finish today, I would again like to echo my support for the campaign. That is a subject that needs to be brought more to the public's attention, and I hope across the chamber that many personal speeches today will help to achieve that. We must create a society where mothers feel able to share their experiences, rather than feel that they have to hide away. That is why I hope that more resource will be put towards services that reach out to mothers who find themselves affected. I congratulate Clare Haughey on bringing this important debate on perinatal mental health to the chamber, and I would like to acknowledge her significant experience and expertise on the topic. I would also like to thank Aberlour for everyone's business campaign and spice for their briefing materials prior to the debate. Perinatal mental health issues are estimated to affect up to 1 in 10 women during pregnancy. I support the call of the everyone's business campaign for all women who experience perinatal mental health problems to receive the care that they and their families need wherever and whenever they need it. I believe that the establishment of a national managed clinic network on perinatal mental health, the first MCN covering mental health in Scotland, is a good sign of the Scottish Government's determination to give mental health parity alongside physical health. Those clinical networks operate in other parts of the health service, and they have a proven track record for driving up standards of care. Good perinatal mental health is vitally important in improving outcomes for mothers and their young children. Poor mental health can impact significantly on child development outcomes if untreated. It can impact on a child's emotional, cognitive and even physical development, and, although that is not inevitable, the consequences can be serious and potentially lifelong. That is why the Scottish Government-funded MCN on perinatal mental health is so important. The MCN brings together specialists on perinatal mental health, nursing, maternity and infant mental health practitioners who are currently assessing current provisions across all levels of service delivery in Scotland. In the longer term, ensuring all women, their infants and their families, importantly, have equity of access to the perinatal mental health services that they need across Scotland. With all that we know about the importance of early development on a child's life, intervention and support at the earliest possible stage can have a really positive impact and can prevent or mitigate issues later on. I wholeheartedly agree that there is a way to go in raising awareness of the issue of perinatal mental health, which I am struggling to say, Presiding Officer. It is not an easy word to say. I thank my colleague for taking my intervention. She is aware of my campaign to increase paternity leave up to four weeks for organisations and public sector. Does she think that that might be helpful in helping women who are struggling in the early days? Thank Fulton MacGregor for that intervention and a chance for me to put my teeth back in. Absolutely. I think that the children having both their parents around in the early years is good for mum, good for dad and good for everybody, so I would wholeheartedly support his campaign. The most effective work will be done in partnership across local authority, health, third sectors and, of course, perinatal mental health services. Those services straddling both adult and child services means that the investment that you make protects two generations at once, supporting child development outcomes and improving maternal mental health. It is work that will ultimately prevent unnecessary suffering for women and families and both improves children's early experiences and removes future pressures. There is an obvious human cost of undiagnosed or untreated illness. Additionally, if those mental health problems were identified and treated quickly and effectively, serious and sometimes life-changing human and economic costs could be avoided. I think that we all agree in this chamber that we want Scotland to be the best place to grow up and address perinatal mental health issues effectively. Addressing them as early as possible is one of the things that we can do to help to make that aspiration a reality. Let's pledge to do all that we can to make perinatal mental health everyone's business. Anna Sir, why are you followed by Alex Cole-Hamilton? Thank you, Deputy Presiding Officer. I start by congratulating Clare Hockey on bringing forward this important debate, particularly as we are in mental health awareness week. I thank the charity, everyone's business campaign, all the campaigners, all clinicians and indeed all charities involved in mental health for all their efforts, not just this week but all their efforts throughout the year. Specifically on perinatal mental health, it is important to recognise that this is about supporting an individual yes, but it is about supporting that individual because the impacts of perinatal mental health issues will impact with them for the rest of their lives, impact on their family life, impact on their social life, impact on their working life and crucially impact on their children as well. It is about health outcomes for the mother but also health and life outcomes for the child too, and that is why this is so important. That is why we need access to specialist service, that is why we need access to wraparound services, but to make that happen we need to have a change of culture and a change we think about how we think about mental health. I will tell you what I mean by that, we often say in the statistics that one in three of us as a population will have a mental health issue at some point in our lives. I prefer to think about it that every single one of us is on a spectrum of mental health throughout our lives, and I think that if we think about it that way it can help us to change the culture in terms of where the resource goes, in terms of where the workforce goes and how we address not just the stigma but back up that commitment to tackle mental health with the services that we need. That involves perinatal mental health services, that means anti-natal depression, post-natal depression, anxiety, post-traumatic disorders, all support that women need. We should look at that in different places as well. One is looking at perinatal mental health straight after a child is born. When that woman goes back into the workplace, what is happening in the workplace, how we have better access to mental health services in the workplace? If that woman is back in a university or college sector, how do we give them better support in our university and college sector with better access to mental health services? However, I think that there is a specific challenge around crisis services. I think that we heard that from First Minister's questions as well. I think that if you are asking people to wait days on end to see a GP and then sometimes weeks if not months on end to see a councillor or a psychologist, for many people that time difference can literally be life or death, literally be life or death. If we look at another way, if someone breaks their leg, they will be seen by an A and E within four hours, but they will not lose their life by breaking their leg. However, if someone was to have a serious crisis mental health issue and they are not seen quickly, that could mean the end of their life. We need to change the culture of how we have crisis centres. I think that looking at crisis centres and backing that with resource is really important. How do you have care in the community? One is how you have direct services, whether that is an acute setting, whether that is a primary care setting, whether that is access to a councillor through your workplace, through a college university campus, or indeed an emergency service through a crisis centre. However, in the community, having genuine local crisis teams that identify individuals who need that support, who need that rapid support, is really important. I read one case yesterday about someone who tried to access a local crisis team in their local community, who had a history of mental health issues and was turned away. Four hours later, the police picked that person up from a well-known suicide site at a bridge in the west of Scotland. That gives us a stark example of how we need a better thinking in terms of our crisis teams. Alongside that, that means the workforce. How do we have more clinical psychologists, how do we have more councillors in all those places to support individuals, perineate a woman as well as women throughout their lives, and indeed all our citizens throughout their life? I welcome the everybody's business campaign. I thank Clare Haughey for bringing forward this debate, and I would hope that this Parliament, as a collective, can work to put mental health, give it the priority that it needs, and back up with services, back up with resources, and back up with the workforce, too. I call Alex Cole-Hamilton to be followed by Alison Johnson. Thank you very much, Deputy Presiding Officer. I would like to start by echoing the thanks of the chamber both to Clare Haughey and to everyone's business campaign for securing parliamentary time for us to debate this important issue today. Welcome to the best club in the world. Your life is going to change, but only in good ways. Those are some of the utterances that come from society whenever you are expecting a child. It is not surprising then that, with such a weight of societal expectation around pregnancy and parenthood, that it is very difficult for mothers to come forward and admit that they are not necessarily coping or not enjoying things in the way that they thought they might. Yet, for all too many mothers, that is the reality. It is, as such, a hidden issue very much in our mental health landscape, and I am very glad that we are airing it today. Like many other mental health issues, it is a spectrum. You can have it very severely or very mildly. It can be anxiety or depression, it can be OCD and leading to post-traumatic stress disorder and real psychosis in some extreme cases. It happens during pregnancy or after pregnancy. I want to take a moment to recognise a group that is not often mentioned in debates like this. That is for those who miscarry, because my sister Roe, who is in the gallery this afternoon, is one such person. She miscarried in 2016 and then suffered mental health issues directly after. She has allowed me to share her words with the chamber this afternoon. She said that it hurts so much. Along with the feelings of guilt and failure at not successfully bringing my baby into the world, there was a chemical change that I didn't understand or expect. Rosie is among many mothers and or would-be mothers who suffer in this way, and we need to do far, far more for them. It is that tension between the stigma of not wanting to put your hand up and say that you are not coping, which gets in the way of identification. It is why that first six-week check that every new mother goes through is all important, but it means nothing if our doctors, our midwives, our health visitors are not adequately trained in understanding what those early warning signs are for people that are not just coping or might need a little bit of extra support. That is why we urgently need to rectify that to make it a matter of course that people are adequately trained in perinatal mental health issues. Once we identify those women, we do them a profound service. If we cannot stand that recognition up with adequate service provisions in the communities and in the hospitals in their locale, we know that less than half of mothers are served by adequate perinatal mental health facilities or services in their communities or local hospitals. I am intensely proud to have been involved with Abalara at the time that they started their perinatal befriending service in 4th valley and all told that has helped 160 mothers in that area since it started three years ago, but there is no guarantee that they will be able to sustain that when the funding goes. We need to mainstream services like that right across the country so that there is not that postcode lottery. The worst comes when we talk about inpatient provision, because we in this country have only 12 beds on any given day available to mothers and their babies to come in for perinatal mental health support. 12 beds. If those beds are full, mothers are directed to adult services and they cannot take their babies with them, so not only are we compounding mental turmoil of the chemical changes going on in their brains, but we are compounding that with the separation anxiety of having to remove a child from the situation as well. It has to be the nexus of where we take this agenda. It is absolutely critical. I want to finish by once again thanking Clare Haughey for this time to raise this debate and for the campaign, because I think that it is very easy for us to let these women drift back into the shadows and just try and muddle through and carry on regardless, but they are looking to this chamber for answers and it is time that we woke up to that. Alison Johnstone, followed by Rona Mackay. I thank Clare Haughey for securing this debate and the maternal health alliance for their campaign for perinatal mental health care and treatment on all the organisations that work in this important area. I would also like to thank colleagues whose contributions have been passionate and sensitive today. Like all members, I was glad to see a managed clinical network for perinatal mental health established, but it is clear that there is much more to be done. Women are more likely to experience severe mental health problems following childbirth than at any other time in their life. Though we know that up to one in five women may experience some kind of mental health problem during pregnancy or in the first year of their child's life, mental health difficulties go undiagnosed and untreated for too many women. Prioritising maternal mental health is a preventative approach to mental health, because we know that the mental health of mothers and new parents is such an important factor in children's development, in their wellbeing and their own mental health in later life. In his review of NHS targets, Harry Burns advocated a life course approach to planning health services, and that means acting more in early life to support people in the long term. It is about teacher training, it is about training the early years workforce that we are trying to attract. Investment in maternal mental health is an investment in infant mental health, but the support that we offer families at this crucial time is lacking. The Royal College of Midwives have said that we are also lagging behind England and Wales in making improvements. It is concerning that only one health board in Scotland has a specialised perinatal community team that reaches the Royal College of Psychiatrists perinatal quality standards type 1. To be clear, in the Royal College of Psychiatrists' view, failing to meet those standards is a threat to patient safety and rights and may even breach the law. While it is clear that there is very good work going on in parts of Scotland, as colleagues including Annie Wells have noted, seven health boards in Scotland offer no specialist community perinatal mental health care at all. The Mental Welfare Commission has also found that some women who would have benefited from specialist inpatient care in a mother and baby unit felt that the units were simply too far away from home. The travel and disruption to their wider family life was too challenging at a time when they were already in severe distress, so we must think seriously about how to improve provision for women who are not close to Livingston or Glasgow. I know that the managed clinical network has been looking at this and I would be grateful if the minister could comment in closing. Bliss have also stressed the need for better mental health support for parents whose babies are cared for in neonatal units. That is an incredibly anxious time for parents and they need access to psychological support. The links between financial stress and mental health problems cannot be overstated. I very much welcome the new neonatal care fund to ease financial pressures for parents whose babies are in hospital. We must also ensure that the basics are in place for all new families. Starting a family or having another child means huge change for most families' financial circumstances. For those on low incomes, the prospect of long periods on statutory maternity pay, navigating the benefit system and paying for childcare can be quite frankly terrifying. Parliament has shown the will to tackle child poverty. We have put targets to reduce child poverty back in place and I am pleased that the Government has listened to green calls to roll out healthier welfare children. That is an income maximisation approach that really works. In Lothian, the region that I represent, family-friendly advice and healthy start projects are really helping to boost the incomes of young families here in this city and beyond. There have been other positive steps, too, such as the new best start grant, but there is no room for complacency. Child poverty is predicted to rise. That will have an impact on maternal mental health. The IFS predict that nearly 30 per cent of children in Scotland will live in poverty by 2021. That financial stress for parents cannot have a serious impact on their mental health. I look forward to working with colleagues to improve perinatal mental health in Scotland, and I look forward to the minister's response to the challenges that we face in delivering that. Before I call Ms Mackay, there are still a few members who wish to speak, so I am minded to accept a motion under rule 8.14.3 to extend the debate by no more than 30 minutes. I ask Clare Haughey to move such a motion. Are members all in agreement? As there is no disagreement, I extend the debate understanding order rule 8.14.3, and I call Rona Mackay to be followed by Michelle Ballantyne. I, too, would like to thank Clare Haughey for her bringing this very important subject to the chamber and for her really informative and moving opening speech. I thank her because this is an issue that is rarely discussed, and it should be because it affects a lot of women more than one in ten, as we have heard. Pregnancy is traditionally portrayed as a happy, joyful time in a woman's life. People say things like, you're radiant, you're blooming and all the rest of it. For many women, that is true. They reveal in this amazing chapter of their life feeling fulfilled, happy and well, if a little exhausted towards the end. For others, as we have heard, it is just not like that. As the motion states, more than one in ten women develop a mental illness during pregnancy or within the first year of having a child exactly when you need your health and energy most. They often pretend that everything is all right, as they don't want to seem weird or different because of societal pressure, as Alex Cole-Hamilton articulated. That's why the campaign Everyone's Business is so important. It raises awareness of those issues. It says, it's okay to not be okay and you're not alone. The fact that this illness often goes undiagnosed and untreated has a devastating effect on women and family and friends. However, there is patchy provision of specialist care throughout the UK, and, like Clare Haughey and others, I'm glad that this is now recognised in the Scottish Government's mental health strategy by funding a £173,000 perinatal managed clinical network, which will involve training midwives, health visitors, primary care and mental health professionals, so that women know that there will be help when they most need it, no matter where in Scotland they live. Because there should not be a postcode lottery and in an issue as important as this, it is everyone's business. The campaign Sign 127, the national clinical guideline on managing perinatal mood disorders, presents a vision of what a world-class service for perinatal mental health would look like. Scotland is committed to implementing the Sign 127 guideline on managing perinatal mood disorders and has prioritised perinatal mental health in the best start for the maternity and neonatal care plan for Scotland. The gaps in specialist perinatal mental health services in Scotland must be closed, and I believe that the Government has taken the first steps to address that. An example of great practice is Aberlare Children's Charity, who believe in early intervention, and I thank them for their briefing. They point out that not all children are born equal, and since 2014, Aberlare has been providing perinatal support services across 4th valley, and this year they will expand on provision to support mums in their families in East Lothian. They also run a befriending support service to provide intensive community-based one-to-one support throughout pregnancy and during the first year of a child's life. By matching each mum with a befriender, the service aims to improve mental health and wellbeing, increase confidence in parenting, reduce social isolation and support access to wider community supports and resources. They also believe that acknowledging the importance of the father, partner or any other existing supportive relationship in the lives of expectant new mums is essential, which fits entirely with Fulton MacGregor's campaign for perinatal leave. Nothing is more important than our health and the health of our future generation. It is incumbent on each and every one of us to recognise the signs of perinatal and postnatal illness and to offer support to those who are suffering. We do not live in the dark ages, so let's not be kept in the dark about the most serious of issues. I am terribly sorry, Deputy Presiding Officer. I neglected to refer members to my register of interests that I was an employee of Aberlare for eight years prior to coming here. I should have rectified that. Sorry. Thank you very much for putting that in the record, Mr Cole-Hamilton, and I am sure that everyone in the chamber will forgive you. I also want to add my thanks to Claire for bringing this debate forward. It is a really important subject. Why is perinatal health everyone's business? Latest statistics suggest that everyone will know someone with an experience of perinatal mental health problems, be it a mother, sister, aunt, cousin or friend. Our future is vested in the wellbeing of children and therefore in their mothers. There is a saying that it takes a village to raise a child, and that sentiment is particularly important with perinatal health. Is it therefore really acceptable that seven out of fourteen health boards in Scotland offer no specialist care? At present, without specialist perinatal services, it falls to GPs to detect signs of maternal mental health problems. However, how can we expect a doctor to identify and treat the often well hidden symptoms of mental health issues, often of an individual they have never met before? I know from personal experience how important a well-established relationship with your GP can be in identifying when something is not right. It was at a routine visit to my own GP following the birth of my fifth child that she asked me just as I was preparing to leave how I was feeling. My initial quick response of fine was soon followed by a flood of tears when her concern cut through my collected exterior. My GP's knowledge of me caught my postnatal depression early and allowed a quick and effective intervention that saved me and my family from what might have been a very difficult time. We know that the go-to solution for mental ill health these days is often antidepressants. New mothers, whether it is their first child or fifth, are dealing with both physical and emotional change, and some will require a pharmacological intervention, but that should not be the first step. There needs to be prioritised investment in appropriate specialist services. If perinatal mental health problems are identified and treated quickly and effectively, then serious human and economic costs for the whole country could be avoided. Not getting this right not only impacts on maternal mental health but also children's future outcomes, pressure on our health services and on mothers' abilities to return to work. While I welcome the fact that the Scottish Government has made commitments to improved services, there still exists an unacceptable postcode lottery for mothers across the country. Of course, the issue often underpinning all of this is funding. Why is it then that increased funding received through the Barnett formula has not been ring-fenced in Scotland as it has in England and Wales? Our perinatal mental health services are now failing to keep up with those south of the border, which means that mothers and their children in Scotland are being failed. Perinatal mental health struggles both adult and child mental health services. We know that poor mental health can significantly impact on child development outcomes and significantly limit children's life chances. If the Scottish Government is serious about closing the attainment gap, then perinatal mental health must be addressed. There is a real requirement for significantly more joined-up thinking when it comes to the provision of our health services here in Scotland. Investment in perinatal mental health is exactly that—an investment. It is estimated that failing to do so costs public services five times more downstream, but that is nothing compared to the human cost when suffering. Long-term investment and long-term planning will be vital in combating the far-reaching human and economic consequences of perinatal mental health. I hope that the managed clinical networks will now start delivering the resources for appropriate services. However, we also need champions—individuals such as Clare Hocky, but also individuals such as Clare Grieve, a midwife at the boarder's general hospital. Clare recently received the chairman's award at the NHS boarder's Celebrating Excellence awards for her outstanding work in improving perinatal health services in the boarders. The birth of a child should be the most wonderful experience, yet so many new mothers struggle. We have come a long way, but the journey is not finished. If it takes a village to raise a child, then perinatal health really is everyone's business. The last of the open debate contributions is from Mary Fee. Thank you, Deputy Presiding Officer, and I welcome the opportunity to speak in this afternoon's member's debate on the everyone's business campaign. I thank Clare Hocky for securing today's debate. Mental health problems affect everyone directly or indirectly, and the campaign on perinatal mental health raises specific issues that must be addressed for the sake of pregnant women, for new mothers, for their children and for their wider family. As many as 10 to 20 per cent of women face a period of mental health illness either during pregnancy or in the first year after birth. Organisations involved in the care of perinatal health warn that rates of detection and appropriate intervention are still low. The maternal mental health alliance has drawn up a map of health boards across Scotland to illustrate the level of care and service that is available to pregnant women and new mothers by each health board. It is shocking, and it was a point that was very well made by Alison Johnson, that only one health board has a specialised perinatal community team, meeting the perinatal quality network standards type 1, and that is NHS Greater Glasgow and Clyde. Even more shocking is that seven of the country's health board regions have no provision for perinatal mental health care. The Royal College of Psychiatrists have warned that the failure to meet those standards is a significant threat of patient safety, of patient rights and of patient dignity. Most, if not all, mothers will experience that express train of emotions that hurtle towards them after they give birth. How we support women after giving birth is crucial for their long-term wellbeing. I welcome the commitment and the action taken by the Scottish Government to introduce a managed clinical network. That was an action that was set out in the mental health strategy 2017 to 2027, and I am glad that there has been positive action that will help to improve the care, the support and the lives of pregnant women and new mothers. I look forward to further progress being made in the support offer to women affected by poor mental health and will continue to monitor the progress of the Government's mental health strategy and offer any help that I can to ensure that people are not being failed when it comes to mental health. Deputy Presiding Officer, although today's focus is on pregnant women and new mothers, there is a case to be made to include women suffering from fertility problems. As many as one in six couples experience some form of infertility, and for many the effects of that can cause prolonged mental health problems. I know of a constituent who was diagnosed with depression because of her difficulty in becoming pregnant. A huge concern and worry for her was that her mental health problems would continue into a successful pregnancy and the risk of postnatal depression after birth was always in her mind. Thankfully, that was not the case. However, a focus of early intervention for women going through fertility treatment would be beneficial as they become pregnant and after the birth of their child. In closing, Deputy Presiding Officer, can I once again thank Clare Haughey for the debate today and extend my support to the everybody's business campaign to secure better maternity mental health for mothers for the child and for the wider family? I now call Maureen Watt to respond to the debate for around seven minutes, please. Thank you very much, Presiding Officer. I would like to begin by commending Clare Haughey for bringing this motion to the chamber today and, indeed, her knowledge and expertise in this area with her. I would also like to welcome the change agents and Rock Cantwell and others to the garyllary today. We all aspire that mental health should get the attention and sustained discussion that it deserves. I thank all the members for their contributions and sharing their experiences. Over the past while, whether through press coverage, passionate campaigning, parliamentary activity or elsewhere, we have heard about the priority and fundamental importance of perinatal mental health. Just on Monday of this week, I spoke at the maternal mental health Scotland's annual conference on this very issue. We have momentum, which we must keep going, and the everyone's business campaign has played a significant part in ensuring that that happens. This is in the wider context of it being, of course, mental health awareness week and, of course, the year of young people. All of this work and all of these opportunities can together make a real and tangible difference to the profile of issues like perinatal mental health. Ultimately, we want that raised profile to result in better support for women and a more sophisticated understanding of the issues at population level across Scotland. Annie Wells talked about what is available in her area in terms of the quarriers centre. Others talked about the Aberlour project. Indeed, there is the Juno project here in Edinburgh, too. Annie Wells, Ruth Maguire and others have talked about the importance of partnership working. It is not always about a medicalised model. It is the partnership working and the support that we can offer each other in the community. As well as focusing on the importance of good perinatal mental health in general, Clare Hockey's motion is in support of the everyone's business campaign. The campaign calls for all women who experience perinatal mental health problems to receive the care that they and their families need, wherever and whenever they need it. The evidence in support of that is persuasive. We know that between 10 and 15 per cent of women who give birth will suffer from anxiety or depression during pregnancy and the first year. That equates to between 5,500 and 8,000 women each year. Furthermore, we know that in two of every five households with a new baby, at least one parent suffers from depression or anxiety. To quote the Royal College of General Practitioners, up to one in five women are affected by mental health problems in the perinatal period, and, unfortunately, only 50 per cent of those are diagnosed. Without appropriate treatment, the negative impact of mental health problems during the perinatal period is enormous and can have long-lasting consequences, not only on women but their partners and children, too. As others have said, mental ill health is the second leading cause of maternal death after cardiovascular disease. Treating maternal mental health problems is not only good for the women who are affected, but it is good for their babies, too—the intergenerational thing that Ruth Maguire mentioned. It will contribute to breaking the cycle of poor outcomes from early mental health adversity. All of that is why we have prioritised perinatal mental health in our 10-year mental health strategy. Two of the key themes of the strategy are prevention and early intervention and also improving access to treatment and joining up accessible services. That is why we have provided funding of £173,000 per year for the perinatal mental health managed clinical network. That is why we funded the network at nearly double the usual level for MCNs, allowing it to bring together specialists not only on perinatal mental health but nursing, maternity and infant mental health, too. The network has this long-term ambition, which I have no doubt we all support, that all women, their infants and families have equity of access to the perinatal mental health services that they need across all of Scotland. I want there to be a focus on prevention and early intervention that spans the whole range of the early years, starting from preconception through infancy and into the school years, and our aspirations apply equally across the police. I will make sure that the MCN, if they are not already doing so, takes into account miscarriage and fertility problems that two members have mentioned. I thank the minister for that intervention. She says that we have the aspirations, a shared aspiration. Can we then have a timeline on when we expect every health board to have access to those services, not just half the health boards? What is the timeline? I will come on to that. The focus of the perinatal mental health MCN is not just about what we normally expect MCNs to do for professionals to talk and share good practice across their work. The work that the network is currently doing across Scotland involves all health boards and includes third sector organisations, as well as the voices of families in the work that they are doing. We want an approach in Scotland that is based on the most thorough understanding possible of the picture across the country. It is not just about which areas have specialist services, although that is crucial. We know that. It is about what is available across the spectrum of need. That spans from universal education and awareness-raising through to those specialist services, which are so vital when mental illness does occur. That is why continued involvement of the third sector and universal services is going to be so important as we move forward. That is all in the context of integration authorities, remaining responsible for the commissioning of community and mental health services, including perinatal services, and they will all continue to have a central role. Our next step and the investment will be guided by the MCNs' on-going work to build that full picture of current provision in Scotland. I was not going to mention what is going on in England, but while they have put in investment, I have heard quite a lot of criticism about the fact that they think that they are doing it the wrong way around and that we are doing it the right way around. I am looking forward to the MCN's conference next month to say exactly—and they will tell us exactly what they have been doing and what they will be doing in the future, and that will influence what we do going forward. I think that it is the involvement of women in their families that is crucial. It is the work that we can all do together that will ensure that everyone can access the support that they need. I am not going to give Anas Sarwar a timeline here today until I know exactly what is required, where it is required, and to take the advice of experts to tell us what exactly to do. It is important that we get that right from the beginning and not waste very scarce resources that they seem to be doing in England. We have to make sure that it is about all the service and it is a cross-government approach, as Clare has said. I would like to close by thanking Clare Hockey for bringing that motion to the chamber this afternoon. I offer my very best wishes to the continued success of the Everyone's Business campaign, which is doing such important work. It is everyone's business, but I can assure everyone here that it is certainly mine. That concludes the debate and the meeting is suspended until 2.30 p.m.