 The final item of business today is a member's business debate on motion number 13, 077, in the name of Liam McArthur, on supporting CME and work. This debate will be concluded without any questions being put, and I would be grateful if those members who wish to speak in the debate could press the request to speak buttoned now. I call on Liam McArthur to open the debate. Seven minutes please, Mr McArthur. Thank you, Deputy Presiding Officer. With mental health awareness week running from 11 May to 17 May, I am delighted to be leading this latest debate on the issue of mental health. I wish to thank all those who signed my motion, particularly those who did so with unseamly haste, allowing it to secure the requisite cross-party support by the allotted deadline. I am obviously grateful to those who have stayed on to participate this evening and look forward to hearing their contributions. The issue of how we improve services to and the quality of life of those who suffer from mental health is one that I know commands broad and heartfelt support among members across this chamber. That is very much to be welcomed as we continue our collective efforts to ensure that mental health is better understood, more effectively treated and the stigma surrounding it tackled head-on. Without wishing to detrack from this cross-party consensus, which I know is highly valued by those working in the sector as well as those campaigning for improvements on behalf of sufferers, I take particular satisfaction from the priority that Liberal Democrats have attached to the issue over a number of years. As the minister is aware, we have consistently called for equal treatment of mental and physical health to be put on a statutory footing in Scotland as it is south of the border. In conjunction with the measures already set out in the Government's mental health strategy, we believe that this would send a powerful message. In practical terms, it would also ensure that the needs of those who suffer from poor mental health are reflected more fully when decisions about allocating funding are taken. Of course, given the enormous pressure under which the health service in Scotland is currently operating, simply drawing funds away from treatment of physical health, we would only compound those problems. That is why I was so proud of the specific commitment made by the Liberal Democrats to invest £350 million more in mental health services in Scotland—£3.5 billion across the UK—as part of an £8 billion real-terms increase in funding for our NHS. Sadly, the focus of the recent election campaign appeared rather more to be on who was willing to do deals with whom than the niceties of specific policy positions. Nevertheless, I think that the commitment was and remains absolutely the right thing to do. Distressingly, given the outcome last Thursday, the chance of it actually now happening seemed vanishingly small. There are many aspects of the debate on mental health that I could have chosen to focus on. I felt that the efforts that have been made to stamp out stigma and discrimination in the workplace deserve our attention this time round. Colleagues will not need reminding, I am sure, as well as affecting one in four of the overall population at some stage in their life. Mental illness remains the dominant health problem for people of working age at damages, careers, relationships and lives. The financial costs, let alone the human costs, are colossal. In Scotland alone, the cost to employers is estimated to be around £2 billion. I therefore welcome the current programme being undertaken by Sam H and the Mental Health Foundation under the banner of CME at work. As an aside, I was a little surprised that CME appeared slightly less than enthusiastic about the prospect of me lodging this motion and allowing Parliament an opportunity to debate those issues today. CME has always enjoyed strong cross-party support and been very open to working with colleagues from all parties. I know from previous debates that we have all benefited greatly from the expertise and advice available within the organisation. This approach has been one of CME's real strengths. I sincerely hope that as it moves from its campaign into its programme phase, CME will not make the mistake of seeing itself or be treated by ministers as somehow a creature of government. As part of the current programme, however, CME has helpfully taken soundings on workers' attitudes to mental health in the workplace. Some of the findings are fascinating, if alarming. Just under half of people think that someone in their workplace would be unlikely to disclose their mental health problem for fear of losing their job. More than half thought fear of missing out on promotion would encourage a work colleague to conceal any mental health issue. Those findings echo comments that I have heard at a local level in Orkney. The Blyde Trust suggested that its members are often reluctant to declare a mental health problem in applications as they fear that it will lead to an immediate knock-back. That is perhaps unsurprising as research indicates that one in four employers would not employ someone with a mental health problem, particularly in a role that involves contact with the public or with customers. The case study cited in CME's briefing about Gemma Patterson, who has denied her dream job in the Navy, despite passing the entrance exam and fitness test, illustrates that point perfectly. Gemma's history of mental health was used to fail her on medical grounds, despite her doctor, councillor and psychiatrist, all testifying that she had come out of her mental health problem stronger and more able to cope. The figures that I have quoted may be out of date, but I would hope that CME in work can help address the sort of damaging misconceptions that held back Gemma and discouraged others from being open about their own mental health. Certainly the local mental health strategy being developed in Orkney is looking to place a heavy emphasis on working with and educating local employers about mental health. Hopefully this work can draw on some of the resources, training material and positive case studies being developed by CME to back up their four stage engagement strategy with employers. This stage approach seems very sensible, getting by in first of all and providing basic information about how employers can support their workforce in terms of mental health. Through a process of finding out more about staff attitudes, understanding and experience of mental health, employers can then develop plans for improvement, the success of which can be attract over time and continuously improved. At this point I would wish to put in a brief word on behalf of the independent advocacy sector and the role it can play in helping to deliver the sort of changes we wish to see in the workplace. Very often in employment welfare matters an individual will be advised that they can be supported by a colleague or a trade union representative. This is absolutely appropriate in many instances. Under the 2003 mental health act, however, anyone with a mental health diagnosis has a statutory right to an independent advocate. Advocacy Orkney's Andy Spence-Jones explained to me recently that early intervention of advocacy can stop an employment matter progressing, culminating in disciplinary procedures or suspensions. Andy talks of using advocacy's expertise in mental health to work with employers, helping them to recognise that employees with a mental health condition need support to process their options and clearly articulate their thoughts. This, she argues, can help an individual to remain in employment, benefiting in turn both the employee and the employer. Other good work taking place in which I mentioned in this context is the clubhouse service run through the Blyde Trust in Orkney. Since it started four years ago, 26 clubhouse members have moved into employment both full and part time, this side of a total membership of 90. While transitioning to employment is not the primary purpose of the clubhouse, it does demonstrate that where appropriate support is available, both to individuals with a mental health problem and potential employers, real advances can be made. We have made important progress in raising awareness and understanding of mental health over recent years. I am convinced that that has helped to reduce stigma, but there is so much more to do. See me estimate that just less than a quarter of people think that their workplace has a good understanding of employee mental health. More encouragingly, almost nine out of ten surveyed by See Me want a better understanding of issues so that they can behave appropriately. I look forward to hearing what others, including the minister, have to say and hope that we can all play our part in encouraging as many employers and businesses right across Scotland to make a firm and long-term commitment to engaging with a programme that can make a real difference to the lives of the very many people who suffer poor mental health. We now turn to the open debate speeches of four minutes or so, please. I call Dennis Robertson to be followed by Malcolm Chisholm. Thank you very much, Presiding Officer. I thank Liam McArthur for bringing this very important debate to the chamber. I think that one aspect, Presiding Officer, I was a bit disappointed that Liam McArthur decided to bring the politics into it and that I am not going to, I suppose, maybe rise to that debate, because I think that it's too important an issue in many respects. I remember as I believe a responsible employer and I believe that I hope I still am, but when I was in social work, one of the things that we did do and one of the things that I was very keen to do was to bring in external organisations to equip the employees about mental health, to equip them to be able to identify where perhaps maybe stress or anxiety or maybe early signs of depression were maybe more common than people realised, but also to equip them and give them the skills and the confidence to come to their line managers and discuss what could have been or perceived to have been perhaps a mental health issue. I think that this is really important, but what was important with regard to bringing in that training to a workplace, Presiding Officer, is to ensure that the line management fully understand and comprehend that if someone does come to them with a perceived mental health problem that they are listened to and that they are understood and that the appropriate support is given at that time. That's the really important thing because when we give support and when we ensure that there's confidentiality around that support, the person, generally speaking, can come back and they will come back. I know that when we were looking through staff analysis and we worked through things, those that come with early issues were the people that were more empowered later and those were the same people that spoke openly then to their peer group within the staff rooms and openly said, no, I actually had a problem and I spoke to someone and that gives the confidence for others to do the same. No, it's not always easy, Presiding Officer, to do that, but Liam McArthur is absolutely right. There is a stigma around, a stigma that we still associate around mental health and mental illness and it's something we need to ensure that we're moving away from. There is nothing wrong with having an illness. There is nothing wrong if that illness happens to be a mental health issue. Presiding Officer, I lived for many years through that mental health issues and one of the examples that Seami came with was someone with an eating disorder and that reminds me so much of my daughter because my daughter's employer at the time when she was going to work had no idea, had just no recognition of her specific or special needs and I think this is really important that when an employer does recognise that they have this ability to be more flexible because a person would say long term conditions for instance and it could be someone requiring dialysis, that person maybe is a fantastic employee but maybe for the fear of losing their job they actually develop a mental health problem on top of that physical problem and that is because of the uncertainty perhaps that they are given from maybe even some of their peers or indeed from their line management. So it is about actually raising that awareness and ensuring that people are equipped at an employer level to deal with the issues of people with mental health at work but we need to ensure that we equip the employees, those at work, to be able to trust their employer, to be able to go to their employer without fear that they could lose their job just because they are saying, I have an illness. Thank you Presiding Officer. Thank you and I now call Malcolm Chisholm to be followed by Mary Scanlon. Presiding Officer, may I join Natalie McArthur in welcoming this year's mental health awareness week which offers a chance to challenge the stigma that still surrounds mental health issues and also allows us to focus on the particular issue of the effect of stigma in the workplace. I am glad that we also have an opportunity today to highlight the efforts of CME over many years to tackle the lack of understanding surrounding mental health issues. The CME campaign was launched in October 2002 and over the past 13 years it has worked tirelessly to protect the rights of those who live with mental health and bring an end to the discrimination that so often excludes them from the everyday activities that we take for granted. Work is such an activity. The ability to contribute and feel included and more importantly accepted as an individual is a fundamental human need. This starts with tackling ignorance towards mental health conditions and encouraging a more tolerant workplace where employees feel able to discuss any emotional issues with colleagues. As the UK charity Mind Points out, employment is more than just a way of earning a living. It provides identity, contact and friendship with other people, a way of putting structure to your life and an opportunity to meet goals and to contribute. CME's most recent campaign, CME in Work, aims to ensure that workers have more positive experiences when relating problems to their employer, thus changing the internal culture of the workplace to one of compassion and support. The programme will support organisations to improve practice on mental health and provide an environment where staff are able to talk openly rather than living with their problem in silence, which not only leads to a decreased quality of life for the person but also impacts negatively on the wider workplace. As a UGAP survey of Scottish workers commissioned by CMEs highlighted, 48 per cent of Scottish workers have stated that people do not tell their employers about mental health problems for fear of losing their job. The same poll also found that 55 per cent thought that employees would be unlikely to disclose a mental illness for fear of being passed over promotion or moved to another post. The research provides a persuasive case for encouraging a compassionate workplace where feelings of isolation caused by poor mental health are discussed as part of a resilient workforce. From that first job interview to promotion and training, employers must be given the necessary information to ensure that all employees reach their full potential. There is also the economic case. Figures from SamH in 2011 suggested that mental illness costs Scottish employers over £2 billion every year. Figures from studies published by the UK Faculty of Public Health estimate that sickness absence due to mental health costs around £8 billion per year. 70 million working days missed each year are an average of 2.8 days per year per UK employee. The CME in Work works. It works because it puts the necessary information in the hands of employers and makes a convincing case for a better, more compassionate workplace. A number of employers are already working with CME to develop new programmes, including Network Rail, Edinburgh City Council and the Edinburgh Agency, Lewis Creative. I hope that anybody watching today will look into the benefits of working with the programme and visit the CME in Work website for links on the four steps that they can take towards a better, more mentally aware workplace. CME will support organisations through this process and provide updates, resources and essential reports that actively include staff in building a more understanding culture. This is a practical, proactive step that I know we will all welcome as it will have so many beneficial, wider impacts. There is no space for discrimination in an economy that must work for everyone. I support the motion and congratulate Liam McArthur for bringing it today. I thank Liam McArthur for giving us the opportunity to debate mental health. I will not rise to the debate of the politics but a wee bit of advice for someone with more grey hair than Liam has. That is to wait for a little bit more than a week before he confers judgment on the Conservative Government at Westminster. That also gives us another opportunity to acknowledge the excellent work done by mental health charities in Scotland who bring forward a powerful and a very well-informed voice on behalf of patients. Scotland has rightly been given accolade for being LGBT friendly, but in mental health we see there are statistics that 48 per cent of Scottish workers think that telling a manager about a mental health problem could result in losing their jobs. Only 22 per cent think that co-workers have a good understanding of the importance of mental health. We all need to take responsibility here. I acknowledge the journey of Gemma Paterson and thank Liam McArthur for raising that. This Government has gained an excellent reputation for equality and anti-discrimination in employment last week receiving an award for supporting the needs of deaf people in the Parliament, whether they are visitors or staff. I would like to call on the SPCB, of which I was a member, to sign up for this campaign to undertake an online mental health check with staff and to take action based on the results commitment to the CME work programme. Dennis Robertson. I know that you have a very limited amount of time, but thank you for taking the advantage. Did the Parliament not undergo two years ago a programme similar to CME in terms of the workforce when you were a member of the SPCB? I do not remember an online mental health check, but I will quickly give way to an SPCB member, Liam McArthur, who may answer that. Liam McArthur. Thank you very much, Mary Scanlon, for taking an intervention. The point that Dennis made is one that concurs with my recollection, but I will undertake to the chamber to follow this up with the SPCB and confirm it. Mary Scanlon, I will give you a little time back for an online mental health check. I was delighted to be part of the Scottish Parliament delegation led by our presiding officer for Scotland week in New York and indeed the visit to Chicago when I chose to have meetings on mental health with the health commissioner for New York state as well as a meeting with Alderman George Cardenas, chairman of the health committee in Chicago. If we can strip away the finances and the insurances that are backing US healthcare and Obamacare, I do think that there is something that we can learn from their approach to mental health. Healthy Chicago focuses on mental health. Every employee of the city of Chicago completes a questionnaire on their mental health at least once a year. That has led to higher demand for services due to Obamacare identifying the issue. The questionnaire is also used as an incentive for people to address lifestyle issues. In New York, a similar process is in place. What I learned in New York is that we often think about physical health or mental health, but what they have discovered in New York is that, if people have good mental health, they are able to cope so much better with physical health and long-term chronic conditions. Work is also being done to look at the support for childhood trauma with support for the whole family. I was impressed at the priority work being done in Chicago with the prisoners at the county jail to provide services to the prisoner prior to release and to continue that on release and a programme of mental health for the families to stop the repetition of violence. Forgetting all the finances behind American healthcare, I think that we can learn from them from some of the mental health issues. I know that I am probably going over my time, but I will say one more thing and leave my two pages of speech for another day. That is that here we still work in silos and mental health. I thought that Dennis Robertson made a very good point. If you go to the GP and many GPs do not have any training in mental health, some have some and some have significant training, some have none. If you are lucky after a few visits, you may be referred to a specialist and you only have to wait 26 weeks in America. I am not saying that their healthcare is all good, but the psychiatrist and the psychologist work with primary care. I think that we need to do more about breaking down barriers and ensuring the point that Dennis Robertson made about the early diagnosis and the early intervention. I think that that would come much more respect for the patient and the issues. Thank you. Thank you very much and now I call Han Salam Alec. Thank you very much and good afternoon, Presiding Officer. I thank Liam McArthur for today's debate. Thank you very much, Liam. Most people find it difficult enough with one problem at work, but if you suffer from mental health issues, you would have to deal with so much more. One in four people experience mental ill health, so we all need to change the way we think about people with mental health problems. The reality is that most people at some point will suffer from mental health challenges and will struggle to cope. Now in its 15th year, Mental Health Awareness Week aims to encourage the conversation around mental health to fight discrimination and stigma and promote good mental well-being. Last year alone, over 11 million working days were lost due to stress, anxiety and or depression. The economy cost of poor mental health has been estimated at 100 billion in the UK alone. Businesses and organisations know the impact of mental health in the workplace, but struggle to develop a mentally healthy working environment. Attention to mental health in workplace concerned me that only 22% of people think their workplace has a good understanding of employees with mental health issues, but that 88% want a better understanding of their colleagues in the workplace with mental health problems so they can behave appropriately or, in fact, in other matters, support appropriately. So there is a definite need for see me and work. See me at work works with employers to develop resources, training and materials, effective case studies and other support to employers. They also work with people with lived experience of mental health issues to further understand the activities that can take place to support and change the needs in workplaces to transfer the culture and make work safe for people with mental health problems. Their overall aim is to support employers and making changes to their work practices to improve the working lives of employees with mental health problems. I encourage organisations to work with see me at work to help develop this important new initiative. I join Leon MacArthur in supporting see me in work and wish them every success to encourage employers for better awareness in the workplace to enhance and help support people with mental health issues. At the closing, Presiding Officer, I wanted to point out that mental health issues don't only affect well-being people. It affects people with disabilities, it affects people who are from minority communities, disadvantaged backgrounds and the list goes on because it affects at least one in four people. The issue around that then is that if they also have an additional burden to deal with in terms of mental health issues, it becomes controversial. The issues to deal with that become so much that they break down. It affects the families, it affects the local environment in the living and they find it very difficult to cope with. Liam McArthur. Thank you very much and I thank Hans Alamalek for taking an intervention. I think the point he makes is underscored by recent research by Sam H, which pointed to those from ethnic minorities, also those in rural communities, where actually the social structures worked against people being open about the mental health illnesses that they had. Therefore, the chances of them seeking the support that they needed were a bit more limited. I very much echo the points that Hans Alamalek has made. Hans Alamalek. Thank you Presiding Officer. You actually thumbed it up better than I was managing to do, but yes absolutely. Just as a last point, Presiding Officer, I know I'm over my time. That's all right. I've given you the extra time for the intervention. That's so kind of you. Thank you very much. Just to round up what I'm trying to say is that this is an issue which is very understood. People don't understand the concept, they don't understand the implications of this and I think sometimes people feel that they don't actually need the support and that couldn't be more further than the truth. People actually do need the support and therefore I think it's absolutely crucial and essential that organisations like this are in fact helped and supported so that they can help our communities out there. Thank you very much for that. Many thanks. Can I now invite Jamie Hepburn to respond to the debate? Minister, seven minutes are so pleased. Thank you very much Presiding Officer. Can I also begin by joining others in thanking Liam McArthur for bringing this motion before it is, as others have mentioned, Mental Health Awareness Week. I think it's right that we hold this debate on the CME campaign on work and mental health. This member's business debate continues to the attention that our Parliament has on mental health. I think that this is the exact figures in front of me. I think that I'm right in recollecting, Presiding Officer. This is the fifth debate that we've had in mental health this year and I'm proud that we have had that number of debates in this calendar year so far with an estimated of one third quarter to one third of the population being affected by mental health disorders every year. It's quite rightly on the topic that occupies us. We need to be as comfortable talking about mental ill health as we do talking about physical ill health and ensuring that this Parliament is the focus of political life. If Scotland is engaged in debating issues around mental health, it is important. It's not just talk that's needed. The Scottish Social Attitude Survey shows that mental health awareness activities are still necessary and the interest in mental health is shown in this Parliament. Elsewhere demonstrates to me that there is a thirst for that and I very much welcome that fact. People are still sadly experiencing negative attitudes because of their mental health problem and CME's survey on attitudes in the workplace shows that there's fear amongst people. Fear that people might lose their job or not get promoted. Fear that people will struggle to get a job if their mental health problems are known about but there are also bright signs. Some three quarters or nearly three quarters of the people in CME's survey thought that someone in their work with a mental health problem would be supported by colleagues asking what they could do to help them. More than half thought that someone in their work with a mental health problem would be supported by the workplace to make adjustments to their workload to allow them to remain in work. People are keen to understand mental health issues. Many people want to do the right thing and there are workplaces and colleagues and friends who are keen to learn. Members have referred to the UGF poll, which I've just alluded to. A moment ago, Mary Scanlon mentioned that some 48 per cent of people think that someone in their work would be unlikely to disclose their mental health problem for fear of losing their job. 55 per cent thought that people would be unlikely to disclose for fear of being passed over for promotion or being moved to another job if she was absolutely right to highlight these figures. More has to be done in that regard, but it is also important out of the survey that we more positively report that 88 per cent responded to the better understanding of colleagues' mental health problems so that they can behave and respond appropriately. That shows a willingness amongst the workforce to help tackle and reduce stigma. Those people can be helped in that regard with SEMI's activities. The activities rightly focus on changing behaviour. SEMI was, as Malcolm Chisholm mentioned, launched in 2002 with Scottish Government funding. We still contribute some £1 million per annum. SEMI quickly established a reputation as internationally groundbreaking at scope, ambition and delivery. It has put the issue of mental health stigma firmly within the public arena. SEMI in work aims to help employers to develop a mentally healthy working environment. That's important for people who have work and the families that they are supporting, and for people who are looking for work as well. Being in the right work is good for health, remaining in work-age recovery, for a mental or physical health condition. Return to work after illness improves health long-term and employment is associated with poorer health in general and we know with more psychological distress. Yes, briefly. Dennis Robertson. I thank the minister for taking a brief intervention. The minister perhaps agree with me that sometimes a mental health illness is caused by the workplace and sometimes it's actually looking at what's happening at work needs to be adjusted to enable that person to move on as well. Minister. Yes, just as I have been articulating that being in work is good for a person's physical and mental health, I would observe that if things aren't done properly, if there's too much stress in the workplace, then yes, absolutely, it can have a negative effect. I think that the overall pattern shows that where people are in employment, their mental health is better than those who are in long-term unemployment. I think that to return to my remarks on an individual basis and on a national basis, improving the working lives of people with mental health problems is the right thing to do. Developing mental health and working violence can support people into work and help them to stay there. It makes sense to tackle this in a range of ways. Again, going back to the intervention from Dennis Robertson, where it can be identified that our individual workplace is not doing so well in that regard, this is particularly important. The CME toolkit has a set of steps for employers to work through. CME has resources, training materials and case studies to help to support employers on that. I emphasise that, as the Scottish Recovery Network has said, people can and do recover from even the most serious and long-term mental health problems. Employment can play a role in that and support in the work environment can play a role in that. Structural changes in workplace attitudes help. Individual attitudes also need to change tackling stigma and discrimination should make people more comfortable to seek treatment for a mental health problem. When that happens, a structural response is, of course, required. Scotland was the first nation in the UK to introduce a target for psychological therapies. For all ages, the target for boards is that patients get a referral to treatment for psychological therapies within 18 weeks. Between October and December 2014, there were over 30,000 referrals to psychological therapies. That compares to over 25,000 in the previous quarter. We are seeing more people coming forward for treatment. The NHS boards are responding in the latest data, showing that the average adjusted waiting time for psychological therapies is eight weeks and 81.4 per cent of people were seen within 18 weeks. That is some approaches and some boards are doing better than others. I want to thank all the staff and the boards who are working to help people to get access to the treatment, but I recognise that we still need to go further. We are investing an additional £15 million over the next three years to improve mental health to have time. How can a general practitioner refer someone to psychological therapies without being able 100 per cent to make an accurate diagnosis of the mental health issue? Psychological therapies do not work for several mental health conditions. Of course, I would observe that there are a range of options that are not necessarily the case that a GP would necessarily refer for psychological therapies. Of course, that is an appropriate option for them to do so. Picking up on the point that Mary Scanlon made in her contribution, because, seeing as she has mentioned primary care in her intervention, she raised it in the chamber. Last week, I just had recently a meeting with the Royal College of General Practition. Of course, we discussed the issue. It is actually the case that GPs are trained in mental health. That is part of their core training. They have got to constantly upskill and continue that training. There is support there for that. To return to my remarks and I will close shortly, we are investing an additional £15 million over the next three years to improve mental health service, which will be targeted towards the mental health innovation fund, as well as to boost staff numbers to address the mental health needs of children and adolescents. This spending covers part of NHS expenditure on mental health of nearly £900 million in 2013-14 mental illnesses. One of the top public health challenges in Europe, our work in Scotland across the sectors is key in meeting that challenge. We need support of the NHS, the third sector, and I am pleased to support Simeon's role in that regard. Thank you very much. That concludes Liam McArthur's debate on supporting Simeon work. And I now close this meeting of Parliament.