 The next item of business is a statement by Marie Todd on vision for Scotland's mental health. The minister will take questions at the end of her statement, and so there should be no interventions or interruptions. I call on Marie Todd up to 10 minutes, minister. Thank you, Presiding Officer. I'm glad to be making this statement this afternoon as we publish our mental health and wellbeing delivery plan and workforce action plan. Those plans, published jointly with COSLA, describe the work that we'll undertake together with a wide range of stakeholders and partners to deliver the vision set out in the mental health and wellbeing strategy published in June. Mental health is a topic that attracts passionate, robust debate in Parliament and rigorous scrutiny of the Government. That's as it should be, but there's a consensus across all parties about the importance of supporting good mental health and wellbeing across the country. We are all here today with the ambition to ensure that anyone who needs help for any aspect of their mental health and wellbeing should be able to get that help. To that end, I'll outline the strategy's vision for improving mental health in Scotland at all levels of need. I'll cover the importance of taking an outcomes-focused approach to how we monitor and evaluate progress. I'll also highlight some of the key commitments contained in the delivery plan and the workforce action plan. Over the past 18 months, we've undertaken a significant programme of stakeholder engagement. We heard from people and families with lived experience of mental health conditions, as well as organisations that are led by and support those with lived experience. Today, I want to thank the hundreds of people and organisations who passionately shared their views. Your input has been invaluable. The Mental Health and Wellbeing Strategy's vision is of a Scotland free from stigma and inequality, where everyone fulfills their right to achieve the best mental health and wellbeing possible. The vision covers a very wide spectrum from maintaining good mental wellbeing to supporting communities, to ensuring specialist services are available whenever they are needed. Crucially, it means recognising and responding to the many underlying social determinants, circumstances and inequalities that can affect mental health and wellbeing. The strategy has people at its heart, and our outcomes demonstrate the changes to people's lives that we want to see. For example, we want everyone to have an increased knowledge and understanding of mental health and wellbeing and to know how to access appropriate support. We acknowledge that people will have different starting points, life experiences and journeys. They may have experienced different kinds of inequalities and discrimination. Although needs may vary and people will require different kinds of support, it's vital that the overall outcomes that we are aiming for are the same for everyone. Monitoring progress towards our outcomes will allow us to better understand what is working well and where we might need to change our focus in future. The delivery plan that we are publishing today illustrates that the work that we feel is key to progress over the coming 18 months. I'll give some examples. Building capacity in local communities is absolutely vital. We're driving a shift in the balance of care across mental health and wellbeing to ensure a focus on prevention and early intervention. We'll therefore build on the success of our community-based supports, which have benefited over 45,000 children, young people and carers in the second half of 2022 alone. Recognising the recent Audit Scotland report, we'll work collaboratively to improve access to mental health support. That involves developing multidisciplinary teams around general practice and maximising the role of community mental health teams, digital provision and NHS 24 to make access quicker and easier. It's crucial that we acknowledge that not everyone wants to or is able to access support in the same way. Ensuring a range of provision with a key role for universal services, the third sector and peer support is essential to achieving our vision. As is building on the successes that we have achieved to date through our expansion of digital therapies, we'll continue to improve access to clinical services including CAMHS and psychological therapies. In addition to boards core funding, we'll invest over 50 million this year in our mental health outcomes framework supporting the delivery of clinical services in priority areas. Our actions will continue to evolve over time. We'll regularly refresh the delivery plan based on full assessment of where we know we can build on existing good work. There'll be actions that we will want to expand or refine and our actions must also continue to reflect the significant challenges that remain. We've record levels of investment, record staff numbers and are treating and supporting more people than ever, but we know that demand continues to increase. Today I make an offer to all parties please work with us to identify where we can go further and what our commitments in future years should be. I'll always approach such discussions constructively with anyone across this chamber. The first iteration of the delivery plan represents work across government. It shows how the mental health portfolio is fully aligned with core work on going across government, child poverty, employability, housing and so much else. This cross portfolio approach is essential to address the underlying causes of poor mental health as well as ensuring the provision of the right support for those who need it. I'll turn now to workforce. Our amazing workforce is foundational to our vision. We must ensure that our whole workforce is diverse, skilled, supported, sustainable and able to operate at safe levels. The workforce action plan is aligned to national workforce strategy for health and social care. It places training, wellbeing, job satisfaction and the principles of fair work at its heart. The plan also looks at the whole workforce journey. This includes how we attract, train, employ and nurture. Some of our key actions will support and improve workforce planning, such as for psychological therapies delivery. This is linked to the new national specification for psychological therapies and interventions. We'll promote existing and alternative pathways to widen access to careers in mental health. This involves going beyond the traditional university and college routes. Improving equality, diversity and inclusion training for staff is central to our plans. We'll prioritise upskilling the workforce by providing funding for training to help with treatment, support and recovery. In recent weeks, I've met representatives of mental health nurses, psychologists and heard from those with lived experience. I've seen many examples of the good practice, high-quality support and innovation that's currently happening across all parts of the system. So many people play a key role in our workforce. We recognise the existing and potential contribution of everyone who supports mental health and wellbeing at every level of need, not just in the NHS. It's critical to recognise and value volunteers, experts by experience, unpaid peer support workers and unpaid carers who both work with and support people. That includes family, friends and frienders. While we can recognise successes, we should also acknowledge the scale of the challenges that we face. To meet those challenges, we must work collectively to consider what the future workforce needs to look like. Developing more multidisciplinary approaches that meet the diverse needs of those seeking help. This action plan sets out our first steps. We know that much more will need to be done over future iterations. Achieving and sustaining our ambitious vision will require time and incremental change as funding and resources permit. Both the delivery action plans require local and national leadership. Both the delivery and action plans require local and national leadership as we collectively work towards national outcomes whilst maintaining local flexibility. For that reason, I am delighted that we've published those documents jointly with COSLA as key partners for so much of the work that's outlined. Governance will also be crucial to ensure that we are making the right progress. We will establish a mental health and wellbeing leadership board. That will provide national leadership and strategic oversight of priorities. It will ensure that our commitments deliver clear benefits aligned with the strategy's vision and outcomes. It will provide constructive support and challenge to ensure progress against actions and will play a key role in evaluating impact. The publication of the strategy, the delivery plan and the workforce action plan is a reset and a refocus on our whole mental health policy. That allows us the opportunity to set a new level of ambition. It allows us to be very clear about what a high-functioning mental health system should look like. Most importantly, it describes what help anyone is entitled to receive when they ask for it, for any aspect of their mental health. Presiding Officer, I commend the strategy, the delivery plan and the workforce action plan to the chamber, and I'm happy to answer questions. The minister will now take questions on the issues raised in her statement. I intend to allow around 20 minutes for questions after which time we'll move on to the next item of business. I'll be grateful if members who wish to put a question were to press their request-to-speak buttons. I call Sandesh Gulhane. I wish to draw members to my register of interests as a practicing NHS GP. Minister, whilst a robust strategy is needed to tackle mental health, it is incredibly difficult for our mental health professionals to do their job without sufficient funding, with the Royal College of Psychiatrists contradicting your statement saying workforce is not going to grow to keep pace with demand. In the latest budget, funding for mental health was frozen, and since then, CAMHS waiting times have continued to suffer, with around 30% of patients still waiting over 18 weeks and health boards struggling to recruit the staff they need. So, whilst new funding is welcome, it will be too late for the thousands of children on CAMHS waiting lists, waiting lists that Whom's a use of himself promised to clear by March 2023. Like the drug death strategy and the code recovery plan before it, this is just another flimsy plan which will fail to deliver results for the Scottish people, and when not achieved, this government will simply say it will learn lessons. Can the minister reiterate that is the SNP Government still committed to clear CAMHS and psychological therapies waiting lists, or has this target been abandoned, and, with one in four vacancies in the CAMHS workforce having been advertised for six months or more, how will this plan eliminate those long waits to fill vacancies? The member will be aware that we have made record-breaking investments in CAMHS in the last number of years. In fact, since this Government took power in 2007, we have doubled the amount of money that goes into mental health compared to prior to this Government taking charge. CAMHS staffing is more than doubled under this Government, and the last six quarters, and I absolutely agree that there are still challenges for us to rise to meet, but what I would argue is that we are on the right trajectory. The last six quarters have seen the six highest figures on record for the number of children starting treatment from CAMHS. We have gone further than that. This Government has made sure that there is counselling available in every high school in Scotland. We have also invested in local governments and local authority community-based mental health support, which more than 45,000 children, young people and their family members have accessed just in the second half of last year. We have absolutely not lost our commitment to meeting the CAMHS targets. We will achieve the waiting list target for CAMHS. We will achieve the waiting list target for psychological therapies. We are making the right investments. We are improving the situation, and I would expect to see further improvement continuing on the same trajectory. The scale of Scotland's mental health crisis cannot be understated. A recent survey by the Royal College of Psychiatrists found that 53 per cent of respondents were not confident that a family member could access mental health support if needed. The latest strategy rightly focuses on the need for patients to be able to access good mental health support earlier and in their own communities, but the accompanying work plan failed to acknowledge the increased pressures on a declining GP workforce that is constantly firefighting and simply has no headspace to do service improvements. Can the minister tell us how patients can have confidence in the strategy when the workforce has already been in touch with me today to tell me that it is not possible to deliver it? We will work very closely with the workforce. I recognise that general practice is under immense strain, and we talk about that day in and day out in this chamber. There were challenges prior to the pandemic, but there is absolutely no doubt that the pandemic has placed our health and social care system under an even greater strain than it has ever experienced before. However, we are investing in primary care. We are investing in a diversity of workforce in primary care, so we do not just rely on general practitioners in primary care to deliver support to mental health. We have invested in specialist mental health workers, community link workers and the full multidisciplinary team, including nurses with special skills and special qualifications. Practitioners, nurses, pharmacists and sometimes psychologists and counsellors are all available through the primary care door at the GP practices. I recognise and absolutely recognise that we are not able to wave a magic wand and fix absolutely everything about what is needed in mental health care in Scotland. I would say that we are absolutely on the right track. It is important to recognise the challenges that we face, but it is important to acknowledge the progress that has been made in recent years. There has been sustained investment. We have record numbers of staff providing more varied support and services to a larger number of people than ever before. Although I recognise that there are still challenges and that there is a rising need, I think that we would all acknowledge that. I would absolutely say that this strategy, this workforce plan and this action plan are the answer to those challenges. I refer members to my register of interests and my registered mental health nurseholding registration with the NMC. The independent forensic mental health reviews final report was published in February 2021 and it made wide-ranging recommendations for the future of forensic mental health services in Scotland, including that all forensic mental health services, both inpatient and community services, should be brought under the management of a new forensic board. Can the minister update me on the progress in implementing those recommendations? Continuing to improve support for those in the forensic mental health system is one of the priorities that set out in Scotland's mental health and wellbeing strategy. The delivery plan that is published today includes an action to progress issues identified by the independent review. That includes continuing to bring together stakeholders to agree a clear plan for addressing the strategic planning and the governance of forensic mental health services. The first phase of that work was the establishment of a planning and collaboration short-life working group that undertook an options appraisal and the report of that appraisal was published back in August. I have taken into account of that work, which did not result in a clear consensus. My plan is to update Parliament and to publish a document on progress towards delivering the independent review's recommendation early in the new year. I recognise the member's on-going commitment and interest in making progress on this issue and I am more than willing to keep her updated on progress. It is good to see that the strategy recognises the importance of perinatal period for mothers, but it does little to deliver. Last year, a consultation on extending mother and baby unit provision found that most respondents want another unit outside the central belt, many of them being in the Grampian health board area. After requesting an update on progress, yesterday I was told that a report will be published once the options have been fully considered and next steps determined. Will the minister finally listen to women and tell them when that will be? I thank the member for his question and for her on-going interest in this area. It is an interest that we share and I would acknowledge. The options appraisal that you referred to has been completed and I have read it and the Scottish Government are considering our response to that options appraisal. I am more than happy to update Parliament and certainly to update stakeholders of what that options appraisal recommends once we have made plans and how to respond to it. I do not want to come to the public with the options appraisal until I can set out what the next steps are. It is important to remove stigma around mental health and wellbeing. Can the minister provide an update as to how those plans in this statement can help to continue to tackle this? The member asked an excellent question. Stigma is the bane of my life. It is the bane of many colleagues' lives because it prevents people from getting the help that they need and it prevents people from getting the help that they are entitled to. That is why one of the first priorities of this strategy is to aim for a Scotland that is free of stigma and inequality where everyone fulfills their right to achieve the best mental health and wellbeing possible. The member will be aware and agree that we have made great progress over recent years and now we are in the lucky situation where many people feel comfortable talking about mental health, many people feel comfortable talking about mental ill health and what they do to keep themselves well but we have more to do. One area that attracts my interest personally with my history of working with people with severe and enduring mental illness is that particular group that still faces relatively large amounts of stigma. Can I ask the minister why there is little detail regarding how we retain existing staff in this statement? Staff turnover and recruitment is as great a problem as lack of recruitment. The Royal College of Psychiatries produced a report last week stating that 42 per cent of existing consultants are over 50 and half of them are considering early retirement. Can the minister give detail on what strategy is in place to retain those hardworking staff? A number of pieces of work right across the workforce, including a review of mental health nursing for example. Right across the spectrum of people in the working force to try to support and enhance the conditions under which they work. I thank the Royal College for the comprehensive and wide-ranging psychiatry workforce in Scotland report and I absolutely acknowledge the issues that they raised in the report. The workforce action plan ensures that the commitments in our mental health and wellbeing strategy are underpinned by plans for a resilient and sustainable workforce. It is absolutely our agree important that they feel valued and supported in order to promote better health and wellbeing outcomes. We are going to use the Royal College of Psychiatries report to support the work of the newly created psychiatry working group. I look forward to engaging with the college and many other stakeholders. I have met recently with mental health nurses and psychologists to ensure that the issues that are identified in the report are considered as part of on-going work to implement the new workforce action plan. In June this year, the minister responded to me regarding my concerns about the lack of ADHD assessments for adults in my constituency. I quote, There is no routine reporting of community adult mental health service activity nor any national routine reporting, close quotes. Can I ask therefore in the accompanying documents to the statement, is there a commitment to improving and collating data on ADHD in adults which would inform workforce requirements? In terms of data, we know that our gaps in current reporting in our mental health and wellbeing strategy acknowledges this. The need for better data and evidence is specifically reflected in both the strategies, outcomes and the priorities. As I said in response to Christine Grahame's earlier question, I am very happy to consider it going forward, but we are aware from regular discussions with HSCP leads that the number of adults coming forward has increased significantly, so capturing what we have now may not capture what we need in future. We have published quality standards to support general adult secondary mental health services, and that is part of a wider ambition to develop a suite of standards for mental health services that will improve the quality and safety of mental health care and support. Those standards will be measurable. They will provide a basis for continual improvement through enabling greater scrutiny and assurance of services against the standards, and I think that they will be a real part of the solution, and they will undoubtedly focus on access to services and set out expectations around services, prioritising referrals based on need, and providing clarity around that prioritisation process, and the need to support people who are waiting for them. There are many members still interested in putting a question, and I'll be grateful for concise questions and responses. I call Liam McArthur to be followed by Gillian Mackay. I thank the Minister for her offer of cross-party collaboration and welcome the new delivery plan. Although the crisis in mental health remains, despite the best efforts of staff, the documents published today promise more working groups, more reviews, more plans for future plans, while last winter the Government cut £50 million from the mental health budget. Where are the extra staff that is promised by the Government to support policing? Where are the extra staff that the Government promised to support in A&Es? As I spoke about the workforce plan and the action plan, the strategy is very much about shifting the balance of care from acute services to community services, building and strengthening resilience and capacity in our communities, making sure that early intervention and prevention is possible. We have work going on, as I have said in response to previous questions, specific work going on right across the specific mental health workforce, but it must be acknowledged that there is also a need to increase resilience right across our communities. Mental health is everyone's business, and that is the ambition of this strategy, is to ensure that it's everyone's business. We know that more rural areas of Scotland often struggle to recruit clinicians with specialist knowledge such as mental health. How will the Government ensure that those in the primary care teams have time to expand their knowledge to do the early intervention work that is so vital, and what work is under way to attract mental health workers to our rural communities? The member will be aware that we have done a lot of work in primary care to try to ensure that there is a healthy multidisciplinary team available as people access care through their general practice. That means that there are very many general practices that are already specialist mental health workers available to support the general practice staff with that. We are keen to continue that, to ensure that we continue to invest, looking particularly to ensure that our investment aligns with the areas of greatest need, recognising that there is a link between the socio-economic factors, the social determinants of health applied to mental health as well as to physical health. We have a lot of work going on to make sure that the right people are available in the right place at the right time for those individuals. Scotland's incredible mental health workforce carries out vital work every day. Can the minister say any more about the work that is currently under way to grow the mental health workforce in Scotland, and how those plans will build on that work? I have said some already, but I am more than willing to elaborate further. We have been proactive in increasing the number of mental health staff since 2007. The number of psychology and CAMHS posts have more than doubled in that time. The number of psychiatric consultants across all specialties in NHS Scotland has increased by 16.3, a total of 525 whole-time equivalents. For mental health nursing staff, the workforce has increased by 36.5. That equates to almost 10,000 extra whole-time equivalents. We have also exceeded our commitment to recruit 800 additional mental health workers, to A&Es, to GP practice, police stations, custody suites and prisons. We know that to achieve our vision for mental health and wellbeing in Scotland, we rely on having the right workforce supported to have the right skills in the right place at the right time. I would aim to have a workforce that is diverse, skilled, supported and sustainable and that can operate at safe levels. That is why our workforce plan outlines a number of actions that we are going to take to support our vision. A review of mental health nursing in Scotland will focus. I mentioned the review of mental health nursing. Some of our other key actions will be for psychological therapies delivery. We are always looking to promote and exist alternative pathways to widen access. The minister has said previously today that every senior school in Scotland has counselling services. I would like to ask the minister how many full-time equivalent counsellors there are in Scotland schools. I do not have that data to hand, but I can certainly follow up in writing to Annie Wells. What I am absolutely certain of is that we have delivered on that commitment to make counselling available in every secondary school in Scotland. It has been well used and a great success. We are keen to building it. Emma Harper I would like to refer members to my register of interests as I am currently a registered general nurse with the NMC. Minister, this vision for mental health rightly has a focus on promoting positive wellbeing. Across remote and rural Scotland, many people, particularly older people, experience social isolation and loneliness, could the minister provide an update on how this plan will seek to tackle loneliness and isolation, particularly in remote and rural areas like Dumfries and Galloway? The delivery plan recognises the need for us to continue to build capacity in local services and third sector community groups to ensure that everyone in Scotland, particularly those who are most at risk, are able to access mental health and wellbeing support within their local communities. Since 2021, we have invested £51 million in our community mental health and wellbeing fund for adults, with approximately 3,300 grants to local projects across Scotland in the first two years alone. The fund supports grass-root community groups in building resistant resilience and tackling social isolation, loneliness and mental health inequalities. It prioritises a range of at-risk groups, including older people and those living in remote or rural areas. During its second year, more than 1,200 of the projects supported by the fund included a focus on addressing social isolation and loneliness. That included Balmuclellan community trust, which I think is in the member's region, providing a fun and formal, safe environment and a place for people to reconnect with each other. That includes the ministerial statement on vision for Scotland's mental health. I cannot take further questions, as we are very tight for time this afternoon, and I need to protect the coming items. We move to the ministerial statement update on education and skills reform, and I will allow a moment for front benches to organise themselves.