 I'm going to move straight on so we lose no time. The next item of business is a debate on motion 12706, in the name of Alec Cole-Hamilton on health. I can ask those members who wish to speak in the debate to press the request to speak buttons now, and I call on Alec Cole-Hamilton to speak to and move the motion eight minutes, please. Thank you very much, Deputy Presiding Officer. It gives me great privilege to lead for my party in this debate, and I move the motion in my name. In her first speech to this chamber after the 2016 elections, the First Minister was very gracious in paying credit to my party when she announced the creation of a ministry for mental health and a minister in that regard. It is something we had fought for for many years and we were gratified to see it made real. After two years, that sense of common purpose that we shared that day has all but evaporated. We can no longer find consensus with the Government, which consistently lets us down on so much on an issue of such importance. We live in a Scotland where less than half of new mothers are served by adequate perianatal mental health services, where we see waiting times for child and adolescent mental health services the worst on record and outperforming that every single month. We see 1,000 adults waiting a year or more for access to a talking therapist. Last year, we saw that terrible statistic that, against a steady decline in recent years over the implementation of the choose life suicide prevention strategy, we saw the first rise—an increase of 8 per cent in the number of Scots taking their own lives in this country. The Government's response to that has been an additional £30 million in the last budget and more money announced today, which will not even cover the 800 link workers that they have already agreed to deploy, and two monstrously delayed strategies that have been roundly criticised by the sectors in which they will be implemented. I am not here to make enemies, Presiding Officer. I treat everybody in this chamber with respect, but, against that powerful index of failure, I am compelled to ask the mental health minister what exactly he does all day. The eyes of the most vulnerable in this country are fixed on the Scottish Government for answers, for solutions and for care, and they have been left wanting. We celebrated the creation of this ministry. It was a staging post. It was the first part of a much bigger vision for a comprehensive, gold-plated copper-bottomed service that would look after people who were mentally unwell from infancy until the end of life. We see at every level deficiencies in policy and in provision at every single stage in that process. I said at the start that, if you are a new mum in Scotland with anxiety or depression as a result of your pregnancy, there is less than half likelihood that you will be seen by adequate perinatal mental health services. There is no standardised training of GPs, midwives or health visitors. If you are a child with any kind of trauma as a result of an adverse child experience, the chances are that we do not even know about you because we are not capturing that information. I thought it was very telling, Presiding Officer, that former chief medical officer, Sir Harry Burns, when he was giving evidence to the health committee about his review of NHS targets, said that the one thing that we should be measuring, that we are not measuring, is those young people who have experienced adverse childhood experiences. Similarly, if you are a young person, you are identified and you do have anxiety or depression or self-harming behaviour, you can wait up to two years for first-line treatment and in terms of if you need admission for tier 4 crisis bed support, there is every chance that you will be turned away just in a second because there are insufficient staff there to tend you. Neil Findlay. Last week, during carers week, I met a group of young carers to speak about their lives and 10 out of 14 of them told me that they had to be referred to CAMHS, most having to wait an extraordinary length of time and some the result of self-harm etc. All, some were only given advice to go to a website. That is clearly not sufficient. I will give you a little time back to go, Hamill. Thank you, Presiding Officer. I agree with Neil Findlay absolutely. I think that he underscores that group who are most vulnerable, who are already delivering a service that we exploit the love of for the care of the people around them, that we should look after them in their time of need as well. It is so bad, as calms, that chief officer of North Lanarkshire, Janice Hewitt, said that referrals in child and adolescent mental health services have risen in tier 3 and severe by 23%. She said that there is something not right. There is something that we are not doing right with families or children. This was to the health committee in evidence. That was the red warning flag that we should all heed. Put simply, Presiding Officer, if your daughter fell off her bike and broke her arm, you could reasonably expect her to be in plaster by the end of the day, but if she came to you with anxiety or depression or even self-harming behaviour, you could then expect her to join the longest queue in our NHS. It is simply not good enough. However, it does not get better when you transit to adult services either. Those two are characterised by long waits and a fractured continuity of care. Many of us in the health committee heard very compelling stories by families bereaved by suicide, and one person talked about their loved one, who had, in his last five months of life, had appointments with no less than five psychiatrists. You would not expect a cancer patient to have to see five different cancer surgeons, and every time he had to start at the beginning, retell his story and potentially retraumatise himself at that. There is no support for families in how to look after somebody who is experiencing suicidal tendency. No provision for non-English-speaking citizens, people who are from other countries for whom English is not their first language, and precious little training of police. It is only optional, we need to make that mandatory, because it is often the police that form that all-important first response. I should also say that this is not a reflection of how I view our hard-working healthcare staff, who are absolute champions of the health service and deserve our respect. They only want for training, capacity and adequate resources, but it is the sharpest end of this agenda that I think should cause us all great concern. That 8 per cent increase last year against a marked period of decline in suicide, those Scots taking their own life. Tony Giuliano said in the health committee yesterday from the mental health foundation that there is no longer strong ministerial guidance to local communities on directing money towards suicide prevention. I wholeheartedly agree with that. I hope that the Government listened to his message. We have come a long way in this country in getting people to finally talk about mental health and to come forward, but we do them profound harm if once bringing them out of the shadows, getting them to recognise the problems that they are experiencing. If we then have a void of services to offer them, that is a cruelty that is just unconscionable. I say it enough. Today, I am asking the Parliament to take this department under special measures and ask it to bring forward plans to delineate how it will turn this situation around. The mental health strategy was 500 days late and panned by stakeholders. Let us be clear. We often hear the First Minister say that that is because of the health committee. Of the 68-week delay caused to that mental health strategy, only three weeks of that was caused by the health committee. I will not hear anybody say otherwise in this debate, but the suicide strategy we are still waiting for—more than 500 days late. In those 500 days, 1,000 fellow Scots have perished at their own hands. It is a human tragedy—I will not come to my end here—that is visited on the north shore of my constituency every single week. My party can no longer excuse the deficiencies in this Government or its minister, so I say to the minister, do your job or make way for somebody who will. I now call the more important minister to speak to and move amendment 12706.4. Six minutes, please. Thank you, Presiding Officer. Six minutes is a rather short time to address those important issues, but I will do my best. As stigma around mental health has lifted, we have witnessed a sea change in our society. More and more people are comfortable talking about their own mental health and coming forward for help when they need it. As a result, it is right that our expectations on services for mental health should also change. Our mental health strategy sets out a vision of a Scotland where people can get the right help at the right time, expect recovery and fully enjoy their rights, free from discrimination and stigma. Achieving that vision is not an easy task, but is one that I believe everyone in this chamber is committed to. On child and adolescent mental health services, I am clear that performance for new referrals is simply not good enough. I have met and continue to meet the chairs and chief executives of NHS boards on the issue. I have made clear to them my expectation for them to produce new plans on how they will take forward their services to best meet the needs of their patients. We are entering a period where services are being redesigned to meet the changing demand of young people and children coming forward. We have put young people themselves at the heart of some of the key upcoming reports that will help to shape that. Last year, I commissioned an audit of rejected referrals by SAMH to provide us with recommendations on how we can reshape services to ensure that those who need our care can receive it, and that will be published later this month. We have invested £95,000 in a youth commission on mental health, led by young Scott and SAMH, which will also set out recommendations on how the mental health services should be going forward. To improve care planning for children and young people, we are working with the youth Parliament examining provision for those transitioning, including from CAMHS to adult health services, and this work will also conclude shortly. We are also working to reshape provision on adult services. In primary care, we are investing in multidisciplinary teams. Each integration authority is developing a primary care improvement plan, which must include meeting the needs of people with mental health issues. All four test sites for distressed brief intervention are under way, with early indication of positive outcomes. That is a world-leading innovation attracting international interest. Our mental health and incapacity legislation is based on rights and principles. The review of how the mental health act works for those with learning disability and autism is under way, and we consulted on proposals for reform of our incapacity legislation. A further piece of work that will conclude soon is the development of our new suicide prevention plan. That will be published before recess and building on our current investment in prevention of more than £2 million a year. The loss of anyone to suicide is a tragedy. That represents not only the pain and distress that has led someone to take their own life, but also the pain and loss of their loved ones. As a result, I believe that it is impossible to be too ambitious on aiming to prevent suicide. The new plan will signal a step change in our approach to suicide prevention. I would like to put on record my thanks to stakeholders like Samaritans, whose tone in their briefing is in stark contrast to Alec Cole-Hamilton's. To the Samaritans, Penumbra, the Mental Health Foundation, the Alliance and many others for their help in improving the prevention plan in recent months. In a recent amendment, we outlined that the prevention plan would include the development of a new national leadership group. That group will help to drive improvement and we are creating a new suicide prevention innovation fund of an additional £3 million over the next three years to assist that work. Of course, I expect to be held to account for the delivery of the change to mental health. The Scottish Government will publish plans detailing how it will improve performance against key targets. I will be reporting on the progress on the mental health strategy in the annual report to Parliament in the autumn—just in my last minute—and the next programme for government will deliver a further step change in both ambition for and investment in mental health. I move the amendment in my name. I call Annie Wells now to speak to and move amendment 12706.1. Five minutes, please. Thank you, Deputy Presiding Officer, and thank you to the Lib Dems for bringing this extremely important topic to the chamber today. Last week's figures for mental health waiting times showed without doubt that, when it comes to mental health, Scotland has fallen behind. As much as I welcome the announcement of £3 million over the next three years, I am disappointed to see the Scottish Government attempt to override a motion that rightly highlights what has been a patchy record at best when it comes to mental health. Attitudes to mental health have improved in recent years, which I wholeheartedly welcome, but we do have a mental health crisis and there is no reason to wash over it. We are where we are. To put the debate into context, one in three people presenting to a GP will have a mental health problem, and about one in 12 people in Scotland use antidepressants every day. We need ambition and a step change urgently. What is so evident from figures last week is that we are waiting too long before assisting people with mental health problems. Nearly 30 per cent of children and over 20 per cent of adults are not being seen for mental health treatment within the 18-week target set by the Scottish Government. That is why, as highlighted in my amendment, it is so important that we refocus our efforts on early intervention and prevention by supporting those in front-line services. When it comes to children and young people, there is a vital opportunity to provide support for teachers who are struggling to cope with the demands of what has become a generational epidemic. 10 per cent of children aged between 5 and 16 have a clinically-diagnosable mental health problem, and 75 per cent of mental health conditions are on set before the age of 24. A SAMH survey showed that more than two thirds of teachers do not feel that they have received sufficient training in mental health to allow them to carry out their role properly, and only a third of school staff say that their school has an effective way of responding to pupils experiencing mental health problems. We must recognise the incredibly important role teachers take in the lives of young people and support them in navigating the web of where-to-sign post-pupils. That is why I am calling for the commitment from the Scottish Government to a national roll-out of teacher training, as well as improved counselling services, something that the First Minister was not able to guarantee when I asked her last month. As well as alleviating the pressure on teachers, we also need to look at the health service provision for mental health. As I have mentioned before, social proscribing is absolutely key in order to promote more intermediate forms of treatment and to ease the pressure on CAMHS and psychological therapy services. We know that, with children and young people alone, there have been 18,000 rejected referrals to CAMHS in Scotland over the past three years. That is why I am also calling on the Scottish Government to commit to provision of specialist mental health support in every GP practice and hub and to concentrate on the faster recruitment of key mental health-linked workers. As well as that, I also want to say that mental health support is being provided in every A&E department on a 24-7 basis. Broadly speaking, the strategy has been widely criticised for its lack of ambition, and much of what we have seen from the past year, I feel, has been a Government playing catch-up. Nowhere have we seen this more than with the suicide prevention plan, a strategy that expired two years ago, the time in which we have seen suicide numbers rise. I appreciate that a new plan will be published shortly, along with extra funding, but the process in reaching this point has been arduous to say the least. Only this weekend did we see another third sector organisation, the Mental Health Welfare Foundation Scotland, express concerns over what it saw as lost impetus at both national and local level. To conclude today, I would again like to thank the Lib Dems for using this business time to highlight the urgent challenges that we face in tackling mental health issues right across Scotland. Many of the statistics raised across the chamber today will show why we cannot bury our heads in the sand over mental health. The appointment of dedicated mental health minister in the Scottish Government two years ago was welcome, but we have arguably gone backwards since then in assisting those who require our support the most. It is time for us to be bolder and more ambitious in our mental health strategy and to ensure that no patient is left behind when requiring treatment and support. I move the amendment in my name. I thank the Liberal Democrats for bringing forward this timely and important debate. I say right from the outset that we will be supporting their motion today. We will also be supporting Annie Wells's amendment, but sadly we will be voting against the Government's amendment, because while we welcome much of what is in the Government's amendment, I do think that sadly it is a complacent amendment that feels to recognise the failures of this Government and feels to give a coherent long-term strategy about how we get to grips with the long-term impact of mental health services. This debate also comes just a few weeks after we debated the appalling situation with mental health services in Tayside. Perhaps the minister can give us an update on the progress with that. Do we yet have a reference and the appointment of an independent chair who has the confidence of the families? Perhaps that can be addressed in the closing remarks. This debate also comes hot on the heels of some of the most appalling, most distressing, shocking and shameful statistics on the time mental health patients have to wait to get treatment under this Government, under this Cabinet Secretary and under this mental health minister. Over 1,000 children waiting longer than they should. Thousands of children rejected for help after being referred by their GP. Thousands of adults waiting longer than they expected standard. So, Presiding Officer, while I welcome the fact that we have a mental health minister, that alone isn't good enough. It's not good enough to have the symbolism of a minister. It's delivery that matters. It's the workforce that matters. It's the services that matter. And most importantly of all, it's the patients that matter. But yet today, in Scotland, under this Government, the number of children with recorded mental health problems and skills has more than doubled between 2012 and 2016. In CAMHS—let me just finish this point— in CAMHS, 1,147 young people have waited longer than they should have for treatment in the first three months of 2018 alone. That's an increase of 60 per cent on the same period last year, a 60 per cent increase in one year. That's not a record of improvement. That is a shameful record under this Government. I'm happy to take the intervention. Tom Arthur. I'm very grateful to Mr Sarwar for giving way. He referred to CAMHS waiting times and workforce. As Mr Sarwar will be aware, staffing for CAMHS has increased by 69 per cent since 2007. Clearly, he thinks that that's inadequate. Can he say by which percentage he believes that it should have increased by 2007? Anna Sarwar. Well, the first thing is we have consultant vacancies going up, not going down. Secondly, we have a failure to adequately workforce plan. That's why we've had to launch our own workforce commission. And we've seen a cut in the number of educational, psychologist places under this Government in the last four years, not an increase. So I think perhaps we should have some more reality in this debate. Last March, the Scottish Government promised an audit of cases where children who have been referred to child mental health services have been rejected and why. Since we have promised that audit, more than 5,000 cases have been rejected, 5,000 young people. Now, the First Minister told this chamber and the minister repeated it today that the audit would report before the 30th of June. Can the minister therefore give a commitment to the chamber today that that audit will be published before Parliament goes into recess and that the publication will be accompanied by a ministerial statement in this Parliament? On psychological services for adults, the number of patients waiting too long for help is also on the rise. In the first three months of 2014, almost 3,400 adults waited longer than the Government's own target. 400 more than last year. Again, progress going backwards, not forwards. Real people in need of help and not getting it. Sometimes with devastating consequences. That is why we need a genuinely transformational approach. We need to ring-fence mental health budgets to make sure that they go to the front line. We need to listen to the concerns of senior doctors and have a mental health counsellor in every school across the country. We need to go further by restoring the bursary for education psychologists. And we need to see the number of educational psychologists training places that have been cut over the last four years going up. And crisis mental health services are also in need of urgent support. Presiding Officer, some patients can't wait days or weeks to see a GP. They can't wait weeks or months to see a psychologist. For some people, that time difference is literally a matter of life or death. That's why we need a fundamental rethink on mental health services. Our patients, our staff deserve better. So in closing, Deputy Presiding Officer, we must recognise that the challenges that mental health services go beyond Tayside. The review in Tayside therefore has a national significance. So perhaps the time has now come for a nationwide review, perhaps a commission to look at service provision, to look at funding, to look at models of care, to look at community support, to look at access to crisis services and to look at patient involvement. But let's be clear, our review, a strategy or a ministerial title, which is always so popular for this Government, can't be a fig leaf for this Government's failures and an excuse for them not to act. So today I urge this Parliament to help to send a message to this Government that that time to act is now. Thank you. I now call on Alison Johnstone for minutes please, Ms Johnstone. Thank you Presiding Officer. I'm pleased that one of the amendments selected today, the Labour amendment, acknowledges that the prevalence of mental health problems is linked strongly to disadvantage in inequality. I agree that there's a mental health crisis in Scotland now, and if we want to tackle it in the long term, we must make sure that people have the social and financial security they need. Just yesterday, the health committee heard from the mental health foundation that the austerity agenda and welfare reform have had a huge impact on people's mental health, particularly around employment, and we need to look at in-work poverty and job security. That's why my amendment, though not selected, called on the Government to improve support for mental health and primary care. We know that the erosion of social security support has placed increasing pressure on people's health and on GP practices. Access to primary care in Scotland remains inequitable, and as I've stressed many times during debates on health, GPs practising in the most deprived areas of Scotland typically have longer patient waiting lists, see many more patients with mental health problems. Supporting GPs in areas of high deprivation is fundamental to supporting mental health and tackling health inequalities. The Government has committed to putting 800 additional mental health workers in place, but progress is slow and we still lack clarity on how many staff will be based on primary care settings and what degree of specialty they'll have. We know that there are real issues with access to talking therapies. I agree that there should be access to specialist support in every GP, practice, every hub, every cluster. As well as prioritising early intervention, we need urgent improvement to support people experiencing a mental health crisis. At the moment, that support, particularly out of ours, is just not good enough. As we heard from Samaritans yesterday, many people in Scotland would not know where to turn if someone close to them was in crisis. Sam H pointed out that there is now a crisis care concordat in England, which aims to make sure that there is 24-7 provision of crisis support. We need to know that the specialist mental health staff are lazing effectively with A and E services and emergency services. I know that there is good practice in many areas of Scotland, but there are real concerns. As James Joplin from the Samaritans said yesterday, there is no line of sight to the minister, from the minister to what is happening locally. In their written submission, Samaritans said, there is no longer an effective structure of suicide prevention, leadership or delivery in Scotland. I have repeatedly raised the lack of leadership on self-harm too. The mental health strategy didn't set out any action on reducing self-harm. The Government said that it would be part of the suicide prevention action plan, but it was not a priority in that consultation either. We cannot allow people who have self-harmed or who are at risk of self-harming to fall through the gaps in those strategies. The Scottish Young Greens are campaigning for every pupil to be given high-quality mental health education. My colleague Grossgreer has made the review of PSE in schools a priority. It is fundamentally important that young people also have good access to counselling, and both the Labour and Conservative amendments reflect that today. The Government, however, has cut the bursary for those wishing to study educational psychology. I would ask that they review and reverse that decision. We cannot look away from the fact that children and young people from the most disadvantaged areas are three times more likely to develop mental health problems than peers from more affluent areas. Presiding Officer, a truly preventative approach to mental health has to tackle that inequality at its root. I welcome the fact that we are debating this important issue in the chamber this afternoon. I will be pleased to support the Lib Dem motion, the Conservative amendment, and I will support the Labour amendment 2. However, I would point out that I am concerned about ring fencing. Janis Ewing from North Lanarkshire Health and Social Care Partnership has told the committee that one thing that we ask is that partnerships are trusted to invest where they think the greatest need is. She did go on to say that. No, she can't. I'm sorry. That has you up to conclude. Thank you Presiding Officer. Your major points. Thank you. It's now the open debate, and I'm afraid it's a strict four minutes. I call Liam McArthur, followed by Tom Arthur. Thank you, Deputy Presiding Officer. Scottish Liberal Democrats have consistently sought to keep the spotlight on mental health over the years. We've repeatedly used the time available to us in this chamber to highlight concerns. I'm sure that we all share about the lack of progress that's being made, and to demand from ministers the sort of response that there's justice to the scale of the challenge we face so that mental health gets the priority it needs and deserves. My colleague Alex Cole-Hamilton has already vividly set out the scale of that challenge, the failure of government rhetoric to be matched by effective and timely action, and the alarming evidence showing that in key areas, far from making progress, we appear to be going backwards. I don't doubt the sincerity of the minister's commitment, like most I welcomed her appointment as he dedicated minister for mental health. But by any measure, this has not resulted in the step change needed in addressing mental health issues in this country. In CAMHS, we're seeing the worst performance against waiting time targets since the current targets were established in December 2014. Children and young people who need help are waiting longer and or travelling further for that support. For psychological therapies, the picture appears little better as the Government's target is now met in only one health board area. Meantime, the number of adults waiting over a year for treatment has doubled to 1,000 since the minister was appointed. Shocking as this is, it should not be taken as criticism of staff working in our mental health services. They do outstanding work despite lacking the resources and support that they need. And while turning this situation around does take time, the apparent lack of urgency or recognition by the Scottish Government of the scale of what is needed is alarming. The approach to suicide prevention illustrates this perfectly. Like the mental health strategy, the suicide prevention strategy was allowed to lapse. When a draft was finally published 18 months late, it fell woefully short. Samaritans branded it very disappointing. The mental health foundation suggests that it has quote, significant gaps and lacks clarity over fundamental issues, including resourcing, timescales, structures and the future of choose life. It is one thing taking your time to make sure you get things right. It is quite another to drag your heels for months and then come up with a strategy that patently falls far short of what is needed. Again, the mental health foundation hits the nail on the head when pointing out that while mental health has taken a more prominent place on the political agenda over the past decade, suicide prevention has lost emphasis and drive at both national and local levels. It calls for radical redesign, strong national leadership and efforts to recapture the impetus that was seen during the early years of choose life when the number of suicides fell significantly. That certainly strikes a chord with me in terms of what I am seeing locally in Orkney. In recent correspondence, for example, the minister assured me that Orkney has a choose life co-ordinator. She then named the chair of the local choose life group, who does excellent work, but is not in a position to co-ordinate activity either in Orkney or far less across the region. Moreover, the local group has no access to any resources, removing any chance it has of undertaking the sort of work that such choose life makes such an impact in its early years. While suicide in Scotland is on a downward trend, the most recent figure showed a disturbing reversal of that. Hopefully, that is just a blip, but it reinforces the urgency for government to up its game on leadership, resources and timescale. On average, two people every day in Scotland take their own lives. Each is a tragedy, each devastating for those left behind, but each needs to be seen in the context that suicide is preventable. As the mental health foundation rightly put it, no caring society or government should tolerate the suffering and despair that leads a person to take their own life. I therefore urge Parliament to support the motion in Alex Cole-Hamilton's names as well as the amendments from Labour and the Conservatives and to send a strong message that we believe that treatment of mental health deserves the same priority as physical health. Thank you. We are very tight for time, so I have to be strict. Tom Arthur, followed by Miles Briggs. Thank you, Presiding Officer. I am very grateful for the opportunity to speak in this debate. It is a debate that takes place at a time of significant change in attitudes towards mental health. Here in Scotland, all the parties elected to this Parliament, we are done so on manifesto commitments to improve provision and quality of mental health services. While we may differ on approach, we are united in challenging all stigma associated with mental health. We are proud to support our third sector partners and, collectively, we have played a part in pushing mental health to the top of the political agenda. That is something to be welcome and demonstrates what can be achieved when we can speak with a common voice. I believe that, despite what has been said so far in the debate, there is much common ground. Just as we all recognise the priorities of increasing awareness, tackling stigma and achieving parity between mental and physical health, we all recognise the challenges to making this vision a reality. I am sure that it is something that all members fully appreciate. We have all supported constituents and their families who have had difficulties in accessing timely treatment. I certainly know how frustrating and time-consuming it can be in achieving a successful outcome for constituents in such cases. I understand clearly why frustration and anger informs the language used by some to discuss mental health services in this debate and I understand why that leads to demands for immediate action from the Government. However, we all know and appreciate that there is no shortcut to achieving our shared vision for mental health services. The welcome increase in awareness of mental health in Scotland has seen a commensurate increase in demand. As all members appreciate, this situation is not unique to Scotland. Our neighbours and other parts of the United Kingdom are experiencing the same challenges. Indeed, my commonwealth cousins in Canada, Australia and New Zealand are facing the same rising demand, resulting in political debates similar to the one that we are having here. The fact that other countries not even far are tackling the same problems as we are here in Scotland is, of course, no comfort to a young person and their family who have had a rejected commensurate error or have received one only to find themselves on a long waiting list. However, I do believe that it is vitally important to understand that Scotland is not alone in having to adapt and develop its health services to meet new needs and demands. Something is true for mental health as it is for the demands arising from an ageing population. And just as we need that perspective internationally, we are required when we look at Scotland internally. As members are well aware of with mental health services and all public services, there is performance variation within Scotland. That is a consequence of having 32 local authorities, 31 integration boards and 14 teditorial health boards. Clearly, our aim must be to minimise variation and work towards equity and service provision. Achieving that will, however, take time. I can say that, as a member for Renfrewshire South, Greater Glasgow and Clyde's camps waiting time for the last quarter, 88.7 per cent of people were seen within 18 weeks and bordering Ayrshire and Arran, 98.3 per cent. However, I know that that is not the same in other parts of the country and we must work to achieve that parity. However, as I said, that will take time. However, what that is going to be about if we just take one example with CAMHS, is that we do not want a situation where people are not getting to tier 3 and tier 4. That is about having the strong community provision there. In Scotland, we have taken a lead. We all support integration, but we know that the benefits will take time to feed through. And just as it will take time to feed through, you must close, please. Well, and that I will close, Presiding Officer, but I would say that there is common ground and if we work constructively together, we can achieve the vision that we all share. I call Miles Briggs, to be followed by Jenny Marra. Thank you, Deputy Presiding Officer. I welcome today's debate focusing on mental health and thank the Liberal Democrats for using their business to bring forward this important debate. The motion rightly refers to the disappointment of many working within the mental health and voluntary sector and the disappointment that they have felt when the Scottish Government's new mental health strategy was published in late March 2017. At the time, I called the strategy a missed opportunity and that would not deliver the transformative change in mental health services that we all want to see. Unfortunately, I'm sorry to say that I haven't seen enough additional action since March 2017 for the Government to change my view on this. Despite the strategy and the rhetoric that we've heard from ministers, the sad fact is that mental health services are still failing too many people across Scotland. Waiting times for child and adolescent mental health services are a particular concern as has been highlighted across the chamber today. The latest CAMHS data published by ISD Scotland last week indicated that during the last quarter only around 70 per cent were seen within the 18-week target. A significant fall from the 84 per cent at this time last year and a massive 20 per cent below the Government's own target. NHS Lothian could only meet this target in 65 per cent of cases, which means many vulnerable young people across my region are currently waiting far too long just to start treatment, something that is placing even greater pressure on families across my region. Everyone knows that swift and effective support to tackle mental health challenges in childhood is essential to prevent mental ill health worsening and to reduce the risk it has on resurfacing in adulthood. So these delays are unacceptable and can prove to be devastating for many individuals and families. So I hope today focuses ministers' attention and the need to take genuine decisive action to turn things around. Annie Wells amendment correctly identifies the importance of both increasing mental health support within schools and of early intervention. These are both vital and I continue to believe that we need to be doing far more to offer young people with mental health challenges and indeed people of any age when they go to see their GP with mild or moderate depression or anxiety social prescribing options with local groups and voluntary sector organisations as well as access to counselling and more talking therapies. Under the SNP we're building a crisis in mental health services in Scotland. That's unsustainable and that will continue to fail families across Scotland. The Scottish Government needs to really prioritise social prescribing and support for local groups and we can make sure that that can help provide support when people actually need it. And if the Scottish Government's mental health strategy target of delivering an ask-once-get-help approach to mental health is actually going to be achievable then we need to make sure that change happens because it's absolutely no use for families to ask once and be told to wait a year before they get any help. The Government also needs to understand that other parts of our NHS are not delivering for patients and that this is impact on mental health services. As co-convener of our Parliament's cross-party group on chronic pain the mental health distress and suicide feelings of chronic pain patients for example who face continuous delays of up to a year in accessing vital treatment is an issue of increasing concern. Our last CPG meeting in Parliament heard a moving testimony from one chronic pain patient who had attempted suicide rather than face a year of being in pain before she could repeat treatment. Ministers need to recognise the impact of long waiting times for chronic pain treatments and how this is impacting on the wellbeing of many people across Scotland. And I agree with the concerns set out by Alex Cole-Hamilton and others today in relation to the new suicide strategy. Samaritan Scotland told the health and sport committee only yesterday that we've gone from being ahead to being behind. Samaritan also told us that the Scottish Government has undertaken no evaluation of the last strategy, something that ministers need to understand needs to take place as soon as possible. We simply cannot afford to be complacent when suicide is one of the biggest killers of men in Scotland, especially men under the age of 45. When we know and we must always send that message out and that every suicide is preventable. So to conclude, Deputy Presiding Officer, I welcome to the debate. No, you must close, please. Thank you. I call Jenny Marra to be followed by Stuart Stevenson. Presiding Officer, there are thousands of stories behind the children's mental health waiting time statistics. Each child has their own story of how their name came to be on that waiting list and became a bigger story that we debate today. And each of these stories will inform that child's life, their decisions, their paths and their relationships. And this is why, out of all sections of our society, waiting lists, I believe, are most destructive for children. Because a day is a long time in a child's life, a week seems like an eternity, and nearly eight months, which is the time a child in Dundee has to wait for a calm appointment, that eight months is unimaginable. Last Monday, I went to visit Tayside's Children's Mental Health Service in the Dudup Centre in Dundee. We have the highest waiting list for cams in the whole of Scotland. There is an average waiting time of 23 weeks for cams treatment to begin compared to the Scottish average waiting time of 10 weeks, which is still far too long. The main reason that I was given last week for the long waiting times was consultant vacancies. Tayside currently has four full-time equivalent consultants in cams when they need seven. All their cases are rightly consultant led, so consultant shortages result in longer waits for every child on that list. That is something that I know the Scottish Government is aware of but needs to tackle urgently. If we are not training enough psychiatrists which we are not, then we need to. And the doctor vacancies in deprived areas, GPs, hospital doctors and psychiatrists, the reality is that people in more deprived areas have longer waits for those services. Presiding Officer, we train doctors in Scotland and no one will give me an official figure on this, either the GMC or the BMA, but I understand that we lose around 40 per cent of our trained doctors to New Zealand and Australia. Now, not only is that a huge brain drain, but it is a failure of public policy that we invest, we pay, to train doctors at public expense and then are not able to employ them in the Scottish NHS. Presiding Officer, I believe that location of services is also an issue. To my mind, there is no good reason why consultants based in a centre, the CAMHS centre in each health board can't work for a day in some of the localities. In Dundee, that would be perhaps a day in our broth or in Minas Hill or other areas of the health board. Referral to CAMHS is a significant thing for families and the impact on school and work and the whole family is very significant. I think that more ready access in the community should be considered. On my visit to CAMHS, like other colleagues, I was also concerned about the rejected referrals. I welcome the fact that this will be published before the end of the month but I think that it is imperative that we have an opportunity to scrutinise this before recess in the Parliament and I would welcome confirmation of that from the minister when she closes. My initial understanding of rejected referrals from the health services point of view is that everything is being referred to CAMHS in the absence of an earlier intervention or support in the community. And this is only part of the picture but I wonder if the minister has up-to-date figures on the number of educational psychologists working in our schools at the moment. This is something I have raised in the chamber on many times before but the declining number of educational psychologists make inevitable a referral on to a higher level intervention when that child's problem could have been addressed in their own community without referral on to CAMHS and all that that means for the child family and for public resources. Thank you. The last of the open debate contributions to Stuart Stevenson. Presiding Officer, the motion from Ali Coe Hamilton says that the hard-working staff do not have the resources that is what they require to deliver the services that they would wish. I beg to differ. I agree with Anas Sarwar who said that it is the patient that matters. So my entire speech is simply quotes from the care opinion website, all three cases from the last week covering all of Scotland. First, no, Aberdeen royal infirmary. I intended A&E during a mental health crisis from the start. Reception staff were really patient and understanding. I got seen in triage by Gail and a manor with me was just fantastic. She genuinely listened to me and did not make me feel like I was a burden or anything. Due to the way I was feeling and the state I was in, I was kept in A&E to see the psychiatry team. In A&E, whilst I was waiting, another nurse, Bethan, was looking after me. I appreciated just the small things, giving me some juice and a biscuit, listening to what I had to say. I was in A&E for about three hours and they didn't fix everything, but they gave me somewhere safe when my thoughts were too much and I went with a plan. I can't really ask for more. I know a lot, we're going to hear from patients, we've heard from politicians. I know a lot about the A&E nurses from various admissions with self-harming, but Gail and Bethan did an absolutely amazing job when I needed it most and a kiss then follows. At Crosshouse Pharmacy Services on Monday this week, my son has Asperger's syndrome and mental health issues. I'd appreciate some silence behind me, convener. My son is dreadful that people have mental health, Mr Rumbles. My son has Asperger's syndrome. It is getting a bit silly now. Would you please let Mr Stevenson proceed? My son has Asperger's syndrome and mental health issues. His medication leaked in his bag on Sunday. If he misses a dose of medicine, his mood can change considerably. It's normally a special order prescription. I rang my mortal pharmacy who had none in stock. I phoned the pharmacy at Crosshouse Hospital and spoke to a very helpful pharmacist, Ailsa. She phoned round a number of community pharmacists and found one who had it in stock, making sure that I knew exactly where it was. I can't express strongly enough how grateful both my son and myself are for this excellent service, and from the south of Scotland last week. I suffer from— Will you please take an intervention? I will not be taking any from that source. I suffer from depression and anxiety, which can be pretty severe. I think that Mr Stevenson has made it quite clear that he's not taking any interventions. So all that is doing is wasting time. Please carry on, Mr Stevenson. And which can be pretty severe. And suicidal thoughts and feelings which are present every single day and at times become overwhelming. What I would like to say about the crisis team is how I feel they are really in a league of their own when it comes to mental health services. It was during my first experience of using that health service that one nurse in particular said a few words to me in a moment of such mental and emotional pain. With such compassion and conviction that someone felt my life, me, had value. To know that there was someone out there hoping for me because I couldn't. A nurse in the team would visit me every day for around the next 10 to 14 days. The crisis team are very special people. Yes, there are challenges in mental health. Of course there are. I have experienced suicide in my own family. I know that perfectly well. But there are good stories too. And let's not demean our staffs by pretending there aren't. We now move to the closing speeches and I call Mary Fee up to four minutes please. Thank you, Presiding Officer. Can I begin by thanking Alex Cole-Hamilton and the Liberal Democrats for tabling this motion on mental health? The motion recognises that there is a crisis in mental health in Scotland. No matter how often we debate and discuss mental health, our actions matter more than our words. This is a Scottish Government with a record in platitudes, not performance. And speeches from across the Opposition members today have rightly called on the Government to do more. Young people and adults across Scotland are in crisis and in desperate need of help. They deserve a service that delivers. They don't need platitudes from this Government. Children, young people and adults are all waiting longer for treatment. People are taking their own lives because they can't be seen when reaching out for help and told to go home. A mental health strategy was published late and a suicide strategy is missing. Presiding Officer, those are just a few of the reasons why we support the Liberal Democrat motion, a motion that should shame this Scottish Government into action. Our amendment is a reasoned one and backs up the argument of the motion that there is a crisis in mental health, a point very well made by Anas Sarwar in his opening contribution today. It echoes the concerns of mental health organisations and charities that suicide prevention should be carried out at a local level with ring-fenced funding. It reaffirms our position that every secondary school should have a mental health councillor and it recognises inequality and poverty have a significant impact on mental health. Jenny Marra, in her contribution, movingly spoke of the crisis in CAMH services and in D and the staff shortages and the impact that they have. Anas Sarwar told us in the first three months of 2018 that 3,400 adults waited longer than the Government target, 3,400 people in need of help, 3,400 people not getting help. We welcome the fact that we have a mental health minister, but we need substance, not symbolism. We need a service that works, a service that delivers, a workforce that is properly supported and properly resourced. We want every single person in Scotland who needs mental health support to get that service. We speak for thousands and thousands of people across Scotland who are being failed. The failure of the Scottish Government to implement a new suicide strategy after the expiry of the previous one shows that mental health is less of a priority than the Scottish Government claims it to be. I hope that the recent rise in suicide is an anomaly and that the rate will fall in coming years. However, without the leadership of the Scottish Government in preventing suicide, I fear that many people will miss out on the front-line services that they so desperately need. Presiding Officer, the recent figures for child and adolescent mental health services once again show that mental health is not given the parity the SNP claimed to want between mental and physical health. Over 1,147 children and young people were not seen in the target 18 weeks from an appointment, a rise of over 60 per cent compared to the previous year's figures. That rise means that more children and young people are missing out on the vital support and treatment that they need. The SNP needs to do more than offer warm words. Not all children and young people require specialist services and many can be seen out with a health context, and that is why we want a mental health councillor in every school in order to support young people at an earlier stage. In closing, I would ask members to support the Liberal Democrat motion, our amendment and the Conservative amendment at 5 o'clock tonight. Thank you, Deputy Presiding Officer, and I first refer members to my register of interests, and I have a close family member who is a healthcare professional in the Scottish NHS. I would also like to thank the Liberal Democrats for using their time to debate what is, in my opinion, one of the most important topics for this Parliament to tackle, and I just wish we had the opportunity to give it the time that it deserves. Presiding Officer, we have heard today some very personal and very heartfelt speeches from across the chamber that have been very hard-hitting. From Alex Cole-Hamilton, highlighting a suite of extended and extending waiting lists on mental health, and mental health really should be an acute issue. And we are waiting so long, people are waiting so long to get treatment. It was backed up by Anna Sawa and Miles Briggs and Jenny Marra, among others. We are talking about a limited length of time that it takes to access. Cams is far too long, and it was also highlighted then from transferring from Cams on to adult services. It is really problematic. That is something that myself and Sandra White heard in taking evidence for the Health and Sport Committee last week at Cardinal College, where we got the opportunity to sit round a table with some young adults who were experiencing these issues. That is not a new issue, but it continues deteriorating. I was disappointed to hear Maureen Watt and Tom Arthur talk about encouraging those suffering to come forward and almost congratulating themselves, but they are faced with inadequate services and inability to access those services. If you are encouraging people to come forward, if we are encouraging people if we are reducing the stigma with mental health and we want more people to be treated, how can it come as a surprise when I am not taking any interventions? Well, how can it come as a surprise how can it come as a surprise that the final of those services goes up? It is about poor planning. It is poor planning. We heard from Annie Wells saying that 1 in 3 are now presenting to GPs with mental health issues, and 1 in 12 now have antidepressants. It cannot be a surprise that we need more mental health issues. Early intervention has been highlighted in the Conservative motion and from Annie Wells. I suggest to you that the education portfolio is crucial to tackling poor mental health, especially within the health inequalities and access to opportunity, as was highlighted earlier on. The topic cuts across or should cut across all political divides. It is a subject that we should all want to rally around and pull resource and reverse the crisis. In both the committees in which I sit, public petitions and health and sport, the evidence and testament that we have heard on the state of Scotland's mental health and the mental health strategy is as harrowing as it is controversial. Like the evidence that we have heard on the related suicide strategy and as I have said to Stuart Stevenson that I would ask him we do well to go and have a look at that evidence because from his speech his head is definitely in the sand. One of the things I want to say, I think that throwing people and resource at a symptom of a continually involving crisis without considering the cure is a Government's attempt to a solution that cannot work without dealing with the root causes without taking significant licence of the preventable element of poor mental health or poor health in general. The Scottish Government is not managing the long-term sustainability of the health service. All they are doing is managing the path. I am in my last minute. All they are doing is managing the demise of the NHS. In conclusion, this is without doubt a crisis and it is a crisis that lies at the feet of Maureen Watt and her Government. It is a crisis that is cut through political device today as we have seen. As it should, I would ask the Government to reflect on what has been said today in this chamber and to reflect on the mountain of evidence that continues to pile up. I would ask the definitive action is already long overdue. Maureen Watt Do not leave it any longer. I call Maureen Watt up to five minutes. Oh! Please do not be sorry, cabinet secretary. My mistake. I see on your phone. I call the show on her office and up to five minutes, please, cabinet secretary. Thank you, Mr Deputy Presiding Officer. First of all, I want to use my time to try to respond to as many contributions as possible. I would like to think that all contributions have equal value across this chamber, not least given the subject that we are debating today and should be treated with the respect that they deserve. Alex Cole-Hamilton said a number of things. One of the things he talked about was the suicide strategy. I think that it was important to get the suicide strategy right and the engagement that there has been with key organisations like the Samaritans has got the strategy into a better place because of listening in a minute, because of that engagement. Of course, that has reflected in the Samaritans Scotland briefing today, where they said that we strongly welcome the Scottish Government's commitment to a £3 million innovation fund to support the work of the proposed leadership group, and that they have also welcomed the national suicide prevention leadership group previously. Although they want to see the detail of the final suicide prevention plan, they have been very closely involved in the development of that. I will take your intervention. Samaritans Scotland told the Health and Sport Committee yesterday that there has been no assessment of the evaluation of the last strategy. How are we going to learn from what is working and what has gone wrong in the past? Shona Robison I would say that the fact that the trend in suicide is down by 17 per cent over 10 years would suggest that it has had some success. Now, every individual's suicide is a tragedy, but the trend has been on a downward trajectory. That is positive, but we have to build on that. That is why getting the next phase of the strategy right is so important because we want to do more. So far, the response of organisations such as Samaritans has been very positive, indeed, and we welcome that. The annuals mentioned the need to have co-location with GP practices, which, of course, is what the new GP contract and the new primary care model is designed to deliver. That is backed up with record levels of funding into primary care. Of course, in addition to that, there is the funding for the 800 additional workers, including co-locating in primary care practices. So what members, including Annie Wells, have been asking for is in train, and of course we want to deliver that as quickly as possible. Anas Sarwar asked a couple of specific questions. He asked about the update on Tayside. Now, I am not sure if he is aware, but Tayside put out a statement just two weeks ago where the chair, John Brown, announced progress on establishing the independent inquiry. Well, if you want to listen, he asked me a question. If you want to listen to the answer, do you want to listen to the answer? Could we stop the private spats, please, and have a bit of respect on both sides? Cabinet Secretary. John Brown announced that there are three potential independent chairs that have been identified and expressed a willingness to take up the role. The potential chair of the inquiry will be invited to meet the families and key stakeholders before any final decision is made on who will lead it. The independent chair will be supported by high-level professional advice from a leading psychiatrist. The Alliance, chief executive Ian Welsh, will independently lead a stakeholder participation group made up of families, the public and other external stakeholders. He will meet the families and the public, providing them with expert independent advice and support to ensure that people know how they can input and give evidence to the inquiry. The terms of reference of the inquiry will be shaped and agreed by families and the public in a process led by the Alliance. The families and the public will also be invited to meet potential chairs of inquiry before the decision is made on who will lead the independent review. And of course, Tayside have also made a commitment to staff that they will be supported to continue to make improvements. I heard someone say shocking. Surely we wanted to put families at the heart of this. What I have just read out puts families at the heart of the process. How that can be shocking, I do not understand. I thought members would have welcomed that update. Cabinet secretary is drawing to a close. On educational psychologists, I can confirm as John Swinney announced on 26 May a new joint funding package of £4 million to help train up to 90 new educational psychologists over the next three years. That will include support for those in training over the three years. Again, something that I hope that Annas Sarwar will welcome— You must close. And can I welcome Alison Johnston's recognition of the impact of welfare reforms on mental health and an important point made in this debate? I call Tavish Scott to close this debate up to six minutes, please. Thank you very much, Presiding Officer. Every mental health statistic and we have had an abundance of them this afternoon is a person, a woman, a man, a child, a young person. Few families in Scotland are not touched by some aspect of mental health mine included. And they are, without a shadow of a doubt, the toughest cases we deal with as members of this place. I can think of a number of surgeries that were the only case that I can remember from that surgery is someone who has come to talk about some aspect of mental ill health. And one of those was this, a woman who came to see me some time back about what had happened in her set of circumstances. She was being on medication for depression. She was going through a rough, rough time and she found out last summer that she was pregnant. Now her GP and the maternity services did not feel able or comfortable to help her in providing enough information on the possible side effects of the medication that she was on on her pregnancy. So she was referred to mental health last summer and she heard nothing. She was one of those statistics. She's one of those people who waited and waited and waited. Sadly and deeply depressingly, she miscied during her pregnancy. She got through it through the incredible support of her partner, some friends, other local people who I know and she's in a much greater and better place. But the sad thing for me, not apart from the loss of the child was the fact that mental health didn't quite make it on that occasion. So for every story, and I have no criticism whatsoever of Stuart Stevens when he's every right to set out three examples of where things went properly and went right. For every one of those examples, there are so, so many that have sadly gone the other way. And that's at the heart of this debate today. And it's at the heart of why Parliament is rightly across all the parties. And I suspect also including those in the Government benches challenging our Government to recognise the sheer scale of the problems that do exist. That's why Alex Cole-Hamilton, Anna Sarwar and others have trotted out so many statistics, which I will not repeat. They have been said and the minister and the cabinet secretary are all too well aware of them and all too familiar with them. But it's any Government's response to react both to those statistics, to recognise the depths of the problems, to recognise the scale of the issues that confronts it in this most specialist arguable area. So I don't think any Government minister or any Government could accept that taking more than a year to pull together a strategy is adequate. It's not so much the strategy that matters and I well remember this from ministerial days. It's what you do with that strategy thereafter. We're awfully good at, if I may say so, producing strategies and politics. Less good at making sure they make a difference to real people's lives. Otherwise it would be all of us who could stand up and give three examples in the way in which Stuart Stevenson did this afternoon. Now, more in what was fair in saying that performance was not good enough. So that's why our motion and I note very carefully what the Government had done today. They've actually accepted the last three points of the Liberal Democrat motion today in Alex Cole-Hamilton's name which asks, which says quite specifically that the Government will publish plans detailing how it will improve performance against key targets and also the two further points on both ambition and investment. And if I have one concern about the wind-up that we've just heard from the Cabinet Secretary, who knows this area intimately and rightly so, then there was an opportunity today in that speech to set out exactly what she was going to do in response to those three specific points. I want to pick up just three or four other points that have been made widely in the chamber this afternoon. Firstly on counselling, where a number of members mentioned both organisations outside the formal health service structures that make such a difference to so many others. We depend hugely on them in many different parts of Scotland. In my own AOA in Shetland, mind your head, have absolutely taken on the challenge that is needed. They now see 161 people who would not be being seen by the national health service through their wellness and wellness together programmes, just absolutely essential in providing counselling that is so needed. But that reflects the waiting times that other colleagues have reflected across Scotland, where for example on therapy, for talking therapy services, there is a five to six months wait indeed a year long to see a specialist. The freedom information mentioned somewhat earlier on much more line freedom information regime and we only got these figures through that and it's a side point but there in lies half the problem. Shows that in Shetland alone people waiting for psychological therapy referrals are waiting in 15, 16, 96 weeks in 17, 18 still 105 weeks and currently that that number is 65 weeks. Now by any standards and colleagues will have those figures for across Scotland, these are just too long and more therefore needs to be done. Two final points, one I want to reflect the strong points that a number of colleagues made on workforce planning that Gana Sawa raised that right at the start strikes many of us that the key areas of lacking people in specialisms whether they be psychologists, psychiatrists or indeed mental health nurses is at the heart of many of the problems and that's why I use Cornhill as an example. A student seems to now be both be familiar with Cornhill we see many of our constituents referred to there and have done over years. That facility, important as it is for the north-east of Scotland and for the islands is that it has to close beds at the moment because they do not have enough specialist staff at key times and that is at the heart of this debate. So it is right that Parliament focuses on mental health. It does as Liam McArthur said give it the same parity as physical health and the remarks that Brian Whittle made in that sense were absolutely wrong. It is right that there's a dedicated minister I think few of us would disagree with that indeed that to gain broad parliamentary support but Alison Johnston made a very, very important point about this very important point and I'll finish with this Presiding Officer on that. You need as a minister to have line of sight between the strategy and what you do on the ground and that's the part the Government need to measure up on. That concludes the debate on health and it's now time to move on to the next item of business. I'd appreciate it if people could change their seats quickly.