 R Ut сцен연 Rhy brickwyr, thank you. The final item of business is a member's business debate on motion 9834, on eating disorders awareness week 2018. The debate will be concluded without any questions being put. I can ask to those members who wish to speak in the debate to press their island business week buttoons now. I call on Claire Haughey to open the debate. Ms Haughey, please. Thank you very much. three days into this year's eating disorders awareness week, which runs until 4 March. At this point, in proceedings, I was about to ask members to welcome the visitors to the gallery today. Unfortunately, the weather has beaten us. I would like to mention the Eat Disorder charity beat and the Scottish Eating Disorders Interest Group, which both helped greatly in the preparation for this debate. Before I start, I would refer members to my entry in the registered members' interests. I am a registered mental health nurse and hold an honorary contract with NHS Greater Glasgow and Clyde. Most people will be aware of anorexia, bulimia and binge eating disorder, but they may not be aware that such eating disorders are serious mental illnesses. Those are conditions that are diagnosed according to a list of expected behavioural, psychological and physical symptoms, but they are sadly often misunderstood as merely being diets gone wrong or phases. Evidence shows that over the last three or four decades instances of eating disorders have increased to such an extent that beat estimate that approximately 1.25 million people live with one in the UK. The most recent figures for Scotland show that, in 2015 to 2016, a total of 726 people were treated in hospital for an eating disorder, which represents a 66 per cent increase for the corresponding figures a decade earlier. The rise, however, does not necessarily have to be viewed as a negative and nor may it indicate a rise in suffering. It could instead point to an increased awareness on the part of healthcare professionals and improved access to treatment, which is the mental health nurse of over 30 years, is the assertion that I would agree with. As many people have been diagnosed and are receiving treatment, many more remain undiagnosed and at risk. The risk is not of not treating any mental illness can be incredibly dangerous, however, for eating disorders, this is even more true. Eating disorders are responsible for more loss of life than any other form of psychological illness, with anorexia nervosa having the highest mortality rate of any mental illness. Even when eating disorders are not fatal, they can still lead to severe long-term physical health consequences, such as organ damage, fertility issues and can increase the risk of heart problems and type 2 diabetes. The deniability, secrecy and stigma associated with eating disorders will stop many seeking help and prevent others from taking responsibility to help a sufferer. The latest available figures for Scotland, however, are only the tip of the iceberg, as most people are treated within community outpatient settings and have no need or desire to visit a hospital. The systems that currently operate in Scotland and England are different and should not be directly compared. However, for information's sake, the Scottish Government has set a target that all patients, no matter their age, should not have to wait longer than 18 weeks from referral to the start of treatment for a mental health condition, including that of eating disorders. Within my constituency, the average time to refer an adult to appropriate services is within 15 days—a fact that I checked yesterday—whilst urgent cases are seen within the day much quicker than the standard target. Although I appreciate that this is not the case everywhere, there is good practice to be found across the country. In England, for under 19s only, the target referral time for non-urgent eating disorders cases is four weeks and the urgent case is seven days. Scotland is already doing tremendous things in tackling mental illness, with the ground-breaking mental health strategy 2017-27, and I have full trust in our mental health minister. Nonetheless, we can always look to see how we can improve things, and it may be the case that the successes in my constituency could be looked at being replicated to Scotland-wide. When preparing for today's debate, I had the pleasure of hearing about Beats Ambassador programme from their senior national officer, Sarah Preston. Beats Ambassadors all have lived experience of eating disorders, and through their own knowledge and expertise they are helping others who are going through similar situations. One of those people was Valerie Connor from Glasgow, who was to be with us in the gallery today. Valerie has the rare experience of previously having suffered from anorexia nervosa and currently now from bulimia. She spoke bravely of her own difficult and challenging battles, and of the real positives of her experience is that the help she has received through peer support groups. Many years ago, after growing impatient and frustrated with being unable to access services, she began to meet up with others in Glasgow, who created their own support service to assist one another through their journeys to recovery. Such groups, such as the Glasgow Eating Disorders support group, are easily found online, so I hope that from today's coverage others will know that they can look on the internet to find help from others in similar situations. Another great example of online support is through the tremendous website managed by Eva Musby, anorexiafamily.com. Eva's daughter fell ill around 10 years ago, and she now devotes a substantial portion of her time helping other parents and sufferers themselves. Her website and indeed the book that she has written is a great resource for those looking for further help. From a parent's perspective, her website assists with general information and practical advice, as well as offering the companionship of someone who knows what it is like to support a child with an eating disorder, providing hope and confidence. I cannot thank Eva and Valerie enough for their assistance in preparing for today's debate, and I hope that they will be encouraged by what they have heard thus far. Before I close my speech, I wish to pay tribute to former MSP and now councillor for Stonehaven and Lord Eastside, Dennis Robertson. Dennis was supposed to be here for today's debate, however sadly due to the weather, he has been unable to attend. Dennis was the main driver behind me lodging today's motion for debate due to bravely sharing his own harrowing experiences. Nearly seven years ago to the day, 25 February 2011, to be exact, Dennis lost his daughter Caroline to anorexia after she suffered from the illness for over five years. Dennis in a heartfelt speech marking eating disorders awareness week two years ago recalled the death of his beloved daughter and he said, and I quote, I felt the pain then and I feel the pain now, but the pain that I feel now is perhaps slightly different. It is not just grief. I miss Caroline very much as do Anne and Caroline's twin sister Fiona. Of course we miss her, but we must continue to try to establish a pathway so that other people do not have to go through the pain and anguish that we've gone through. I'm incredibly sorry that Dennis is no longer an MSP to continue this campaign at Parliament. However, I wish to reassure him that there are others like myself who will continue to fight the fight for. Thank you very much. I call Annie Wells to be followed by Stuart Stevenson, Ms Wells please. Thank you, Deputy Presiding Officer, and I would also like to thank Claire Hawkey for bringing this important topic to the chamber today. Eating disorders are complex mental illnesses, and anyone, no matter their age, gender or background, can develop one. When we know that around 1.6 million people across the UK are affected by an eating disorder, it's not only important that we provide the proper support to those who need it, but that we work together to raise awareness among the population at large of who can be affected and what having an eating disorder actually means. Her views of who can be affected are sometimes distorted, and that's our response to identifying and supporting friends, family and colleagues who may be struggling may also be distorted. Studies, for example, suggest that around a quarter of people with eating disorders are male, and when it comes to visible symptoms, 80 to 85 per cent of people are actually not underweight. Data from Beats shows us also that 15 per cent of phone calls taken in 2015 to their helpline were from those aged 40 and over. As a society, we are constantly bombarded with messages about food, weight and body image, and to an extent, many of us are affected by emotional eating, using foods as a means of reward or improving self-esteem. There is no specific cause for an eating disorder, and people may not have all the symptoms pertaining to one specific type. The term eating disorders refers to a broad number of conditions, which is again why it is so important that we raise awareness by encouraging everyone in Scotland where they are currently affected, knowingly or not, to go on-line and look at websites such as Beats and Sedgwick. On a personal level, those sites were invaluable to me in broadening my knowledge of different types of eating disorders and their signs and symptoms. When it comes to supporting people with eating disorders, I feel strongly that we work towards improving, identifying and treating people before the point of hospitalisation. Wyringly, the number of people hospitalised has risen by about two thirds over the past 10 years, and in my own region, Glasgow, numbers increased by 15 per cent between 2015-16 and the previous year. Although hospital admissions will always be crucial, improving the provision of evidence-based psychological treatments that are offered in community settings across Scotland is fundamental in allowing people to access treatment quickly, particularly when around one in four children and adults are waiting too long for mental health treatment. I am pleased to see examples of that taking place. NHS Lothian Cams, for example, has partnered with Beatt to provide online peer support for young people under 25 and for them and their families to reduce the sense of isolation that an eating disorder can cause. Volunteers who have recovered from eating disorder and parents who have cared for a young person who has recovered are paired up with young people or families who are currently experiencing these difficulties. I am also pleased to see that this week, NHS Lothian Cams will also be launching a website designed to support parents in the first few weeks of diagnosis and treatment. This kind of support will be essential in treating eating disorders in the early stages, and I am interested to see how that will be rolled out across Scotland. To conclude today, I would also like to extend my heartfelt thanks to the charities that support those with eating disorders, CME, BEAT and SEDGE, to name a few. Raising awareness, reducing stigma and creating a clear pathway of help in the early stages of an eating disorder will be absolutely key to ensuring that we provide the best support to those who need it. Thank you very much. I call Stuart Stevenson to be followed by Mary Fee, Mr Stevenson, please. Thank you very much, Presiding Officer, and thank you to Claire Hoggy for providing the opportunity to have this important debate. Claire mentioned our colleague, Dennis Robertson, to remind me and others who were here of Dennis's first contribution about his daughter, who made the hairs in the back of my neck come up. I can remember the personal emotional charge that I felt when he spoke about those personal circumstances. Dennis turned what could have been a life-constraining tragedy into the driver for a very, very worthwhile campaign, which we would all support. Of course, he continues public service in Aberdeenshire Council, where I regularly see him and continue to have good discussions. We have all referred to the increase in the number of people presenting with eating disorders. I am delighted to hear that, in Claire Hoggy's constituency, the 18-week target for being seen is substantially being better. Perhaps more interestingly and more troubling is that, on average, it is 149 weeks before people experience eating disorder symptoms seek help. Perhaps we should look in the mirror at some of the ways in which we and wider society respond to people with eating disorders and perhaps without meaning to discourage people from seeking the kind of help that they really need. It is said that 34 per cent of adults in the UK cannot identify signs of an eating disorder, while 79 per cent do not know that there are psychological symptoms associated with eating disorders. Part of those anomalies lie in the fact that we still view sufferers of eating disorders as having only one body type—skinny, sickly, perhaps selfish. That is utterly, utterly wrong. Many people believe that people of normal weight or who are overweight cannot be suffering from an eating disorder. Unless they look very unhealthy and weak, people will assume that they are fine. A common misconception is that sufferers are simply attention seekers. Clare mentioned anorexia and bulamia and gave us a list of other conditions that apply. There are a huge number of those that we need to take attention to. I want to talk a little bit about social factors. I am personally disturbed and I do not know if others will be. The Weight Watchers has just started offering free six-week memberships to children as young as 13. I am sure that they have their reasons for doing so, and I am sure that part of what they will say is that they are fighting childhood obesity and other health complications. I think that offering this kind of illusory opportunity to people who are potentially vulnerable emotionally and whose body shape is likely to be rapidly changing is not likely to be something that I feel comfortable to support. Simple consent of parents is all that is required and teens are granted this imperfect opportunity to get that supermodel physique. It has been some years since I have paraded on beach or side of a pool my physique and there are good reasons why that is so because I am somewhat short of that ideal shape. I can see members around the chamber nodding in agreement without much knowledge. In a society that glamourises the illusion of perfection, it is something that we should all seek to address. We need to educate people about symptoms, about treatments and about that. There is no condemnation in accepting that we have eating disorders. We are endomorphs, we are exteromorphs and that is from our genetic dispositions. Let me once again congratulate Dennis for having first brought this in the way that he did to this Parliament and to Claire for allowing this opportunity for us to further discuss a very important subject. I remind members to address other members by their full name, please, even in the rather more friendly, usually, members' debates. I call Mary Fee and I follow by Alison Johnstone, please. I thank Claire Hawkey for bringing this very important issue to the chamber. I would like to touch on two main points during my contribution. First, the importance of improving general awareness of the symptoms of eating disorders to help aid earlier detection. Secondly, on the support that is available to children and young people who experience mental health problems, particularly those around eating disorders. Knowledge of eating disorders is not extensive among the population at large, with anorexia often portrayed as the archetypal and the only eating disorder. However, there are four classifications of eating disorders. Anorexia, bulimia, binge eating and eating disorders are not otherwise specified. The expression of each of them is often quite discreet. It is unseen to the untrained eye of both family and of friends. It is important to raise the general awareness of the key indicators of eating disorders to help family and friends to identify a disorder in an individual as early as possible. In advance of the debate tonight, I posted on Facebook that this was eating disorder awareness week and my intention was to speak in the debate. I was contacted by a constituent who asked if the issue of compulsive eaters could be raised, as there are many people actually eating themselves to death. The individual went on to say that some people still see this as someone just being too greedy, yet no sane or rational person wants to eat themselves to death for the sake of an extra pudding. Knowing this person, I know how heartfelt the comments that he made have been, because this person has been at both ends of the unhealthy weight spectrum. The individual goes on to acknowledge that it is a psychological problem that they are suffering from and that the NHS needs to invest as it would generate long-term savings in the treatment of obesity patients. A recent survey by YouGov revealed that one in three adults could not name any signs of an eating disorder and that 79 per cent were unable to name the psychological symptoms such as low self-esteem. The Scottish Eating Disorders Group has a very useful section on its website that outlines a comprehensive but not exhaustive list of symptoms that might indicate that an individual is suffering from an eating disorder and includes self-induced vomiting, the use of laxatives and drinking large quantities of fluids both before and after a meal. Secondly, it is important to recognise that eating disorders commonly manifest themselves during adolescence. That is why it is so important that the child and adolescent mental health service is able to provide the appropriate support to young people who are suffering from an eating disorder. However, at present, the provision of CAMHS across Scotland can be patchy and unsatisfactory. Too many children are waiting too long to be treated, resulting in their condition deteriorating significantly before they receive their first treatment. Simply put, too many children and young people face a postcode lottery in relation to their access to CAMHS. The Government's target is that 90 per cent of children and young people reporting mental health problems should be seen within 18 weeks. However, last year, only 73 per cent of children were seen within 18 weeks. Across the country, there was a huge variation in waiting times. NHS Grampian only had 33 per cent of children, young people being seen, and in Lothian there was only 57 per cent. We must ensure that we improve the provision of CAMHS across Scotland to guarantee that all children and young people are given a service that gives them the appropriate level of support for their condition no matter where they live. In Scotland, we should do more to identify and support individuals suffering from eating disorders, particularly children and young people. As a starting point, we must work to improve general awareness of the discrete physical and psychological symptoms of eating disorders and support greater investment in child and adolescent mental health services to reduce the waiting times and to reduce the geographical discrepancies in provision. I thank Claire Hawkey for bringing this important issue to the chamber for discussion this evening. I associate myself with her moving comments on the experience and contribution of our former colleague Dennis Robertson. The motion reminds us that eating disorders are serious mental health conditions that have psychological, social and physical effects on those who suffer from them. Often, those effects are not clearly recognised by those who suffer from an eating disorder or those closest to them. As Stuart Stevenson noted and Mary Fee too, a recent survey by the charity Beat found that 34 per cent of adults could not name a single symptom of an eating disorder, reflecting the fact that those illnesses are not widely seen to be mental health conditions. Symptoms are often not directly related to someone's physical appearance or weight, which may not always dramatically change, but it is revealed in their behaviour from being secretive about what and when they eat, to social withdrawal, excessive exercising and displaying feelings of guilt and shame around food. A person's symptoms may also not be neatly classified as anorexia or bulimia but overlap multiple areas and be an unspecified eating disorder. Better understanding of the symptoms and range of disorders can help family and friends, support their loved ones and encourage those with an eating disorder to seek help. We must also change our view about who is affected by eating disorders. Around 10 to 15 per cent of patients are men and boys, though it is likely that a large number are not reporting their symptoms in the belief that those are illnesses that affect women only. Black and minority ethnic populations are also likely to be under reporting their symptoms. There remains a high level of stigma and shame around eating disorders that prevents people from coming forward. I applaud the work of the charity Beat Scottish Eating Disorder Interest Group and CME Scotland in supporting people to open up about their mental health and providing a wealth of resources to understanding eating disorders. In yesterday's healthy weight strategy debate, it was clear that there is growing awareness of the need to address issues around under- and overeating with the utmost compassion. I warmly welcome that. The resources that the organisations that I have mentioned have emphasised the importance of supporting someone with an eating disorder in a compassionate way. However, just as important is to support the family members and the loved ones of those who are affected, reducing carer stress can make a big difference in speeding up recoveries. For where carers are able to model self-reflection and self-care, it is easier for an ill person to treat themselves with kindness. I welcome the Scottish Government's 10-year mental health strategy and note its target to create a digital tool to support those with an eating disorder. I would be interested to hear more detail from the minister on what that tool might offer and when it might be delivered. However, there is a very urgent need to reduce the time that it takes for someone with an eating disorder to receive professional mental health treatment. Beat estimates that, on average, it takes sufferers 18 months to become aware that they have an eating disorder. It can then be another year before they seek help from their loved ones. A further six months can pass before they approach their GP. It can be around three and a half years before they receive specialist treatment, which is why the figures suggesting that only one in three requests for CAMHS are being met within the 18-week waiting time target are particularly worrying. The research is clear that, the earlier the intervention from health professionals, the easier it is for a young person to recover from an eating disorder, anorexia becomes much more difficult to treat after three years, so it is imperative that waiting times are kept at a minimum. Guidance in England has a target for waiting times for treatment of an eating disorder for those aged under 18 to be reduced to four weeks by 2020-21. I hope that the minister will reflect on those concerns and consider including actions to reduce the time to receive treatment in any future revisions to the mental health strategy for both young people and adults. I wish to close by thanking the efforts of all those involved in raising awareness of the condition in running eating disorders awareness week and their work to help people into recovery. I thank Clare Haughey for paying tribute to the work that she does, not just in this area, but in many aspects of mental health and the immense professional expertise that she brings to the chamber. Joanne Lamont, in yesterday's debate around the healthy weight strategy, drew the stark corollary that exists between those two debates and reminded us that we spend a great deal of time in the chamber debating things such as obesity, but very seldom do we address important aspects of the issues that we are discussing today. It is also linked to many debates that we have in this place around mental health, around pressure in the NHS and, to the member's debate that happened a couple of months ago in the name of Gail Ross, about adverse childhood experiences, because dramatic significant life events can be a trigger to any one of the four types of eating disorders that we have heard about today, whether that is about times of traumatic experiences that are beyond a person's control, that sometimes there is a grief response in eating disorders, that they are a subliminal attempt by a person to regain some control of their life. We also see that relationships can be a cause, whether that is through a response to abuse or as a tool of coercive control, an aspect of coercive control in an abusive relationship. We know that personality types and genetic factors are part of the reasons behind eating disorders, but it is societal pressures that I find most egregious to a certain extent. In some respects, we are most empowered as a chamber to do something about it. We are all familiar with the pictures of airbrushed supermodels that we see in magazines, or the narrow punishing idea of what beauty should be in this society. That is amplified by the body shaming that we see, particularly in tabloid newspapers every week, where privacy is invaded, photographs are taken without permission and then exploited for some kind of sensationalist journalism. That is met with a peer pressure that we see in the rise of online bullying, particularly in the advent of social media. We have heard a lot about the statistics, but they bear repeating that 1.25 million people across the UK will experience some kind of eating disorder, but the impact of that is much wider. Anyone who has a family member with a mental health issue of any kind will know just the strain and the anxiety that that can cause to them as well. The group beat that we have heard a lot about today has launched the campaign hashtag, Why Wait? It is very important, because it brings attention to the fact that there is that 3.5-year average treatment time between the start of a disorder and first-line treatment. I want to thank those in my constituency, Louise Allen and Louise Gibbon, who have brought that to my attention, which is something that I did not know before. In Scotland, that is compounded by the two-year weight that we have in some parts of this country for first-line treatment in child and adolescent mental health services, in a lack of tier 4 inpatient bed capacity. As our chief medical officer described to the health committee in what she calls an atlas of variation, that postcode lottery that exists, I think that that is absolutely made clear by the advent of a formation of a peer-led eating disorder in support group in Orkney, where there is no actual provision of services. We need a transformational investment in mental health. That is the first line in our response to that. We need to ensure that each health board, each of the territorial health boards in this country, offers some meaningful provision in this area. We need to build awareness in our society, but we also need to challenge our society as well. We need to address the body-shaming that goes on, for which many outlets are complicit, and we need to make it clear to people that there is help, but we only need to ask for it. Can I say to the chamber that I have four members who are still wishing to speak in the debate? I am therefore minded to accept a motion under rule 8.14.3 that the debate be extended up to 30 minutes. I invite Clare Haughey to move that motion. Are we all agreed? I now call Rona Mackay to be followed by Jeremy Balfour. I thank my colleague Clare Haughey for bringing this important debate to the chamber and for raising further awareness of a condition that has affected many people for decades, but, as Clare Haughey says, has often been misunderstood. I think that most of us will know or have known someone from their past who has suffered from an eating disorder. I have to say that I am learning tonight from this debate about the many variants of eating disorders that I was unaware of before. Two of my school friends suffered from anorexia nervosa through their teens, and it has dogged them all their lives. Back then, very little was known about this terrible condition. It was scary watching your friends almost fade away before your eyes. I now know that those friends had suffered adverse childhood experiences. One girl was teased mercilessly in front of the entire class by a sadistic teacher about her appearance and build. She was hospitalised when she reached four stones and just pulled through. Her body was so damaged that she became infertile. Stuart Stevenson, Alex Cole-Hamilton and, yesterday, Joanne Lamont in yesterday's debate on healthy weight and obesity made excellent points. The mentally damaging culture, which glorifies thinness, resulted in body dissatisfaction, which mainly affects young girls and has devastating effects. Societal attitudes must change to allow our youngsters to feel happy in their own skin without having to conform to some unrealistic notion of what looks good. What are eating disorders? One definition of it is extreme shape and weight control behaviour, which leads to the development of rigid rules about food. The most common, I believe, being anorexia nervosa and bulimia. I think that the word control is key here, taking control of your body in the worst possible way. We know that psychological factors are a huge cause of eating disorders and they are common amongst those who deal with depression, anxiety and obsessive compulsive disorder. They can develop due to a combination of factors such as genetic, biochemical factors. People with eating disorders usually have abnormal levels of chemicals that regularly appetite, mood, sleep and stress. For example, it is known that people with bulimia and or anorexia have higher levels of the stress hormone cortisol. As I mentioned earlier, if a person experiences ACEs or other traumas in their childhood, they are more likely to use eating disorders to cope. However, one size does not fit all, and sometimes a child who experiences a happy childhood with loving parents can be affected for no obvious reason. At this point, I would like to pay tribute to former MSP Dennis Robertson. When it comes to statistics, clinicians rarely publish many about eating disorders because the stats can be misleading because so many people affected are not receiving treatment, as Claire has said. Statistics are tentative. However, we know that anorexia nervosa affects on average about 1 in 250 females and 1 in 2,000 males, and it has the highest mortality rate of any psychiatric disorder of adolescents. However, to conclude on an optimistic note, I am delighted that the Scottish Government has announced new resources to give young people and families peer support. I am sure that we will hear more from the minister about that at the end. An online peer support tool that allows young people to pair with a trained volunteer who is recovered from an eating disorder such as anorexia or bulimia. To all those struggling with the condition at the moment and to families that are lost to know how to support their daughter or son, there is light at the end of the tunnel and, hopefully, the dark days of confusion and fear of how to cope with this terrible condition are coming to an end. I thank Claire Hawke on bringing this issue to the attention of the Parliament tonight. I first became aware of this issue as a young teenager when I attended a family funeral of a girl lady who had died of an eating disorder, brought up in her loving family for different reasons the disease got her and ultimately led her to death. As Mary Fee is absolutely right, what we need to do is ensure that eating disorders and identifying the symptoms are on everyone's radar. Too often, people are simply unaware of it. As a father of two young girls, I want to make sure that I am looking at her, them and their friends to make sure that, if the symptoms do come, I am aware of them. This year's eating disorder awareness week campaign asked the question, why wait? I think that that is an absolutely valid question. The eating disorder charity Beats which has already been mentioned states that averaged nearly three years past before those experiencing eating disorder symptoms seek help. As Alison Johnstone said, it becomes harder to treat that condition with that delay. On top of that, a YouGov survey revealed that more one in three adults in the UK who were given an answer could not name any of the signs or symptoms of eating disorders. The low level of awareness combined with delayed treatment is resulting in an increased risk of the illness becoming severe and enduring, and some very sad cases lead into an early death. Alison Johnstone again picked up the point that there are services coming out that show that perhaps 25 per cent of people with a decent or eating disorder are male. We need to recognise that and we need to deal with it in an appropriate way. The causes of eating disorders are complex. They may be linked to social pressure to be thin as others have pointed out. There may be mental health issues, there may be issues within somebody's former life, but eating disorders however they come about are serious and, ultimately, they are a mental illness and need to be treated quickly and juted appropriately. I welcome the Scottish Government's mental health strategy, recommendations to support the development of digital tools to support young people with eating disorders, and I too wonder whether the minister can give more details on that in her closing speech. The Scottish Government has waiting time targets for access to NHS child and adolescent mental health services treatment, but, as we have heard already this evening, there is not an accurate picture across the whole of Scotland and, depending on your health board, you do get different forms of times. I encourage the Scottish Government to work with the health boards to ensure that they are meeting the target as clearly early intervention is key in the treatment of young people with eating disorders. As we approach international women's day on 8 March, I urge all of us to use this important day to help and encourage teenage girls, young women and ladies of our age to challenge the view that is often portrayed in the media and social media when, in order to be successful, accepted or attractive, you must be skinny. Let's stop that expectation and, instead, support women of all ages to redefine success in healthier ways for them and for the rest of society. I add my congratulations to my colleague Claire Hawke for securing this debate during eating disorders awareness week. I would also like to pay tribute to members of Scotland's eating disorder interest group, who I know were intending to be here for the debate today, as was former MSP Dennis Robertson, who deserves enormous credit for his heartfelt and continued campaigning on the issue. As a fellow nurse with Claire Hawke, Dennis asked us both to help carry on his work. Immediately after tonight's debate, I was going to be sponsoring an event highlighting the work of sedage. Unfortunately, the red weather alert and the snow have prevented that from going ahead, but I am hoping to reschedule as soon as possible, and I hope that, when we do, members present here tonight will be able to come along as will Dennis. Please visit sedage's website, which includes conferences and events to support persons and carers. The next event is March 10. Prior to the debate tonight, sedage passed me a written account of anorexia from the point of view of a woman called Hazel. One of the things that struck me reading Hazel's account was the difficulty that she encountered when health professionals engaged with her because she did not look thin enough. She was misdiagnosed as having a personality disorder by a psychologist because she was not thin enough and she faced lengthy waiting times for counselling on the NHS for the same reason. Clearly more needs to be done to educate people about the reality of how eating disorders manifest themselves so that help can be offered as quickly as possible. I saw a similar case when a constituent of mine, whose daughter suffers from an eating disorder, was told that she would have to wait six months to see a psychiatrist. That is not optimal, especially as we know that early intervention is key to tackling the disease. As a person with type 1 diabetes, one condition that I am very well aware of and would like to highlight is diabilemia. Diabilemia is a common term used among diabetes community and although it is not officially recognised, it is a very real eating disorder. Diabetes Scotland is doing important work to raise awareness and my colleague Annie Wells, MSP, led a member's debate on the subject last year. Diabilemia refers to an individual reducing their insulin or not taking insulin at all in an effort to control their weight. I knew a young lady when I was growing up who sadly died of the condition. She would have been my age today if she had survived. Diabilemia is incredibly dangerous. Research shows that people with it have a much shorter lifespan. It can lead to severe diabetic ketoacidosis, or DKA, which can be fatal. It can also cause complications of diabetes, such as retinopathy, neuropathy and nephropathy, appearing much earlier. It is difficult to diagnose and extremely complex in its condition. People with diabilemia require mental health support over and above the physical medical needs associated with diabetes. I am aware that NHS and Freeson Galloway has a diabetes dietician with a special interest in diabilemia, so that is good news for Freeson Galloway. Research that emerged last year from Toronto suggested that 60 per cent of females with type 1 will have experienced a clinically diagnosable eating disorder by the age of 25, and it can affect men, too. Like any eating disorder, it is a mental health issue, so healthcare professionals and the family and friends of those with type 1 diabetes should be aware of the signs that could indicate diabilemia. Diabetes Scotland suggests that they can include weight loss or fluctuation in weight, regular symptoms of high blood glucose levels, secrecy or fear of injecting, reluctance to be weighed and lack of blood glucose monitoring or reluctance to self-monitor. It is important that healthcare professionals are aware of diabilemia as a condition. I would ask the Scottish Government that when they consider their approach to eating disorders, I would ask that measures are put in place to ensure that sufficient time, resources and training are available to enable diabetes healthcare professionals to identify and support people with diabilemia effectively. I, too, would like to thank Clare Hockie for bringing this debate forward. As you know, Presiding Officer, I had not planned to speak in this debate, but at the prompting of quite a few constituents who contacted me, I decided to, albeit very briefly, make a plea. I doubt that there are many of us who do not have a family friend who have experienced the distressing fact of having a child with an eating disorder. A great friend of mine watched helplessly as their child starved themselves to a state where doctors judge their child's life to be in danger. Despite all that they did, they could not move their child from their self-destructive actions. Actions were more about the child's wish to take control of their life as they felt the rest of their life was spiralling out of control. Warm words, supervision, support and counselling do not always work, and sometimes it is only when the individual's BMI gets so low on their weight plummets that medical care becomes available. I therefore like to make a plea in this week, which highlights eating disorders, that we do more to support families who struggle to cope as they watch their child waste away in front of them. I would also like to make a plea that we tackle the problem head on with compassion, support and early intervention. I stress early intervention when it is asked for. Sadly, I am not convinced that early intervention is widely available, as it should be, especially in rural areas and the islands. Hopefully, that will change and that we can reduce the three and a half years, which it takes on average for treatment to be given, post the diagnosis of an eating disorder. We can dramatically reduce that, and I give you an undertaking to the Government that I will do everything that I can to support you if you do this. Thank you very much. I call on Maureen Watt to close for the Government minister. Seven minutes are thereabouts, please. Thank you very much, Presiding Officer. I am pleased to be able to respond to this debate on behalf of the Scottish Government. I congratulate Clare Hockey in continuing this Parliament's long-standing interest in eating disorders. It is disappointing that, due to adverse weather conditions, we are not going on to the reception that Emma Harper was hosting tonight. I look forward to it happening later on, but I do see that we have some people in the gallery listening to the debate now. As Clare said, Dennis Robertson had hoped to be here this evening. He was down, but has gone home because of the weather. As has been said, Caroline died seven years ago this week, and as the neighbouring MSP to my constituency, I can assure Dennis and others that he has seared eating disorders in my brain. I welcome the opportunity to mark eating disorders awareness week, and it is right that we recognise the efforts of all the people and organisations across Scotland involved in raising awareness and treating eating disorders. The motion recognises the valuable contribution that is made by BEAT, the United Kingdom Eating Disorder Charity and the Scottish Eating Disorder Interest Group. I know that there are many others. I am in no doubt about the seriousness of the condition and the impact that it has on those individuals who are living with an eating disorder and on their friends and families. Emma Harper mentioned diabolemia. As was said, we debated this topic last year with the cabinet secretary. It highlights the importance of health professionals looking at the physical and mental health conditions together and that health professionals look at the whole person when people present with an eating disorder and why it is obviously a mental health condition that has triggered that. It is the guiding ambition of our mental health strategy that we should only have to ask once and get help fast and that we must prevent and treat mental health problems with the same commitment to passion and drive as we do physical health problems. The strategy commits to specific actions to help improve prevention and early intervention, drive improvement in the quality of care provided, ensure equal access to effective and safe care and treatment and ensure services promote and support recovery-based approaches. We will best demonstrate equal access to effective and safe care and treatment by increasing the proportion of people who receive and benefit from treatment from a mental illness. Several speakers mentioned the stigma surrounding eating disorders, including self-stigma. The CME campaign, funded by the Scottish Government, is instrumental in realising through its work the importance of reducing stigma and discrimination. Better identification and early intervention for eating disorder, together with a reduction in stigma, and a greater willingness to seek treatment will inevitably lead to greater demand. It is excellent that Beats campaign this year is called why wait. Why are people waiting so long to access treatment for this condition? It is important that more people realise the signs and actions and behaviours that those with eating disorders are taking. The increased demand in services means that we must all work together if we are to meet our ambition for a sustainable health and social care system that helps to build resilient communities to be realised. Through delivery of the strategy, we seek to improve access to psychological therapies and treatment for children and young people. There are significant on-going challenges, I admit, in delivering on the waiting time standards. I do not shirk from that challenge. We have made progress, and it is important to recognise that. Some boards are making significant efforts, as Clare Hockey mentioned, to drive down waiting times. I can assure Mary Fee and others that I am very concerned about waiting times. I am in the process of meeting the worst performing boards, chief executives and chairs right now—a few have cancelled because of the weather. I mention that Alison Johnstone compared us to England's commitment. England's commitment is not coming in until 2020. We are working now to meet our commitment to ask one's get help fast. We are not waiting to start work on that. Alison Johnstone's point was that the English commitment to a four-week waiting time is notably shorter than the current Government commitment. There are many people in the region that I represent in Lothian who are not getting an appointment within the 18-week waiting time. That was the point that I was seeking to make. I appreciate that it will not happen tomorrow. I can assure the member that, for many boards, the mean waiting time is much lower than the 18-week waiting time. Some are down as low as nine weeks and some people who are seriously getting help much, much faster than that. However, I accept that we need to do better. I am keen to ensure that the work that is being taken forward to deliver improvements at a local level fully reflects national mental health priorities and ambitions. The motion also highlights the mental health strategy action that several members have mentioned to develop a digital tool to support young people with an eating disorder. I was delighted to launch the action earlier today at the Royal Edinburgh hospital. It is a resource that meets the action 22 in the mental health strategy. I can assure Annie Wells that it is available across Scotland. If she visits www.caredscotland.co.uk, she will be able to see what is available there. There is one-to-one email support. There are befrenders available, from whom you can expect one to three emails per week, a listening ear, encouragement and sign posting. I can leave her one of those leaflets if she wishes. The tool is funded by the Scottish Government. NHS Lothian in partnership with Beatt have developed the resource, and tech has also been involved. In launching it today, I met parents who were involved, people who have recovered, who are involved, along with many of the CAMHS professionals at the Royal Edinburgh, who have all been involved in the resource. It aims to provide an innovative forum and a training resource to promote early intervention for children and young people and to support people to manage their own mental health. We know that, as with most health conditions, quick and timely access can really make a difference. We also need to ensure that we have services that reflect the digital lifestyles that many have now. I think that this resource will actually do that. I make no apology for repeating what I said at the launch earlier today. Development of this resource has demonstrated the boundless ability of our partners in the mental health system, in the third sector, and people with lived experience to think creatively and innovatively about how we can improve mental health and our response to eating disorders. It is that kind of spirit and co-operation that will help us to achieve the wider ambitions of our 10-year mental health strategy. On that note, I thank Clare Hocky for raising the important issue and allowing me to reaffirm our commitment to improving the quality of life for all those living with an eating disorder.