Healthy Start, Healthy Scotland Campaign

– in the Scottish Parliament on 3rd November 2015.

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Photo of John Scott John Scott Conservative

The final item of business is a members’ business debate on motion S4M-14431, in the name of Mark McDonald, on welcoming the healthy start, healthy Scotland campaign. The debate will be concluded without any question being put.

Motion debated,

That the Parliament welcomes the Royal College of Psychiatrists in Scotland’s Healthy Start, Healthy Scotland campaign, which raises awareness about the importance of mental health for pregnant and post-natal women and their infants; understands that one in five women develop a mental illness during pregnancy or in the first post-natal year; notes the evidence that early intervention for mothers can encourage healthy cognitive and emotional development for infants; recognises that there is positive work being done by organisations across the public and third sector across Scotland, including in Aberdeen Donside, in facilitating early interventions, and commends the campaign’s focus on breaking through medical barriers and working holistically with practitioners on many aspects of mother, infant and family care.

Photo of Mark McDonald Mark McDonald Scottish National Party

I being by expressing my gratitude to the members across the Parliament who supported my motion and enabled us to have this important debate. The healthy start, healthy Scotland campaign was launched at a meeting of the cross-party group on mental health, which I co-convene alongside Mary Scanlon and Malcolm Chisholm. At that meeting, I said that I would seek an opportunity to debate the issue in the chamber, and here we are. Never let it be said that I am not a man of my word.

The campaign is aimed at improving awareness among professionals and the public of maternal mental illness, reducing the stigma surrounding mental health problems for mothers and increasing professionals’ confidence in detecting and treating maternal mental illness. To drive that forward, the Royal College of Psychiatrists in Scotland aims to hold public events with professionals, politicians and the media, and to ensure that practitioners who work with mothers and children are aware of the issues that relate to maternal mental health problems and work holistically to address them. It will seek to establish an interfaculty group and links to other royal colleges and to host a round table that brings together representatives of parents and children, voluntary agencies, statutory early years agencies and professional organisations to share best practice across Scotland.

One woman in five will develop a mental illness during pregnancy or in the first postnatal year and, beyond that, seven women in 10 will hide or underplay the severity of their illness. One in two women who experience depression in the perinatal period will go undiagnosed—while one in five will develop a mental illness, only one in two will be diagnosed. The term “postpartum depression” is most commonly used, but maternal mental health problems can also include anxiety, obsessive-compulsive disorder, post-traumatic stress disorder, bipolar disorders and postpartum psychosis.

We often talk about the baby blues, but those problems are considered to be separate from postpartum depression. The baby blues are a feeling that affects about 70 per cent of new mothers—a feeling of despondency that occurs after the birth of a baby. Often, however, the two terms are conflated, which can be unhelpful.

We know that inequality is correlated with poor maternal mental health. Postnatal depression can occur in any mother, regardless of income, but we know from Scottish Government figures that 6 per cent of the highest-income mothers were found to have poor mental health compared with 24 per cent of the lowest-income mothers.

The Scottish Government’s growing up in Scotland reports have shown that children whose mothers were emotionally well during their first four years have better social, emotional and behavioural development than those whose mothers had brief mental health problems, so as well as this being an issue for the mother, there is an impact on children that has to be borne in mind. About 5 per cent of children aged five to 10 are thought to display problems that merit mental health diagnosis, which is of concern to all of us. However, treatment is available for both mothers and children. We need to ensure first that people come forward for diagnosis and then, once they have achieved diagnosis, that the most appropriate treatment is available.

Work is being done with families across Scotland, and it is not just about treatment. I highlight a project that is being undertaken in Aberdeen and which merits a mention. One of our duties as MSPs is to highlight positive examples from our areas. Four organisations have come together in Aberdeen to form a family support network: the family learning team, Aberlour Child Care Trust, the Scottish Childminding Association and Home-Start Aberdeen. Their integrated working strategy has reduced duplication of services and enabled the third sector to work closely with national health service midwives and health visitors to ensure appropriate referrals and targeting of support.

Home-Start has supported 115 families since 1 April this year. It works closely with health visiting teams, which 80 per cent of its referrals come from. It provides support from peers who are mostly parents, who are matched with an individual family who they visit weekly. More than 80 per cent of its referrals in Aberdeen are made as a result of a mental health issue arising or involve a mental health issue, more than 90 per cent of which are related to isolation, which impacts on the mother’s mental health and on the child, who does not have the opportunity to socialise with their peer group.

The Aberlour service supports parents who are affected by substance abuse issues and parents with learning disabilities. Referrals are made through social work. The Scottish Childminding Association provides a community childminding service; in Aberdeen, that allows parents to access up to 72 hours of free childminding to support them, which is invaluable for many families. The family learning team can provide one-to-one, in-the-home support for parents with children aged nought to three or support programmes in small groups for parents with children aged three to eight. Fantastic work is being done out there.

One thing that led me to bring the debate to the chamber was that I wanted to reflect my experience. Following the birth of our second child, my wife went through a period of postnatal depression and I saw at first hand the effect that that can have, not just on the individual but on the family unit. One of the difficulties, which I referred to when I talked about Home-Start, was that my wife became isolated. She lost the confidence to go out and interact with other family groups and, therefore, the opportunity to get my daughter into situations where she would meet other small children.

Two things helped. One was a local coffee morning, which my wife attended regularly and which enabled her to interact with others outside the home environment. When my son was in education and I was down here in Parliament, my wife found it difficult to get out of the house. The other thing that helped was a local toddlers group that we took our daughter to, which enabled her to have social interactions and meet her peer group.

That is why I was taken by the Scottish Association for Mental Health’s recent remarks in the press about the benefits and possibilities of social prescribing, which are particularly relevant to maternal mental health issues, where isolation, an inability to socialise and the feeling that they cannot reach out to other mothers for fear of stigmatisation can often grip those who are affected.

There are examples of good work out there. It is a question of making sure that the dots are joined up and that we in the Parliament do all that we can to support our constituents who are affected by such issues and to ensure that they get the support that they deserve.

Photo of Jenny Marra Jenny Marra Labour

I congratulate Mark McDonald on securing this important debate, which brings a focus to this important area of mental health, and on sharing so eloquently his personal experience, which is never easy.

Every expert, every report and every piece of advice that we are given about tackling child poverty and other social injustices tells us that we should invest in the early years. The healthy start, healthy Scotland campaign has reminded us of the importance of the early months, weeks and days.

We know much more today than we did in the past about postpartum depression and anxiety and about the challenges that women face in the first year as a mother, often while feeling quite alone. Despite that, it is clear that we still face a significant challenge in ensuring that women have the support and care that they need, that the symptoms are noticed and that there is awareness of the issues.

It is estimated that

“One in two women who experience depression in pregnancy or the postnatal period will go undetected and untreated.”

We are only now discovering the full impact on children of mental health problems in that crucial time. The relationship between mother and baby, and the early bonds, are vital to the optimal development of the child’s brain and can shape social, emotional, cognitive and language development. Because of the nature of mental health problems at that time, it can be all too common for the signs to be missed and for care not to be in place to help both mother and baby. Awareness of and support for maternal mental health are vital to giving all children the best start in life.

We welcome this significant report by the Royal College of Psychiatrists and the broad support that it has received across Parliament. It contains a modest set of proposals that could make a big difference to families and to the lives of many women and children. I am sure that there is a broad consensus throughout the chamber for the actions that the report suggests. I look forward to hearing more speeches, including those from the Government benches, on what can be done. We are ready to work with the Government to achieve our shared goals.

Photo of David Torrance David Torrance Scottish National Party

I, too, congratulate Mark McDonald on bringing the motion to Parliament.

I commend the Royal College of Psychiatrists for its efforts to raise the issue of mental health among new and expectant mothers through its healthy start, healthy Scotland campaign. Although mental health is complex, those issues can be mitigated with the proper awareness and advocacy, which the RCP seeks to foster.

I would like to focus, in particular, on the problems surrounding the diagnosis and treatment of mental health issues affecting new mothers. I start with the diagnosis. The Royal College of Psychiatrists reports that

“One in two women who experience depression in pregnancy or the postnatal period will go undetected and untreated.”

According to the national health service, postnatal depression is one of the most common mental health issues affecting new mothers. Symptoms include inability to sleep, irritability, tearfulness and fear of failing as a mother. However, one of the main challenges surrounding postnatal depression is that those symptoms are not always noticeable to an observer or even to the mother herself. Women who are affected by the illness often perceive those symptoms as a product of exhaustion and stress and, because they do not connect their symptoms to postnatal depression, some women do not seek help. As a result, issues for new mothers persist much longer than necessary.

According to the Royal College of Psychiatrists, some women also fear the judgment of others—they are worried about the stigma that surrounds mental health issues and about being deemed unfit mothers. That is why it is essential that we raise awareness of prenatal and postnatal mental health. We can show mothers that help is available and reduce the social stigma.

The problems surrounding diagnosis connect to my second point: the treatment of mental health for mothers. I am proud to say that there are several organisations in my constituency that address the issue and support new mothers. Volunteers from Home-Start Kirkcaldy provide weekly support to any family in need, including mothers who are suffering from postnatal mental illness. Our local branch of Carers Trust Scotland provides further counselling and support. Fife Gingerbread provides not only support after the birth of a child but counselling during pregnancy to try to prevent mental health issues once a child is born. Those services are invaluable to those who use them.

I was concerned, however, to learn that primary support groups for postnatal mental illnesses have a larger presence in England than in Scotland. For example, the PANDAS Foundation, which runs support groups for mothers who are coping with postnatal mental illness, sponsors 31 support groups in England and only five in Scotland. It is clear that there is a need for greater awareness, advocacy and action on the issue in Scotland. I have no doubt about the dedication of the staff and volunteers of those organisations in Scotland and that, in the work that they do, they will continue to highlight this important issue and seek to develop their services even further. However, I feel that it is essential that community support be aligned with medical treatment.

Mental health requires professional care and treatment that can be given only by a physician. In fact, the RCP reports that 25 per cent of mothers who suffer from postnatal mental illness and do not seek help do not recover by the time that their child is one year old. That places a great deal of strain on the relationship between mother and child and can ultimately affect the child's development.

Early intervention and treatment facilitate recovery for a mother and a healthy start to life for a child. Additionally, it is crucial to involve physicians, mothers and family members in the treatment. In talking about the importance of early intervention, I draw attention to one of the RCP’s action items regarding its healthy start, healthy Scotland campaign, namely its desire to establish links with other royal colleges in the United Kingdom. By co-operating with organisations such as the Royal College of Obstetricians and Gynaecologists and the Royal College of Paediatrics and Child Health, the RCP can better ensure that new mothers and infants will receive the care that they need. I believe that that move will increase cohesion in antenatal and postnatal healthcare, and will benefit mothers and children.

I fully support the RCP’s healthy start, healthy Scotland campaign and its attention to the mental health needs of new and expecting mothers. I am pleased to see that the organisation is taking steps to provide essential care to help mothers, their families and their new babies.

We should send the clear message to all mothers that postnatal illnesses are easily preventable and treatable. Only by achieving greater awareness of mental health issues will we create a brighter, healthier future for Scotland.

Photo of Mary Scanlon Mary Scanlon Conservative

Like others, I thank Mark McDonald for securing this debate on improving the mental health of mothers and babies. He gave a commitment at a meeting of the cross-party group in the Scottish Parliament on mental health to raise the issue in a members’ business debate, and I say well done on that point. For my part, I committed to submitting parliamentary questions. I very much regret to say that the responses to my questions were disappointing and a bit dismissive. I only hope that we get a more favourable and positive response to today’s debate.

I commend the Royal College of Psychiatrists in Scotland for its initiative and for stating that much needs to be done to support mothers and babies across Scotland in terms of improving maternal early years mental health as a clinical and mental health priority. The RCP states that the cost of not treating maternal mental illness is £8 billion, so any investment in diagnosis and support will be money well spent.

There is probably not much new knowledge in the briefing paper and the research. What is needed is the will to put the measures in place, get health professionals and others to work together and ensure that mental health, at this critical time in a child’s development, becomes the priority that it has not been in the past.

It is understandable that depressed mothers find it difficult to give their babies the security that they need. There is also increasing evidence that social relationships in early life have a crucial influence on the infant brain—Jenny Marra alluded to that—and the relationship between infants’ attachments and their brain anatomy and biochemistry is now well established. Brain development is dependent on strong, early bonds with the infant’s main caregiver—most often their mother—and the relationships that an infant makes in early life form the bedrock of their future development.

We are currently considering legislation on attainment in schools. However, as can be seen from this debate, we do not need to wait until a child gets to school. Intervention at the antenatal and postnatal stages, with the appropriate support for mother and child, could bring many benefits. We have all heard of some children who are 12 months behind in terms of their development when they start school, which makes it difficult for them to catch up with the rest of the class. We know that it is in the first year of life that the interaction with the primary caregiver shapes the infant’s social, emotional, cognitive and language development.

However, untreated mental health does not have only a financial cost. The longer-term effects on the child’s cognitive and emotional development can hugely affect their educational attainment, their life chances and their opportunities. It is therefore surely preferable and more effective to prioritise early work with infants and their mothers than it is to even attempt to reverse harm at a later stage.

The RCP states that one in two women who experience depression in pregnancy or the postnatal period will go undetected and untreated, and many for whom depression is detected are not offered the option of being accompanied by their babies if they require in-patient care. That is quite unacceptable, because they are supposed to have a right to be accompanied by their babies. However, it is also unacceptable that few mental health services in Scotland specifically address the needs of infants and focus on the mother-infant relationship.

I lost a very dear friend who struggled to cope with postnatal depression and left two very young boys. I am sorry to get emotional—today has brought it back to me. It was difficult for her. She worked in the NHS, had a staff of 20 or more people and, because she was so good at her profession, found it difficult to admit that she could have a vulnerability. She felt weak and something of a failure.

The royal college’s campaign to improve awareness is welcome. The main thing is that it is not only the Royal College of Psychiatrists; it links with the other royal colleges in Scotland, such as the Royal College of Obstetricians and Gynaecologists, the Royal College of General Practitioners and the Royal College of Midwives, as well as the Royal College of Paediatrics and Child Health. The campaign brings them all together, which is needed to improve detection of mental health and attachment issues and look forward to the future.

There is not a good record of public agencies working together for seamless assessment and care. However, what the Royal College of Psychiatrists proposes can be made to happen. It does not cost a lot of money; it simply brings people together and makes mother and baby mental health the priority that it should be.

Photo of Bob Doris Bob Doris Scottish National Party

As others have done, I congratulate Mark McDonald on securing this important debate. I am proud to join the Parliament in welcoming the Royal College of Psychiatrists in Scotland’s healthy start, healthy Scotland campaign.

I am deputy convener of the Health and Sport Committee and we have focused on the health of mothers. Perhaps we should focus on it more often, but we have considered aspects of it, whether the benefits of the family nurse partnership, our inquiry into teenage pregnancy and the impact that that can have on mothers’ mental health or the groundbreaking work that local authorities and the Scottish Government are doing together in the early years collaborative.

A lot of things are happening, but it is particularly poignant for me to take part in the debate, because I will be a father for the first time in February next year. My wife is due to give birth then, so I hope that maternal mental health will flourish and be positive for me and my family but, as Mary Scanlon points out, we can never take anything for granted in this life. None of us, whether mothers or others, should neglect our mental health. Therefore, speaking in the debate is of particular importance to me.

The campaign is an important initiative to raise awareness of mental health problems that many expectant and current mothers face each year. I was going to put a number of statistics in the Official Report, but they have been pretty well aired. Needless to say, unfortunately, not every pregnancy will be a positive experience. The emotional, physical and psychological stress of carrying a child, as well as the financial costs of pregnancy and of raising that child, can wreak havoc on the emotional wellbeing of pregnant and postnatal women.

The Centre for Maternal and Child Enquiries has established that mental illness is one of the leading causes of maternal death in the UK. That is why such a campaign is crucial in raising awareness and is worth prioritising. By encouraging and providing resources for early intervention, we can not only reduce rates of mental illness in mothers, but save lives.

I will mention an organisation that works in my locale and does fantastic work throughout the country: Home Start. It provides practical and emotional support for women, families and children under the age of five through volunteer visits that encourage families to widen their support networks and help them to take advantage of resources and opportunities that the community provides. It is a non-judgemental service and a non-statutory service. At its heart, Home-Start Glasgow North, which is the branch of Home-Start that I know best, is about building relationships. I was proud and privileged to speak at its annual general meeting just a few weeks ago. Its work to help mothers across the north of Glasgow—in Maryhill, Springburn, Royston and beyond—is exceptional.

A variety of organisations do equally fantastic work. I recently visited a parent and toddler group at Rosemount Lifelong Learning and, with reference to relationship building, I am pleased to say that some dads were there. There is also the positive Possilpark initiative, in which Barnardo’s, Stepping Stones for Families and other agencies are getting together to prioritise families in the area.

In the short time that I have left, I want to put another couple of points on the record. I would not forgive myself if I did not talk about the mental health of those who lose their unborn child through miscarriage. We should put on record the psychological and mental health impact that that can have on families.

I should also mention the inequalities that befall certain women and which are not just economic. If somebody has a strong support network, that does not mean that they will have strong maternal mental health, but it gives them a fighting chance to do better than those who do not have that community resilience. We should bear that in mind, too.

Fittingly, next year is the international year of the dad—I did not know that until a few weeks ago when I attended Home-Start Glasgow North’s AGM. Surely men have a significant role in ensuring that maternal mental health flourishes.

There is no rule book for being a mum or dad and there are no rights and wrongs. We learn from our mistakes. If we are lucky, we have a support network. Some people’s mental health will be impacted, but that does not make them a bad parent; it makes them vulnerable and in need of support. The debate, which was so ably led by Mark McDonald, draws attention to that fact. I have been delighted to share my experiences with members.

Photo of Jim Hume Jim Hume Liberal Democrat

I, too, congratulate Mark McDonald on bringing the debate to the chamber and the Royal College of Psychiatrists in Scotland on its healthy start, healthy Scotland campaign. We should also congratulate in advance Bob Doris and his very much better half on their forthcoming parenthood.

I have raised on a number of occasions the lack of parity between mental and physical health in Scotland. During a Scottish Government debate back in January, I pointed out the lack of parity in law. Ten months later, we still do not have legislative provisions that place mental and physical health on an equal footing. I have not stopped raising the issue and, of course, I will take the chance to do so again today.

Our discussion on the mental health of pregnant and post-natal women points to the increasing importance of guaranteed good mental health for all. The healthy start, healthy Scotland campaign makes provision for the earliest possible preventative measures for mothers and their infants. The briefing paper from the Royal College of Psychiatrists states:

“The early time after childbirth is a period of greater risk for severe mental illness than any other time in a woman’s life.”

That can unfortunately translate into damaged brain development of the infant, whose relationship with its mother is absolutely vital at that early stage.

Given that one in five women develop mental illness during pregnancy or in the first post-natal year and that one in four people in the overall population develop a mental health illness at some point in their lives, it is clear that we need to address the problem head on. If it is left untreated, it can have the most tragic of consequences, such as those that I and many members, including Mary Scanlon, know about. However, the good news is that effective treatments are available, so I urge the Scottish Government to make those preventative measures available to all. The UK Government, in its 2015 budget, announced £75 million over five years for perinatal mental health. I would like that to be replicated in Scotland.

The responses to a freedom of information request that I submitted to health boards showed a rise in need for psychological support for new mothers. One board saw its cases nearly triple, and, to quote the board,

“the apparent rise in cases reflects the creation of the specialist perinatal midwife position in that year, which increased mental health awareness in the service”.

We welcome that. That successful example of awareness and trust in the services for new mothers could be followed elsewhere.

The report marks a necessary step and, when it is adopted, it will have a positive two-fold effect. The first is good mental health for all, from the earliest start in life; the second is a gradual reduction in health inequalities that are compounded by poor mental health.

Mental health is not the starting point or the end point in reducing inequalities. It is, however, a major component that disproportionately affects people in the most deprived areas, who are five times more likely to have below average mental health than those in the least deprived areas. Yet, through deprivation, people still want to lead normal lives, work and have families. We need to ensure that every member of a family is able to access the right therapies at the right time.

Mark McDonald’s motion correctly identifies the importance of working holistically with practitioners across medical specialisations. Breaking down the singular concern of mental health for mothers and infants should be the guiding principle of those actions. The healthy start, healthy Scotland campaign is making the call for the right time to be early on for infants and their mothers.

I want to end by renewing my call for parity in law between mental and physical health. It is the next step that Scotland must take if we are to provide meaningful mental health treatments for mothers and their babies.

Photo of Jamie Hepburn Jamie Hepburn Scottish National Party

I join others in thanking Mark McDonald for bringing forward this subject for debate. I echo Jenny Marra’s comment that his bringing in his family’s personal experience added to the debate. Similarly, Mary Scanlon spoke of the experience of her friend, which was understandably very difficult for her to do, but I want to thank her for doing so. As Bob Doris has gone public, I join others to make public my congratulations—previously privately expressed—to both Bob and his undoubtedly much better half, Janet, as they prepare for parenthood.

I also welcome the Royal College of Psychiatrists’ healthy start, healthy Scotland campaign and I support the campaign’s aims. This members’ business debate continues the attention that our Parliament has focused on mental health. I am proud that we have that focus.

Mental illness, including perinatal mental illness, is one of the top public health challenges in Europe. With an estimated third of the population being affected by mental health disorders every year, it is rightly a topic that occupies us. We need to be as comfortable talking about mental ill health as we are talking about physical ill health. I think that the focus on debate and discussion in this Parliament is an important part of that process.

The Government agrees that good perinatal mental health is a vitally important issue. David Torrance spoke about how mental illness could affect new mothers. Of course, there is a common idea that when a woman gives birth, it is the happiest time of her life. We know that for many women, however, it can be an extremely difficult time.

Mary Scanlon mentioned that a couple of written parliamentary questions have been lodged of late, but she did not expressly say that I had answered them; I presume that I was the minister who answered them. If she feels that the written answers have been unhelpful and dismissive, that was certainly not my intention. That is never my intention with any answer that I give to a question and certainly not in this area, where I think that there is broad consensus, so I say to Mary Scanlon and any member who has particular concerns that if they want to discuss them with me anytime, they need only to ask.

My overriding expectation is that individuals will be treated according to their clinically assessed needs, with care and support put in place to respond quickly and appropriately to those needs. In Scotland, we ensure that general practitioners, midwives, health visitors and obstetricians have perinatal mental health education as part of their undergraduate training. NHS Education for Scotland will soon be launching a national resource—an online module on perinatal mental health that will have open access for staff in any sector. That, of course, is in addition to any local education that will be offered.

Our national mental health strategy and clinical guidelines for health professionals support mothers who are experiencing mental health problems and ensure that the NHS delivers safe and effective care to those who need it.

There is an issue with those who are not being identified, and Mark McDonald set out clearly the nature of the challenge. My expectation is that NHS boards should provide safe and effective care and services that support and respond to the needs of the individual. For women who are at high risk of perinatal illness, that includes the development of a detailed plan for their late pregnancy and early postnatal period. Psychiatric management of the plan should be agreed with the mother-to-be and shared with maternity services, the community midwifery team, the GP, the health visitor and mental health services in order to ensure that we take a cross-cutting approach.

Members including Mary Scanlon spoke about the importance of the connection between mothers and children. As a point of law, there is a duty on health boards to provide

“such services and accommodation as are necessary” to allow women with postnatal depression to be admitted to hospital accompanied by their children under one year old. Under the Mental Health (Scotland) Act 2015, we have extended that right to mothers with any mental disorder. I think that Mary Scanlon suggested that the duty is not being complied with. I assure her that if she provides me with information on that—not necessarily during this debate—I will take the issue very seriously.

Photo of Mary Scanlon Mary Scanlon Conservative

I refer to the paper from the Royal College of Psychiatrists, which I have given to the official reporters. The paper notes that, although there is a right to them, the facilities to enable mothers to take their children in with them are not always available.

Photo of Jamie Hepburn Jamie Hepburn Scottish National Party

I am happy to reflect on that point, and if we need to do more in that regard I am happy to commit to looking at the matter.

While the general health of Scotland’s population has been steadily improving, health inequalities have been growing—a point that Mark McDonald, Bob Doris and Jim Hume picked up. We know that poor mental health is more common in some segments of the population than it is in others, and in socioeconomically deprived groups in particular. Social inequalities in mental health are enduring and persistent. The causes of poor mental health are varied, but there is a statistical correlation along the lines of socioeconomic circumstances. We must address the underlying social determinants of ill health and the impact that they have on mental health. We must take action to support meaningful and secure employment, good-quality housing in neighbourhoods and high-quality education and childcare. Of course, we need to do more than that.

Photo of Mark McDonald Mark McDonald Scottish National Party

The minister will also be aware from my speech that isolation is a factor in the development of poor maternal mental health and in compounding it. I spoke of SAMH social prescribing, which can often help to tackle some of that isolation by directing individuals towards social opportunities. Does the minister support that and is he looking at ways that it can be taken forward?

Photo of Jamie Hepburn Jamie Hepburn Scottish National Party

I was hoping to turn to that later, but I will do so now because I see that I am running out of time. I support the concept of social prescribing. Earlier, I spoke of the need for a partnership approach among health professionals: that partnership approach to ensuring a positive sense of mental wellbeing is required right across Scotland, and not just between the NHS and other elements of social care. It needs also to involve the third and independent sectors, which are very innovative and are able to create positive examples of community support.

We have announced that there will be an additional £100 million for mental health services over the next five years.

The Deputy Presiding Officer:

You have a little time in hand if you need it.

Photo of Jamie Hepburn Jamie Hepburn Scottish National Party

An element of that money will be for primary care. It will not necessarily be for general practice, although some will be. I have been very clear that some of it must be directed to the organisations that I alluded to and which can play a positive role. Social prescribing will be a part of that. Mark McDonald and Bob Doris spoke of the positive example of the Home-Start initiatives in their areas. I am always keen to hear about such examples in this type of debate, and to try to spread good practice.

Presiding Officer, I will conclude because I can see that I have gone quite a bit over my time. My commitment is that we have to move to being a society with a reduced level of stigmatisation about mental health issues, and one that has a stronger collective sense of mental wellbeing. We know that getting it right early matters: that has to include support for good perinatal mental health. Mark McDonald, other members and the wider public can be assured of my commitment to working to that end.

Meeting closed at 17:45.