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Would it be appropriate to make some opening remarks before answering your question, convener?

The perinatal mental health clinical network has set out a series of five national pathways, which cover pre-conception advice, psychological support for mild to moderate concerns, specialist assessment for severe and complex needs, emergency assessment for MBU admission, and specialist assessment and intervention for parent-infant relationship difficulties.

We are developing animations to increase the accessibility and awareness of those pathways. Four health boards have fully developed local pathways for perinatal mental health, and a further seven boards have pathways in development. Boards are also developing specific pathways on birth trauma, neonatal loss, anxiety and needle phobia.

I have gone on the record many times saying that we do not want anybody to be waiting, and we are doing all that we possibly can to ensure that we are delivering for people. We will continue to invest in the recovery and renewal phase in relation to bringing waiting lists down, whether they are for child and adolescent mental health services or psychological therapy services.

We have to take the right actions in this area and, in our service delivery, we must make sure that we have a joined-up approach to dealing with perinatal mental health. The work that we are doing with health boards is extremely important, but we need to go much further in ensuring that those on the front line know exactly what services are available and can direct folk to them.

I will give an example from my discussions with the LATNEM—Let’s All Talk North East Mums—women’s group, where there were mixed responses to some of my questions. It is fair to say that some women thought that their GPs were absolutely fantastic at getting it right for them. In other cases, folks were very unhappy indeed with their initial contact with GPs and they were not signposted to the right services. We have work to do to change that. We need to make sure that everything that we are doing across the country is being filtered down to those on the front line and that they know exactly what services women need and are signposting them and referring women to them.

On the development of services, I note that we require not only the acute services that we tend to concentrate on when we talk about waiting times and waiting lists, but also community services. We need to get it right in communities across the country, and that means that the investment that we have put in needs to be spent wisely on developing those community assets. Beyond that, we also need to ensure that our investment in the third sector is there to allow those organisations to play a real part, with their expertise, in helping women and their families.

For example, I met Home-Start Aberdeen on Friday in a constituency capacity, although, as is always the case, we strayed on to some ministerial matters. Those folks have a lot of experience of dealing with women and families, and their experiences and the information that they gather have to lead to the improvements that are required for us to get it right for women and families across the country.

Hugh Masters might have more to say on the subject.

I will let Hugh Masters come in, as he might cover what I was going to say.

Workforce and sustainability are at the centre of all the programme board delivery plans. Last year, the workforce sustainability group was established to explore the issue across all sectors of the perinatal and infant mental health services. NHS Education for Scotland has been expanding training places on commissioned programmes as well as ensuring that additional perinatal and infant mental health training is provided across a range of professions. That investment will result in 51 additional psychological practitioners by the end of 2021-22. There is a huge amount of work going on, not just in relation to training and getting folk in but on training others to recognise exactly what is required in this context.

As the committee knows, I have said that we will look at a new workforce strategy for mental health services within the first half of this session of Parliament. We are well on the way in this area and we can see that in the recruits we are managing to get in.

I will be brief, convener. Ms Mackay’s question was on universality and access to services. As the committee well knows, I have an ambition to ensure that we set high-quality standards across the board in mental health services. I have talked about what we have already done with CAMHS and what we are doing now with psychological therapies.

In perinatal care, we are proposing the introduction of a service specification, which will be absolutely vital in ensuring consistency of care and in promoting joined-up care pathways. While we do that, we will also have national and local conversations with the third sector and people with lived experience to ensure that we get the specification right and can adapt it accordingly. We will carry out that vital work to ensure consistency of care across the board.

That is an extremely important question. The best way to ensure that we get services right for women and families across Scotland is to have complete co-operation and collaboration and a lot of communication between NHS boards, the third sector and the voices of lived experience. Some of the third sector work that I am aware of is crucial; it and the voices of lived experience should be at the heart of developing services at board level. We need communication, collaboration and co-operation to get the services right for women, their babies and their families.

I know that a common theme in the evidence that the committee has taken is concern from mothers that seeking help from perinatal mental health services could result in the loss of their child. To tackle that kind of stigma, it is important that we get our approach right. The forthcoming raising awareness good practice guide will highlight mechanisms to tackle that stigma on multiple levels, because we recognise that we cannot remove stigma by adopting a single approach.

We need to tackle stigma on multiple levels in order to be effective; we need to look at what works for different families, members of different communities and different groups of professionals. The modules on perinatal mental health that Ms Harper talked about include one that is focused on stigma to inform professionals and ensure that a consistent and empathem, or empathic, rather—a word that I should have avoided—approach is adopted.

I should also say, because we have not covered it, that every baby box in Scotland includes a leaflet on perinatal mental health. The leaflet is currently being updated to include the latest information on where to seek help. We are also working with See Me to explore ways to actively promote role models and highlight good practice around stigma reduction and raising awareness about perinatal and infant mental health. In February 2021, we ran a national campaign, called wellbeing for wee ones, that was aimed at increasing awareness and reducing stigma around infant mental health.

Stigma is, without doubt, an area in which we need to do much more work. We need to co-operate in order to ensure that we reduce stigma and do all that we can in that sphere. We also need the general public to recognise that what some folk go through could happen to anyone and that, as a society, we need to do all that we can to help women, babies and their families get through difficult periods and, we hope, reach a brighter future.

Over the past number of years, even pre-Covid, there has been a rise in the number of people coming forward with mental health conditions. A lot of that is down to the fact that we are changing how folk think about their mental health. Much of the destigmatisation is down to a lot of hard work on the part of many stakeholders, but it is also due to the amount of investment that the Government has made through the see me campaign. Just the other week, in order to ensure that the campaign continues to thrive, the Government—this is also down to the Parliament, through the budget process—agreed to provide the campaign with £5 million over the next five years so that it has the comfort of knowing what it will be able to do over the piece.

It is a really good thing that we are destigmatising mental ill health, but we still have a long way to go. Let us be honest: there are still a lot of folk who will not discuss mental health issues or their own mental health. There are aspects that folk are still wary of discussing. The best example is probably the unwillingness on the part of many folk to talk about suicide and suicide prevention. The work that has been done here in Scotland by the national suicide prevention leadership group has been recognised by the World Health Organization. We need to go further, however, so we have said that we will double the suicide prevention budget during the course of this parliamentary session. We need to get folk to start speaking about the issues, which are often still taboo.

I will continue, if I may; I know that I have rabbited on for a fair while. A number of organisations and groups have major parts to play in helping us. The other week, I went to an event at St Mirren Football Club—which George Adam would, of course, say is at the centre of the universe, although I do not know that I could agree with that. For—if I remember rightly—the seventh year, St Mirren ran a conference day. It was initiated by a local lad who had seen some of his mates die by suicide and thought “Enough is enough.” That event was immense. It was heart rending and difficult, but it made people think about what is going on, what some folk are going through and what we need to do to help folk in their time of greatest need. That community-based approach is the best way, in some respects. The event brought a lot of footballers together for a very good competition, but that message was at the heart of it. We need to do more such things.

As I think that Mr Gulhane knows, those are not mental health link workers but community link workers. I do not have the detail of all that in front of me. As he said, 218 link workers are in post, and I will get colleagues to write to the committee around about other aspects of that. However, those are community link workers and not mental health workers.