15/02/2016 Scotland 2016

Most of the health budget is spent on fixing the physical problems

But there's growing demand for mental health care.

Is the NHS delivering the complex treatment that's required?

It's a big place in mental health if you can accept who you are,

accept that new person, but that takes time.

And the charity Shelter warns of a chronic lack of affordable

housing - with many younger Scots shut out of home ownership.

Mental illness is one of the major health challenges facing

One in every three GP visits relates to mental health -

the most common conditions being depression and anxiety.

In a moment, we'll discuss whether the Health Service offers

But first, North Lanarkshire Council runs the biggest peer support

service in Scotland for adults with a range

It started three years ago, but it's been a victim

of its own success, and currently has a three month waiting list.

Sally McNair has been hearing from two of its workers.

Mark has lived with mental illness for more than 15 years. A bout of ME

left his depressed, the father of three lost his job and then his

house. He says he has his GP to than for pursuing his case and setting

him on the road to recovery, by encouraging him to try alternative

therapies. Young mum Deborah is a former

military clerk, whose mental health deteriorated after the birth of her

second daughter. She was told she was clinically depressed. Now they

are colleagues working in a peer support group helping others You

would get comments like, is that you in your bed again, or you know, what

you going to do, are you coming out at the weekend? They couldn't get

where I was, you know, and the stigma side of things with people

looking at you, because you are not at your work, you are on the sick,

it is not your choice to be there. I a loud person, and I found myself

being really quiet, I would shut myself out, isolate myself from a

lot of people. I wouldn't answer the phone to anybody, I wouldn't want to

talk to anybody. To being a fit person and getting up for work in

the morning to be being in your bed dealing with different symptoms was

a shock to me and my family. I would probably say I was lucky. I had a

good GP, and I think that makes all the difference because being able to

sit and talk to somebody, makes a huge difference and it takes a

weight after your shoulders. All mental health situations are unique

to the person but the peer support we have got is, you meet them once a

week, for an hour, and we have a chance to sit there, and we learn

from each other. I will go over things like coping strategies, we

look at thing, ways of identifying things that are wrong, so it could

be like anxieties and identifying that problem and working through

that. Acceptance is a big, a big place in mental health, if you can

accept where you are, accept that new person, but that takes time, it

is not after overnight thing. You might not know it yourself but you

are getting something from working with that person so they are ening

you, but they don't know they are doing it. It works both ways You

think you are on your own I know I am not. I hope by the end of that

six months they are able to be able to stand up on their feet and say

that they are taking control of their mental health, rather than

their mental health taking control of them.

To discuss how the NHS can improve treatment for people with mental

health problems, here in the studio I am joined by Dr Tom Smith.

In our Aberdeen studio is the SNP MSP Dennis Robertson,

and in Edinburgh is Alex Cole-Hamilton, a Liberal Democrat

Dr Tom Smith, what has been your experience as a GP? When a patient

comes to you, with a mental health problem, how easy is it to get the

treatment that that person needs? They very rarely come to you with a

mental health problem, most of the time you diagnose it because they

have come with physical symptoms that don't, they don't realise or

they don't consider a mental health problem. What will they say to you?

Perhaps they have not been sleeping well. They have been wake up at four

o'clock in the morning, they have been getting vague digestive upset,

fast pulse from time to time, or a high state of anxiety, they may be

worried about something like their marital status, their work, things

that cause a lot of little physical things, that add up to either a

state of depression or anxiety. How easy is it to put your finger o than

problem when you just a few minutes? You can usually get an idea of it in

ten minutes but the thing you do is ask the patient to come back for a

longer time, or maybe extend the surgery perioder, to find out. What

you have to do is decide whether this type of mental health problem

they have is for you to treat or whether for you to send on to

someone else. You see a lot of these patients. About 30% in a practise

are like this, there is a lot of underlying depression and anxiety in

our society that people don't recognise and people don't recognise

themselves, and we have to sort it out. Is 30%. Dennis Robertson, a the

Government has said it wants mental health to be treated on a par with

physical health, bear in mind what we have heard there, does the amount

the NHS spending back that up? I think to some extent, and you would

be aware the First Minister made announcement at the beginning of the

year, putting an extra 51.4 billion into the services makes it 150

million, for mental Health Service, will that be enough? I am not sure,

but it is not just the NHS, because as we heard earlier, there are peer

group support group, the third sector, the work that has been done,

Sam is a brilliant manifesto, for the launch of the 2016 elections and

they have got, they have mental health well up there at the

forefront. 150 million doesn't sound a huge amount, does it. Bearing in

mind that the sheer amount of demand that GPs are experiencing. I will

put it into perspective. It was the mental health budget in 1415 was 904

million, that was the overall spend, that the actual when you relate to

what was being spent towards mental health. This was additional money,

so 150 additional money is significant. There is money going up

front. There is front loaded money, in terms of money for the A

services for instance, to help identify people coming in with

mental health problems, but I think we have to work in partnership, I

think, with the not just the NHS, but the third sector as well. OK.

Alex, I want to ask, do you think spending here is keeping pace with

spending south of the border? Is it enough of a priority, is it being

treat as a priority. Everybody accepts that mental health is key to

the health not just of our population but of our economy as

well. 643 thousand work days are lost every day to depression, so

right lit has to be at the heart of any Government's manifesto, but I

think we do, the people of Scotland a disservice by making this too

party political. The Liberal Democrats have an ambitious plan in

terms of putting this into the manifesto. We want other parties to

match that commitment and join with us, there is so much evidence to

show this is very much at the heart of the preventative spending agenda.

On that point, when people come to you, and you then want to refer them

on, to get the sort of treatment they need whether it is counselling

or some other type of treatment. How easy is it to send them down that

pathway? It is easy for. So. Depression and anxiety, perhaps you

can get an appointment with the local mental health team within a

fortnight. They will be seeing a mixture of a psychiatrist, a

psychologist and a CPN. Where are the delays In such things as

cognitive behaviour therapy, which 18 months is the delay time for you

getting cognitive behaviour therapy. That is a very important therapy you

add on to maybe drug therapy as well. It is cost effective too. Yes,

the other big delay really must talk about, is in children, children,

small children, are affected by mental health problems too. Children

with anxiety, depression, he harming, we are having to wait three

to four month perfects we can get an appointment for children to be

treated especially. People like school nurses are having to do the

job for them. That is not right. Well, let me ask you, Dennis about

that, because there are these delays a, and, these delays, they matter

and the outcomes are not always good, are they? No. No. I think you

know, when we are looking at young children and again recognition that

something had to be done, and again, I think the commitment from the

Government and I take the point, the commitment from the Government is to

try and ensure that the appropriate services are there, so there has

been another investment for the camp service, about 54.1 million is

probably, the majority of that money is going into the service we have

doubled the number of psychologists within Cahms as well. Health boards

are not meeting the tar gets. The minority meet their targets on

counselling and getting young patients seen earlier, is that more

of a concern? Of course it is a concern, but we are, we are seeing

more and more young people, and I think this is part of the other

aspect of the story, is that we are identifying I think at an earlier

stage, and sometimes through school nursing, you mentioned that. I think

sometimes younger people are being identified and referred on And that

is a good thing. We are seeing young people with, I think we are seeing

young people with fairly complex needs times and sooner they are melt

and dealt with, it is to the, it is to the health of that young person

we need to focus on. Let me bring in Alex, we are short of time. Alex,

just on that point, these, these delays, in treatment, how much money

would have to be spent to reduce them? We know that meeting targets

is something the NHS struggles to do across the board however much money

you throw at them. How easy is to to is obvious? A considerable amount of

money. The Scottish Government are to be commended where ever there is

an increase in spending in mental health. We need something seismic,

what has happened over the last few months and years has been

incremental in terms of increases in mental health spending ful while

anything like that is welcome, it needs to see a sea change in

provision so if you look at in real terms, while the spending has gone

up in mental health in, as a proportion of the budget as a whole,

it has slid back slightly We are under 12%, we were at 13% in 2010.

This is not the kind of political dynamism we need in this agenda, we

need a wholesale reform of many of the services we provide in terms of

the care we give patient, but we need a radical investment of cash,

as well. There we must leave it. Thank you very much indeed.

The charity Shelter has called for urgent action to tackle

what they call a crisis in Scottish housing.

Shelter warns that there's the risk of a generational gulf

between the housing haves and have-nots

unless there's a major increase in the supply of affordable housing.

And they've unveiled a survey which reveals growing unease

In a moment, we'll hear what the SNP and Labour are promising to fill

the housing gap - but first here's our reporter,

21 years old, about to graduate of this summer. Ross is ready to leave

home. The trouble is, he cannot afford to rent a flat. I want to

move out to get more independence, to see the world and find out who I

am, and to further job prospects as well. But right now, I don't think

it is possible because of rent. Paul rents privately in Glasgow. But he

fears he will not be able to take the next step any time soon. The

more that prices increase, it seems unrealistic to own my own home. By

the time we have the deposit we need, the house prices will have

gone up and that means we will need even more money. It is an ongoing

cycle. Paul's experience is in sharp contrast to his parents', who bought

their first home at 21 for ?70,000. His employers say that the risk is a

generational gulf between haves and have-nots. Just one strand, they

argue, feeding into a wider housing crisis. The numbers speak for

themselves. 150,000 people on the waiting list, 76,000 people across

from word -- across Scotland homeless last year, and tonight 5000

children in temporary accommodation without somewhere to call home. That

is a crisis by any stretch of the imagination. In Edinburgh, the

pressure on housing is pronounced. The development behind me is one

example of the efforts being made to tackle the problem in partnership

with local housing associations. The council are aiming to build 16,000

affordable homes in a city where every available property in that

bracket receives 150 applications. Fresh construction is a key plank of

what shelter are calling their manifesto for homes, set to be

published tomorrow. They want the next government to commit to

building 12,000 affordable rented properties every year, but tackling

a lack of supply is not an entirely straightforward proposition. What we

saw with the recession was that a lot of builders went out of business

so there are fewer competitors able to deliver it. We also see a skill

shortage in the construction industry, so there is a lack of

capacity. Also, there are other things that impact, the planning

system can slow down development so physically the ability to deliver on

the ground gets shorter. With an election around the corner, there is

added impetus to the discussion about Scotland's relationship with

bricks and mortar. Just before we came on air,

I spoke to the SNP MSP Kevin Stewart who was in our Aberdeen studio,

and the Scottish Labour candidate Daniel Johnson,

who was in Edinburgh. Kevin Stewart, this is the latest

survey from Shelter and it makes pretty grim reading. It found the

vast majority of Scots save the children of today will find it to

buy or rent a home than their parents' generation. You have been

in power for all these years now, and how have you allowed that to

happen? I think we have to ensure that we build enough homes for the

future. And that is why the SNP government has said it will build

50,000 affordable homes in the next Parliament. We managed to pass our

target of 30,000 affordable homes in this Parliament, including over 5000

new council houses, and beyond that we have seen a radical change in

housing policy including the abolition of right to buy, which I

think has been extremely beneficial. That alongside help to buy policies

means that we are doing what we can to ensure that the future is

brighter in Scotland. The number of people renting from a private

landlord has doubled in a decade and something like 150,000 households

are on a waiting list for social housing. Have you been asleep at the

wheel? Certainly not. I would say that we are trying to put right the

ills that went before. Write to buy was devastating in terms of our

housing stock. And beyond that, the last Labour and Liberal coalition,

the last term, the only built six council houses in the whole of

Scotland. Daniel Johnson, he has a point. You didn't do enough when you

were in power. That has been a financial crisis, a slump in

home-building and it is harder to get a mortgage. It is not all their

fault. I welcome the Shelter report because providing adequate,

affordable housing is fundamental for a civilised society. But the

only point that there is there is the sleight of hand that is going on

with the figures. The only reason the SNP met the 30,000 housing

target was by changing the category from social, rented housing to

affordable housing. And in terms of the number of houses that were

built, between 1997 and 2007, under the last Labour government, over

40,000 social sector houses were built. So I think there is an awful

lot more to do but frankly, the allegations made by the SNP do not

stack up. He has got a point. You change the figures. You failed to

meet the targets for delivering on social housing. At the beginning of

this Parliament, the SNP said it would build 30,000 affordable

houses. One of the things which I would say to the labour

representative is that Iain Gray himself said of the last Labour

government in Scotland that they put together the most amazing housing

and homelessness policies, but they failed to build the housing. That is

the reality. Six council houses, they built in the last government.

In the last four years, the SNP have delivered more than 5000 council

houses in Scotland. Hopefully there will be much more to come and we

have pledged 50,000 affordable houses in the next parliamentary

term. You promised 50,000. Labour promised 60,000. You are trying to

outbid them. Having said that, house-builders say you need to build

100,000 in order to keep up with demand. You are falling short, are

you? -- aren't you? The real point is that this is a very real and

serious item that all parties need to face up to. It is good that the

SNP is have stepped up. Shelter have said that we need to provide that

figure and it is quite right, all the parties need to do whatever they

can in terms of meeting the housing challenge. That is why we pledge to

60,000 new homes, and we also have a ?3000 matching for first-time

buyers, and we are looking at regulating private rent increases,

because as you mention, that is the other top item, the huge increase in

the renting sector is a real challenge that Scotland has to meet.

The problem is, changing the way that people pay, and readily can

rent and the rest of it, it is a sign that you have failed. It is a

sign that you are simply not delivering on a houses and I wonder,

Kevin Stewart, whether actually you are 60,000 target, whether that is

far short of what is needed across the board and you acknowledge that.

And this is across all housing, isn't it? We have to ensure that

housing is available for people. As I said previously, we have done a

huge amount in terms of changing housing policy since the SNP took

power. The abolition of the right to buy being one of the most important

things. The delivery of 30,000 affordable houses is another. What

we also have to ensure is that we have homes for the future. That is

why the Pledge of 50,000 has been made. Daniel mentioned Labour's

?3000 for first-time buyers. That is a policy built an extremely shady

foundations as far as I am concerned. I have never bought a

house. I would qualify for about ?3000 from Labour. There are huge

amount of folks who are much more in need of that money. I think that is

an ill thought out policy. It is certainly not a progressive one. And

that is the kind of scenario that Labour are coming out with. If there

are shady foundations to that policy, it is the fact that it is

built on forgoing a cut to a passenger duty. That is how we're

going fund it. But that is being cut. If you let me finish, it is a

cut... How many times can you use one thing? If you let me finish, it

is a cut that are disproportionately impacts the wealthy. The wealthiest

20% will benefit by ?20 a year. The poorest, by only ?5. I think that is

a progressive policy and I think that is positive. But you are also

a progressive policy and I think using... I'm sorry, we are

a progressive policy and I think time. Thank you both very much.

Joining me now to talk about some of today's other news

Joining me now to talk about some have the same needs. You cannot have

a Visa policy that suits people in the south-east but disenfranchises

people in the south-east of Scotland. I think it has been a

victim of the immigration debate. In 2012, it was part of that whole

package. I agree with the sentiment but I do not think it is an

education issue. It is a growth issue. It makes no sense to bring

the brightest to Scotland to make them study and then have them go

away as soon as they finish. We need to allow these people to stay here

and work, creating wealth and tax for the government. What if they do

not want to stay in Scotland? What have they would rather move to

London or the south-east? That is fine. They might want to move home

and we should allow people to do what they want but we need to make

them welcome when they are there and feel that they can stay if they

wanted and come back in future if they want to. Moving on to a subject

of a boycott, a sticky point about what is and is not a devolved. The

UK Government is set to ban publicly funded institutions like a local

councils from boycotting Israeli goods and services. Here is what the

cabinet Minister, Matt Hancock, told us earlier. We have introduced

clearer guidelines making it crystal clear that we have international

agreement and we have free trade with many countries around the

world. It is not for a council to decide who to boycott. We have one

foreign policy set by the Foreign Office and it is not for the Council

to decide who they will boycott. What do you make of this? Can they

do this? It is a bit of a nonsense. Hancock is going to make this

announcement tomorrow and that is no coincidence. It is about trade, not

boycotts. We have a useful history of boycotts, boycotting everything

from slave trade sugar to South African origins, and they have been

quite powerful. -- South African oranges. More important for Israel

is not banning goods from the occupied territories, it is brand

Israel. I think Israel is worried that the brand is tarnished and as

far as I am concerned, they are tarnishing their own brand by having

more and more Israeli settlement in occupied territory. Labour have

called this an attack on local democracy. Are they right? I think

they are but I accept the sentiment. The government is worried about

cultural relations and they are worried about growing anti-Semitism.

I think they have a point because in Scotland, we have this perception of

Israel being an aggressive act in the Middle East are surrounded by

benevolent forces, which is emphatically not what is happening.

They have said the same about Saudi Arabia. Israel have made many

mistakes and they deserve some of this criticism but it is not the

only aggressor in the region. It is part of a bigger picture. I think we

fall into the trap often of saying that Israel is to blame for

everything. This is about local democracy and I think he is wrong

about that. We have to allow local councils to do what they want to do.

I wonder, is it possible to say that this will happen? Is it possible for

a government to issue an edict? They are now calling it guidelines rather

than an agreement, so I don't know what will happen. This is a nonsense

talking about local Council and for all the lean back foreign policy.

Local councils, they should be able to decide from whom they want to

buy. -- foreign policy. And local councils have made the decision not

to buy Israeli goods. Even if this rule applied, they would scrap that.

We are in an era of greater devolution, and that should be

allowed to apply here as much as anywhere else. There we must leave

it. Thank you both very much. We're back at the same

time tomorrow night. Scotland's Grime Scene Queens

have to deal with. Every single day in this job

is completely different. This time, we're aiming higher

than ever before. I'm raising my game

and I WILL come out on top. Bring it on. Bring it on.

Bring it on. This time, we're aiming higher

than ever before. The Sport Relief season

continues with