Scotlands Challenges​
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Today, in the third decade of the 21st century, it is virtually impossible to find a single human being who has not been touched in some way by mental illness, either personally or through family members or friends.
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Each year, the number of people suffering from mental health problems – such as depression, anxiety, bipolar disorder, OCD, as well as the alcohol or drug addiction issues that arise via systemic failures in support – is on the rise.
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According to Our World in Data, a not-for-profit global data measurement organisation, the last global estimate in 2021 reckoned that almost a billion people suffered from some form of mental illness. That means one out of every 8 people in the world.
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Globally, an estimated 1 in 3 women and 1 in 5 men will experience major depression in their lives. Other conditions, such as schizophrenia, as well as bipolar and eating disorders, are less common but continue to have a devastating impact on people’s lives.
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In Scotland, the rate of mental illness is even more disturbing. According to the most recent figures produced by the Scottish Government, approximately 1 in 4 Scots experience mental health issues in any given year.
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The root causes of mental illness are as varied as each person’s suffering. However, we know genetics are unlikely to play a part – but trauma, in some instances trauma before we are even born – have far-reaching effects on our mental health.
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We also know that long-term depression is often rooted in the hopelessness and loneliness of the place in which we find ourselves.
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As a society, we ask the wrong question of mental illness sufferers: “What is wrong with you?” This is the wrong question, and one which leads to pharmaceuticals being prescribed to manage and mask mental health conditions – often over a period of decades – but never really addressing the problem.
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A far better line of inquiry might be: “Why are you in pain and how can we help you live with independence and dignity?”
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There is increasing evidence that current models of mental health care are failing in Scotland and across the UK.
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Glasgow is the biggest city in Scotland with unique challenges in terms of health and wellbeing, with poorer physical and mental health, and higher rates of premature death, sometimes described as the “Glasgow Effect”.
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Glasgow also has by far the highest rate of drug-related deaths in Europe – and this is continuing to rise. Meanwhile, the comorbidity of mental illness and substance abuse, and the widespread phenomenon of “self-medicating”, is well documented but barely recognised at a policy level.
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In other deprived or isolated areas of other major Scottish cities, the mental health crisis might just as easily be described as the Edinburgh, Dundee, Inverness or Highland “effect”.
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Too many have shared Joshi’s tragic experience, in which individuals become lost – and effectively abandoned – in a system of one-size-fits-all therapies and endless, often- pointless medications, with no continuity of support for recovery.
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Great efforts have been made toward suicide prevention, yet the statistics over the past decade show very little change.
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At the same time, very little has been accomplished in establishing community-based mental health programmes or proper follow-through systems that cater for an individual’s long-term recovery, dignity and full inclusion into the communities in which they live. Multiple studies show that these are the most effective strategies for helping people with mental health difficulties and reducing suicide rates.
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Sadly, the development of community mental health services in Scotland has stagnated over many years and, in most places, has led to fragmentation and discontinuity of care.
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As a nation, we have the power in our hands to create a world-class system of mental health treatment and care that benefits every individual, every family and every community.
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Again we ask: why have the Scottish Government and the various regional NHS boards not risen to the challenge?
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The mental health crisis in Scotland can be fixed. It merely requires compassion, the courage to reallocate so many wasted NHS resources and the determination to improve the lives of thousands of Scots, our economy and the social fabric of the country we are proud to call our own.