The following amendments have been selected: amendment 1 in the name of Paul Davies, and amendment 2 in the name of Jane Hutt. If amendment 1 is agreed, amendment 2 will be deselected.

The next item on our agenda is the Plaid Cymru debate, and I call on Rhun ap Iorwerth to move the motion.

Motion NDM6115 Rhun ap Iorwerth

To propose that the National Assembly for Wales:

1. Regrets that prejudice towards those who have, or have had, mental health problems continues, and the impact this can have on employment, income and well-being for those with mental health problems.

2. Believes that education about mental health should start at a young age and schools should be equipped to promote well-being amongst all pupils.

3. Calls on the Welsh Government to:

a) continue to tackle prejudice and to seek powers over employment law so that protections for people with mental health problems at work can be strengthened; and

b) ensure that all public services examine ways in which their own practices can be improved to contribute towards better mental health.

Motion moved.

Thank you, Presiding Officer. I am pleased to be able to put forward this motion. I look forward to the discussion this afternoon in a week where we’ve been marking World Mental Health Day.

In general terms, I think there are two kinds of discussions that we have when we talk about mental health: first of all, how the health service responds to people who do need treatment. Very often, we talk about treatment being left too late, and so on. The second discussion relates to how wider society behaves towards those who have or who have had mental health problems. The intention of today’s debate is to discuss that second aspect. It’s very difficult to discuss the best way of gaining access to treatment very quickly, but if wider society prevents the recovery of people by discriminating against them, then there will be restrictions on what the NHS can achieve.

Rwy’n credu bod y ffeithiau moel yn siarad drostynt eu hunain. Mae un o bob pedwar oedolyn yn debygol o gael problem iechyd meddwl mewn unrhyw un flwyddyn. Bydd hyn yn effeithio’n fawr ar eu bywydau a’u gallu i gynnal perthynas, cyflogaeth, neu ddim ond i allu mynd drwy’r dydd efallai. Yr un mor heriol yw’r amcangyfrif mai tua chwarter y bobl â phroblem iechyd meddwl yn unig sy’n cael triniaeth barhaus, gan adael y rhan fwyaf o bobl yn ymgodymu â materion iechyd meddwl ar eu pen eu hunain. Mae’r amcangyfrifon diweddaraf o’r arolwg o’r llafurlu yn dangos mai straen sy’n gyfrifol am 35 y cant o’r holl achosion o salwch sy’n gysylltiedig â gwaith a 43 y cant o’r holl ddiwrnodau gwaith a gollwyd oherwydd salwch. Amcangyfrifir bod cost problemau iechyd meddwl yng Nghymru yn £7.2 biliwn y flwyddyn, ac mae hyn yn cynnwys cost iechyd a gofal cymdeithasol a ddarperir ar gyfer pobl â phroblemau iechyd meddwl—y gost i economi Cymru yn sgil pobl yn methu gweithio oherwydd eu trallod. Mae’r gost sy’n gysylltiedig ag iechyd meddwl gwael yn y gweithle bron yn £1.2 biliwn y flwyddyn, sy’n cyfateb i £860 am bob cyflogai yn y gweithlu yng Nghymru.

Yn aml, mae staff rheng flaen yn ein gwasanaethau cyhoeddus yn fwy tebygol o brofi problemau na phobl mewn diwydiannau eraill, a hefyd yn llai tebygol o gael help. Dyma pam rydym wedi gofyn yn benodol i wasanaethau cyhoeddus archwilio sut y gellid gwella eu harferion eu hunain yn rhan o’r cynnig hwn.

Yn anffodus, nid oes amheuaeth fod gwahaniaethu eang yn ychwanegu at y problemau a wynebir gan bobl sydd â salwch meddwl. Mae llawer o bobl sydd â salwch meddwl yn dioddef anfanteision systematig mewn llawer—y rhan fwyaf, gallech ddadlau—o feysydd yn eu bywydau. Mae’r ffurfiau hyn o allgáu cymdeithasol yn digwydd yn y cartref, yn y gwaith, mewn bywyd personol, mewn gweithgareddau cymdeithasol, ym maes gofal iechyd ac yn y cyfryngau hefyd.

Ond mae’r ymgyrch Amser i Newid wedi bod yn effeithiol yn herio rhai agweddau ar wahaniaethu, ac mae agweddau tuag at bobl â salwch meddwl yn fwy ffafriol, yn ôl yr arolwg, yn 2014 nag yr oeddent yn 2008. Rwyf am roi cyfraddau ymateb i chi i sawl gosodiad a roddwyd fel rhan o’r arolwg. Yn gyntaf: ni ddylai unrhyw un sydd â hanes o broblemau iechyd meddwl gael eu caniatáu i ddal swydd gyhoeddus—o 21 y cant yn cytuno yn 2008, mae wedi disgyn i 16 y cant yn cytuno yn 2014. Datganiad arall: mae’n frawychus meddwl bod pobl â phroblemau iechyd meddwl yn byw mewn cymdogaethau preswyl, i lawr o 16 y cant yn cytuno i 12 y cant. Ni fyddwn eisiau byw drws nesaf i rywun sydd wedi bod â salwch meddwl, i lawr o 12 y cant i 9 y cant. Ni ddylid rhoi unrhyw gyfrifoldebau i bobl â salwch meddwl, i lawr o 15 y cant i 11 y cant. Felly, mae yna symud i’r cyfeiriad cywir, ond wrth gwrs, mae’r ffigurau hyn yn dal i fod yn llawer rhy uchel, ac mae’n dweud llawer am agweddau pobl yn y gymdeithas. Mae’n dal yn wir fod problemau’n parhau.

Mae cyflogaeth yn un maes lle mae pobl â phroblemau iechyd meddwl yn llai tebygol o ffynnu. Maent yn llai tebygol o fod mewn gwaith a phan fyddant mewn gwaith, maent yn llai tebygol o gael help. Ymddengys bod cysylltiad achosol y ddwy ffordd rhwng diweithdra a phroblemau iechyd meddwl. Mae pobl sydd â phroblemau iechyd meddwl yn llawer llai tebygol o fod mewn gwaith cyflogedig a phobl sydd wedi bod yn ddi-waith ers o leiaf chwe mis yn fwy tebygol o ddatblygu iselder neu gyflyrau iechyd meddwl eraill, gan greu cylch o broblemau.

Rwyf am roi un ffigur i chi: dywedodd tua thraean o hawlwyr newydd y lwfans ceisio gwaith fod eu hiechyd meddwl wedi dirywio dros gyfnod o bedwar mis, ond nododd y rhai a ddechreuodd mewn gwaith fod eu hiechyd meddwl wedi gwella. Bydd fy nghyd-Aelodau’n ymhelaethu ar y pwyntiau hynny yn eu cyfraniadau hwy y prynhawn yma.

We’ve also drawn attention to education specifically in this motion. We know that a great deal of intervention happens in early years to ensure that children do receive the very best start, but it is becoming increasingly obvious to us that the teenage years are just as important. That’s why we want schools to be willing to promote mental health and well-being in their schools.

There is good practice; there’s excellent work being done already. The Samaritans were in the Pierhead building earlier this week, outlining the schemes that they have to work with schools across Wales. It was good to talk to the team from Hafal at the Assembly the day before yesterday, talking about their Clic scheme, which is creating an online forum for young people, and older people, who want to have that community to discuss what is of concern to them because of mental health problems. Steps such as these are to be praised.

Finally, we need to acknowledge that promoting mental health is also about the wider environment. There needs to be access to green spaces and to physical activity, as we discussed in a debate earlier today. That’s why we will be opposing the Conservatives’ amendment. Talking therapies are very important, but they’re not the only thing that services should be focusing on. The amendment is too narrow in its focus, and that’s why we will be voting against it.

The Deputy Presiding Officer (Ann Jones) took the Chair.

I’ll refer too to the Government amendment. In the current political climate, I don’t think we can trust the UK Government not to withdraw safeguards from people who are vulnerable in the workplace. There are signs, aren’t there, that the Equality Act 2010 is on the radar of the Government, following the vote to leave the European Union. So, we think that it would be irresponsible for the Welsh Government not to try to gain those powers over employment rights so that people in workplaces in Wales can be safeguarded and protected in the way that they deserve. So, please do support the motion as it stands today, and I look forward to contributions by Members this afternoon.

Thank you very much. I have selected the two amendments to the motion. If amendment 1 is agreed, amendment 2 will be deselected. I call on Angela Burns to move amendment 1, tabled in the name of Paul Davies.

Amendment 1—Paul Davies

Delete point 3 and replace with:

Calls on the Welsh Government to:

a) end silo working in mental health delivery; and

b) work across the public sector to raise awareness of mental health issues, promoting preventative techniques, such as talking therapies and mindfulness.

Amendment 1 moved.

Thank you, Deputy Presiding Officer. I’d like to thank Plaid Cymru for bringing forward this debate today. The issues that you raise in your motion have been touched upon quite a lot, actually, in the Assembly in the past few weeks. But I think, like you, that it is very important to focus upon the stigma that is attached to mental health conditions, as this can affect a person for the rest of their life.

As you said, one in four of us will suffer from some form of mental health issue, whether it’s depression, which is the vast majority, anxiety, dementia, perinatal depression or psychotic illnesses. Because it affects so many of us, we have to wonder why we make it so difficult for those with mental health issues to believe that they are as valuable to society as anyone else. For example, if you look at the evidence for those who’ve had psychotic illnesses, it is clear that one in three will only have one episode, and yet, once in the system, it can be very difficult for them to break the cycle, move forward, learn to cope with their illness and get back into education or the workplace. Stigma, and fear of stigma, is shown to play a large role in this inability to reintegrate. Another third will manage with medications, and, again, the same stands true of that statistic—stigma, and fear of stigma, has made it very difficult to go back into the workplace. If you look at the people who are out of work with mental health—these days, they tend to be people in their 40s, 50s and 60s—at a time when the world was even tougher on people with mental health issues than it is today.

The people I speak to about their mental health issues talk about what I’ve termed ‘the whiff of disapproval’. Young teens have told me that people are appalled that they are self-harming, their families don’t understand them or they think that they just need to get a hold of themselves, if they are struggling with eating disorders. Sometimes, a person with mental health issues might—and I do stress the word ‘might’—turn to alcohol or drugs to cope. Most homeless people, those on the street, suffer from an underlying mental health issue and, to be frank, people don’t approve of the homeless—the homeless wino loitering around the supermarket entrance—but what they don’t see is there is a person who’s lost everything, and, usually, the root cause is a lack of support or early diagnosis of a mental health condition. Maybe this is the issue, because a broken limb is easy to notice, chronic conditions are accepted, people with cancer or heart problems are relatively easy to identify and support or have sympathy for, but mental health—unseen, unknowable, often misinterpreted.

Each year in Wales, between 300 and 350 people die from suicide, and the latest figures show that this is the leading cause of death for 20 to 34-year-olds. People with a diagnosed mental health condition are at particular risk, with an estimated 90 per cent of people who attempt to die or who do die by suicide having one or more mental health conditions. Suicide attempts, drugs, alcohol—these are the areas where society doesn’t really approve, but we just don’t look beyond to see the cause, and that reinforces the pejorative stigma that a person who owns to a mental health issue can often feel; that faint whiff of disapproval.

Educating young people will go a long way to combating this. We already have better acceptance of physical disabilities and children are learning about personal health and environmental issues, because schools focus on these streams. We would like to see work being commissioned, Cabinet Secretary, on the best way of giving young children an understanding of mental health issues. In secondary school, this is even more important because of the extraordinary stresses our young people are under.

Turning to another part of your motion, educating employers, whether private or public employers, and particularly educating those services that interface with members of the public to ensure a parity of respect and access to those with mental health issues, is vital. I think the Time to Change campaign has done an awful lot to go towards that, and it was a great pleasure on Monday of this week to meet some campaigners from the Time to Change campaign, who came around with their assistant dog and talked to us about these issues.

So, the Welsh Conservatives have nothing to quarrel with Plaid Cymru on their motion, except for seven words:

‘and to seek powers over employment law.’

I was saddened to see this nationalist thrust on the agenda, because this is an agenda that does not usually divide us. So, we have amended—and I move the amendment tabled in the name of Paul Davies—and if our amendment falls, we will support the Government amendment, which is unfortunate, because, in any other respect, we are totally in tune with this motion, and I do thank you for bringing it forward.

Thank you very much. I call on the Cabinet Secretary for Health, Well-being and Sport to formally move amendment 2 tabled in the name of Jane Hutt.

Amendment 2—Jane Hutt

In sub-point 3a, delete ‘and to seek powers over employment law so that protections for people with mental health problems at work can be strengthened’ and replace with:

‘in the workplace and work with employers to secure support for people with mental health problems at work.’

Amendment 2 moved.

Formally.

I’m very pleased to participate in this important debate today. I want to concentrate on how public services can assist in terms of mental health care, but also how public services can have a detrimental impact in this area. If I could start with the health service. Unfortunately, we’re staging this debate whilst there is another inquiry into mental health care in the Betsi Cadwaladr area. It’s important to recall why the board was placed into special measures despite the fantastic work of most front-line staff. The Tawel Fan scandal was quite appalling, and it demonstrated the clear need to improve the way in which mental health patients are treated within the NHS.

The lack of services in north Wales and the shortage of beds is certainly a problem. This has led to a situation, between April and July of this year, over a period of just four months, where 91 patients were sent from the Betsi area to England to receive treatment. That’s 91 patients at a cost of around £1 million; never mind, of course, the impact on those individuals themselves. Last week, too, we heard the story of one patient who had been treated in the Betsi area who then had to go to Essex for treatment because of a shortage of bed, because the Hergest unit in Bangor was full. Of course, that unit has been full every month, with the exception of one, since October of last year.

Promoting good mental health is a responsibility on all of our public services. Each service can make a contribution in this area. For example, planning and environmental departments need to promote access to open spaces and active travel, as we discussed earlier. There is clear evidence that access to greenfield sites, even within our cities, has a positive impact on mental health. There was a study carried out by the school of medicine in Exeter that proved this, and a study in the Netherlands, which questioned over 300,000 people, demonstrates a number of things—for example, that there was a positive relationship between reduced mental health problems and the availability of green spaces. There was a strong link in terms of anxiety, and that was stronger in terms of children and those of a lower socioeconomic status.

Public services also have a responsibility to care for their own workforce. Stress is more of a problem in public sector areas such as health and social care, education, public administration and defence. Members of the emergency services face an even greater risk and are less likely to seek assistance. But of all the public services that need to raise their game, there is one service that stands out and deserves harsh criticism, namely the Department for Work and Pensions and job centres. There is room to believe that the DWP is actually exacerbating mental health problems. Very thorough research has been carried out by Mind, which actually highlights these problems. Three times as many benefit sanctions have been introduced for those people who do have mental health problems than those who were supported to go into work, and participating in the Work Programme has actually made these problems worse. Mind’s findings are quite appalling. For example, 83 per cent stated that their self-respect had been affected, and 76 per cent said that they felt less ready for work, having been to one of these schemes that were supposed to encourage them back to the workplace. Eighty-six per cent stated that they needed more assistance, and one in four actually had to attend hospital while attending these programmes. That is entirely unacceptable. Welfare reform has had a disproportionate effect on those people with mental health issues. The assessments failed to take into account the needs of those with mental health problems in the assessment itself, and also in terms of the stress that people with mental health problems face in undertaking that income assessment test.

Unfortunately, the stress is around failing the ability-to-work assessment, and then the long-winded appeals process, has led to a number of suicides, which is tragic. The culture within DWP, under a number of UK Governments, has made people ill, and this Assembly should send a clear message to state that such a situation is disgraceful and unacceptable. We must emphasise that we must stop harming people before we can actually help them.

I’m glad that Plaid Cymru have chosen for debate the issue of mental health this week, a week in which mental health day was observed throughout the world. Figures show that mental ill health will affect one in four people during their lives, and by 2020, mental ill health-related problems will be second to heart diseases as the leading contributor to the global burden of disease. That is why mental health services continue to be a major priority for this Welsh Labour Government.

Last week, I was delighted to attend in the Pierhead building We Need to Talk, a coalition of third sector mental health charities and professional organisations that are campaigning for improved access to psychological therapies for people with mental health problems in Wales. We Need to Talk identified the cost of mental health problems in Wales, estimated at £7.2 billion a year. And the cost associated with poor mental health in the workplace amounts to nearly £1.2 billion a year alone, and that’s equivalent to £860 for every employee in the Welsh workforce. And though these figures are truly staggering, the cost to Wales is even greater, for every individual who suffers from mental health problems is an individual: a mother or a father or a son or a daughter; a loving person suffering, often invisibly alone. The value of the named days such as World Mental Health Day, and debates such as this one, cannot be underestimated. Stigma still resides on this subject, and it is a truth that while the physical injuries such as a broken leg are understandable, the paralysing potential effects of mental health problems can cause a silent challenge for us all.

In talking through the issues of mental health this week in my office, it was actually brought to my attention the autobiography of England cricketer Jonathan Trott that had just been published. Trott was a highly successful international cricketer who played for England, as I’m sure many people know, before making headline news in 2013 by returning home from Australia after the first Ashes test. This seemingly super-healthy sportsperson at the peak of his powers writes:

‘I hadn’t slept, I hadn’t eaten and I hadn’t been able to stop the throbbing in my head.’

He recounts that he had to telephone his father to tell him that he was unable to cope any longer and he was flying home.

‘He didn’t say it’, he said,

‘But I knew he’d be disappointed.’

And he wrote:

‘The man I most wanted to make proud, I’d shamed.’

His use of language is illuminating and harrowing. Interestingly, it is his description of his anxiety-related illness and his explicit and public decision to describe his situation as an anxiety-related illness rather than depression that caused controversy itself. Former England captain Michael Vaughan said he felt a ‘little bit conned’, saying:

‘When I hear players talking about burnout, I suspect it is an excuse.’

This public example of Jonathan Trott, misunderstood by fellow players, seemingly with every trapping of success, is a clear warning to us of the stigma that continues to swirl like the fog proverbial of Baker Street in ‘Sherlock Holmes’. It still surrounds mental health issues. Nine out of 10 people with mental ill health find that stigma and discrimination can be a barrier to everyday activities, and that is why one of the central themes of ‘Together for Mental Health’ is about changing attitudes to mental health culturally, and why Welsh Labour is committed to ending mental health discrimination in the programme for government.

I was heartened to hear the statement of the Cabinet Secretary for Health, Well-being and Sport on the second delivery plan of the Welsh Government’s 10-year cross-governmental strategy, ‘Together for Mental Health’. I acknowledge that there are criticisms, and Sarah Moseley, director of Mind Cymru, whilst welcoming the plan, stated Mind’s concerns that mental health services are significantly underfunded, but yet, in 2015-16, the budget for mental health services in Wales is £587 million, up from £389 million in 2009-10. This equates to 11.4 per cent of the total Welsh NHS budget, the single biggest area of Welsh NHS expenditure. As the health Minister stated yesterday, over the last two financial years, we have announced over £22 million of new funding for a range of new provision across all ages. The delivery plan identifies a priority area that aims to ensure children and young people with mental health problems get better sooner. Yesterday I was fortunate to attend Childline’s thirtieth birthday celebrations in the Senedd with Dame Esther Rantzen, and it is worth noting that NSPCC Cymru, commentating on the delivery, welcomes the emphasis that the Welsh Government has given to prioritising this issue. Recent additional investment into child and adolescent services in Wales should continue, and it’s important that delays in accessing services are further reduced. It’s a shame, therefore, that Plaid Cymru have sought to focus their new motion on their usual preoccupation with powers for politicians, unlike the opposition amendment that addresses this subject. As such, I very much welcome—

Can you wind up, please?

[Continues.]—this important debate and, equally, Welsh Labour Government’s strong determination to confront the challenges of mental health provision head on. Thank you.

We’ve had many debates in this Chamber over the years on mental health, and I think, obviously, it’s been a challenge for us to discuss this, but more of a challenge for people to be able to deliver services in this area, and to speak about personal experiences, as many have in this room today.

Usually, I start off by speaking about the rights and the protection of the sufferers, but today I just want to tell you a small story about someone who is employed in the mental health service in south Wales who spoke to me over the weekend. She’s an administrator working for a centre for mental health in my region, and she’s not trained in mental health at all. In fact, she’s requested on numerous occasions to be trained up so that when she sees somebody coming through the door, she can know and she can deal with it. She’s had an experience three or four times where one gentleman has rung her telling her that he is stabbing himself physically in his stomach because he doesn’t want to live anymore, and asking how she can help him. Sometimes she can’t refer on to a doctor, because the doctor is seeing somebody else in the clinic and she has told me, ‘I am scared because I have no qualifications, but I am dealing with this man. What if he actually kills himself while doing this? Because the next time, he will die, and I will not be able to save him.’ I think hearing stories like that—. Statistics are important, but when she told me that I just thought, this woman, who’s on the lowest pay grade in the whole of the NHS in that area, is having to deal with such a traumatic experience, and she has to take that back to her family every single night. I think that’s something that we should all remember in this discussion.

Of course, I want to discuss employers also. I think it’s important we discuss this in relation to how we can protect employers in Wales. It’s not a nationalistic propaganda discussion. It’s about how, because of the Brexit vote, we can protect workers in our NHS situations, in our public sector work, when they are rolling back on those very workers’ rights that the Labour Party advocated in the first place. If we do not want those powers here, and we want the Conservatives in Westminster to rule over those powers, then why are we in politics? I want those powers here so that we can protect the people who work within our environment and make sure that they are safe working in such environments.

We’ve talked here today about employers who, potentially, have refused or will not employ people with mental health problems. I think the stigma is still there, even though I and Llyr and others, and David Melding, have spoken out. I’ve had messages from people saying to me, ‘Well, it’s great that you’ve done that, Bethan, but I still will not tell my employer that I suffer with either bipolar or depression, because I know that if I go into work tomorrow they will look at me differently and they will see me differently, and will think that, by virtue of the fact that I have that depression labelled on me, I will not be able to do my work.’ I think that’s still a massive challenge for the Welsh Government to be able to deal with.

What I’m passionate about also is about having more self-esteem and confidence lessons in schools. I’m not necessarily saying we should have mental health lessons, because that may be a danger in and of itself, where we would tell somebody about a condition and they may feel nervous around knowing more about that condition at such a young age. So, that’s why, over the years, I had a meeting with Jane Hutt, when Jane Hutt was the education Minister, about trying to have those well-being lessons in schools so that people, young girls especially, can have the confidence to go out there and not just believe that they are a sexual object walking down the street, with the adverts on display boards, and that they’re going to be objectified for the rest of their lives, and to have that difficulty to empower themselves when they do grow up to be women in this society.

I think I’ll finish by saying that it’s very important that we have these debates, but I think it’s much more important that we see action now. Services are struggling and schools have counselling services that are creaking at the seams. We need to take our rhetoric out of this Chamber and make sure that we all campaign in our respective areas to make sure that we end the stigma and also talk to people in a positive way about why their mental illness does not define them. Some people may never be able to totally—. Like a physical illness, it may be able to be treated and be gone forever, but sometimes it will stay with you. That shouldn’t be seen as a bad thing and it shouldn’t define who you are as a person. It should be just part of a bigger picture as to who that person is. I hope that’s what we can leave this Chamber today thinking about. Diolch yn fawr.

I want to focus my comments on services to children and adolescents. Of course, we can’t talk about improving child and adolescent mental health services without talking about CAMHS waiting times. We know that they are still far, far too long and haven’t been restored to the 2013 levels, never mind achieving the improvement that each and every one of us wants to see happening. Waiting times are, of course, important in terms of outcomes. The Gofal survey of mental health service users shows that there is a clear interrelationship between lengthy waiting times for treatment and the likelihood that someone won’t actually state that their mental health and well-being has improved. But, of course, waiting times is just one issue.

Nid yw ond yn crafu’r wyneb. Crafu’r wyneb yn unig y mae amseroedd aros—mae’n un agwedd. Mae iselder, gorbryder a hunan-niweidio wedi dod yn rhy gyffredin ymysg cenhedlaeth sydd â llawer o bryderon am bethau fel seiberfwlio, pwysau i gadw at bwysau corff delfrydol ac wrth gwrs, cael cynnig dyfodol o gontractau dim oriau, dyledion myfyrwyr enfawr a chaledi diddiwedd gan genhedlaeth o wleidyddion, gadewch i ni fod yn onest, nad ydynt wedi wynebu yr un o’r pethau hyn yn eu dydd. Rydym i gyd yn gwybod bod buddsoddi yn y blynyddoedd cynnar yn hanfodol i sicrhau canlyniadau cadarnhaol o ran addysg ac iechyd, ac yn arbennig i atal rhai o’r problemau a all godi yn nes ymlaen mewn bywyd.

Mae datblygiadau mewn niwrowyddoniaeth hefyd yn dangos y gall blynyddoedd yr arddegau fod yr un mor allweddol i ddatblygiad person â’r blynyddoedd cynnar. Mae cyfraddau problemau iechyd meddwl yn codi’n serth yng nghanol a diwedd y glasoed. Ar gyfer y glasoed rhwng 11 a 16 oed, roedd cyfradd problemau iechyd meddwl yn 13 y cant ymhlith bechgyn a 10 y cant ymhlith merched. Mae’r ffigur hwn yn agos at gyfraddau oedolion o tua 23 y cant—chwarter—erbyn iddynt gyrraedd 18 i 20 oed. Gwyddom hefyd fod 70 y cant o blant a phobl ifanc sy’n dioddef problemau iechyd meddwl heb gael ymyriadau priodol ar oedran digon cynnar—cwbl annerbyniol.

Er bod Llywodraeth Cymru wedi rhoi llawer o sylw i lansiad—neu ail-lansiad, efallai, Plant Iach Cymru ar gyfer plant hyd at saith oed, nid oes strategaeth ar gael ar gyfer gwella iechyd rhai yn eu harddegau, ond mae’r angen am un yn glir. Mae’r gyfradd farwolaethau ymhlith rhai yn eu harddegau rhwng 15 a 19 oed yn uwch yng Nghymru nag yn Lloegr, ac ni chafwyd unrhyw ostyngiad yn nifer y marwolaethau o anafiadau bwriadol ymhlith y grŵp oedran rhwng 10 a 18 oed ers tri degawd.

Mae angen cynorthwyo plant sydd ag oedolion â phroblemau iechyd meddwl yn eu bywydau hefyd wrth gwrs. Gall edrych ar ôl aelod o’r teulu sydd â phroblem iechyd meddwl arwain at effeithiau sylweddol ar iechyd meddwl y gofalwr ei hun, ac wrth gwrs, dyna reswm arall pam rwy’n siŵr ein bod i gyd yn cytuno bod angen gwella cymorth i ofalwyr.

Felly, beth y gallwn ei wneud? Wel, mae’n amlwg fod gan ysgolion rôl allweddol i’w chwarae yma ac mae arnom angen dull o weithredu ar sail ysgol gyfan mewn perthynas â hyrwyddo iechyd meddwl a llesiant. Mae angen dysgu disgyblion am broblemau iechyd meddwl posibl a all ddigwydd a’r camau y gellir eu cymryd i gadw’n iach. Mae arnom angen gwersi mwy rhagweithiol, wedi’u hanelu’n benodol at ferched mewn perthynas â chael delwedd iach o gyrff—ac nid merched yn unig, ni ddylai bechgyn ychwaith deimlo pwysau i gydymffurfio â delweddau afrealistig o gyrff. Mae angen i addysg ar berthnasoedd iach ddigwydd hefyd ac mae llawer mwy y gellid ei wneud wrth gwrs.

Wrth i mi ddod at ddiwedd fy nghyfraniad, hoffwn gyfeirio at y sefyllfa yng ngogledd Cymru’n benodol.

I want to refer specifically to the situation in north Wales as it is today. The reality is that the Betsi Cadwaladr health board is facing a debt of £106 million by the end of this three-financial-year period. They are expected, of course, to make right that debt, but cutting £106 million would lead to some 10 per cent less in expenditure next year. I have to say that the most recent minutes of the board show that 27 finance managers have refused to agree to cuts in their budgets, and this is the important point, of course—most of these managers work in mental health, and many work in the field of learning disabilities. Betsi Cadwaladr, of course, is Wales’s largest health board and is a board under special measures, and those cuts do mean that this important service will be under even greater pressure in ensuing years. Many are already complaining that it’s a cinderella service. Well, given that things are going to be even more difficult financially over the next few months, it is a cause for real concern for all of us, I’m sure. I would be eager to hear the response of the Cabinet Secretary to that particular situation in north Wales as he responds to this debate.

Bethan Jenkins gave us a very powerful example of somebody having to deal with mental health issues on a day-to-day basis, without any of the training that you would normally expect. My daughter, as a primary school teacher, often tells me about very painful circumstances that she describes of children in her care, which is a daily experience for any primary school teacher, unfortunately, in areas of deprivation. They really do bring tears to your eyes, because those children rely on the school to be their place of safety. I wanted to talk about the importance of the school in helping to resolve some of the issues that children encounter, which if not resolved in school, do end up as pretty substantive mental health problems in adulthood.

We know from the Welsh Government’s figures that last year self-harm among young people has reached a five-year high, with more than 1,500 young people between 10 and 19 treated in Welsh hospitals for harming themselves. We also know that children are using self-harm as a way of trying to deal with very difficult emotional states. Often, children will misinterpret events that adults would regard as trivial and unimportant, but, without having the ability to discuss them properly with an adult, will become major issues in the child’s mind. I want to highlight the fact that the Public Policy Institute for Wales report that was published in February focused on the fact that pupils supported by the pupil deprivation grant are at greater risk of mental health problems than other pupils.

Yesterday, the Cabinet Secretary for Communities and Children spoke about the focus on adverse childhood experiences, and the need to reduce them if we’re not going to have more and more of the same inter-generational problems reoccurring, with people ending up in unemployment, in mental health hospitals, in prison. I absolutely agree with that. So, I think that there’s much that can be done in schools, and I think we have to prevent these adverse childhood experiences of mainly verbal abuse and parental separation being passed down from one generation to the next.

I just wanted to pick up on the point you made about deprived areas. I visited a friend who works in a private school in London to talk to him about many of these issues, and, actually, there was isolation from their parents because they were living away from them, and they suffered mental health problems, just as people do in deprived areas.

I wouldn’t disagree with that, but I still think that deprivation is a substantive contributor to emotional ill health.

I’d like to pay tribute to Angela Rayner, who’s the shadow Secretary of State for Education in another place, who spoke so courageously about the inability of her mother to love her, and this was in the presence of her mother, in front of about 1,000 women. I think that that was such a courageous act, both on the part of her mother and her, which was really part of her journey to ensure that that inability to love was not passed down to the next generation.

One of the things I think I’ve spoken about before is the Roots of Empathy programme, which Action for Children has been running in Llanedeyrn Primary School in my constituency, which has been evaluated as being something that really does deal with children’s agony over the inability to understand what makes for positive relationships. And this is about having a parent with a baby who comes in to the school once a fortnight, and those children being able to develop that relationship. This reduces aggression in the playground and absenteeism.

At Cathays High School, we have mindfulness training and restorative practices, which have also ensured the building of emotional resilience in our young people for later life. I think that it’s absolutely clear from the PPI report and other reports that have been done that it has to be a systematic, whole-school approach to emotional health, well-being and resilience. It can’t just be in a single lesson; it’s got to be something that’s carried out across the school, and I think that it then does support children who are having unhappy times elsewhere to at least develop the emotional resilience to overcome them.

I would like to thank Plaid Cymru for tabling this important debate, allowing us to mark Mental Health Awareness Week. With one in eight people in Wales currently seeking medical help for mental illness and an estimated one in four of us experiencing mental health problems at some point during our lifetimes, it’s clear that we need to give mental health a high priority.

It was great to see so many people taking to social media on Monday to help reduce the stigma that is still attached to mental illness. It is truly disturbing that, in the twenty-first century, people suffering with poor mental health have to also deal with stigma, harassment and a total lack of understanding. A survey undertaken by Time to Change found that stigma and discrimination is all pervasive, with close to nine out of 10 service users reporting its negative impact on their lives. Two thirds have stopped doing things because of stigma and two thirds have stopped doing things because of the fear of stigma and discrimination. How often have we heard people suffering from depression being told to, ‘Man up’ or that they needed to get over themselves, or pull themselves together? This is not acceptable. These attitudes prevent people suffering from mental ill health from speaking out or even seeking help. Far too many people are made to feel isolated, ashamed and worthless as a result of their mental health issues. We all have a part to play in making it easier for people with health problems to make friends, to work and lead an absolutely full life.

In addition to tackling stigma and discrimination, we have to ensure that any suffering from mental health problems have timely access to treatment. Early access to talking therapies such as cognitive behavioural therapy is proven to improve recovery and reduce the need for more acute services. Mind recommend that the maximum waiting time from referral to first treatment should be 28 days, and when someone presents with a mental health emergency, the wait must be shorter.

Of course, if we are to improve mental health services we must ensure that the correct funding is in place. Mental health problems account for around a quarter of all health problems, yet we are spending 11.4 per cent of the NHS Wales budget on mental health. In England, where the mental health budget is not ring-fenced, they are spending 11.9 per cent of the NHS budget on mental health. One local health board, Aneurin Bevan, routinely spends over 17 per cent more than its ring-fenced allocation. PricewaterhouseCoopers, in their review of the financial ring-fencing arrangements for mental health services in Wales, state that the ring-fenced allocation is not based on a robust assessment of healthcare needs. The Welsh Government needs to change the ring-fencing arrangements as a matter of priority.

I would like to thank Plaid Cymru for giving us this opportunity to hold this debate. I welcome and support their call to educate young people about mental health issues. However, we cannot support the devolution of employment law and will therefore be supporting the Welsh Conservative amendment. Thank you.

I think much has already been said very powerfully in this debate, and covered, so I’m not going to touch on those areas that have already been covered. I want to confine my comments, quite briefly, to support for mental health in the workplace.

Could I start by commending the intent behind this motion from Plaid Cymru? But I believe the third proposal of the motion is a diversion away from what should be the main thrust of the debate. We could spend many months or longer engaging in legal arguments with the UK Government over the competence of this devolved administration legislating on employment matters. And those arguments are certainly pivotal when it comes to addressing, for example, applying the provisions of the insidious Trade Union Act 2016 here in Wales to devolved public services, but they are not what we should be focusing on when we come to talk about mental health issues in the workplace.

We do, of course, already have employment law that provides protection for employees against discrimination under the Equality Act 2010, although I do understand the mover’s reservations about the UK Government’s commitment to that. ‘Is the legislation strong enough?’ is a question, of course, that one can always pose, but perhaps the question should be, ‘Is the legislation being effectively applied in the workplace?’ If I learned one thing during my 30-odd years as a trade union activist and organiser, it is that you can put in place as much legislation as you like, but you will never put an end to discrimination of any sort in the workplace unless you tackle the culture of prejudice at work and ensure that robust support mechanisms are in place for victims of discrimination. That’s why I am fully in support of the amendment from Jane Hutt, which recognises the important role for employers in supporting people with mental health issues at work.

I’m also pleased that, in his statement in this Chamber yesterday, the Cabinet Secretary for Health, Well-being and Sport made reference to the Welsh Government’s support for businesses and organisations to recognise that mental ill health should not be a barrier to effective working. There are some excellent examples of major companies in Wales, like Admiral and Dŵr Cymru, that provide comprehensive mental health awareness training for their employees, not only to help them in their engagement with customers, but also to support colleagues in the workplace. These companies see raising mental health awareness as an integral part of their health and safety strategies.

I also want to give recognition to the important role that trade unions in Wales play in both raising awareness of mental health issues at work, but also being at the forefront of providing that robust support in the workplace. I’m particularly proud of the work undertaken by my own union, Unison Cymru Wales, which has organised training courses to appoint mental health champions to enable them to best support colleagues suffering with stress, anxiety and depression.

So, in conclusion, Deputy Presiding Officer, I’m just grateful for having had the opportunity to speak in this debate and to support the amendment from Jane Hutt, which, as I said, I think would make this a motion that all in the Chamber could support, and would provide the impetus for tackling issues around mental health in our workplaces.

Thank you. I call the Cabinet Secretary for Health, Well-being and Sport, Vaughan Gething.

Thank you, Deputy Presiding Officer, and I’d like to thank Plaid Cymru for bringing forward the debate and Members who have contributed to a mature and sensible debate, which I think reflects the approach that this Chamber has taken through a range of terms on this issue. Because, as others have said, we all recognise that mental health issues will affect all of us at some time or another, whether directly as individuals experiencing that, or friends, families or loved ones. I do support the principles of the motion today.

Of course, Monday was World Mental Health Day, when I launched the Government’s second delivery plan to support our 10-year cross-Government strategy, ‘Together for Mental Health’, and yesterday, during my oral statement, we went through that delivery plan in more detail for the next three years. We set out 10 priority areas for improvement, and how we expect to see that driven forward and actually delivered.

I’ll start with the area of stigma and discrimination, which, again, we discussed yesterday. I’m pleased to hear a range of Members raise this issue in their contributions today, and also to reflect back to those Members in this Chamber who actually talked about their own experiences of suffering from mental health illness. I think it’s really important that we all display an element of leadership here, as individuals and as Members in this place, in the way we conduct ourselves. The way we talk about these issues does make a difference.

Whilst we know that attitudes are changing, there’s still much more to do. That’s why it’s a priority within the new programme for government and it’s also a key element of the ‘Together for Mental Health’ delivery plan too. I’m really pleased that other Members in this Chamber, in every party, have recognised the value of the Time to Change Wales campaign. It’s the first national campaign of its kind to help end discrimination and stigma for those who experience mental health problems. Of course, the main aim of that is not just to challenge those problems, it’s to try and change the way we think and talk about these issues, as well. That partnership that’s brought that together is with Mind, Hafal and Gofal, and the Welsh Government is proud to have supported that with £0.5 million of funding.

We’ll also be supporting a state of stigma event early in the new year, run in partnership with Mind, Gofal and Hafal, to make sure that this issues does not fall off the agenda. There’s much that we have done, which we should be proud of, but there’s still much more to do.

The issues about stigma and discrimination will also inform the new young person’s anti-stigma programme that will be led by the Time to Change partnership. Over the course of the project, we expect young champions to engage with at least 5,000 young people and aim to develop a whole-school approach to mental health awareness, anti-stigma messaging and activity to reinforce that.

I also recognise that many Members referred to the world of work in their contributions. Of course, as we set out yesterday, again, mental health problems can have a huge impact on someone’s ability to work, but also good work is good both for people’s physical health and mental health too. So, through our Healthy Working Wales programme, we’re supporting employers to recognise that mental health is not necessarily a barrier to work and sustainable employment is often the best way to support individuals to help them to recover from any episodes of mental ill health. That Healthy Working Wales programme allows us to support employers to support their own staff to improve their own mental health and well-being. Over 3,000 employers are already engaged with Healthy Working Wales and between them, they employ over 460,000 people in Wales. So, there is significant reach with that programme already.

To build on this and take it forward, we’ve developed a programme, funded through European structural funds, to sustain people in work and help people to move closer to work as well. That’s got a focus on supporting people with mental health problems. So, the in-work support service aims to help over 4,000 people and 500 employers by providing rapid access to work-focused therapies for those at risk of long-term sickness absence. The out-of-work service aims to assist 6,000 people to overcome health barriers to employment, moving them closer to work or actually into work. These programmes have secured over £8 million of European structural funding support over three years.

Again, I’m happy to recognise what’s been said, not just in today’s debate, but during yesterday’s statement and many others, and I’m sure that will continue to be the case in the future, and that’s about how we support children and young people. Again, this is a key element, as you’d expect it to be, of our approach to improving mental health and well-being and tackling stigma and discrimination. We’ll continue to have debates around CAMHS and what we’re doing until we recognise that waiting times are in a position where all of us recognise that we’re in an acceptable position and we see real and sustained improvement. I do not shy away from that. That is why it is a priority within our delivery plan. In particular, the broader objective to develop resilience and emotional well-being amongst children and young people to make sure that before children reach teenage years, we’ve actually helped to develop that resilience and emotional well-being so that we do see fewer problems arising at that time and later on in adult life.

As you’ll have heard yesterday from the Cabinet Secretary for Communities and Children, there’s strong evidence that the well-being of children is linked to their educational outcomes. Children with higher levels of emotional, behavioural, social and school well-being, on average, have higher levels of academic achievement. They also appear to be more engaged in school, further and higher education, work and other aspects of life in later years. That’s why we will be strengthening our work with schools and colleges to help children and young people feel better and, hopefully, to tackle some of the newer problems that people like myself did not have to face. For example, the internet and social networking provide different challenges and problems that we need to be aware of.

So, we aim to do more than intervene when problems start to emerge; we aim to promote actively that positive well-being. And that’s why we are supporting school counselling services. They’re in every secondary school and for year 6 pupils as well. I was pleased to hear Jenny Rathbone mention the fact that some schools are positively using their PDG money to actually help with this area of school counselling to promote well-being for children and the whole parent community. There is, of course, the opportunity in the PSE part of the curriculum: it’s standard, it’s expected, and so it’s a part of every curriculum for pupils in maintained schools, and the opportunity is there to think about how we positively promote messages in this area, too. But, just as a matter of—. This is a matter where we’ve put £13 million in grant funding over five years into this area. It’s now part of the RSG for local authorities to make sure that that money is available for a school counselling service.

In terms of the role of public services—and, again, I’m pleased to see these mentioned in the motion—you’ll be aware the Well-being of Future Generations (Wales) Act 2015 requires all public bodies to maximise their contribution to the well-being goals, and that is about physical and mental health and well-being as well. You will, of course, be aware that the Assembly Commission and other public bodies—over 30 public bodies—have signed the Time to Change Wales organisational pledge.

I do want to deal with the reference to employment law in the motion, and here I agree with Dawn Bowden, who I knew in a different life, when she had a job that people respected in a trade union and I was a lawyer, which wasn’t necessarily respected by everyone, but the reality was always that the law would say one thing, but it was all about how you enforce your rights. Actually, in mental health stigma and discrimination, the challenge was how you get to that point where you’ve resolved those issues without needing to go to the law. That was almost always about organisational culture and changing the minds of employers, because often the policy position that each employer had sounded perfect. The challenge was always: how do you deal with that and how do you make that change? The law is part of it, but that cultural challenge is an even bigger part. I’d say to colleagues in Plaid Cymru, we will be supporting the Conservative amendment. If that isn’t passed, we will ask the Chamber to support the Government amendment. But, having an honest disagreement about the devolution of employment law does not mean that we don’t care. It does not mean this is not a priority for the Government. It’s simply disagreement on how we get there and where powers should lie.

I just want to finish on this part, because, in today’s debate and previously, there’s been a real measure of cross-party support and consensus. It’s how the mental health Measure was passed in the first place, and each party in this Chamber that’s been here for the last few terms has a real share of credit for the way that Measure was introduced and is being implemented. I hope that we maintain that broad consensus, because each of us has a shared responsibility and ability to influence this debate positively, so I look forward to working with people across each of the parties, because we recognise that there’s much we have already achieved, but also much more to do until all of us can say that we’re happy and satisfied. Many thanks.

Thank you. I call on Rhun ap Iorwerth to reply to the debate. Rhun.

Thank you very much, and may I thank everyone who has taken part in the constructive discussion this afternoon for the contributions from across the Chamber? We’ve heard very powerful accounts. I’ll name Bethan Jenkins as one who brought the experiences of one constituent to our attention as part of this discussion in a very powerful way.

Felly, diolch i chi am eich holl gyfraniadau. Nid yw’n syndod fod llawer o gytundeb ar yr egwyddor hon ynglŷn â’r hyn rydym yn ceisio’i gyflawni o ran agweddau pobl, ac rwy’n croesawu cyfraniadau’r Aelodau o bob rhan o’r Siambr, ar draws y rhaniadau gwleidyddol. Yn ymarferol, o ran polisi, dywedodd Angela Burns fod y gwahaniaethau rhyngom yn seiliedig ar saith o eiriau. Rwy’n gresynu na fydd y Ceidwadwyr, ynghyd â Llafur ac UKIP, yn mabwysiadu’r her o geisio datganoli cyfraith cyflogaeth. Dywedodd Angela Burns ei fod yn bwyslais cenedlaetholgar. Rydym yn ceisio datganoli yn y maes hwn i bwrpas, a chyda bygythiadau ei phlaid yn San Steffan i hawliau cyflogaeth pobl, mae angen i ni sicrhau bod gennym yn ein dwylo—ni, pobl Cymru—y pwerau i warchod buddiannau’r Cymry, yn enwedig rhai o’r bobl fwyaf agored i niwed yn ein cymdeithas. Felly, cytunodd UKIP â’r Ceidwadwyr; dewisodd Llafur hefyd, yn eu gwelliannau, wrthod y syniad o gymryd cyfrifoldeb yn y maes hwn ac ymddiried yn Llywodraeth Dorïaidd y DU yn lle hynny, er bod yr Aelod dros Ferthyr Tudful wedi cydnabod ein bod mewn cyd-destun gwahanol iawn yn dilyn y bleidlais ym mis Mehefin, ac yn wynebu bygythiad gwirioneddol, o bosibl, i rai o’r deddfau sy’n diogelu pobl yn ein cymdeithas, a deddfau sy’n diogelu gweithwyr â phroblemau iechyd meddwl.

Ond, gan roi’r mater pwysig hwnnw i’r naill ochr, mae’r ddadl hon yn dod â ni i gyd at ein gilydd yn briodol yn ein penderfyniad i fynd i’r afael â rhagfarn yn ein hagweddau tuag at iechyd meddwl. Ar y pwynt o anghytundeb, byddwn yn apelio ar Lafur a’r Ceidwadwyr i ailystyried eu gwelliannau i ddiogelu ein gweithwyr mwyaf agored i niwed, a byddwn yn dweud, ‘Byddwch yn ddewr a cheisio’r pwerau a fydd o bosibl yn gwneud ymladd y rhagfarn honno’n haws yn y dyfodol’.

Thank you very much. The proposal is to agree the motion without amendment. Does any Member object? [Objection.] Thank you. Therefore, we defer voting under this item until voting time.

Voting deferred until voting time.