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Yes. I think that many folks who have thought about this for a long while acknowledge that, if you are in a rural area, particularly in a remote rural area or an island community, not everything will necessarily be on your doorstep. That is right. However, there are other ways of delivering services within those communities. Let us take, for example, rural Aberdeenshire—let us go with your constituency, convener, which contains many remote rural places, although some folk might find that hard to believe. There are different ways of delivering services there that ensure that those communities can still flourish and benefit from those services.

During the course of the pandemic, we have seen a rise in the use of telemedicine, but Grampian was a trailblazer in telemedicine long before the pandemic period. We can deliver a lot of services to remote rural communities online. We have to think about what is required. I have to say that I was sceptical around some of the online provision in relation to mental health services, but it works for people—it works well. Again, in your neck of the woods, convener, over the course of the pandemic period, the Grampian resilience hub did extremely well in bringing services into folks’ own houses at a point where they could not get out or could not get from Newmachar, Insch or wherever to services in Aberdeen.

There are ways of doing what we are talking about, and it is not just about the physical aspect of that 20 minutes; it is about what we can do in terms of the online world to bring those services to communities that are more remote and rural and to island communities? I am sorry if I have gone on too long but I am quite passionate about this.

I agree with the points that Ms Mackay has made. We have a job of work to do to ensure that we have the right mental health workforce for the future. That includes looking at the entry into the profession. It also includes getting the educational elements of this right and allowing folks to follow the career pathways that they may wish. We have some work to do there, but if we are truly serious about getting mental health services right and fit for the future—which I am—we need to recognise that we need more diverse folk in the profession.

Again, we have to be flexible in terms of the workforce. We have talked about school counselling. One of the next big moves, of course, is around folks in the primary care setting, which is extremely important. I have had conversations with a number of colleagues around the table about how we can get that right, because it cannae be the same old. We need folk from diverse backgrounds but, beyond that, we need workers to be multidisciplinary in what they do.

I will be honest with you and say that I am willing to steal good ideas from elsewhere. I met Dr Gulhane a couple of weeks ago about children’s wellbeing practitioners south of the border. I am quite happy to nick good ideas if they fit in. That is grand.

One of the main things that we need to do is to make sure that there is a diverse workforce that caters for the needs of all of society—not just the LGBT+ community but, as Ms Todd mentioned earlier, our minority ethnic communities, which are often not brought into play enough in this regard. In particular, folk will know that I have had an interest in what more we need to do to support our Gypsy Traveller community. We have to get this right for all.

The evidence has been clear since before the pandemic that girls and young women appear to experience poorer mental health and wellbeing than boys. We undertook research on the reported worsening of the mental wellbeing of young women and girls, which was published in 2019. That research highlighted several interrelated drivers that may have contributed to that trend, which included things such as body image concerns. To further explore some of the causes of the trend, we established the Scottish Government national advisory group on healthy body image for children and young people, which published its recommendations in March 2020. We are currently working on meeting those recommendations. That is one area where we need to move further forward.

I know that there has been discussion at the committee and evidence given about the impact that screen time and social media use can have on young folk, so body image is not the only aspect, although it is way up there. We are looking to resource work on that and to work with Young Scot to bring forward a national conversation on body image, screen time and mental wellbeing. We want to hear the voices of young folk about this directly, so that we shape our future work absolutely right.

We have touched on eating disorders today. Young girls are disproportionately impacted by eating disorders, which was again exacerbated during the course of the pandemic. I have already outlined some of the work that we are undertaking there.

We also need to better understand the mental health needs of women and girls who are affected by gender-based violence. Having recently funded and published an Improvement Service report on that important subject, we are now considering how best to take forward its recommendations. We will link all that work to a refresh of the Scottish Government’s equally safe delivery plan.

I would like to touch on another area where we need to do more: autism in young women. I have heard—and I am looking at members’ faces because I think that others have probably heard the same thing—that it is much more difficult for a young girl or a young woman to be diagnosed as autistic, and often they are left in limbo for a long while and diagnosis comes far too late. We have to ensure that we work on that. It will take a fair amount of graft to get it right for the future.

I hope that that gives you a flavour of some of the work that I see as being a priority, but there are many other things that we are doing also.

I will add to what Ms Todd has said, as there are a number of other things that we need to do. We need to raise awareness of adverse childhood experiences in our communities and across the nation. We have to recognise the impact that trauma can have on people. That is why we are investing in our national trauma training programme and providing some £4 million to support the development of trauma-informed workforces and services.

In some parts of the country, trailblazing work is going on. I had the pleasure of talking to folks from South Ayrshire and Dundee recently. I was very impressed with the huge amount of work that South Ayrshire Council has done with its workforce and with elected members on trauma-informed practice. We have to ensure that such work is exported across the board.

Ms Harper asked about eating disorders. Eating disorder services are extremely important to me because, as folk know, I know people who have been impacted by family members having eating disorders. During the pandemic, the number of eating disorder cases has risen, and we have to continue to monitor and react to that.

As folks know, we conducted a national review of eating disorder services. The review group is jointly chaired by Dennis Robertson, a former MSP, who has campaigned vociferously for improved services, and Dr Charlotte Oakley, who was previously the clinical lead of the connect-ED—eating disorders—service at NHS Greater Glasgow and Clyde. The group’s aim is to ensure that stakeholders are empowered, through collaboration and engagement, to provide their input, experience and expertise and to play a leading role in delivering the recommendations and improving services.

I am sure that the committee is well aware that, in June, we announced an additional £5 million to respond to the review’s recommendations. We have also provided further investment in third sector organisations—for example, we gave £400,000 to Beat, the UK’s eating disorder charity—to provide a wider range of options and support for those affected by eating disorders, including families and carers.

I do not think that we should underplay the issue. There has been an increase in the number of folk presenting with eating disorders, so we have a fair amount of work to do to get it right for folk.

I do not want anyone to have to go elsewhere for treatment. I want folk to remain as near to their home as possible, because one of the key things in all of this is family support. We have some very good practice in supporting families when there is a distance to travel, but we probably have to do more on that front.

The key thing for me—I am sure it is the same for Dr Gulhane—is that we get to a situation in which folk do not have to go into acute services. That is why an amount of our investment has gone to the likes of Beat. We need to build on the community support that is available. I have visited the unit here, in Edinburgh, and a huge amount of its work is in the community rather than on the ward. We are in a situation in which we will have to keep a very close eye on beds. It may well mean more investment and an increase in the number of beds, but I think that it is preferable—I am sure that Dr Gulhane would agree—if we can keep folk out of hospital and provide them with the right support community. That would be the best way forward.

As Ms Baillie well knows, we have gone through a global pandemic, and are now getting back to some kind of normality. I have outlined what we have done around CRWIAs. We know that we have more to do and we will do it.

You might get it from a mental health perspective and perhaps a bit of a history perspective and a planning perspective as well.

Ms Callaghan has asked an important question. It is one of the reasons why 20-minute neighbourhoods featured in the SNP manifesto and in the manifestos of the Scottish Greens as well, if I remember rightly—Ms Mackay may correct me there. It is important that, as we plan our neighbourhoods we get it right. In terms of our net zero ambitions and our ambitions for vibrant communities, that is the right way forward.

I know that, in some local authorities, there is much more advancement in this kind of work. There should be more of it, as far as I am concerned. I know from my own experience in local government that initiatives such as planning for real exercises, which involve communities and individuals, are a good way of getting that balance right. Not everybody gets what they want—that is the reality—but, if you set down the parameters, that is helpful in shaping the future of communities.

This is an important issue. I think that we now have the right planning regime in place to allow that to go forward, including the opportunity for neighbourhoods and communities to be involved in local place planning. In order to do that—I apologise to those folks who have heard me say this before, because it is a point that I make all the time—we need to bring community planning and spatial planning together and not see them as separate. We know that achieving that will bring about results that can be good for folks’ physical health and their mental wellbeing.

There is a lot of work to be done. Many areas are embarking on it, and some are further on in that journey. However, this is good stuff as far as I am concerned and it is the right thing to do as we move forward.

I think that, in many places, they are. Again, I think that we do very well in those places where services listen to young folks with lived experience, where there is that communication, collaboration and co-operation. That does not work so well for others, I have to say. That is one of the reasons why we have put in place the child and adolescent mental health service standards that we have. There is work to do there, without a doubt, and we need to have young folk at the very heart of shaping those services in the future.

I have talked to a lot of young folk over the past number of months and I will be honest with the committee and say that some of the issues that have been raised with me are ones that I would not necessarily have thought of. I think that we need to make sure that we are capturing all of the difficulties that young folk face.

Let me give some examples. The school counselling service is an important move forward in terms of mental health service delivery. We are beginning to get data from those counselling services on what the main challenges are that young people are coming to those counsellors about, and LGBT+ issues are up there. We have to take cognisance of that and ensure that we are shaping the right services for the future to do right by folk.

We only have to look at news reports from yesterday to see the impact that it can have on young women. Day and daily, this is difficult for young women, so we have to get this right as we move forward and we are committed to doing that.

I will not stray into talking about education and early years, although it is tempting, because I know that the committee will hear from Shona Robison and Clare Haughey next week.

The investment that we have made in perinatal and infant mental health support can also make a big difference. I know that the committee has been discussing that subject and that you will report on it very soon. The four-year investment makes a substantial contribution to improving and supporting the mental health and wellbeing of women and infants, which can have a huge long-term impact. We await your report and recommendations with anticipation.