Maree Todd: People need to get help in the right place at the right time

It isn’t always easy changing jobs, particularly when it is something you enjoy so much, but, as Maree Todd explains, being a minister in government isn’t a normal job.

The former Minister for Public Health, Women’s Health and Sport in Nicola Sturgeon’s government had been in the role for just under two years and admits there were still things that she wanted to achieve. But when she was asked by the incumbent first minister, Humza Yousaf, to become Minister for Social Care, Mental Wellbeing and Sport, it was an opportunity Todd could not refuse.  

Having worked in the NHS for 20 years as a mental health pharmacist before her career in politics, she says it is the “privilege of my life” being entrusted with the role – a line so often spoken by Nicola Sturgeon and Humza Yousaf in the last 12 months.  

She takes on the portfolio at a particularly difficult time, as Scotland is dealing with the aftershock of the pandemic and while the cost-of-living crisis continues to plunge more Scottish families into financial uncertainty. But Todd is not shy, nor unwitting about the task at hand, describing the change in role as “daunting” and acknowledging that the “country has come through real trauma”, but says she is “very keen to get cracking”.  

And get cracking she must. The country’s mental health is continuing to worsen, particularly among young peoples, something reflected by the most recent CAMHS figures. From the quarter ending in December 2022, referrals were up by 19.4 per cent on the previous three month, and although the number of children and young people being seen within 18 weeks of referral has risen from 67.9 to 70.1 per cent between the last two quarters, it is still a long way off the 90 per cent standard set by the Scottish Government. Todd is confident that there are signs of improvement. 

“When I look at the CAMHS figures, and I don’t want to underestimate the scale of the challenge that is ahead of us, I see green shoots of recovery, I see very strong foundations,” she says. “I see that the trajectory is good, and I am confident that the next time we look at everyone’s figures nationwide we’ll have seen even more boards achieving targets that we are looking for.” 

Todd admits that there isn’t a quick fix to the mental health crisis, saying that “you don’t work in psychiatry, and come into government thinking you can wave a wand and fix things overnight”, but she again suggests there are early signs of improvement, emphasising she thinks the country is “heading in the right direction”.  

Increased funding for mental health services is paramount while also making the most of resources already available. Todd highlights that since the SNP came into government funding has doubled. And last month Todd opened a new £1.5m CAMHS centre in Lanarkshire that will assess people up to the age of 18 with emotional, behavioural or mental health difficulties. The upgrade takes away a good deal of the clinical nature attached to older centres, one service user intimated when asked about the new facility. Speaking on the relaxed interior of the new environment they said: “That makes it much better and easier to express yourself.”  

As well as that, a further £15m of funding on top of the £36m that has already been invested through the Scottish Government’s Communities Mental Health and Wellbeing Fund was announced to help address social isolation and loneliness in adults. It will support activities for older people, areas of economic deprivation, people with long-term health conditions or disability and LGBTI communities. 

Healthcare professionals have been working under extremely difficult conditions in the last few years, though. Having spent two decades working in mental health, Todd reflects on what it would be like to still be working in the NHS. She says: “I think it would be tough, there is no getting away from that. I think everybody who works in the NHS has found it really hard in the last few years – they put in a shift above and beyond the call of duty, and it has been relentless. People are used to stepping up and working extra in the face of a winter crisis, but this has been three years of challenging times and we have had to transform the way they work.  

“I have no doubt that people will be feeling concerned, what I hope is happening is that people are starting to come out of the other side of it, they are starting to feel enthused about how they can make a difference.” 

She points to positive work that is going on in the NHS, highlighting the Scottish Patients Safety Programme (SPSP), which was launched in 2008. Working as a frontline pharmacist at the time of its launch, Todd reflects on how that impacted her job.  

“I felt it was really empowering, it empowered me to change things that I knew weren’t working right for my patients and to make services better,” she says. 

A recent freedom of information request by the Scottish Conservatives revealed that there are 190 job vacancies in CAMHS. Todd accepts the figure, and offers reasoning for it, the first being that “we are creating more roles than ever before”, married with a concerning “global shortage of psychiatrists”. She adds: “We have vastly increased the amount of people working in mental health, but there will be a high level of vacancies in certain areas and professions.” 

But the vacancies in CAMHS are not isolated, “we are feeling that across the board in all sorts of different areas of medicine”.  

An area that Todd wants to see improved in the service is being able to offer help the first time of asking. She says: “We are going to have to work more efficiently, and we need to make sure that people get the help that they need in the right place at the right time at the first time they call. 

“We have a lot of energy and effort going into the system where people are going from pillar to post trying to get help. They are using resources, but they are not getting the help that they need. We can definitely improve on that. I am a Highlander, and we are short of folk at home, we can’t knit people, but we can make things work better, so that the resources that we have, which are precious, are used wisely.”  

A community-focused approach to dealing with children suffering from mental health issues is one move that Todd believes can dampen the current strain on mental health services. By giving “children appropriate help quickly they might not require specialist help later on at all”, or “their problem may be less severe if we catch them early”.  

“We are investing a lot to try and do that,” she says. “We have got counsellors in every school, we have all sorts of resources going on in terms of school nurses, and there are lots of third sector organisations doing amazing work that we are trying to fund to try to help children, but also adults in the community. 

“It doesn’t all need to be in the acute, that is where the crisis appears in the sort of acute desperate need; a crisis has happened, and they need something now. There is a lot of work that we can put in to prevent it ever becoming that severe.” 

The economic strain on families as a result of the cost-of-living crisis is causing a great deal of mental struggle, Todd says.  

“I look at the situation in the Highlands, we pay four times more for our heating than in the south of Scotland – and it’s colder. I came down the road last night and it was snowing despite the fact there was a heatwave last week. People are really struggling to heat their homes and more help is needed because they are expending all of their mental energy on surviving.” 

Asked if she thinks there is any collaboration that could be done between the Scottish and UK governments to lessen the effects of the cost-of-living crisis, Todd says she“hasn’t seen much evidence of that so far” but “in an ideal world there could be”.  

“When I was public health minister, I would feel like we were giving with one hand and the UK Government was taking away with the other,” she says. “It was almost as if they were actively working against us undoing some of the efforts we were making. I think when your population is under so much pressure it behoves both governments to work together. I am not seeing that so far. I have seen some help in fuel poverty, recognising that it is a bit of a drop in the ocean.” 

Todd’s thoughts on the pandemic are very clear throughout our conversation. “Like everyone, I probably did have a difficult time,” she says, describing herself as a very extroverted person, and if her social media is anything to go by that is a fair self-assessment. 

“Even though there were six of us in our household, that wasn’t enough for me,” she continues. “I did feel constricted in terms of not being able to see the people I wanted to see – I didn’t see my sister for nearly three years, she lives in Ireland. It was the longest we have been apart in our lives.  

“And I didn’t see nearly enough of my mum and dad, and my mum recently died, so like many people, I reflect on the last few years of her life and find that quite hard. I wish we hadn’t had to spend so much time apart.” 

Being in government is something Todd relishes, but she notes that, particularly around the time of the pandemic, ministers “were making very difficult decisions”.

“I came into politics because I am motivated by people, and I knew very much the impact our decisions were having on people,” she says. “It is not without consequences – I can’t help but think about the people that we serve. I think we made the best decisions that we could in a difficult situation.” 

A year into the pandemic, Todd’s husband had a heart attack which “changed our lives”. He is still recovering from it and, Todd says, it has “had a lasting impact on how our family works”.  

“[During the Covid restrictions] it certainly made it difficult to access healthcare and to navigate the system,” she explains. “Like everyone else I use healthcare, and we have certainly found it harder to have our needs met with the changes that have been in the system, than we might have done beforehand.”

She continues to reflect on the last three years: “It’s difficult, every time I catch up with my sister forevermore it’s going to be a precious time... 

“We never imagined we would end up living in different countries – we had a double wedding. We are close and our families are close. It didn’t feel like we were far apart until the pandemic hit, so yeah, she is a huge source of positivity in my life.” 

Todd is a big advocate for sport and getting outdoors – and is very happy to have retained sport within her portfolio from her previous role in government. She talks very openly about her “daily mile” something that makes her “feel good every day” and allows her to “connect with nature”, seeing the “incremental changes in the season”.  

“There is a real comfort in that. In really difficult times, if you’re running every day, you notice the changes, and you think whatever decisions I make today, be they right or wrong, spring is going to roll into summer, summer is going to roll into autumn. All of that will carry on happening, and there is real comfort in that in tough times.”