The smell of green [cannabis] scorched my nostrils, a heavy door gaped open, and I stepped into bedlam again.

Large, empty plastic cider bottles spewed on the floor; a coffee table covered in blackened tinfoil; blue tablets and broken cigarettes.

A young, half naked man stood on the veranda shaking in the cold, tears staining his face. A policeman stood calmly in the midst of the storm.

Our eyes met, we nodded and moved towards the veranda.

If you think that Scottish psychiatry is a cosy Frasier affair, think again. It’s an archaic drama starring the police, paramedics , A&E staff and GPs seeking to manage the unmanageable mental health crises.

As for the deluge of other mental health problems, these drown GPs, schools and families. For NHS psychiatric services are distant, inaccessible, non-responsive and offer nothing to the majority of patients.

Modern medicine has presided over the great decline in wellbeing: more depression, more anxiety, more drug deaths, and ever more self-harm.

Doctors' belief system is that mental illness is simply a “chemical imbalance”.

The solution, seemingly, is to prescribe ever more drugs with a 70% increase antidepressants in decade and some 20% of the population popping psych pills.

This great national experiment has failed; our mental health has never been worse. The scientific evidence for a chemical imbalance theory is weak at best, and a gross over-simplification at worst.

For psychological pain has purpose, is normal and common to us all. We are disempowering people, denying them the opportunity to establish their own coping skills and resilience. Pouring yet more money into healthcare won’t work, for happiness is not in the gift of medications.

We are all experts in mental health. Family, friends, a partner, purpose, a safe place to live, a decent house, educational opportunity, limiting drugs and alcohol, faith, meaningful work and having enough money is the route to good mental wellbeing.

Scotland’s poorest suffer the greatest burden of mental health illness, with a welfare system that has locked generations into benefits poverty and a country with the worst social mobility in the UK.

We need to support people back into meaningful work by reforming the welfare system and offering real opportunities to our most marginalised communities. Both taxation and benefits are devolved responsibility so have an opportunity to be progressive and innovative. Social reform is the key addressing poor mental health.

Drugs and alcohol are linked to our high rates of suicide. Scotland is in denial over our systemic alcohol and drug dependence. Alcohol is the gateway to addiction and touches us all. As our children start drinking regularly in their mid-teens , so our national narrative of drug dependence starts over.

As for recreational drugs these are everywhere in our clubs and bars and widely available in our high schools. Prisons are mills of misery and addiction, yet we have amongst the highest incarceration rates in Europe. Methadone can help stablish heroin addiction, but then often becomes a blind alley. Our drugs policy is simply not working.

Policies like minimum alcohol pricing are a band aid. We need to drastically limit the availability of alcohol to our children both in our homes and through local licensed grocery stores and supermarkets.

Abstinence groups with their 12 steps programmes have saved generations of addicts, and these peer support organisations should be embedded within the care system.

Other countries have legalised cannabis and are decriminalising the rest in attempt to regulate this chaos. We need an honest national debate of how we change our toxic drug and alcohol culture. We need to be bold.

Most mental health issues are cast in childhood, but our child mental services are dysfunctional. More money and resources never seem to translate to better access. If children are eventually assessed, there seems to be a ‘label gun’ approach to diagnosis.

Labelling kids with attention-deficit hyperactivity disorder (ADHD), Autism and all manifestations of anxiety is now commonplace. But labels are a dead end, stigmatising, suggesting something is wrong with children, setting up kids to fail.

Labelling denies our children the opportunity to learn to cope and find ways to manage. All psychological resource should be based in schools and our communities to help normalise and manage specific behaviours before we label children for life.

In Scotland, 80% of 11-17-year olds don't get enough exercise; obesity rates in five-year-olds has risen to staggering 29%. This contributes to Scottish girls suffering the worst mental health in Europe.

We are failing in the most basic care of our children. This is a failure of public health policy.

Again, we need something different.

Countries with the highest rates of childhood activity see this sustain into adulthood. A simple health policy of reintroducing school teams at Primary Schools would be a solution.

These don’t have to be traditional team sports; it could be rounders, dance, ultimate frisbee and even Quidditch. Sport and activity has to be compulsory, and involve all the children.

Let’s make fitness and maintaining a healthy weight as core to education as academic outcomes in schools. Esteem is not a right; it has to be built.

The experience of previous generations of parents, focused on the importance of routine, sleep, diet, exercise, the outdoors, and sports has been dismissed.

Parenting has been invaded by micro-managing authoritarian psychobabble, with a blind child-centric dogma. It's making parenting increasingly impossible. Parents need common sense advice to let children make mistakes, to live and learn, allow children to change their minds, and sometimes be compelled to do things they don’t like.

Technology is poisoning wellbeing in children. I cry every time I see a child with headphones wearing a Minecraft T-Shirt, clutching a computer tablet.

How many times do we see families in restaurants on mute, glued to individual screens, atomised and disconnected. Social media and screen time are destructive to the development of children and predictably is linked to autism and anxiety.

We need policy limiting screen to addictive social media and banning content with unrealistic body imagery and pornography. This should be key public health objective. Humanity is social; children must be placed in social situations with their peers - even if they find this uncomfortable.

Scotland is standing on the mental health veranda looking down. More of the same won’t work.

There is hope, but hope is based on rebuilding our sense of community and society. If nothing else, all new resources most go to schools and primary care to provide accessible generalist psychological support close to communities.

Dr Des Spence is a Glasgow-based GP, a partner in the Barclay Medical Practice group, and a former columnist for the BMJ