Children and Young People’s Mental Health and Wellbeing Joint Delivery Board information bulletin: December 2021

The following information is provided to the Joint Delivery Board on work being progressed across the children and young people and mental health policy landscape in order to provide context and support connectivity. This bulletin will continue to be developed and may highlight further areas of policy work at future meetings.

Mental health in primary care 

Scottish Government will shortly announce developments to improve the capacity of primary care teams to respond to mental health and wellbeing in local areas. These developments form part of 2021 manifesto commitments.

The Mental Health In Primary Care Short Life Working Group (SLWG) concluded in December 2020 and it recommended the establishment of multi-disciplinary Mental Health and Wellbeing in Primary Care Services (MHWPCS), within areas served by GP clusters, to provide assessment, advice, support and some levels of treatment for mental health, distress or wellbeing. This approach will create 1,000 new roles within multi-disciplinary teams which could include, Mental Health Nurses, Psychologists, Peer Support Workers, Enhanced Practitioners and Occupational Therapists. It will also ensure that every GP Practice has access to a Community Link Worker who, through their role, will support mental wellbeing.

The proposals are that every Integrated Authority area should have a local planning group and a plan to deliver these expanded multidisciplinary teams. The plans should be inclusive i.e. these services are not age or condition specific and need to support CYP as well as adults to access the best supports and interventions available for them if they present to primary care. This investment will sit alongside the Community Development funding that has been issued through Local authorities and Third Sector Interface groups. The plans for MHWPCS will be approved by a national oversight board with intention of seeing these teams develop and expand over a three-year period to 2025.

Quality and Safety Board

The Quality and Safety Board are developing quality standards to support general adult secondary mental health services. This is part of a wider ambition to develop a suite of standards for mental health services, building on the work of the CAMHS service specification. The aim of these standards is to improve the quality and safety of mental health services. They want to ensure that individuals, their families and carers know what they can expect from mental health services, ensuring a person-centred approach is at the heart of the approach. The standards should provide an opportunity to build a collective understanding of performance and enable effective benchmarking to drive improvements in quality of care. In addition, they should reduce scope of unwanted variation of quality of care and therefore reduce inequalities in experiences and outcomes. The standards should provide a basis for continual improvement though enabling greater scrutiny and assurance of services against the standards.

Perinatal and Infant Mental Health Programme Board

The Perinatal and Infant Mental Health Programme Board is taking a strategic oversight of the commitment to improve perinatal and infant mental health services across Scotland. This includes the development and implementation of community and inpatient statutory services, third sector provision, workforce/training development and awareness raising/stigma reduction. The priorities for each year are laid out in the annual Delivery Plan and the plan for 2021/22 has been recently published and is available here: Perinatal and Infant Mental Health Programme Board: delivery plan - September 2021 to September 2022 

Current priorities for the Perinatal and Infant Mental Health Programme Board include the ongoing provision of statutory services, implementation of the Small Grants Fund (sitting alongside the main Perinatal and Infant Mental Health Third Sector Fund) and consultation on an options appraisal regarding specialised tier four care for perinatal mental health.

Mental Health in Schools Working Group

The Mental Health in Schools Working Group will meet in December to consider how the new online professional resource has been utilised since its publication in June 2020. The free online professional learning resource supports school staff to understand and recognise the range of mental health and wellbeing concerns that children and young people may experience.

Family Support Delivery Group

The Family Support Delivery Group is feeding in to work to develop and deliver the Whole Family Wellbeing Fund. The Fund will provide £500m over the parliamentary term to enable the building of universal, holistic support services in communities across Scotland, giving families access to the help that they need, where and when they need it. 

Work to design and deliver the fund is underway, including establishing appropriate governance arrangements. The Fund will support outcomes across a range of policy interests including mental health, and we are keen to align our strategic and delivery approaches in terms of support to families to ensure we achieve the transformational change necessary to #KeepthePromise. A programme of activity will be developed to support the whole system change necessary, and mental health colleagues are seen as a key contributor to that work.

The COVID-19 Children and Families Collective Leadership Group (CLG)

The COVID-19 Children and Families Collective Leadership Group (CLG) has been taking immediate action throughout the pandemic to support children and families in vulnerable situations based on the data and intelligence that it receives and engagement work with children, young people and families. CLG will continue to receive regular updates on data trends, identify areas of concern, undertake deep-dive work to establish immediate actions to be taken and monitor the impact of the response. 

As the emphasis now shifts from crisis response to intermediate and longer-term recovery, CLG will focus on providing support for Covid recovery and renewal. CLG is currently developing its action plan for 2022/23 which will reflect these priorities. This includes the work of CLG’s two sub-groups the Family Support Delivery Group and Children and Families’ Services Workforce Development and work to Keep the Promise, embed GIRFEC and implement UNCRC Incorporation. Other priorities for the plan include the development of a wellbeing outcomes framework.

Further information on the Collective Leadership Group can be accessed here: Coronavirus (COVID-19): Children and Families Collective Leadership Group

Digital Mental Health Programme Board

The Digital Board is progressing several workstreams:

• computerised CBT for young people experiencing anxiety is currently being rolled out through a Test of Change project in four Health Board areas, this looking at routes into treatment through schools, GPs and specialist mental health services
• support programme for parents and carers of child and teen suffering from anxiety and low mood have been made available through self-referral across all areas of Scotland
• work to evaluate the Kooth peer and counselling platform is underway
• work across CYP service continues across all areas of activity within the Digital Mental Health Programme

National Suicide Prevention Action Plan (NSPLG) – Every Life Matters

The current national action plan began in 2018 and has been extended until September 2022. The Action Plan contains ten actions four additional actions were identified within the Covid statement from the National Suicide Prevention Leadership Group (NSPLG) in July 2020. There are identified delivery leads for the actions and NSPLG sponsors for each action. Progress against each action is contained in the table below. While work continues to implement the current action plan, engagement has begun to develop the next suicide prevention strategy which is due for publication in September 2022. Links with the work of the JDB have been made with relevant delivery leads attending the task and finish groups to ensure the alignment with the suicide prevention work. See Annex A for updates to the action plan.

Action

• the Scottish Government will set up and fund a National Suicide Prevention Leadership Group (NSPLG) by September 2018, reporting to Scottish Ministers and also to COSLA on issues that sit within the competence of local government and integration authorities
• this group will make recommendations on supporting the development and delivery of local prevention action plans backed by £3 million funding over the course of the current Parliament

Progress

• NSPLG in place since 2018
• Local Area Action Plan Guidance published in April 2021, work continues with local areas to support development of local action plans

Action

• the Scottish Government will fund the creation and implementation of refreshed mental health and suicide prevention training by May 2019, the NSPLG will support delivery across public and private sectors and, as a first step, will require that alongside the physical health training NHS staff receive, they will now receive mental health and suicide prevention training

Progress

• new resources developed to fulfil the requirements at Informed and Skilled level within the Mental Health and Suicide Prevention Framework and available on TURAS
• work continues on development of Enhanced and Specialist level learning opportunities

Action

• the Scottish Government will work with the NSPLG and partners to encourage a coordinated approach to public awareness campaigns, which maximises impact

Progress

• the United to Prevent Suicide social movement launched with over 10k visits to the digital hub in September, specific campaigns around men @_FCUnited was launched in September and a further campaigns focussed on children and young people and men in the workplace will take place in 2022

Action

• with the NSPLG, the Scottish Government will ensure that timely and effective support for those affected by suicide is available across Scotland by working to develop a Scottish Crisis Care Agreement

Progress

• a pilot of bereavement support services in NHS Ayrshire and Arran and NHS Highland began in August 2021 and will continue for two years

Action

• the NSPLG will use evidence on the effectiveness of differing models of crisis support to make recommendations to service providers and share best practice

Progress

• a report of the recommendations was published in October 2021 and will be taken forward by a dedicated Suicidal Crisis Support Action Group

Action

• the NSPLG will work with partners to develop and support the delivery of innovations in digital technology that improve suicide prevention

Progress

• work with NHS Inform to create safer online suicide journeys using vlogs created by those with lived experience is underway
• a digital innovation scheme is also in development which will be aimed at young people

Action

• the NSPLG will identify and facilitate preventative actions targeted at risk groups

Progress

• reports on the specific needs of BAME and Veterans groups have been produced, discussions continue within NSPLG regarding the best way to progress this work

Action

• the NSPLG will ensure that all of the actions of the Suicide Prevention Action Plan consider the needs of children and young people

Progress

• work focusses with each delivery lead to ensure the needs of children and young people are fed throughout their actions
• a youth advisory group will be in place from early 2022 to ensure the voices of children and young people are fed into the work of the other actions and the new strategy development directly
• more information about engaging children and young people in the development of the new strategy, and a guide to assist with facilitating these discussions can be found here, Youthlinkscotland.org - a new suicide prevention strategy for Scotland

Action

• the Scottish Government will work closely with partners to ensure that data, evidence and guidance is used to maximise impact, improvement methodology will support localities to better understand and minimise unwarranted variation in practice and outcomes

Progress

• the NSPLG and the delivery leads for each action are supported by an Academic Advisory Group and a lived Experience Panel
• work also continues to gather evidence of good practice from across local areas which will become part of the guidance described in action one

Action

• the Scottish Government will work with the NSPLG and partners to develop appropriate reviews into all deaths by suicide, and ensure that the lessons from reviews are shared with NSPLG and partners and acted on

Progress

• pilots of multi-agency reviews of all suicide deaths in Scotland are taking place in three areas across Scotland with a view to establishing a national process

Action

• closer national and local monitoring of enhanced and real time suicide and self-harm data to identify emerging trends and groups at risk for early preventative action

Progress

• more timely suicide deaths data is now available from PHS for local leads and appointed individuals, work continues to establish ways of collecting self-harm data

Action

• specific public suicide prevention campaigns, distinct from and in partnership with the umbrella ‘Clear Your Head’ mental health and wellbeing campaign, to encourage people at risk of suicide and in suicidal crisis to seek help without stigma and to encourage others to give it

Progress

• this has been picked up as part of the work of action three

Action

• enhanced focus on specifically suicidal crisis intervention to ensure that those in suicidal crisis can access timely help and support, and meet any increase in numbers

Progress

• will be aligned with the work from action five

Action

• restricting access to means of suicide to reduce the availability to those in crisis of the most commonly used means of suicide

Progress

• work to understand the most effective measures is being undertaken by the academic advisory