Children and Young People’s Mental Health and Wellbeing Joint Delivery Board information bulletin: March 2022

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 

Letters allocating initial funding to support planning for Mental Health and Well Being Primary Care Services under the new model were issued on 14th December 2021. This should allow the development of local planning groups and intention is that these will produce high level plans by April 2022. The plans will be assessed by a National Oversight Group that will meet for the first time in March.

We will shortly issue indicative funding for 2022-2025 against which local plans can be developed. Funding rising to a total of £40 million pa in 24/25 should allow the local planning groups to make substantial progress towards meeting the commitment of 1000 additional posts in this area by 2026.

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 2021-2022 has been recently published.

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 4 care for perinatal mental health.

Mental Health in Schools Working Group 

The Mental Health in Schools Working Group will meet in April to discuss an initial evaluation of the new online professional resource which was published 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.

Keeping The Promise

The Scottish Government is committed to Keeping The Promise by 2030, working in partnership with Local Government, The Promise Scotland, the third sector, health boards and importantly the care community to do so. 

The Scottish Government will publish its Implementation Plan setting out how it will Keep The Promise and key actions to do so by Easter. 

Read further information.

Holistic family support

The Programme for Government 2021 committed to investing at least £500m over the life of this Parliament in Whole Family Wellbeing Funding (WFWF).  This funding will support the whole system change necessary at a local and national level to transform the delivery of holistic family support to ensure families get the support they need, when they need it.

We will invest the first £50 million of this transformational funding in 2022-23, with the delivery approach currently being refined with stakeholders and delivery partners. This investment is an important part of how we will #KeepthePromise, and will support our approach to tackling child poverty and our National Covid-19 Recovery Strategy. In recognition of immediate pressures, £3.275 million has been allocated in this financial year to local authorities and Third Sector organisations to provide cash support to low income families with immediate financial needs who are navigating challenges linked to poverty, including those with children who are care experienced or on the edges of care.

Tackling Child Poverty Delivery Plan

The Scottish Government will publish the second Tackling Child Poverty Delivery Plan by the end of March, setting out the transformational action need to deliver on Scotland’s National Mission to tackle child poverty. The Plan will outline action to tackle the three key drivers of poverty reduction – increasing income from work and earnings, reducing household costs and maximising incomes from social security and benefits in kind – and to support the families at greatest risk of poverty, in order to drive progress against the ambitious targets set in statute by the Child Poverty Scotland (Act) 2017.

The Cabinet Secretary for Social Justice, Housing and Local Government will lay the Plan in the Scottish Parliament and deliver a statement outlining the measures to be taken.

The Covid-19 Children and Families Collective Leadership Group 

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’s priorities for this year include maintaining momentum on work to Keep The Promise and the development of a Children, Young People and Families Outcomes Framework. 

The Children, Young People and Families Outcomes Framework will be aligned to the National Performance Framework and provide a set of wellbeing outcomes, based on what matters to children and families, and a means of measuring progress against these in a meaningful and transparent way. It will provide a way of connecting what is done at national and local level, with the difference it is making to the lives of children and families in Scotland.  

Read further information on the 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 4 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

Wellbeing and prevention

Early intervention and prevention are key priorities for the Scottish Government in taking forward our approach to mental health and wellbeing. The COVID-19 Mental Health Transition and Recovery Plan, published in October 2020, and associated £120 million Recovery and Renewal funding, gives a renewed focus to these. Our aim is to support people to positively engage with their mental health at an early stage, promoting and supporting the conditions for good mental health and wellbeing at a population level.    

We are taking forward a range of key actions focused on prevention and early intervention by promoting and supporting the conditions for good mental health and wellbeing at population level and providing accessible signposting to help, advice and support. These programmes of work are focused on upstream support for mental health and wellbeing with the aim of reducing the need for clinical interventions by helping to address some of the social determinants of mental health. Key actions include:

• the development of a new wellbeing website to support the mental health of Scotland’s people
• an online platform for employers to support the promotion of mentally healthy workplaces
• support for grassroots community groups, through the Communities Mental Health and Wellbeing Fund, to deliver activities and programmes for adults facing social isolation, loneliness and mental health inequalities. In addition to the initial £15 million for this fund, we have just announced a further £6 million

Mental Health Strategy refresh

In the Programme for Government 2021/22 and the Green Party Agreement, we said we would: “refresh and refocus our mental health commitments in 2022, including a review and refresh of the Mental Health Strategy 2017 2027.” This is in line with action 40 of the Mental Health Strategy which committed us to a review of the strategy at its halfway point. 

This exercise will allow us to look ahead to make sure we are doing the right things to meet the changing mental health need over the coming years as we recover from the pandemic. 

Work is underway, with a number of stakeholder engagement events taking place throughout March.

Workforce strategy

Mental Health remains an absolute priority for the Scottish Government. We are committed to improving the population of Scotland’s mental health and wellbeing and to ensuring everyone receives the best possible care and treatment from our health and care services. 

Our Mental Health Transition and Recovery Plan sets out our response to the mental health effects of the Covid-19 pandemic, backed by an unprecedented £120 million investment to transform services. Delivering service improvement can only be achieved with the right workforce capacity and capability. 

This is why we have committed to develop a long-term Mental Health Workforce Plan in the first half of this Parliament, and to ensure that by 2026, 10% of frontline NHS budget is invested in mental health, with 1% directed specifically to children and young people. Existing workforce commitments include but are not limited to: 

• recruiting 800 additional Mental Health Workers to A&Es, GP practices, police station custody suites, and prisons, ensuring that local provision and support is at the heart of our plans. We have made almost £84 million available to date since 2018/19 to deliver our commitment to recruit 800 additional mental health workers by March 2022
• creating a network of 1,000 additional dedicated staff in Primary Care Mental Health and Wellbeing Services by 2026 to ensure every GP practice in the country has access to a dedicated mental wellbeing link worker who can help grow community mental health resilience and help direct social prescribing
• providing funding for around 320 additional staff in Child and Adolescent Mental Health Services (CAMHS) over the next five years, with the potential to increase capacity for CAMHS cases by over 10,000

Self harm strategy

The Scottish Government is determined to improve our responses for people who self-harm, and has committed to developing a self-harm strategy which will be separate from (but linked to) our suicide prevention strategy. The views of people with lived experience of self-harm – and their families – will be at the heart of developing the strategy, and it will be informed by insights from services that already provide compassionate support to people who self-harm. 

Although this is our first standalone self-harm strategy, we have some good work to build on, including engagement undertaken by Samaritans around their Hidden Too Long - uncovering self-harm in Scotland report. However, many aspects of self-harm are hidden and not well understood and we will build our approach in an iterative way. The initial phase of the strategy will be exploratory, where we will listen to the views of people with direct experience of self-harm and organisations that support them. This will help us understand the changes that are needed, and how we go about delivering them and will be the foundation of the strategy.  We know how important it is to get this exploratory phase right, and so will be working alongside people with lived experience to design the programme of engagement. 

We have also provided funding to Penumbra to pilot new self-harm services, and we have started to build our understanding of the data and evidence about self-harm and how that can be improved.  

National Suicide Prevention Action Plan – 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 recommended by the National Suicide Prevention Leadership Group (NSPLG) in its July 2020 COVID Statement. 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 (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 (the 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 suicide prevention 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 campaign focussed on children and young people 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 two-year pilot of bereavement support services in Ayrshire & Arran and Highland areas began in August 2021.

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.

The ‘Time, Space, Compassion’ recommendations were published in October 2021 and are being taken forward by a dedicated Suicidal Crisis Support Action Group, led by Nigel Henderson, National Lead for this work.

Progress 

The ‘Time, Space, Compassion’ recommendations were published in October 2021 and are being taken forward by a dedicated Suicidal Crisis Support Action Group, led by Nigel Henderson, National Lead for this work.

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 suicidal 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.

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.

Read more information about engaging children and young people in the development of the new strategy, and a guide to assist with facilitating these discussions.

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 1.

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 3 areas across Scotland with a view to establishing a national process.

Action

C1. 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 from Police Scotland is now available through Public Health Scotland for local leads and appointed individuals. Work continues to establish ways of collecting self-harm data.

Action

C2. 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 3.

Action

C3. 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 5.

Action

C4. 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 Group.