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

Attendees and apologies

Attendees – board members

• Nicola Dickie (ND) Cosla (Co-chair)
• Angela Scott, SOLACE
• Alex Pirrie, Integration Joint Board (IJB) Network
• Morven Graham, Association of Scottish Principal Educational Psychologists (ASPEP)
• Judy Thomson, NHS Education for Scotland (NES)
• Michael Chalmers, Director of Children and Families, Scottish Government
• Beccie White, Scottish Youth Parliament 
• Abbie Wright, Scottish Youth Parliament
• Erin Campbell, Scottish Youth Parliament
• Kirsty Morrison, Scottish Youth Parliament (YP support)
• Paul Carberry, Coalition of Care and Support Providers in Scotland (CCPS) Forum representative
• Cathy Richards, Mental Health and Social Care Directorate, Scottish Government
• Alison Taylor, Deputy Director: Improvement Attainment and Wellbeing, Learning Directorate, Scottish Government
• Hugh Masters, Perinatal and Infant Mental Health Programme Board
• Laura Meikle, Improvement Attainment and Wellbeing, Learning Directorate, Scottish Government
• Angela Davidson (AD), Mental Wellbeing and Social Care Directorate, Scottish Government
• Hannah Axon (HA), COSLA

Additional attendees

• Anne Lee on behalf of Angela Leitch, NHS Chief Executives
• Cheryl Burnett, on behalf of Margaret Wilson, National Parent Forum of Scotland (NPFS)
• Bryony Monaghan (BM) on behalf of Carrie Lindsay, Association of Directors of Education in Scotland (ADES)
• Lynne Taylor, Professional Adviser, Scottish Government
• Kay Dunn, Mental Wellbeing and Social Care Directorate, Scottish Government
• Rory O‘Connor, Professor of Health Psychology, University of Glasgow, Distress Brief Intervention (DBI)
• Duncan Clark, Clinical Director NHS Lanarkshire, Distress Brief Intervention (DBI)
• Kevin O’Neill, National Distress Brief Intervention Programme Manager

Support 

• Stephen McLeod (SM), Mental Wellbeing and Social Care Directorate, Scottish Government
• Peter Innes, Mental Wellbeing and Social Care Directorate, Scottish Government
• Neil Guy (NG), Mental Wellbeing and Social Care Directorate, Scottish Government
• David Leitch (DL), Mental Wellbeing and Social Care Directorate, Scottish Government
• Jean Carwood-Edwards (JCE), Mental Wellbeing and Social Care Directorate, Scottish Government
• Carolyn Wales, Mental Wellbeing and Social Care Directorate, Scottish Government
• Louise McKay, Mental Wellbeing and Social Care Directorate, Scottish Government

Apologies 

• Donna Bell (DB), Scottish Government (Co-chair)
• Jackie Irvine, Social Work Scotland 
• Alison Sutherland, SWS, Sponsor, Task and Finish group six
• Martin Dorchester, Children in Scotland (CiS) Forum Representative 
• David Gibson, SWS, Sponsor, Task and Finish group three
• Margaret Wilson, National Parent Forum of Scotland (NPFS)
• Carrie Lindsay, Association of Directors of Education in Scotland (ADES)
• Maggie Fallon, Mental Wellbeing and Social Care Directorate, Scottish Government

Items and actions

Accessibility

Whilst we try to make sure that JDB documents are accessible as possible for everyone we recognise that some language we might use is specific to the subject being discussed. Young people on the board have put together this helpful A-Z of terms we use often if you would like to check any terminology.

Welcome and introductions

ND provided an introduction, welcomed everyone to the board and introduced new members.

ND also welcomed colleagues invited to present at this meeting on Distress Brief Interventions and the Psychological Wellbeing Hub.

ND provided the following update:

• following DB and HA’s appearance at the Public Audit Committee in October, a letter was issued from the committee to Caroline Lamb, Director General of Health and Social Care, the letter and the response from Caroline Lamb can be found on the Scottish Parliament’s website
• the Minister for Mental Wellbeing and Social Care and COSLA leaders met to discuss progress of the Joint Delivery Board and Task and Finish groups, they agreed steady progress had been made and emphasised the importance of outcomes, these meetings will be held on a quarterly basis
• at the meeting it was suggested that an ‘Information Bulletin’ which summarised progress around related national and local government workstreams would be helpful for future meetings and that these would also be helpful for board meetings
• the next JDB newsletter is currently being drafted, it will be issued shortly and members were asked for assistance in sharing across networks, as well as comments and suggestions for improvement
• the previous Engagement Officer has moved onto a new role and two new Engagement Officers are starting in the new year
• discussions have taken place with the board’s CiS and CCPS forum reps about the opportunity for a link from the sector to support the work of the board and in particular deliverable three looking at Support Mental Health pathways and services for vulnerable children and young people, a job advert has been drafted and will be shared through both forums if/ when approved
• many of the deliverable leads have attended each other’s meeting and this is proving very helpful in joining up across the workstreams

 Member’s comments included:

• that the update was helpful, as were the reports from the Task and Finish Groups
• that there remained a need to ensure that all the groups work cohesively and also that the work is placed within the greater context of all work taking place across Government
• for example, ensuring that the board’s work complements the work of the Mental Health Quality and Safety Board and its current focus on Quality Standards, thought was being given to the principles which underpin all standards and this topic was likely to be discussed by the MH Stakeholder Group and an update shared as part of the next JDB information bulletin
• the Board needs to consider the entirety of the programme of work and ensure that interdependencies are identified and actioned across the Task and Finish groups and also wider policy areas, the Covid Recovery Strategy with its focus on CYP wellbeing and wider socio-economic drivers is key to the work of the board
• HA has been linking with Public Health Scotland around the evaluation of the programme as a whole and provided an update on progress, a further paper will be presented to the board at the March meeting

AP01

• CW to consider overall programme and reporting procedures, linking the work of T and F groups and wider relevant boards

Information bulletin

The Information Bulletin was issued with the papers in advance of the meeting. The bulletin will be updated prior to every board meeting to provide context and support connectivity across the policy landscape. The Information Bulletin is on the covering email and can be found on the Joint Delivery Board webpage. 

ND invited questions and feedback from members on the information bulletin. Members comments included:

• that the bulletin was useful and that a version that could also be shared outwith the board would be valuable
• that it is important that parents and carers are offered relevant information from the bulletin
• suggestion that a version of the bulletin could be included with the minutes from the board meeting

AP02 

• CW and HA to consider publishing the Information Bulletin or key elements together with the board minutes, further discussions with policy leads required

AP03

• CW and HA to discuss future communication options with NPFS reps

Task and finish group reporting templates

ND had to leave to attend another meeting and invited AD to chair the remainder of the meeting.

AD invited the leads and sponsors of the Task and Finish groups one and three to provide an update on progress. Updates provided can be found at Annex B.

The chair invited comments on the other task and finish group should they wish to raise anything specific.

AP04:

• NG to draw on the recommendations of Task and Finish group one and feedback of the board within formal proposals for independent evaluation of community based mental health support for children and young people, proposals are subject to ministerial agreement

AP05:

• DL to provide updated terminology to the Task and Finish group

Distress Brief Intervention (DBI)

DBI colleagues provided board members with a presentation on the progress of DBI and the findings from the under 16s small scale pilot. This included:

• a brief history of the project
• how DBI and their referrals work
• the test pilot of CYP DBI and the early data they currently have resulting from this, this included data on the ages and gender of those using DBIs, the reasons given for distress and the reported effectiveness of the intervention
• the continuous improvement and development inbuilt in the extension of the project
• the reflections and recommendations of service users, those referring CYP and their parents/carers
• links to other supports and pathways (including CAHMS)
• the commitment to DBI for adults will be embedded by 2024 and the independent evaluation will report in 2022
• overall feedback from the pilot was very positive
• no plans for DBI to be extended to under 14’s

Members comments included:

• that the emerging data would be of great use to other early intervention/prevention services
• the importance of ensuring links with school counselling and community funding, important to link with the Mental Health in Schools Working Group
• the need for further engagement with the Directors of Education if there is to be a national roll-out
• educational psychologists need to be a key partner
• consider what added input is required for parents

National Psychological and Wellbeing Service

Lynne Taylor (LT) provided an outline of the proposed National Psychological and Wellbeing Service, which is based on the Grampian Psychological and Resilience Hub developed for young people and adults to access during the pandemic.

A brief presentation included:

• the context of the Psychological Wellbeing Hub
• the vision and priorities of the hub
• the levels of support offered to CYP and the staffing structure that underpins this
• the process of referral and supports the service offers
• a breakdown of the treatment pathways taken by service users, the reported issues users most often present with and the feedback and recommendations emerging from the Grampian hub

The Board expressed general support for the proposal and interest in shaping its further development. Comments from members included:

• ensuring that the hub works well within the whole system will be paramount
• a particular ask for the test of change can be how this can most effectively interact with the various supports available in different areas
• it will also be particularly key to work alongside out of hours services such as Kooth

As discussion was curtailed due to time pressures, it was agreed that a workshop would be offered to interested members to develop their understanding of the proposal and contribute ideas to its further development.

AP06

• CW to arrange a workshop in January to follow up

AOB and close

The next meeting is scheduled for 23 March 2022. AD thanked all for attending and wished everyone a happy festive break.

AD drew the meeting to a close.

Annex A

Deliverable one

Continue to enhance community- based support for emotional wellbeing/mental distress through ongoing investment and support for local partnerships.

Action

• to note progress, raise any points they wish to clarify and confirm they are content with recommendations the group are submitting to the Scottish Government, ahead of the independent evaluation of community supports and services for five to 24 year olds

Update

• there are now a wide range of services and supports in place across Scotland to support CYP mental health, key work of the group has been developing proposals for the Scottish Government Community Services evaluation
• this aims to complement the current six monthly reporting which explores number/sex/type of services by providing qualitative data in areas such as service user experience and awareness/accessibility of services, this information will inform future planning and investment
• the Task and Finish Group had recommended that the evaluation should be a supportive process, whilst it will be too early to demonstrate long-term impacts, it could help us gain insights into incremental changes that will link with the six monthly reporting
• the evaluation needs to take account of the pandemic and clearly indicate what deliverables/outcomes will be being evaluated, it should identify if services are accessible and meeting the needs of children, young people, their parents and carers
• the focus of the evaluation should be on qualitative data rather than quantative data and highlight what is working well in terms of good or emerging practice
• the partner/s for the evaluation will be selected by the Scottish Government following a standard competitive process, the outcome of the evaluation is expected in August and the board will be kept updated on progress

Members comments included:

• being broadly supportive of the paper and of independent evaluation
• ensuring a clear connection back to the origins of the work re the CYP Mental Health Taskforce, Rejected Referral Reports, Youth Commission and Audit Scotland reports
• the importance of making the best use of data already collected, including that collected as part of 6 month evaluations on this work
• that process and systems metrics of the evaluation would need to be carefully considered and appropriate for preventative interventions in order to measure the difference (albeit not yet long term) made by these supports, a suite of metrics is likely to be required
• showcasing early interventions and good and emerging practice will be important in terms of showing parents that there are positive changes occurring
• the evaluation should help us understand if services are accessible to children, young people, their parents and family and capture their experiences
• that there is an opportunity to gather more data relating to CAHMS referrals and whether CYP are reaching the appropriate support/service
• a question about the suggestion that the evaluation could be ‘opt-in’ for local authorities, board members felt the aim of the evaluation needs to be carefully considered to understand if this is the best approach (if, for example, future investment decisions might be based upon it) but this was helpful in the sharing of good practice

Deliverable three

Support Mental Health pathways and services for vulnerable children and young people, aligned to the work of The Promise.

Action 

• to note progress, raise any points they wish to clarify and confirm content with the direction of travel

Update

• concerns were raised, both in the task and finish group and in the Joint Delivery Board meetings, that the wording of the deliverable may hinder its work, the word ‘vulnerable’ was considered to have the potential to stigmatise young people and their families and an alternative term ‘those in need of care and protection’ had been suggested, it is important to ensure no group was excluded
• the group are at a stage of information gathering and considering where their value add lies and how this links to the work of The Promise

Members commented:

• the desirability of changing the title was accepted following a discussion by the board
•  it was agreed that, there was a need to ensure the title remained specific and clear about who it was referring to as well as who would be providing the care and protection, a different formulation might be helpful
• that it could be strengthened by referencing issues of accessibility, for example, ‘those seldom heard’ or ‘hard to reach’
• those ‘experiencing disadvantage’ or ‘experiencing vulnerability’ may also be a useful phrase to include
• important not to define children and young people by what has happened to them, more important to provide support for the situation they are in
• existing legislation and guidance makes use of the terms ‘in need of care and protection’ and ‘in vulnerable situations’

Based on this discussion the group title will now be: ‘Support Mental Health pathways and services for children and young people in vulnerable situations and in need of care and protection, aligned to the work of The Promise.