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

Attendees and apologies

Attendees:

• Donna Bell (DB), Scottish Government (Co-chair) 
• Jane O’Donnell (JO’D), Cosla (Co-chair)
• Angela Scott, SOLACE
• Alex Pirrie, Integration Joint Board (IJB) Network
• Carrie Lindsay, Association of Directors of Education in Scotland (ADES)
• Morven Graham, Association of Scottish Principal Educational Psychologists (ASPEP)
• Judy Thomson, NHS Education for Scotland (NES)
• Martin Dorchester, Children in Scotland (CiS) Forum representative
• Martin Crewe, Coalition of Care and Support Providers in Scotland (CCPS) Forum representative
• Alison Taylor, on behalf of Director of Learning, Scottish Government
• Michael Chalmers, Director of Children and Families, Scottish Government
• Beccie White, Scottish Youth Parliament
• Erin Campbell, Scottish Youth Parliament
• Kirsty Morrison, (support) Scottish Youth Parliament
• Paul Carberry, Coalition of Care and Support Providers in Scotland (CCPS) Forum representative
• Elaine Lockhart (EL), Mental Health and Social Care Directorate, Scottish Government
• Rory O’Conner (ROC)  (DBI) Lanarkshire NHS
• Duncan Clark (DC) (DBI) Lanarkshire NHS

Support:

• Angela Davidson (AD), Mental Health and Social Care Directorate, Scottish Government
• Maggie Fallon (MF), Mental Health and Social Care Directorate, Scottish Government
• Stephen McLeod (SM), Mental Health and Social Care Directorate, Scottish Government
• Neil Guy (NG),  Mental Health and Social Care Directorate, Scottish Government
• Della Robb (DR), Mental Health and Social Care Directorate, Scottish Government
• Lewis McGarry, Mental Health and Social Care Directorate, Scottish Government
• Carolyn Wales, Mental Health and Social Care Directorate, Scottish Government
• Leon Young (LY), Mental Health and Social Care Directorate, Scottish Government
• Zac Gilmiche, Mental Health and Social Care Directorate, Scottish Government

Apologies:

• Angela Leitch, NHS Chief Executives
• Cathy Richards, CAMHS Lead Clinicians
• Margaret Wilson, National Parent Forum of Scotland (NPFS)
   

Items and actions

Welcome and introductions

JO’D welcomed members to the second meeting of the Joint Delivery Board and thanked everyone for attending. Introductions of new board members were made. JO’D provided a summary from the previous meeting and covered updates and housekeeping which included:

• this work will be taken forward in partnership with Scottish Government and COSLA and the work of the board remains a high priority for both
• the meeting was recorded via TEAMS, which will only be used by SG officials and COSLA purposes. Members are asked to let the board administration know of any issues
• following suggestions at the previous meeting the Terms of Reference and the draft minutes were issued by email correspondence on the 19 May, final comments are due by the 2 June. Documents will then be published on the JDB website  
• Mr Kevin Stewart has been appointed as Minister for Mental Wellbeing and Social Care; the reporting process for the JDB is currently being arranged
• Angela Leitch will be joining the next meeting to represent NHS Chief Executives

AP01:

• members to submit comments on the minutes and Terms of Reference by 2 June

Distress Brief Intervention (DBI)

EL provided a brief background to the DBI service which included:

• DBI provides connected and compassionate support to young people and adults through a distress collaboration between NHS24, health and social care, emergency services, and third sector. 
• DBI provides early intervention, improving outcomes and experience for people experiencing distress
• Scottish Government established the DBI programme, which is hosted and led by South and North Lanarkshire H and SCP’s, via a DBI Central Team and has been tested, developed and continuously improved in Aberdeen, Inverness, North and South Lanarkshire, Scottish Borders and more recently Moray
• initially, DBI provided support for 18 year old and above and more recently has been rolled out to 16 and 17 year olds 
• DBI works closely with Glasgow University which is leading work to explore the applicability of the DBI approach to those aged under 16. Glasgow University are also providing resources, training and evaluation along with Stirling University

There are two levels of training:

• level 1 is for front line staff e.g, NHS 24, police, ambulance and primary care staff
• level 2 training is provided by commissioned and trained third sector staff who contact the person within 24-hours of referral and provide compassionate, problem solving support, wellness and distress planning, supported connections and signposting for a period of up to 14 days
• DBI is currently testing and developing the pathways for 16 and 17 year olds to consider gaps and what needs to be developed. The work is live in Lanarkshire and Aberdeen city and looking to expand further. There has been over 40 referrals made over two schools. Referrals can be made to level 2 DBI staff or to CAHMS
• the short term intervention is for up to 14 days, referrals can be escalated in statutory services. They make sure young people have consent from parent or guardians. Evidence from small numbers has shown that young people are getting to the right place at the right time. So far none of the YP have required CAMHS support. However, the close links that have been established between the schools, DBI and CAMHS would ensure this is facilitated
• reflective activity sessions with schools have shown school staff in test sites were very positive about DBI as a pathway
• RO’C confirmed that when developing further roll out of DBI, offering the service to those in the justice system will be considered

Comments from members included:

• noting a need for distress support being observed across the system
• the group queried current sources of funding for the pilot, if this is ongoing and requested clarification for the programme governance. An update from DBI colleagues was provided following the meeting, this can be found at Annex A
• noting that this model is useful for 16+ year olds who present as homeless have limited supports and suggested linking homelessness team within ACC to the Aberdeen pilot
• noting that involvement with the criminal justice system is key to the work on complex needs and mental health (as well as homelessness, substance use, domestic abuse, experience of care system etc). Very important we consider how these issues may affect young people in particular and what this means for services
• the DBI programme is highly relevant to many of the Task and Finish groups and leads/sponsers need to ensure this is considered

JO’D suggested that it would be useful to invite the DBI team back to a future board meeting to provide an update on progress. 

AP02:

• CW to invite the DBI team to a future board meeting to provide an update towards the end of 2021

Principals for participation and engagement paper

This paper was issued to board members in advance of the meeting. HA invited comments on the paper which included:

• overall the paper was welcomed by the group
• there was a suggestion that each young board member had a mentor on the board
• members felt some of the language in the paper could be strengthened
• all quotes used from young people require specific consent from the young person providing them
• children and young people in the Youth Justice System must be considered. We need to consider their needs and how best to engage more broadly with the some of the most vulnerable young people in Scotland. The third sector role in this engagement was highlighted
• members are keen to see how the paper translates into actions
• over the past 3 years of this work, CYP have been involved throughout, the group needs to consider how their views can continue to be included across all deliverables and discussions should take place locally to explore how this can be taken forward collaboratively
• the new Minister is keen to ensure that the voices of CYP with lived experience help shape and inform policy

AP03:

• the Principles for Participation paper will be strengthened to reflect the comments above then published on the SG website

Deliverables – general overview – updates

MF provided a brief overview on progress of each of the deliverables. A suggested membership list was issued in advance of the meeting and board members were invited to highlight any gaps. Any final suggestions should be submitted by 2 June.     

NG provided an update on progress of deliverables 1 and 2 following the last meeting:

• deliverable 1 – the first Community services Task and Finish group meeting took place on 24 May. The group will be focussing on what has been happening on the ground, initial returns on the Community funding are expected back from local authorities in July. The group will also be looking at ways that best practice can be shared across the authorities
• deliverable 2 – the first Crisis Delivery Task and Finish group met on the 25 May. Group members were brought up to date on the history of this deliverable from the Programme Board and considered what this service should be going forward
• DBI links directly to both these deliverables

SMcL provided an update on progress of deliverables 4 and 5 following the last meeting:

• both groups have a few gaps in membership, look forward to receiving suggestions from board members
• welcomed a new colleague onto the team who will help facilitate the Task and Finish groups
• there are members of the group who have great experience in CAMHS. SMcL has met with various groups to draw in different people and different perspectives and support currently available
• a submission will shortly be sent to the new Minister to provide an update on work underway
• one area of work for the Task and Finish groups to explore further, would be what data do we want to know more about and how do we increase involvement from academics
• crucial to have GP representation on deliverable 4

Comments made by the group: 

• the CAMHS Task and Finish Group will focus on the implementation progress and the impact for the implementation of the CAMHS service specification – linked to improved waiting times and outcomes, but also the impact of the wider range of support options e.g. CMH and WB resources
• improving data collection and reporting for both service standards will be a priority
• including experience of children, young people and families in the work of both groups will be a high priority
• members suggested areas for test for change to support the implementation of the Neurodevelopmental Principles and Standards so that this can be progressed swiftly

AP04:

• Board members to submit any final suggestions for membership of T and F groups and feedback from networks to LY by 2nd June

AP05:

• SOLACE and ADES reps to support identification of suitable local areas for neurodevelopmental test for change

Deliverable – mental health pathways and services

A paper on mental health pathways was issued to board members in advance of the meeting but was included for discussion as part of the summary and not discussed individually.

Comments made by the group:

• broad deliverable, needs to be clear how it aligns to The Promise and clear framing of the task will be required in order to support the task and finish groups
• there is not enough health representation on this Task and Finish Group, consider including LAAC nurses onto membership
• opportunity here to link in with the GIRFEC process

Deliverable – developing a programme of education and training

A paper was issued to board members in advance of the meeting. 

JT provided an overview of the paper and asked board members for help with membership of the Task and Finish proposed group. Agreement was sought on embedding education and training Task and Finish group members across the other task and finish groups to ensure connectivity. 

JT provided an update on the Knowledge and Skills Framework which was recently published. This framework sets out the levels of knowledge and skills required by staff, across agencies, to deliver wellbeing and mental health supports and interventions within the framework of Getting it right for every child (GIRFEC). A plan to map training resources to the framework has been developed.

Comments from board members included:

• members agreed with JT suggested way forward re membership and structure of the proposed Task and Finish groups
• that it is important to have a fully skilled workforce but the framework is not mandatory. There has not previously been an appetite to mandate specific training. Members queried if there would be an appetite to do this now
• the model created for the training to support the PIMH Programme Board has been very successful, especially spanning different sectors and professions
• Scottish Youth Parliament has carried out consultation related to mandatory mental health training for people working with Children and Young People

AP06:

• AD and COSLA to meet to discuss further 

Deliverable – 3-5 years research

NG provided a brief overview on the 3 – 5 years research and explained this is at a very early stage of thinking. However, NG outlined 2 key tasks for the T and F groups to consider – what support do children require and what support do parents/families require? NG currently developing a gap analysis looking at what work is done in primary schools and what we could replicate and learn from.  

Comments from board members included:

• ASPEP colleagues may have or be able to undertake research, NG to contact
• the ADES Early Years network may also have information available
• look to get support from other groups

AP07:

• Board members are asked to send in any known research into 3-5yrs during the pandemic. This should be sent to Neil Guy at Neil.way@gov.scot

AP08:

• NG to liaise with ASPEP and ADES on research

Deliverable – communications strategy

The draft communications strategy was issued in advance of the meeting. HA explained that papers outlined links to specific groups of stakeholders and linked to traditional communications.  

Comments from the board included:

• the paper requires resourcing
• in terms of social media platforms for networking with children and young people, Instagram and twitter would be best

The board approved the paper. 

AP09:

• officials to publish the Strategy on the SG website

AOB and close

JO’D thanked members for all contributions and closed the meeting.

Scottish Government
May 2021

Annex A - DBI update provided following the Board meeting

Governance 

The University of Glasgow lead this work and as such chair the DBI CYP Advisory Group, take and produce the minutes, provide BRAG Reports, which are distributed every two months to programme board and produce six monthly reports. They report direct to Programme Board with the SG officials represented at the Board. 

Finance 

Since 2017 DBI has been tested, developed and continuously improved in Aberdeen, Inverness, North and South Lanarkshire and Scottish Borders, providing the valuable foundations upon which DBI has grown. These sites will continue to play a vital role in the continued development of DBI and expansion as they share their knowledge and experience with the growing DBI community. 

These core sites currently remain centrally funded in respect of their original testing and future development role. Regionally specific transition plans will see regional sustainable resourcing of the DBI programme beyond 2024 in line with PoG objectives and learning from Associate Programme below.

Training

A DBI associate programme has been established for other regions to benefit from the learning, infrastructure, training, tools and collaborations to embed DBI within existing programmes. This inlcudes Moray, North, South and East Ayrshire (pan Ayrshire and Arran) and Inverclyde H and SCP’s established and delivering DBI, bringing the total to 10 H and SCPs. In addition, seven other H and SCPs are working extensively with the central team to complete development and open their DBI services in 2021, with many more formally expressing interest in being a DBI Associate and at varying stages of discussion and development. NHS24 is also now a live DBI Associate Pathway. All associate sites currently bring their local resources to the DBI programme supported by some seed funding from DBI, with a commitment to sustain the DBI services via local resources into the future, which provides excellent foundations for the Scottish Government objective to embed DBI by 2024.  

Further information can be found on the DBI website.