Children and young people - community mental health and wellbeing: supports and services framework

Context

The Framework

1. This Framework intends to support an approach based firmly on prevention and early intervention. It specifically addresses establishing or developing supports and services that target issues around mental wellbeing and emotional distress rather than mental illness and other needs that may be more appropriately met through clinical services such as Child and Adolescent Mental Health Services (CAMHS), or adult mental health services for those aged 18 and over. For most children and young people, the support they need is likely to be community-based, with a smaller number requiring a specialist response from CAMHS or adult mental health services.

2. The Framework applies to the provision of supports and services for those aged 5-24 (26 for care-experienced young people, in line with legislation), and also their parents, carers and siblings (hereafter referred to as “their families”).

3. The Framework is supported by Scottish Government funding intended to resource local partnerships to deliver sustainable, effective and easily accessible community-based support for mental health and wellbeing.

4. The Framework is focused on the additionality required for the development and delivery of supports and services in the prevention and early intervention space. As provision should be informed by local needs, it is not expected that the full range of supports and services described in the Framework will be available in any area.

National policy and delivery landscape

5. The first version of the Framework was published in February 2021 further to the findings of the audit of rejected referrals to CAMHS, Audit Scotland’s report on children and young people’s mental health, and the Children and Young People’s Mental Health Taskforce. These recommended the provision of easily accessible support for children and young people with mental health problems not severe enough to fit the eligibility criteria for CAMHS, based in the community and focused on prevention and early intervention.

6. This revised version of the Framework is issued further to the recommendations of the Children and Young People's Mental Health and Wellbeing Joint Delivery Board and the Scottish Youth Parliament’s independent evaluation of the supports and services, taking into account learning from the initial delivery of the Framework and relevant wider developments in the children and young people’s policy landscape.

7. The Scottish Government and COSLA published their joint Mental Health and Wellbeing Strategy in June 2023. This recognises that children, young people and families should be able to easily access support in their local community when needed, and that this support should be focused on prevention and early intervention. The strategy highlights key issues impacting mental health and the delivery of mental health services, including health inequalities that should be considered. It also outlines the value of a whole-system approach where support, care and treatment should be delivered in a way that is as local as possible and as specialist as necessary, within a system that is responsive to local and individual needs.

8. Aligned to the overarching strategy, the joint COSLA and Scottish Government Suicide Prevention Strategy (Creating Hope Together) and the Self Harm Strategy and Action Plan were published in 2022 and 2023 respectively. While supports and services aligned to the Framework are intended to be preventative in nature or offer early intervention rather than be delivered at a point of suicidal crisis, it is acknowledged that preventative and early mental health and wellbeing support may contribute to suicide prevention and reducing the impact of self-harm.

9. Individuals in crisis may sometimes present to community-based supports and services. While the supports or services presented to may not be appropriate, it is important that they are familiar with the above strategies, and that their initial response and escalation routes are aligned with the ethos and principles of the strategies, and those of Time Space Compassion.

10. Work has also continued to progress commitments to The Promise, and Plan 24-30 was published in June 2024. Where appropriate, community-based supports and services should be delivered in a way that aligns with Keeping The Promise.

11. Funding related to the delivery of The Promise has included significant Scottish Government investment in Whole Family Wellbeing, which aims to help family support services make transformational system changes to reduce the need for crisis intervention and shift investment towards prevention and early intervention. Local partnerships should consider how supports and services aligned to the Framework and Whole Family Wellbeing Funding complement each other, and consider what learning is available from each.

12. The principles of Getting It Right For Every Child (GIRFEC) are already central to children’s services planning and the delivery of universal services, and continue to be relevant to the delivery of the Framework.

13. In addition to the rights that children and young people have under existing human rights and equalities legislation, the United Nations Convention on the Rights of the Child (Incorporation) (Scotland) Act 2024 has brought the UNCRC into Scots Law and put in place measures to achieve a culture of everyday accountability for children’s rights across public services in Scotland. The revision of the Framework and its ongoing funded delivery contribute to addressing the recommendation made in the Concluding Observations of the UN Committee on the Rights of the Child in June 2023 that strategies should be developed or strengthened, with sufficient resources, for ensuring the availability of community-based mental health services for children of all ages.

14. The policy landscape around mental health, children and young people, families and human rights should continue to be considered when developing and delivering supports and services aligned to the Framework.