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

What does community-based support look like?

15. Supports and services aligned to the Framework should focus on prevention and early intervention. They should be provided to children, young people and their families who will benefit from additional help to promote, manage and improve their mental health and wellbeing, and to help them develop coping strategies and resilience. This support may be required for a variety of reasons and circumstances and should be holistic, recognising that children, young people and their families might experience a range of challenges and need whole-person flexible support.

16. Supports and services should support those in emotional distress and promote positive mental health and wellbeing. With appropriate professional oversight, supports and services can safely deliver help that targets a variety of issues. The following lists are not exclusive but give an indication of the kind of emotional distress that should be addressed and the positive mental health and wellbeing that should be promoted:

Emotional distress

• Anxiety
• Attachment
• Bereavement support
• Depression (mild to moderate)
• Emotional and behavioural difficulties associated with neurodevelopmental disorders
• Gender identity
• Repetitive/perseverative behaviours
• Self-harm
• Substance use
• Trauma

Positive mental health and wellbeing

• Body image and self-esteem
• Building resilience and coping strategies (emotional regulation)
• Healthy and positive relationships
• Healthy digital interaction
• Parenting support

17. Consideration should be given to different presentations of emotional distress, particularly for children and young people with complex needs, whose first language is not English or who have neurodevelopmental conditions.

18. The support available should be highly flexible, personalised, and adaptive to need and the changing circumstances of the child, young person or family member. Support should be compassionate, empathetic and kind, and take account of the evidence from stakeholders of what works, which includes:

• Continuity in provision. Wherever appropriate, getting support from people that children and young people know and trust, who should be enabled to be confident in addressing mental health and wellbeing. This may include continued contact with practitioners from CAMHS in community-based support, or continued contact with trusted practitioners during the transition from children’s to adult services.
• Confidential services for those who choose them, for example not in their school or immediate community.
• Relation-based practice, which enables support to be provided and change achieved through one-to-one professional relationships.
• Self-referral services that are as accessible as possible. Consideration should be given to age and stage appropriate language, neurodevelopmental conditions and learning disabilities. Self-referral must remain accessible by other means, e.g. through an advocate.
• Support for advocates or supports to attend with a child or young person.
• Support for language barriers, e.g. written materials in a range of languages and interpreters to attend with a child, young person or family member.
• An understanding of the impact of trauma and adverse childhood experiences (ACEs), which can affect the wellbeing of children, young people and their families.
• Awareness of the principles of Time Space Compassion, a relationship and person-centred approach to supporting people experiencing suicidal crisis.

19. Examples of the types of supports and services that might be delivered are reflected below, recognising that this is not an exhaustive list:

• Support from staff trained in listening, counselling or other psychological therapies and interventions in appropriate settings.
• Early support in school for children and young people with mental health and wellbeing needs (in addition to the core provision of school counsellors).
• Targeted interventions for at-risk groups, where staff are trained in addressing the specific needs of the community in question.
• Enhanced youth work provision for early intervention, prevention, positive relationships and facilitating peer support.
• Parenting support groups which include information on brain development and help parents to understand and manage difficult behaviour and distress and empower them to strengthen their relationships with their children.
• Whole-family approaches involving supportive work with family members.
• Support for children and young people that helps them to contextualise their emotions by age and stage, understand brain development and develop self-care.
• Support for emotional regulation based on models such as dialectical behaviour therapy (DBT) and cognitive behavioural therapy (CBT).
• Therapeutic interventions, e.g. play therapy, art therapy, music therapy and drama therapy.
• Digital services such as online support platforms and text-based services.
• Supports involving sport or physical activity to enhance mental wellbeing.
• Peer support networks, including support groups, peer-led programmes and facilitated peer-to-peer support.
• Age- and stage-appropriate services, e.g. for those aged 16 and over or for children and young people with complex needs.

20. Local partnerships are not expected to be able to put in place all the types of supports and services listed above. As provision should be informed by local needs, it is not anticipated that supports and services will look the same across different areas.