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

Design, delivery and evaluation

23. Effective design and delivery should ensure that the needs of children, young people and families are understood, drawing on available data and information, and that appropriate supports and services are identified and put in place to address those needs.

24. Supports and services should build on existing structures, with strong links established to children’s services planning and community planning, maximising the opportunities for children and young people to improve their mental health and emotional wellbeing and ensuring clear pathways between services.

25. Supports and services will normally use evidence-based and evidence-informed interventions, but may sometimes use less well-evidenced approaches where these are considered to be best placed to help the child or young person. Any risk arising from this should be managed as appropriate.

26. Under Article 12 of the UNCRC, every child has the right to be heard in matters affecting them. A rights-based approach should be taken to the design, delivery and evaluation of supports and services, and these should be developed and co-produced with children, young people and their families, who should be involved as early as possible and going forward to ensure that local needs and priorities are identified and continue to be reflected. There should also be appropriate consideration of how stigma and discrimination can be addressed in the design of the supports and services.

27. Local partnerships should actively engage with under-represented and at-risk groups, including communities who may often find themselves excluded or who are seldom heard from. These groups are likely to be at heightened risk of experiencing poor mental health, and of not receiving the right help at the right time. This includes for instance children, young people and their families who:

• are care-experienced
• are from minority ethnic backgrounds
• are LGBT+
• are young parents or carers
• have learning disabilities or complex needs
• have experience of the criminal justice system
• are experiencing or are at risk of poverty
• are asylum-seekers or refugees

28. The above list is not exhaustive, and local partnerships may identify other groups who are in particular need of support in their area.

29. Local partnerships should consider their assessment and child’s plan processes alongside the design and delivery of supports and services, to ensure the right service at the right time for children and young people with mental health needs. Where services require to co-ordinate, this should involve a lead professional and should be part of a single process with other needs the child or young person may have. Such work might include process mapping to reduce delay and achieve an effective response to requests for help, wherever children, young people or their families might ask for it.

30. In providing support and considering where it should take place, local partnerships should also consider the physical environments in which supports and services are delivered with particular consideration around creating safe, non-clinical environments that are accessible to all. Children and young people consistently ask for somewhere comfortable and pleasant where they can feel relaxed talking about their mental health and wellbeing.

31. To help understand local needs and aid the ongoing development of supports and services, local partnerships should consider meaningful and proportionate monitoring and evaluation of the provision of the supports and services. Appendix A contains the outcomes that delivery of the supports and services should achieve, and these can support monitoring and evaluation work.

32. Measuring or evaluating the impact of services that support children and young people’s mental health and wellbeing can be challenging, particularly where these are preventative in nature or focused on promoting positive mental health and wellbeing. Supports and services may choose to use a range of tools to measure progress towards desired outcomes, depending on what is appropriate to the child or young person and the support being offered. Examples utilised by supports and services to date include but are not limited to:

• Practitioner-developed surveys
• Goal-setting and Outcomes Stars
• Stirling Children’s Wellbeing Scale
• SHANNARI Wellbeing Web
• Warwick-Edinburgh Mental Wellbeing Scale
• Strengths and Difficulties Questionnaire

33. Population level data can also be considered. While this will not demonstrate outcomes for individuals or the impact of a specific support or service, it may help local partnerships assess wider need and the direction of travel. This might include data from:

• SHINE (school-based staff)
• Health and Wellbeing Census
• Growing Up In Scotland

34. In addition, mental health indicators have been developed by Public Health Scotland.