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

Whole-system approach

43. It is vital that supports and services are integrated with and contribute to a whole-system approach, with strong links to the support provided by universal and specialist services to ensure a continuum of support around the child or young person. This should include use of the GIRFEC national practice model and wellbeing indicators (SHANARRI) to identify, describe and evaluate needs, as a co-ordinated approach to planning that brings professionals from across different disciplines together to deliver the right support, in the right place at the right time.

44. There should be clear points of initial contact and access through any appropriate source to ensure that a child or young person is provided with the help they need. There should be no wrong way to access support and “no wrong door” for children and young people.

45. Supports and services should have strong links with CAMHS when considering issues such as substance use, self-harm, depression and trauma, with shared risk assessments and clear pathways of escalation. There should also be appropriate links to out-of-hours and crisis services.

46. Education is a key part of the whole system, and supports and services should complement the mental health and wellbeing support provided in schools by pastoral care practitioners, school counsellors and school nurses.

47. Supports and services should recognise and respond to the factors that can contribute to poor mental health and wellbeing, such as poverty, unemployment, homelessness and substance use. There should be clear links to other services that can provide support in relation to those matters. This could be facilitated by co-locating services such as money advice alongside community mental health supports.

48. Children and young people should experience a seamless pathway through support. Local partnerships should take a whole-system approach to supporting children, young people and their families, and work together as appropriate with CAMHS, adult mental health services, perinatal and infant mental health services, primary care, education, social work, the third sector, wider children’s services, and other services that children and young people may be involved with such as youth work, employability and alcohol and drug support.

49. There should be strong connections between supports for those aged 5 and over and perinatal and infant mental health services, and this should help children and their families as they transition between different stages. There are now a number of statutory and third sector perinatal and infant services across the country, including community perinatal services, infant mental health services, and maternity and neonatal psychological intervention services.

50. Everyone involved in supporting mental health and wellbeing should be clear about the role of community-based support and have a good awareness of wider services available in their local area, not only for children and young people but also for younger adults. This is important as those aged 16 and over are able to access community-based support for young people as well as for adults, for example through community projects for adults, and wider services will also be relevant in supporting family members. The community projects for adults have the same focus on prevention and early intervention, and are supported by third sector interfaces (TSIs) in each local authority area.

51. Good awareness between wider services should also help make the transition to adult services smoother for older young people. Young people’s experience of transitions may also be enhanced by taking a holistic approach, making processes less complex, improving young-person-friendly information and signposting to other local services.

52. Local partnerships should engage with the third sector as appropriate to local needs and delivery. Collaboration with the third sector can help to deliver creative solutions, increase the capacity of grassroots organisations, and support community engagement and the involvement of people with lived experience.