Children and Young People's Mental Health Task Force: recommendations

The Foundations for improving Children and Young People's Mental Health

The whole system model described emphasises early intervention and prevention. There is incontrovertible evidence that strong relational health is a key factor in reducing negative outcomes in relation to emotional and mental health and wellbeing. It is also clear that effective early responses to need result in improved outcomes. It is therefore critical investment decisions are informed by an early intervention and prevention approach that will support the team around the child to provide universal, early and additional support. Resourcing must support the whole system model by investing fairly in early intervention as well as specialist and crisis support. To achieve this ambition some work may be required to ascertain the totality of current spend on children and young people's mental health, investigating budgets at both a national and local level.

Recommendation 5: Scottish Government and COSLA should support future investments in children and young people’s mental health that prioritise early intervention and prevention approaches.

A long-term, preventative approach is required and the advice of workstreams intends to complement the whole systems approach.

The ambition is summarised well by the Mental Health Policy Commission's recent report:

By systematically deploying evidence-informed practices and programmes that maximise resilience and minimise risk factors, it is within our grasp to halve the number of people living with life-long mental health problems in a generation. What is required is transformational change that embeds prevention in all policies and practices that affect young people. (Mental Health Commission)^[1]

Further supporting information can be accessed at the following link:

https://www.birmingham.ac.uk/Documents/research/policycommission/Investing-in-a-Resilient-Generation-Executive-Summary-and-Call-to-Action.pdf

A preventative approach, with a resilient generation of children, and resilient families and communities, can form the foundational building blocks in the Taskforce's model for improving the mental health of Scotland's children and families. The Taskforce is investigating what these building blocks need to be to create a whole system approach to children and young people's mental health that ensures the right help at the right time.

Recommendation 6: The Taskforce has begun to identify a set of building blocks integrating the recommendations of all its workstreams. These will embed prevention and best practice in all our work with children, young people and their families. Scottish Government and COSLA should ensure future approaches to children and young people’s mental health are based on these building blocks.

These building blocks would help local CSPs to frame and reinforce both their local approach and contribution to the national performance framework. They would supplement not replace GIRFEC and children's services planning arrangements. This framing would be designed to help; partnerships, families and communities plan and organise their role and contribution in ways that are well informed by evidence, to embed preventative approaches and support transformation change

The Taskforce endorses straightforward principles and approaches that are built on the key recommendations of all the workstreams. This approach has been informed by; Birmingham University's Mental Health Policy's Commission's 'Four Building Blocks for Building a Resilient Generation' (Appendix 1), Glasgow's 'Healthy Minds Framework' and Fife's 'Our Minds Matter' strategy (Appendix 2).

To illustrate this principle, foundation building blocks supported by the work of the Generic and At Risk Workstreams for example, might look like:

The Taskforce and its workstreams will develop the building blocks model, adding detail to the key building blocks that will support all families, communities and partnerships to develop their local approaches and contributions to achieving good mental health for every child and young person.

These building blocks will achieve:

• Improved health and wellbeing and life chances of all children, young people and their families in the area.
• Children, young people and families being more empowered to manage their own mental health and make the best use of the support available to them.
• Children and young people's mental health needs being identified and appropriately responded to earlier.
• Improvement in access to appropriate mental health assessment and treatment, with reductions in waiting times for specialist mental health services.
• Reduction in children and young people being passed from one place to the other via inter-agency referrals.
• Greater continuity in the adults that are providing support to children, young people and families.

The Centre of the Developing Child at Harvard University, have published a set of design principles based on child development and the capabilities of adults^[2]. These principles are designed to guide policymakers and practitioners across sectors to redesign policy and practice in improving outcomes for children and families and would support the aims of the workstreams. These are:

• Support responsive relationships for children and adults;
• Strengthen core life skills;
• Reduce sources of stress in the lives of children and families.

The Taskforce strongly supports tackling the provision of support by taking a whole system approach, which progresses the Delivery Plan's concept of a hub-based approach. While the GIRFEC framework and national practice model are in place, much more needs to be done to ensure it is being implemented consistently across Scotland and for all children and young people.