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

Child and Adolescent Mental Health Services

If parents and/or professionals think a child has a problem that requires help, there probably is….we may not be sure what it is, but it's very likely that there will be more than one problem…. and these problems will overlap (Professor Chris Gillberg)^[3]

The Taskforce is clear on the message that there must be a 'single door' approach when children, young people, their families or those who support them seek help, and that professionals from across the multi-agency workforce will successfully work together to ensure this, as part of the whole system.

There is a recognised level of inconsistency in Specialist CAMHS and Neurodevelopmental service (including: community paediatricians, paediatric nurses in the community, speech and language therapists, occupational therapists, and physiotherapists) specifications across Scotland. This incorporates variance in: age range, criteria, capacity and professionals available within these services.

In the Taskforce delivery plan published in December 2018, both the Specialist CAMHS and Neurodevelopmental workstreams committed to developing a specification for Ministers and COSLA setting out the key service requirements within the model of GIRFEC.

Service Performance

The Taskforce have found that, the performance of CAMHS and Neurodevelopmental services across Scotland are inconsistent. There is a lack of direct proportionality with resource and demand (e.g. some areas are doing better with more referrals and less resource).

Recommendation 10: Building on existing work, the Scottish Government should commission a quality/performance improvement plan to improve consistency, in the short term, of CAMHS performance and CAMHS acceptance criteria. This will be of particular importance given the £4m investment in CAMHS to ensure there is a measurable improvement, in line with Taskforce recommendations, as a result of this investment.

Recommended Performance Standards

There is unhelpful variation across Scotland regarding the composition and function of specialist CAMHS teams, and this impacts on the treatments and services they offer, resulting in inconsistency in referrals that they accept and do not accept. Though this reflects the different structures and services across the country, it could be improved to meet the needs of children, young people and their families.

It is suggested that these standards should be discussed with the CAMHS workforce and other stakeholders, and should take account of capacity modelling data for Health Boards across the country, and learning from development work including the pathfinders described. They should seek consistency and best practice with regard to:

• The provision of support and treatment to young people as required, until their eighteenth birthday;
• Steps should be made to explore how support and treatment can be extended to their twenty sixth birthday for anyone with care experience;
• Inclusive referral criteria;
• The provision of crisis support;
• Pathways for whole system support for children who are best assisted by other services;
• Improved transition to adult services;
• Systems for collecting data for measurement and audit purposes.