Children and Young People's Mental Health Taskforce: delivery plan

Chair's Foreword

Earlier this year I was privileged to be asked to lead the independent Children and Young People's Mental Health Taskforce, jointly commissioned by the Scottish Government and COSLA. To me, this really demonstrated the shared commitment to improving the mental health of our children, young people and their families.

The Children & Young People's Mental Health Taskforce recognises that

• waiting times to access specialist services has become unacceptable;
• there are gaps in community services to support Children and Young People with milder mental health problems; and
• there is poor provision of out of hours or crisis support .

These issues were highlighted in the recent reports by Audit Scotland on Children's and Adolescent Mental Health and by SAMH and ISD on Rejected Referrals. The recommendations of both reports were accepted by the Scottish Government.

Alongside the challenges within mental health services for children and young people, there is also a recognition that mental health issues among children and young people appear to have significantly increased in the past few years. This is not only the case here in Scotland but also across other developed countries. The Organisation for Economic Cooperation and Development (OECD) has highlighted the need for us to transform our approach to dealing with this growing problem^[1].

Earlier this year I made a number of recommendations to ensure that immediate and longer-term changes to children and young people's mental health and wellbeing are efficiently and effectively supported. The Taskforce will work with a range of partners to take these recommendations forward.

I very much see this as an opportunity to build on the growing movement across the country to address one of our most pressing and important challenges. Around a third of the Scottish population is aged under 25^[2]. In my view they are experiencing childhood and the transition into adult life in a much more complex world than their parents and grandparents did. Many of our young people are thriving in this world. However, for some, support is needed and that is often around their mental health. Children and young people make up a significant proportion of our population. The issues they face need to be reflected in the attention, care and services they receive.

Approximately 20% of young adults in Scotland reported a possible psychiatric disorder in 2016^[3]. There has been an increase in the percentage of adolescents reporting emotional and behavioural difficulties, particularly among adolescent girls^[4]. This trend is especially evident with emotional problems in particular. We also have a growing evidence base on the relationship between adverse childhood experiences (ACEs), childhood trauma and the increased likelihood of mental health difficulties^[5]. As neurodevelopmental conditions and their relationship with mental health become better understood, we are seeing a clearer picture of their impact on young people. For example 1.6 per cent of those aged under 25 have autism^[6].

Those working in young people's mental health services do a remarkable job in difficult circumstances. However our approach to children and young people's mental health needs to be transformed if we are to capture the passion, expertise and commitment of the workforce to provide what our young people need and deserve.

The recent Audit Scotland report on Children & Adolescent Mental Health Services laid out the challenge very clearly. It said, 'A step change is required to improve children and young people's mental health'. More specifically the earlier Rejected Referrals Report from SAMH and ISD concluded that "There is a strong indication of a gap in services for children and young people who do not meet the criteria for the most specialist help." Also we cannot ignore that we live in an age of austerity and that this impacts on services. More than ever we must ensure resources reach those who need them and deliver effectively on policy intentions.

These are the strategic challenges we face. I am pleased to say that through the establishment of the Taskforce, the Scottish Government and Local Government are showing joint leadership in taking these challenges seriously. Their joint commitment to working in partnership is important in responding with the ambition and determination that our young merit.

During the summer of 2018, I met with lots of people to discuss their experiences of accessing mental health support. That formed the basis for my recommendations which in turn have informed the Taskforce's delivery plan. At a broad level I see four things we need to get right to create the conditions for transformation. These are data & information, money, workforce and redesign & change management. These feature strongly across the delivery plan as do the four key components of a transformed approach to children and young people's mental health which are discussed in detail.

This challenge is not one which can simply be met through processes and funding. People are at the heart of any successful system which serves human beings. As part of and alongside the development and implementation of the transformation we need, we must build on the movement for change which is already growing in Scotland. This has to bring together everyone who has a contribution to make; from young people and their families, the workforce, politicians and other strategic decision makers.

The Taskforce faces a wide ranging set of challenges. This document lays out how we will start that work and where we hope to be at the end of 2020. The plan will inevitably evolve over that time and indeed we intend to bring forward a detailed work plan for each workstream in April 2019. We have an important job to do and we are getting on with it. Scottish and Local Government and other partners have interrelated but separate jobs to do and we will work closely with them.

However as a Taskforce we are also able to help bring about wider change. In this respect I see us having two clear roles. These are to act as bridge builders, and to draw together and share knowledge. On the first of these I believe we can bring different networks together to make a bigger change collectively than they could ever do separately. On the second I think we can help develop and spread at scale some of the really good things that are happening in different parts of Scotland and beyond.

Together we can build an approach to mental health support and services for children and young people that, irrespective of their background or personal characteristics, ensures they receive the right care and interventions at the right time and in the right place.

This is a very exciting time to be involved in children and young people's mental health. It sits at the top of the policy agenda. There is ground breaking work going on in terms of practice and research. And there is a strong commitment across the board to a new and better approach.

The members of the Taskforce and those supporting us bring expertise, energy and commitment. I look forward to work we are undertaking together. There can be no greater motivation than building an approach to mental health which is worthy of Scotland's children and young people. I and my colleagues on the Taskforce are pleased to be part of that.

Dr Dame Denise Coia
Chair
Children & Young People's
Mental Health Taskforce