Community mental health and wellbeing supports and services: framework

Community Mental Health and Wellbeing Support - what is it?

17. Children and families should receive support and services that are appropriate to their needs. For many children and young people, such support is likely to be community based, and should be easily and quickly accessible. A smaller number of children require a specialist response from a mental health professional.

18. Support and services should be provided to children and young people who will benefit from additional help to promote, manage and improve their mental health and wellbeing and to help them develop coping strategies and resilience. This support may be required for a variety of reasons and circumstances and should be holistic, recognising that children and young people may have a number of issues and need "whole-person" flexible support.

19. With appropriate professional oversight, community mental health and wellbeing supports and services can safely deliver help that targets a variety of issues. The following list is not exclusive but gives an indication of the kind of distress that should be addressed and the positive mental health that should be promoted:

Distress:

• Anxiety
• Attachment
• Bereavement support
• Depression (mild to moderate)
• Emotional and behavioural difficulties associated with neurodevelopmental disorders
• Gender identity
• Repetitive/perseverative behaviours
• Self-harm
• Self- injury
• Substance misuse
• Trauma

Positive Mental Health and Wellbeing:

• Body image and self esteem
• Building resilience and coping strategies (emotional regulation)
• Healthy and positive relationships
• Healthy digital interaction
• Parenting support for children and young people of all ages

20. Consideration should be given to different presentations of distress, particularly for children and young people with complex needs, neurodevelopmental conditions and where English is not a first language.

21. There should be strong links with CAMHS, when considering issues such as substance misuse, self-harm, depression and trauma with shared risk assessments and clear pathways of escalation.

22. Each local community planning or children's services partnership should identify and demonstrate clearly any particular local need or priority that should be addressed by community support. Partnerships should actively engage with under-represented and "at risk" groups, including communities who may often find themselves excluded.

23. The support available should be highly flexible, personalised and adaptive to need and the changing circumstances of the child, young person or family/carer. Support should be compassionate, empathetic and kind, and take account of the evidence from stakeholders of what works, which includes:

• Continuity in provision - wherever appropriate, getting support from people that young people know and trust, who should be enabled to be confident in addressing mental wellbeing. This may include continued contact with practitioners from CAMHS within community based services;
• Confidential services for those who choose them, for example not within their school or immediate community;
• Relation-based practice, which enables support to be provided and change achieved through one-to-one professional relationships;
• Self-referral services that are as accessible as possible. Consideration should be given to age and stage appropriate language, neurodevelopmental conditions and learning disabilities. Self-referral must remain accessible by other means e.g. through an advocate;
• Peer support networks, including support groups, peer led programmes and facilitated peer to peer support;
• Support for advocates or supports to attend with a child or young person.

24. The range of support that might be delivered through community mental health and wellbeing services is reflected below, and this list should inform local decisions about the additionality that is required from this framework:

• Additional community based support from staff trained in listening; counselling, or other psychological interventions in appropriate settings;
• Additional early support in school for children and young people with identified needs;
• Targeted interventions for specific groups - e.g. LGBT+ young people, deaf communities, young parents and carers, children and young people with learning disabilities, or complex needs;
• Ensuring that all responders are trained in addressing needs of specialists groups including LGBT+ young people.
• Universal youth work provision for early intervention, prevention, positive relationships and facilitating peer to peer support
• Parenting support groups, which include information on child brain development, and help parents to understand and manage difficult behaviour and distress and empower them to strengthen their relationships with their children;
• Supportive work with family members;
• Support for children and young people that helps them to contextualise their emotions by age and stage and understand brain development; emotional regulation skills based on Dialectical behaviour therapy (DBT), Cognitive behavioural therapy (CBT) or other relevant models and, support to develop self-care.