Community mental health and wellbeing supports and services: framework

Workforce

41. Ensuring safe and effective person centred practice aligned to GIRFEC, will require several elements to be in place in terms of workforce capacity and capability.

42. The most central of these will be a well co-ordinated system to provide quick assessment of need and access to staff with the relevant skills Workforce means both the public and third sector workforce as a considerable amount of community support is provided through third sector organisations.

43. The additional capacity required to supervise the delivery of these supports can draw on the increased investment in the CAMHS workforce. Local partnerships should consider the resource implications of ensuring support from local CAMHS teams.

44. Specific knowledge and skills targeted at mental health and wellbeing needs and outcomes is required across sectors and disciplines in line with the following four levels of practice transcending sector disciplines and professions:

Informed: all staff working in health, social care and 3rd sector settings

Skilled: staff who have direct and/or substantial contact infants, children, young people and their families

Enhanced: staff who have more regular and intense contact with infants, children, young people and their families, who are at risk of, or are experiencing mental health and wellbeing concerns

Specialist: staff who, by virtue of their role and practice setting, provide and expert specialist role in the assessment, care, treatment and support of infants, children, young people and their families, who are at risk of, or experiencing mental health and wellbeing concerns

45. It is expected that most workers in community supports and services would be practicing at the skilled and enhanced levels, providing relationship and listening based supports, with support from CAMHS staff for supervision, coaching and training. Health visitors, midwives, school, and family nurses should also be well integrated into the whole-system of community wellbeing support.

46. Children's services offer a wide range of supports within whole-school approaches including nurture, targeted approaches including the use of mental health first-aid training, and support from school guidance staff, school counsellors, school nurses and other workers such as youth workers and link workers. The provision of counselling through schools is delivered in line with a range of aims and principles, which include:

• Delivered in partnership between national and local government, and relevant partners, and should build upon the services already in place wherever possible.
• Should be part of a holistic, child centred, approach to improving the mental health and wellbeing of children and young people.
• In recognition of the need to ensure young people are safe, services should ensure a robust assessment is carried out and that young people are supported to access alternative services as appropriate.
• Should align to, and/or enhance local services to support the mental health and wellbeing of children and young people.

47. These principles should broadly refer to the whole workforce involved in the delivery of community mental health and wellbeing supports.

48. All staff working across the four levels should themselves be supported, as well as, able to work safely. Priority should be given to staff wellbeing and ensuring that there is appropriate reflective practice or supervision structures to support staff to deliver safe, high quality, evidence-based, relational approaches while maintaining their own resilience and wellbeing. Key to supporting the workforce is having the right training and development in place.

49. CAMHS teams will support both universal and additional children and young people's services, including new and enhanced community mental health and wellbeing supports, by providing consultation, advice and training, and where appropriate, supervision of those staff providing psychological interventions. Children, young people and their families supported in CAMHS will also have access to supports provided within universal and additional services.