Joint Strategic Board for Children and Family Mental Health minutes: February 2024

Attendees and apologies

Present:

Board Members and Deputies

• Stephen Gallagher, Director of Mental Health, Scottish Government, co-Chair
• Nicola Dickie, Director of People Policy, Convention of Scottish Local Authorities (COSLA), co-Chair
• Hannah Axon, Policy Manager, COSLA
• Angela Davidson, Deputy Director, Mental Health, Scottish Government
• Gillean McCluskey, Scottish Council of Deans of Education
• Stephanie Phillips, Director of Transformation, Strategy, Planning and Performance, National Health Service 24 (NHS24)
• Carsten Mandt, Senior Programme Manager, Perinatal Mental Health Network
• Cheryl Burnett, Chair, National Parent Forum of Scotland
• Joanne Smith, Chair, Parent and Infant Mental Health Scotland and National Society for the Prevention of Cruelty to Children (NSPCC) Scotland
• Amanda Farquharson, Child and Adolescent Mental Health Services (CAMHS) Service Manager, NHS Grampian
• David Mackay, Head of Policy, Children in Scotland
• Karen Lamb, Head of Specialist Children’s Services, NHS Greater Glasgow and Clyde
• Selena Gleadow-Ware, Perinatal Faculty Chair, Royal College of Psychiatrists in Scotland
• Mairi MacPherson, Deputy Director, Children and Families, Scottish Government
• Wendy Van Riet, Director, NHS Ayrshire and Arran
• Jane McAteer, Suicide Prevention, Children and Families, Scottish Government
• Kandarp Joshi, Psychiatrist, Royal College of Psychiatry of Scotland
• Laura Crossan, Inspector, Police Scotland, Oversight for Children and Young People National Portfolio
• Carrie Lindsay, Executive Director of Education and Children's Services, Fife Council.
• Martin Crewe, Director, Bernardo’s
• Matt McDonald, Head of Policy and Public Affairs, Scottish Youth Parliament
• Marita Brack, Associate Director of Phycology for NES Scotland

Speakers and presenters

• Roch Cantwell, Professional Adviser, Perinatal and Infant Mental Health, Scottish Government

• Donna Munro, Clinical Project Manager, Directorate for Mental Health, Scottish Government
• Anne McFadyen, Professional Adviser, Perinatal and Infant Mental Health, Scottish Government
• Stephen McLeod, Professional Adviser, Directorate for Mental Health, Scottish Government
• Jane Ford, Principal Public Health Intelligence Adviser, Public Health Scotland
• Meg Wharton, Policy Manager, Children, Young People and Families Mental Health, Scottish Government

Secretariat

• Georgia de Courcy Wheeler, Team Leader, Children, Young People and Families Mental Health, Scottish Government
• Leon Young, Secretariat, Children, Young People and Families Mental Health, Scottish Government
• Alastair Douglas, Secretariat, Children, Young People and Families Mental Health, Scottish Government

Observers

• Maggie Fallon, Unit Head, Children, Young People and Families Mental Health, Scottish Government
• Ruth Christie, Unit Head, Children, Young People and Families Mental Health, Scottish Government
• Hannah Ross, Policy Manager, Children, Young People and Families Mental Health, Scottish Government
• Bryony Revell, Professional Advisor, Scottish Government
• David Leitch, Team Leader, Children and Young People’s Mental Health Improvement, Scottish Government
• Peter Innes, Policy Manager, Children, Young People and Families Mental Health, Scottish Government
• Carolyn Wales, Policy Manager, Children, Young People and Families Mental Health, Scottish Government
• Chloe Duffus, Team Leader, Children, Young People and Families Mental Health, Scottish Government

Apologies

• Judy Thomson, NHS Education Scotland
• Haylis Smith, National Delivery Lead, Suicide Prevention
• Leanne Blacklaw, Mental Health and Suicide Prevention, Children and Young People, Police Scotland
• Ellen Moran, Principal Education Psychologist, Association of Scottish Principal Educational Psychologists
• Tracy Stewart, Scottish Council of Deans of Education

Items and actions

Welcome and introductions

Stephen Gallagher (SG), as co-Chair of the Joint Strategic Board for Children and Family Mental Health (JSB), welcomed everyone to the meeting and thanked them for their attendance. SG introduced himself and invited members who were not present at the November 2023 meeting to introduce themselves.

SG invited any comments or amendments to the minute of the meeting held in November 2023.

Amendments from the board:

• Gillean McCluskey (GMcC) clarified their title as representative from the Scottish Council of Deans of Education
• Selena Gleadow-Ware (SGW) clarified their title as representative from the Royal College of Psychiatrists in Scotland
• Amendment to the minute to draw out the noted importance of lived experience of postnatal and pregnant women as part of participation and engagement work 

The minute for Novermber 2023 meeting was agreed, subject to the above amendments.

Actions

• secretariat to amend minute as above and recirculate to Board members with papers for March 2024 meeting for information

Terms of reference and membership

Maggie Fallon (MF) gave an overview of the terms of reference, including membership list. MF drew members attention to the proposed model for implementation groups.  This will be issues based, covering all age ranges and looking across the four priority areas. Agreement was sought that the current members list is appropriate at this stage.

Discussion

• there was discussion about the use of the word ‘families’. It was agreed that the word families was chosen to ensure inclusivity, but there were questions raised as to whether it is specific enough
• on membership, SGW advised that it may be appropriate to engage with PIMH clinicians

Actions

• secretariat to make changes to the ToR reflecting the comments regarding the use of the word ‘families’
• secretariat and members to consider involvement or PIMH clinicians on implementation groups

Outcomes Framework

Hannah Axon (HA) and Jane Ford (JF) provided an overview of work done by Scottish Government, PHS and COSLA on the outcomes framework since the meeting in November 2023. It is intended to inform ongoing discussions about potential actions for the JSB, and the type of monitoring and evaluation that may be useful, feasible and proportionate. It links across many related policy areas and supports the Mental Health and Wellbeing Strategy outcomes, as well as the National Performance Framework.

Discussion

• Kandarp Joshi (KJ) raised a question around what “children in vulnerable situations” refers to. HA explained that we recognise the breadth of scope the terminology implies, and it is intended that there will be an initial focus on care experienced children. A paper on this priority will be discussed at the next meeting
• it was noted that neurodiversity needs to be considered across the priorities
• there was discussion around the specific needs of infants and it was agreed that this would be further considered later in the meeting during the discussion on Paper 3
• there was discussion about whether there were further opportunities to link the Boards outcomes and relevant data collection to other work/ outcomes in the children and family policy space

• SGW raised that taking a life stage approach is appropriate in order to avoid considering the four priority areas in isolation from each other

Actions

• Scottish Government and COSLA officials to meet with Directorate for Children and Families colleagues regarding further alignment with the Children, Young People and Families Outcomes Framework
• secretariat to make any changes to the outcomes framework following those discussions, sharing any changes with the Joint Strategic Board

Crisis support (Paper 2)

Megan Wharton (MW) presented the Crisis priority area. The presentation included an overview of the current provision of crisis support for children and young people. MW highlighted three issues for members’ consideration:

• high demand for services and variability of access
• the need to balance in-person and digital supports
• the need for a whole systems approach

The JSB was asked to:

• indicate if the paper reflects their understanding of the current key issues around crisis support for children and young people
• indicate support for, or alternatives to, the way forward outlined in the paper

Discussion

• Stephen McLeod (SMcL) emphasised some of the key messages that children and young people have already expressed as part of research, including that when they are experiencing, or have experienced, crisis they want to be able to tell their story once, without the need to repeat, highlighting the need for a whole systems approach. Children and young people have also told us that they would like a choice of who they present to in crisis, which is linked to the one good adult approach
• the need for a range of training and supports available to all adults supporting children and young people was also raised, noting that the NES knowledge and skills framework could be a way to increase skills and confidence of adults supporting children and young people, and links to the approach taken on suicide prevention and self-harm strategies
• immediate access to support, including out of hours, was also raised as an important consideration 
• Donna Munro (DM) reflected on the need for support to be person centred. DM also raised organisational culture as needing consideration. This links to the Time, Space, Compassion work and the reality that colleagues in services experience compassion fatigue
• Mairi MacPherson (MM) added that school nursing is also relevant to this area, given that the majority of issues the workforce sees relates to mental health in schools
• members raised a question around whether parents’ experience of crisis should fit into considerations of the priority and it was suggested by Roch Cantwell (RCa) that this could be explored at a future meeting. Similarly, members discussed intergenerational experience of crisis. It was noted that adult crisis work is further developed, whereas there is a significant gap for children and young people, which is why it has been identified as a priority

• David Mackay (DM) and Matt McDonald (MMcD) noted that UNCRC should also be considered within the wider policy context for this priority area, and for the remaining priorities. MMcD added that youth work has been raised by children and young people as missing from crisis prevention, post-crisis support and more general mental health support

Board members agreed that the issues identified in the paper reflect their understanding of key issues regarding crisis supports, and agreed to the ‘Way Forward’ outlined.

Actions

• Scottish Government officials to update the Crisis scoping paper to reflect comments, including specific reference to age groups and UNCRC

Perinatal and Early Years Mental Health Support (Paper 3)

Ruth Christie (RC) presented on the Perinatal and Early Years Mental Health Supports priorities, providing an overview of the proposed scope and remit of the JSB in relation to this priority area.

RC highlighted four issues for members’ consideration:

• service specifications
• mental health services for under fives
• support for women and families
• need for a whole system approach

The JSB was asked to:

• indicate if the paper reflects their understanding of the current key issues around perinatal and early years mental health support
• indicate support for, or alternatives to, the way forward outlined in the paper

Discussion

• members recognised that there have been significant advances made in perinatal and early years mental health support, including in terms of service development in urban areas and tackling stigma. However, there have also been challenges including with rural and island communities, sustaining services, emerging workforce challenges and continuity of care in statutory services due in part to limited awareness of where to refer to, or join-up with the third sector. Joanne Smith (JS) added that new capacity in some areas is positive, but we should not become complacent
• RCa noted there is opportunity for some further work to integrate care more effectively and ensure good transitions of care, linking to the whole system approach. MM added that there is a larger role for Children’s Services Planning Partnerships. The benefits of the Solihull Approach were raised and agreed that there is opportunity to promote it further
• the life stage approach was welcomed by members, given that older children/young people are potential parents and the importance of an intergenerational approach
• JS raised the need for developing local perspectives on support in order to create sustainable change and that there is an opportunity for JSB to test this in one area and align with Early Childhood Development transitions. Once it is established what good looks like considerations could be made of how to roll out more widely
• there was some discussion around proposals for a service specification. It was noted that it should be clear what the purpose of a service specification would be, and that this could be given further consideration at implementation group level to determine what is required and what it aims to achieve. RC raised the ongoing work with the perinatal mental health network looking at integration and suggested it might be useful to bring that paper to JSB. RCa raised that a specification will be required to fit with CAMHS and adult work in terms of core standards, but that it presents an opportunity to think about whole systems approach and service standards in an innovative way

• there was discussion around primary and universal services, including acknowledgement that often these settings play a large role in the support required for women and their families, and for some those services are enough. MM noted that there was an opportunity to consider all those services and supports that are touchpoints for families in the early years, and what training and skills could be provided to frontline workers

• several areas for linkages or further consideration were raised, including neurodivergence, trauma and UNCRC, particularly in reference to the voice of the infant and infant pledge

Board members agreed that the issues identified in the paper reflect their understanding of key issues regarding perinatal and early years mental health supports, and agreed to the ‘Way Forward’ outlined.

Actions

• Scottish Government officials to update the perinatal and early years supports priority paper to reflect UNCRC as part of the wider policy context

Close

SG thanked all for attending and contributions to the discussions.

Next Meeting

The next meeting takes place on Wednesday 27 March 2024, 1300 – 1500, and will be held on Teams.