Children and Young People's Mental Health: A Framework for Promotion, Prevention and Care: Draft for Consultation : page 9


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Children and Young People's Mental Health: A Framework for Promotion, Prevention and Care

7. ADDITIONAL & SPECIFIC SUPPORTS

Context

7.1 Evidence suggests that some groups of children and young people are at greater risk of developing mental health problems than their peers. There is also evidence to suggest that some groups are likely to find more difficulty accessing the support and help that they need. Among these children and young people are those:

who are or have been looked after or accommodated, including those adopted from care
who have been or who are living or 'looked after' at home and who have been neglected or abused
who have a learning and/or physical disability
who have a chronic or enduring illness (including mental illness)
who are from homeless families or who are homeless
whose parents have problems of illness, dependency or addiction
of refugee and asylum-seeking families
who are gay, lesbian, bisexual or transsexual
who are in the Children's Hearing system or who are at risk of or involved in offending
who have experienced or are at risk of abuse (including those who have witnessed domestic abuse)
who are from ethnic minority or cultural minority backgrounds (including travelers)

7.2 Additional or specific action is required to ensure that these children and young people are able to access support for their emotional and mental health and wellbeing across promotion, prevention and care.

7.3 The Children (Scotland) Act 1995⁵⁰ sets out the duties of and powers available to public authorities to support children and their families in the interests of a child's welfare. The Act is centred on the needs of children and their families and includes duties of assessment for "children in need" and their carers. The Additional Support for Learning (Scotland) Act 2004 provides a further legislative framework for assessing and meeting the needs of children and young people, whatever those needs might be. The Children (Scotland) Act includes specific provisions to support and protect the interests of looked after and accommodated children and young people, and those who have been in public care. This Framework fits within this overarching legislative context.

Overarching philosophy & culture

7.4 Although there are many factors which are well established as increasing children's vulnerability to mental health problems, there are also many protective factors which need to be considered and supported. These include an individual child's attributes, their relationship with a range of others including their families and their peers, and the availability of support networks. Any assessment of a child's needs, whether formal or informal, should therefore focus on their strengths and skills as well as their difficulties.

SERVICE ELEMENTS	ACTIVITY	OUTCOMES	KEY PARTNERS
Proactive links with local authorities to establish specific policies to identify and support those in need of additional or specific emotional support in a range of contexts	Liaison with local authorities to undertake a local needs assessment to identify groups of children and young people requiring additional or specific emotional and mental health support. Interagency co-operation at planning level on the needs of the community, leading to integrated plans for children's services and joint commissioning. Establishment of formal inter-agency information sharing protocols in relation to families at risk and in need of support. Joint commissioning of support services. Integrated care planning and service delivery for children and families in need of additional support.	All policies and practices relating to children and young people in need of additional support have an explicit mental health promotion element. Integrated delivery of accessible support services for children, young people and their parents/carers. Referral protocols and pathways for NHS CAMHS are agreed and transparent.	Health promotion staff Local authority Health Improvement Officer Staff working with children & young people who require additional support e.g. social workers, residential care staff, LAC health team, LAC teachers & support workers, throughcare & aftercare team Housing staff Social work services Education authority NHS Primary Care team NHS community child health team Learning Disability Local Area Co-ordinators Voluntary sector NHS CAMHS staff (inc. Primary Mental Health Workers) Child Protection Committee
Contribution to the health assessment of individual children and young people	Assessment of the mental health needs of children and young people as part of any general health assessment. Interventions offered by appropriately qualified staff on the basis of mental health needs assessment. Establishment of formal shared assessment protocols. Input to parent/carer held health records.	All of the child's or young person's needs are assessed to inform holistic care planning.	NHS Primary Care team NHS CAMHS staff (inc. Primary Mental Health Workers) NHS community child health team Social work services Education staff LAC health team Learning Disability Local Area Co-ordinators Parents/carers Throughcare & aftercare team Educational Psychology NHS Clinical Psychology Child Protection Committee
Provision of general training and consultation on the emotional and mental health needs of particular groups for: Residential care workers Foster carers Respite carers Adoptive parents Social workers Housing staff Youth justice teams Police Children's Reporters Members of the Children's Panel Safeguarders Adoption Panel members Foster Panel members Child Protection Committee	NHS CAMHS staff work with local authorities, constabularies and the Scottish Children's Reporter Administration to plan, provide and review training opportunities in mental health for staff who come into contact with children and young people with additional support needs. Provision of ongoing consultation and support to these staff by NHS CAMHS. Development and agreement of referral protocols with key partner agencies. Regular planning and review meetings between NHS CAMHS and key partner agencies on service delivery and assessment of vulnerable children and young people. Establishment of explicit arrangements within each NHS CAMHS team for looked after and accommodated children and young people, including those in secure care.	Parents/carers and staff have a basic understanding of emotional and mental health and development. Parents/carers and staff recognise the importance of their contribution to children's emotional and mental wellbeing. Parents/carers and staff have a basic understanding of protective factors and how these can be nurtured. Parents/carers (including prospective parents/carers) and staff know what specialist advice and support is available to them and how to access it. Referral protocols and pathways for NHS CAMHS are agreed and transparent.	Health promotion staff Local authority Voluntary & private sector care providers inc. residential schools, secure units Adoption & fostering agencies/teams NHS CAMHS staff (inc. Primary Mental Health Workers) NHS Primary Care team NHS community child health team LAC health team Foster carers Adoptive parents (& prospective adoptive parents) Local constabulary Scottish Children's Reporter Administration Members of the Children's Panel Safeguarders Youth justice teams
Provision of training and consultation on specific mental health issues (e.g. aggressive behaviour, self-harm, ADHD) for: Residential care workers Foster carers Respite carers Adoptive parents Social workers Housing staff Youth justice teams Police Children's Reporters Members of the Children's Panel Safeguarders Adoption Panel members Foster Panel members Child Protection Committee	NHS CAMHS staff work with local authorities, constabularies and the Scottish Children's Reporters Administration to plan, provide and review topic-specific training opportunities for staff who come into contact with children and young people with additional support needs. CAMHS input to child protection training and systems.	Parents/carers and care staff understand the child or young person's behaviour and feel confident in responding. Parents/carers and care staff are supported and feel confident in implementing specific approaches to address these issues.	Local authority Voluntary & private sector care providers Adoption & fostering agencies/teams NHS CAMHS staff (inc Primary Mental Health Workers) NHS Primary Care team NHS community child health team LAC health team Foster carers Adoptive parents (inc prospective adoptive parents) Local constabulary Scottish Children's Reporter Administration Members of the Children's Panel Safeguarders Youth justice teams Child Protection Committee
Input to adoption, foster care and children's hearings panels	CAMH staff contribute to the work of adoption panels, foster care panels, Children's Panels, reviewing officers and other decision-makers for young people in need of specialist care	Panel members and decision makers understand the roots of wellbeing and the impact of particular life events on care and support needs. Panel members and decision makers are able to identify children at risk of poor mental health in adoption planning and decisions about adoption allowances	NHS Primary Care team Educational Psychology NHS Clinical Psychology LAC health team NHS CAMHS staff (inc. Primary Mental Health Workers) NHS community child health team Medical Advisers to Fostering & Adoption Panels Specialist adoption staff Children's Reporters & Children's Hearings Panel members Local authority legal advisers
Accessible and confidential support for looked after and accommodated children and young people	Work with the local authority to plan and provide non-stigmatising and readily accessible counselling support for looked after and accommodated children and young people.	Looked after and accomodated children and young people have opportunities to talk in confidence when they are feeling troubled.	Looked after & accommodated children and young people. Residential & foster carers Social work services Local authority NHS CAMHS staff (inc. Primary Mental Health Workers) NHS Primary Care team NHS community child health team Children's rights officers Voluntary sector Care providers
Input to care for children and young people with physical health problems, both in hospital and in the community	Liaison between NHS CAMHS staff and medical and nursing staff in other departments to discuss and make arrangements for all of a child or young person's needs to be addressed	The emotional as well as physical needs of children and young people are addressed. Children, young people and their families are supported to cope with their condition	NHS CAMHS staff (inc. Primary Mental Health Workers) NHS medical & nursing staff Allied Health Professionals NHS Primary Care team NHS community child health team Voluntary sector (esp. self-help & condition-specific support groups) Social work services Educational staff providing outreach teaching
Provision of support and advice to parents whose child has physical health problems	Advice for families on the potential emotional and mental health aspects of their child's condition - promotion, prevention and care. Liaison to ensure that parents' and siblings' emotional and mental health needs are recognised and supported	Parents understand the emotional and mental health aspects of their child's experience and condition, and feel confident in supporting them. Families' own emotional needs are recognised and addressed	NHS CAMHS staff (inc. Primary Mental Health Workers) NHS medical & nursing staff Allied Health Professionals NHS Primary Care team NHS community child health team Voluntary sector (esp. self-help & condition-specific support groups) Social work services Education staff providing outreach teaching
Interagency communication about children and young people following assessment	CAMHS staff work with school staff to establish robust information sharing protocols and systems. CAMHS and school staff inform parents, carers, children and young people about the circumstances in which information will be shared. Children, young people and their parents/carers are given appropriate information about the assessment, the results and appropriate support organisations.	School staff understand the needs of individual children. Children, young people and carers know what will happen following assessment.	NHS CAMHS staff (inc. Primary Mental Health Workers) NHS Primary Care team NHS community child health team Learning Disability Local Area Co-ordinators School staff Social work staff Children & young people Parents/carers Education authority Educational Psychology Child Protection Committee
Awareness raising with housing support organisations about children and young people's support needs e.g. when an adult is discharged from hospital	Ensuring better links between health services, housing services and services for children and young people.	The separate needs of children and young people for support are recognised and addressed. Housing is more appropriate for young people's needs.	Housing associations/agencies Scottish Women's Aid Voluntary sector Local authority NHS Primary Care team NHS community child health team NHS adult mental health services NHS CAMHS staff (inc. Primary Mental Health Workers)

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