An inquiry has been launched into the health and wellbeing of children and young people by a Scottish Parliament Committee.
The Health, Social Care and Sport Committee is seeking to find out the key issues around health and wellbeing for children and young people in Scotland. They will investigate what the challenges and opportunities are for improving their health and wellbeing, and how addressing poverty can lead to improved health and social care outcomes.
The inquiry will focus on 4 key areas:
• Child poverty (including the Scottish Government’s current child poverty delivery plan), inequality and adverse childhood experiences; • Issues affecting care experienced young people; • Mental health, access to Child and Adult Mental Health Services (CAMHS) and the importance of early intervention; • Health and wellbeing in schools
Speaking as the inquiry launched, Gillian Martin MSP, Convener of the Health, Social Care and Sport Committee, said: “There are a whole host of factors which impact the health and wellbeing of our children and young people, and our Committee will consider these in detail.
“The physical and mental toll of the pandemic on children and young people cannot be overstated and we know that prior to this pandemic there was already a high and increasing demand for youth mental health services in Scotland.
“As we emerge from the pandemic and with the Scottish Government’s current child poverty delivery plan due to run until 2022, our inquiry comes at a pivotal time. We are determined to find out how children and young people can best be supported to live healthy and flourishing lives.”
Support for children and young people with mental health issues
Funding of £10.83 million has been allocated for the remainder of this year to help improve access to Child and Adolescent Mental Health Services (CAMHS).
The investment will also increase the numbers of trained professionals to support children and young people with neurodevelopmental support needs.
The allocation is part the of £120 million Mental Health Recovery and Renewal Fund announced in February 2021, and will help to deliver a number of improvements, including: · improve access to CAMHS assessments out of hours · help to put in place specialist regional CAMHS services including those with learning disabilities and those requiring secure care · Help provide access to CAMHS Intensive Home Treatment Teams · Support mental health liaison teams within paediatric services.
The Recovery and Renewal Fund supports many mental health measures contained in the Programme for Government.
Other policies include extra support for health and care staff, completion of the commitment to recruit 800 additional mental health workers this year and a pledge that at least 10% of frontline NHS spending will go towards mental health over this parliament.
Mental Wellbeing and Social Care Minister Kevin Stewart, who announced the allocation during a visit to the Young People’s Inpatient Unit at The Royal Hospital for Children and Young People Edinburgh said: “I am pleased to announce the allocation of £10.83 million health boards to support children and young people with mental health issues, and those with neurodevelopmental support needs.
“This funding will lead to substantial improvements in the mental health care that children and young people receive in Scotland, ensuring that the right support is available in the right place at the right time.
“We know the pandemic has had a negative impact on many people’s mental health – whatever their age or circumstances. That is why we committed £120 million to the recovery and renewal of mental health services in this year’s Programme for Government. I hope that the allocation I have announced today makes a real and lasting difference to children, young people and their families.”
Joanna Barrett, Associate Head of Policy for the Devolved Nations, NSPCC Scotland, said: “Before the pandemic hit, thousands of children referred to mental health services in Scotland were having to wait unacceptable periods of time for treatment to begin.
“The profound impact of the conditions of the past 18 months on children has compounded this by increasing the need. Our Childline counsellors have heard from children struggling with loneliness and isolation, worries about education, abusive home environments and suicidal feelings.
“This funding by the Scottish Government to address young people’s mental health is therefore crucial. However, this investment must go alongside more preventative efforts, including the provision of mental health support in schools, to ensure children get the help they need before reaching crisis point.”
The Scottish Children’s Services Coalition (SCSC), an alliance of leading providers of children’s services, has called for the Scottish Government to urgently increase mental health spend in its budget.
The call comes as new figures published today (2nd March 2021) from Public Health Scotland indicate that at the end of December 2020, 1,560 children and young people had been waiting over a year for mental health treatment.
These figures are the worst on record and represent a near tripling from December 2019 (589).
The SCSC has urged greatly increased investment in services for children and young people to tackle a current mental health pandemic. It has also called for a ‘national crusade’ as referrals begin to return to pre-lockdown levels.
The call comes amid growing concerns over a ‘lost generation’ of vulnerable children and young people, whose mental health is being impacted by the pandemic. Even prior to the pandemic cases of poor mental health were at unprecedented levels and there are a growing number of vulnerable children who cannot access services.
However, just over 50p in every £100 of the NHS budget is being spent on specialist child and adolescent mental health services (CAMHS). A frighteningly low figure even though mental health services are literally creaking at the seams due to greatly increasing demand.
The figures from Public Health Scotland also indicate that only four Scottish health boards are meeting the Scottish Government’s waiting time target of 18 weeks from referral to treatment over the quarter to December 2020. One out of four individuals are not being seen within this already lengthy 18-week target.
While 4,091 children and young people were treated over the period October to December 2020 by child and adolescent mental health services (CAMHS), only 73.1 per cent were seen within the 18-week waiting target and only four health boards met this target.
The SCSC has warned that mental health services will face an overwhelming and unprecedented pressure due to pent-up demand created by the Covid-19 lockdown, coupled with a cut in youth support services. This could potentially lead to a ‘lost generation’ of vulnerable children and young people who are missing out on the support they vitally need.
A spokesperson for the SCSC commented: “These latest figures are deeply troubling and point to a highly challenging environment for both our young people and our mental health services.
“We welcome the fact that the Scottish Government is intending to invest more than £1.1 billion in mental health services overall, but significantly greater funding is needed to address the current crisis facing our children and young people.
“While referrals are beginning to return to pre-lockdown levels, it is vital that children and families are provided with the support they so desperately need, especially given the impact of the pandemic on mental health. The fact that more than 1,500 of our most vulnerable children have been waiting more than a year for treatment in this respect is deeply disturbing.
“We would urge the Scottish Government to look to not just the NHS, but the third sector and other private sector organisations to play a key role in this, renewing its focus on prevention and early intervention.
“Our mental health services must receive the funding they vitally need or we face having a ‘lost generation’ of vulnerable children and young people.”
A coalition of leading independent and third sector children and young people’s service providers has called on the Scottish Government to deliver a “budget for mental health” this afternoon.
The call from campaign group, the Scottish Children’s Services Coalition (SCSC), comes in advance of today’s Scottish Budget and Children’s Mental Health Week (1st-7th February). It comes amid growing concerns over a potential lost generation of vulnerable children and young people, whose mental health is being impacted by the pandemic.
The SCSC has urged greatly increased investment in services for children and young people to tackle a current mental health pandemic and called for a national crusade to address this.
COVID-19 has had a devastating impact on young people’s mental health and wellbeing, with the recent Prince’s Trust long-running annual survey of young people’s happiness and confidence returned the worst findings in its 12-year history. It found that more than a quarter (26 per cent) say that they feel unable to cope with life since the start of the pandemic.
In addition, half of the young people interviewed said that their mental health has worsened, with more than half (56 per cent) said they always or often felt anxious. 1
Even prior to the pandemic cases of poor mental health were at unprecedented levels, representing one of the greatest health challenges of our time, and there is a growing number of vulnerable children who cannot access services. With a new lockdown and a return to home schooling, even some children who would not have accessed children’s mental health services normally will need support this year.
However, just over 50p in every £100 of the NHS budget is being spent on specialist child and adolescent mental health services (CAMHS). A frighteningly low figure despite the fact that mental health services are literally creaking at the seams due to greatly increasing demand.
Research indicates that 10 per cent of children and young people (aged five to 16) has a clinically diagnosable mental health problem (around three in every classroom) – however, it should be noted that these figures are some years out of date and it is widely believed that numbers have increased and will increase further given the impacts of COVID-19.
Recent statistics however point to the fact that only one health board in Scotland is treating children and young people within an 18-week waiting time and more than 1,000 have been waiting over a year to be treated.
The SCSC has also called for greatly increased investment in services and for a renewed focus on prevention and early intervention. This includes on-demand counselling services in GP surgeries and greater community support generally, reducing the need for referral to under-pressure specialist CAMHS.
A spokesperson for the SCSC said: “Our children are remarkably resilient, but the statistics on the mental health of our young people does create a compelling case for a national crusade to address what is a mental health pandemic representing one of the greatest public health challenges of our time.
“We are urging the Scottish Government to make the forthcoming budget a budget for mental health for our children and young people. Unless the government takes urgent action to improve access to services, this young generation will be destined for a future of mental ill health, with a resultant societal impact.
“There must be significantly increased investment in and greater collaboration between the public, private and third sectors to deliver adequate mental health support. We must also use this as an opportunity to radically transform our mental health services, both for now and for the future, refocusing on prevention and early intervention.
“This mental health crisis is one we can address, but it will require a similar energy, drive and commitment to that which was demonstrated for COVID-19 if we are to achieve this and prevent this generation of young people giving up on their futures – and themselves.”
As schools reopen, the Scottish Children’s Services Coalition (SCSC), an alliance of leading independent and third sector providers of children’s services, has warned of a mental health “perfect storm” for children and young people.
The warning comes on the back of figures obtained by BBC Scotland via an FOI request which indicate that the number of referrals for child and adolescent mental health services (CAMHS) has dropped by a staggering 57 per cent* between April and June 2019 and April and June 2020.
These range from a 28 per cent fall in requests for NHS Orkney to 80 per cent in NHS Dumfries and Galloway. NHS Lothian reported a drop of 48%.
The SCSC has warned that mental health services will face an overwhelming and unprecedented pressure due to pent-up demand created by the COVID-19 lockdown, coupled with a cut in youth support services. This could potentially lead to a “lost generation” of vulnerable children and young people who are missing out on the support they vitally need.
It has urged the Scottish Government to work with authorities and invest significantly in mental health services as children return to school and to ensure that teachers and other staff are aware of the services on offer for young people needing support.
The SCSC has warned that self-isolation and social distancing have had an impact on young people struggling with issues such as anxiety and depression. It has noted that even the most resilient children are going to need additional support as they navigate this transition back into whatever is the new normal, and some will need a lot of extra support.
A spokesperson for the SCSC commented: “These latest figures are deeply troubling and point to a ‘perfect storm’ for our young people, with increased demand coupled with cuts in services.
“While referrals have dropped during lockdown and children are not accessing support, we are storing up immense problems for the future as mental health services face being overwhelmed due to greatly increased demand.
“The Government needs to work urgently with the relevant authorities to ensure that not only is there sufficient provision available at the local level, but that this is clearly communicated and easily accessible for young people and their parents or carers.
“Mental health services must be given funding and resources equal to that of physical health provision and this pandemic has ushered in an urgency and necessity that cannot be ignored.
“Not just the NHS but also third sector and other independent organisations who play such a key role in addressing mental health services must receive the funding they vitally need or we face having a ‘lost generation’ of vulnerable children and young people.”
Support needed for children as they return to school,says NSPCC
An NSPCC Scotland spokesperson said: “We know that many children in Scotland have suffered difficult and traumatic experiences over the past few months.
“During lockdown, we saw a rise in contacts to Childline about mental and emotional health and our NSPCC helpline made 40% more referrals to Police Scotland and local authorities.
“Now, as children across the country return to school, it is crucial they are given the support they need to help them recover from any mental and physical harm. The Scottish Government, local authorities and health boards need to ensure that they have sufficient resources in place to respond to a likely increased need for therapeutic services.”
The Scottish Children’s Services Coalition (SCSC), an alliance of leading independent and third sector providers of children’s services, is urging the Scottish Government to ‘up its game’ in response to a new report from the Mental Welfare Commission.
The report indicates that the number of young people under the age of 18 admitted to non-specialist hospital wards – mainly adult wards – for treatment of their mental illness in Scotland in 2018-19 rose for the second year running. There were 118 admissions involving 101 young people.
This is an increase on the 2017-18 figures which were 103 admissions involving 90 young people and a further increase from 2016/17 when there were 71 admissions involving 66 young people.
Admission of a young person to an adult ward should only be acceptable in rare situations.
However, despite a greatly increased demand on mental health services, there are currently only 48 specialist hospital beds provided by the NHS in Scotland for adolescents with mental health problems.
These are located in three child and adolescent mental health services (CAMHS) inpatient units (Dundee, Edinburgh and Glasgow) and there is a further six place unit for five to 12-year olds in the Royal Hospital for Sick Children in Glasgow. There is no inpatient provision north of Dundee.
Given the lack of provision, many children and young people with severe mental health problems are therefore being admitted to non-specialist adult and paediatric hospital wards, settings which are in many cases inappropriate to their needs.
The coalition has urged the Scottish Government to ensure that there are adequate specialist bed numbers that can deal with the requirements and to refocus its efforts on prevention and early intervention, ensuring that issues do not escalate so that they require the provision of these specialist services. It has also called for secure impatient facilities for young people with mental health illnesses, of which there are currently none in Scotland.
Under the Mental Health (Care and Treatment (Scotland) Act 2003 Health Boards are required to provide appropriate services and accommodation for young people admitted to hospital for treatment of their mental disorder.
Given admissions to non-specialist mental health wards, it is clearly arguable whether appropriate services are being provided.
There are a number of differences between specialist units and wards designed to treat the needs of adults with serious mental illness, both in terms of staff training and the overall ward environment. Given this, there is a clear concern that the needs of a young person may not be met in comparable way when admitted to an adult mental health ward as opposed to a specialist child and adolescent unit.
A spokesperson for the Scottish Children’s Services Coalition commented: “We are clearly concerned about the increasing number of those being admitted to adult mental health wards, often inappropriate to their needs, both in terms of staff training and the ward environment.
“The Scottish Government needs to up its game on this and provide adequate facilities, ensuring that there are sufficient specialist bed numbers for those requiring them. There is also currently no provision north of Dundee and this requires to be urgently addressed.
“For children and young people who require inpatient mental health care, a lack of such services means that they frequently remain at home, often until the family reaches crisis point, leaving them feeling isolated and delaying recovery.
“These are among the most vulnerable members of our society and we owe it to them to give them the adequate care and support that they need.”
An Edinburgh service which supports children and young people impacted by mental health difficulties has been transformed thanks to funding from a local children’s charity.
Following an £100,000 refurbishment by Edinburgh Children’s Hospital Charity (ECHC), the Child and Adolescent Mental Health Services (CAMHS) space at the Lauriston Building has been remodelled into a more child-friendly, welcoming environment for visitors.
The South Edinburgh CAMHS team sees approximately 1200 young patients every year experiencing a range of modern to severe mental health difficulties, so it is vital that the space feels safe, calming and welcoming.
Children and young people were actively involved in the design and made the decision to have a seaside theme. Colourful pieces of artwork are displayed in the waiting area, corridors and clinic rooms and specialist lighting has been cleverly used to brighten internal treatment rooms. Bespoke, comfortable pieces of furniture feature throughout to ensure visitors are as at ease as possible.
Tommy Blue, Advanced Practitioner for South Edinburgh CAMHS, said: “Children, young people and their families come to CAMHS at a difficult time in their lives, so it is essential that we provide an environment that is fit for purpose and worthy of those who are referred to us.
“Thanks to this funding from ECHC, what was previously an unused area has been enhanced to provide our visitors with a much more positive experience. It feels safe, accepting and comfortable and has been universally well received by visitors as well as staff.”
Roslyn Neely, CEO of ECHC, said: “Waiting for an appointment can be a very stressful time for children, young people and their families so it was important to ensure that, from the moment they arrive at CAMHS, they know they are in a safe place where they will be supported and valued.
“To enhance the space, we worked closely with children and young people and asked them what good mental health looks and feels like. The unanimous answer was the seaside.
“With this theme in mind, the space was designed to be bright and colourful, but also calming – transforming it from bare and clinical to warm, welcoming and child and young person friendly.”
Edinburgh Children’s Hospital Charity believes that nothing should get in the way of being a child and works to make sure children and young people’s lives are less interrupted by illness. It distributes around £1.5 million per year to support the Royal Hospital for Sick Children and other children’s healthcare settings across Scotland.
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