Call for Scottish ‘Budget for Mental Health’ for children and young people

Figures show only 0.56 per cent of NHS expenditure on CAMHS and less than 7 per cent of the mental health budget
Varying figures across Scotland, with 0.75 per cent of NHS expenditure on CAMHS in Tayside and 0.08 per cent in NHS Orkney
Call comes as Children’s Mental Health Week takes place

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’ on Thursday (6^th February).

The call from campaign group, the Scottish Children’s Services Coalition (SCSC), comes in week which also marks Children’s Mental Health Week (3^rd-9^th February). It has urged greatly increased investment in mental health services for children and young people to tackle a current mental health ‘crisis’.

In a letter to Finance Cabinet Secretary, Derek Mackay, it has called for a significant proportion of the Barnett consequentials coming to the Scottish Government from the additional £34 billion a year the UK Government has pledged to go to the NHS to be spent on mental health.

The letter highlights figures indicating that a mere 0.56 per cent of the NHS budget is spent on specialist child and adolescent mental health Sservices (CAMHS), amounting to £67.248 million. In addition to this, only 6.61 per cent of the overall mental health budget is spent on CAMHS, a drop from 6.68 per cent on the previous year.

This is equivalent to just over 50p in every £100 of the NHS budget being spent on CAMHS.

These figures vary considerably across Scotland, ranging from 0.75 per cent of expenditure in NHS Shetland on CAMHS, 7.44 per cent of total mental health expenditure, to 0.08 per cent in NHS Highland, 2.92 per cent of total mental health expenditure.

These very low figures are 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), with 50 per cent of mental health problems established by the age of 14 and 75 per cent by the age of 24.

The SCSC has also called for a renewed focus on prevention and early intervention for those with mental health problems. This includes on-demand counselling services in GP surgeries and greater community support generally, reducing the need for referral to under-pressure specialist CAMHS.

Latest figures on waiting times to access CAMHS, covering the period July to September 2019, indicate that of the 3,901 children and young people who started their treatment, only 64.5 per cent had been treated within an 18-week waiting time period. This is short of the 90 per cent target set by the Scottish Government.

In addition, 204 children and young people have been waiting for over a year to be seen.

A spokesperson for the SCSC said: “As we mark Children’s Mental Health Week we are urging the Scottish Government to make the forthcoming Budget a ‘Budget for Mental Health’ for our children and young people.

“With three children in every classroom having a clinically diagnosable mental health problem, no longer can mental health be viewed as a ‘Cinderella’ service and we must put money behind the rhetoric to address the current crisis.

“With mental health and the issues associated with it representing one of the greatest public health challenges of our time, we must ensure that children and young people are able to get the care and support they need, when they need it. This includes investing in greater community support and support at school, reducing the need for referral to specialist CAMHS.”

Young people dealing with mental health issues are to be guaranteed access to high quality support wherever they live, Mental Health Minister Clare Haughey announced yesterday.

Health boards will receive new Child and Adolescent Mental Health Services (CAMHS) guidance which outlines the level of provision that children, young people and their families can expect to receive when they are referred for help within the NHS.

The first national CAMHS Service Specification, which has been developed in partnership with young people and their families, includes a number of aims such as reducing both the waiting time for a first assessment appointment and the waiting time for any subsequent treatment.

Ms Haughey said: “We are determined to ensure that any young person who is identified as needing support with mental health issues can get services that are appropriate to their needs.

“An important step towards ensuring consistent high standards is the development of agreed referral criteria and definitions and this Service Specification, developed in partnership with young people and their families, will help to ensure everyone gets the right treatment, at the right time and in the right place.

“All health boards are being provided with this specification and will be expected to set out plans on how they will implement it, with a formal review of how it is working across Scotland to take place after six months.

“In 2018/19 our investment in mental health reached £1.1 billion and over the life of this Parliament will exceed £5 billion – investment which will help deliver the best support available for children and young people dealing with mental health issues.”

Development of the service specification has been overseen by the Children and Young People’s Mental Health and Wellbeing Programme Board, which is jointly chaired by the Scottish Government and COSLA.

COSLA Children and Young People spokesperson, Cllr Stephen McCabe said: “We are grateful to the Children and Young People’s Mental Health and Wellbeing Programme Board for their work on the specification.

“This is part of a whole system approach and COSLA will continue working with partners to drive a national conversation on prevention and early support for children, young people and their families.”

Concern over effect of social media on young people’s wellbeing

A national report, carried out every four years, has provided insights into child mental health in Scotland.

The 2018 Health Behaviour in School-aged Children (HBSC) study in Scotland, led by researchers at the MRC/CSO Social and Public Health Sciences Unit, University of Glasgow and funded by NHS Health Scotland, provides data on the health and wellbeing of the nation’s young people.

Key findings include the majority (85%) of young people reported high life satisfaction in 2018, while almost one in five adolescents rated their health as excellent.

However, the report also revealed the lowest levels of adolescent confidence seen in 24 years, with only 51% of adolescents in Scotland reporting often or always feeling confident in themselves.

Beyond mental health and wellbeing, the HBSC study covers areas such as sleep habits, time spent online, physical activity as well as school and home life. The report presents data collected from surveys with a representable sample of 11, 13 and 15-year-olds in Scotland in 2018. The surveys were conducted in schools, with all pupils in the selected classes asked to fill in the confidential questionnaire anonymously.

This is the 8th consecutive World Health Organisation (WHO) cross-national HBSC survey in which Scotland has participated, providing data on the health of the nation’s young people over the last 28 years. A wider pan global report on the health of young people across the world is due to be published later this year.

Lead author of the study Dr Jo Inchley, from the MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, said: “These latest findings from HBSC provide a comprehensive picture of young people’s health across Scotland.

“We’ve seen significant improvements in recent years in areas such as substance use and eating behaviours. But at the same time, new challenges such as social media are increasingly impacting on how young people live their lives and these can have a significant impact on their wellbeing.

“This report helps us to better understand the challenges young people face and the areas where more support and investment is needed.”

Dr Rory Mitchell, Public Health Intelligence Principal, NHS Health Scotland said: “This report highlights some positive trends as well as ongoing challenges. The data shows that children from wealthier families tend to report better health and wellbeing than those from poorer families. This highlights the need for a continued focus on tackling health inequalities in Scotland.

“The information provided by this long-running study has enormous value in helping to improve health and wellbeing. Using such information to make a real difference requires a collaborative effort that co-ordinates local and national action. The formation of Public Health Scotland in April this year will contribute to this.”

Findings of the report include:

Mental health and wellbeing

22% adolescents rated their health as ‘excellent’ but 15–year-old girls were the least likely to report ‘excellent’ health (12%).
The prevalence of multiple health complaints is at its highest for both boys and girls since 1994. Overall 35% of young people experienced multiple health complaints every week. The most common health complaints were sleep difficulties, feeling nervous and feeling irritable.
37% adolescents were classified as having low mood (33% boys, 41% girls) and 14% were at risk of depression (11% boys, 17% girls). Both low mood and risk of depression increased with age.
All the mental health and wellbeing indicators were significantly associated with family affluence, with poorer outcomes for those from families with lower affluence.

Sleep

The average sleep duration on weekdays was 8.3 hours for 13-year-olds and 7.8 hours for 15 year olds – the recommended sleep for teenagers is 8 to 10 hours each night.
The proportion of young people reporting sleep difficulties more than once a week has increased from 23% in 2014 to 30% in 2018.
Among 13 and 15-year-olds, sleep difficulties were more common among girls than boys and young people from lower affluence families were more likely to report difficulties in getting to sleep than those from higher affluence families (25% versus 35%).

Social media and online communication

Nearly all (95%) young people said they owned a smartphone with connection to the internet.
The vast majority (92%) of 15-year-olds kept their smartphones in their bedroom at night.
Preference for online (versus face-to-face) communication was higher amongst 15-year-olds than 11 and 13-year-olds.
Nearly one in ten (9%) adolescents were categorised as having problematic social media use.

At home and school life

Overall 38% of young people reported high teacher support
The proportion of girls who find it easy to talk to their father has increased from 48% in 1990 to 67% in 2018.
36% of young people reported eating a meal with their family every day.
Vigorous physical activity was higher among boys than girls. 47%) of boys and 41% of girls reported taking part in leisure time vigorous exercise at least four times a week. The gender difference was greatest at age 15 (40% vs 29%)

Jo Inchley added: “Many young people report high life satisfaction and have good support from their families and friends. However, the declines in mental health and increase in sleep difficulties are concerning.

“There’s been a small but steady increase in the proportion of girls taking part in physical activity in their free time but overall levels are still very low and screen time has been increasing at a much faster rate.

“It’s important that young people have opportunities to be active and spend time outdoors as these can have substantial benefits for both their physical and mental wellbeing.”

A spokesperson for the Scottish Children’s Services Coalition commented: “As a coalition whose members provide support to vulnerable children and young people we are deeply concerned by a lowering in confidence levels as outlined in this report, which indicates that just over half of adolescents report often or always feeling confident in themselves.

“In addition to this, one in ten adolescents are categorised as having problematic social media use and screentime use has been increasing.

“Clearly social media is having a major impact on young people and their wellbeing, as they often try to meet unrealistic standards as seen on social media, leading to anxiety and depression. This is especially relevant to girls.

“The fact that over 90 per cent of 15-year olds keep their smartphones in the bedroom at night, with a potential impact on sleep patterns is worrying. It is notable that the proportion of young people reporting sleep difficulties more than once a week has increased from 23 per cent in 2014 to 30 per cent in 2018.

“Now we have a greater awareness of the challenges it is vital that there is greater research to gain a clearer understanding of the link between social media and wellbeing, which is also impacting on confidence.

“There is a desperate need to educate young people on how to use social media healthily and how social media promotes unrealistic expectations.”

Tackling mental health for National Breathing Space Day

Glasgow Hutchesons’ Aloysians Rugby Club has teamed up with Breathing Space, Scotland’s mental health phone service, to encourage Scots to take some time out for their mental health.

The initiative is part of a wider partnership between Breathing Space and Scottish Rugby, to raise awareness of the confidential support the phoneline provides for anyone feeling low or stressed.

A video featuring GHA players and their top tips on how to de-stress, will be shared online on National Breathing Space Day (1^st February).

Tony McLaren, Breathing Space National Coordinator, said: “Rugby is a challenging sport, it’s inspiring to hear how these young players stay mentally healthy through physical activity.

“We’re also getting the message across that our helpline is available in the evenings and weekends for anyone who is struggling and needs a listening ear.”

Breathing Space receive around 8,000 calls each month from people across Scotland struggling with their mental health. Trained advisors are able to give support and advice on a wide range of issues, including loneliness, relationship issues and anxiety.

Mental Health Minister Clare Haughey said: “Breathing Space do important work to support people across Scotland who are feeling low, stressed or anxious. Taking steps early on to improve mental wellbeing by caring for ourselves and for others is so important.

“Our Mental Health Strategy stresses that we want to see a Scotland where more people are more active, more often, in part because being active is good for our mental wellbeing. So I think it’s great that Breathing Space are linking up with GHA Rugby Club to support the role that sport and physical activity can play in maintaining good mental wellbeing.”

Brian Tracey, President of GHA RFC, added: “When I took over the presidency it coincided with a couple of tragic events surrounding players at nearby clubs.

“It made me determined that we as a club put in place a framework of help and support. Breathing Space have been part of that network and we value their partnership with GHA.”

Breathing Space is available on freephone 0800 83 85 87, from 6pm to 2am weekdays and 24 hours at the weekend.

GHA will be taking part in the U18 Scottish Cup Semi Final vs Hawick on 1^st February.

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A study commissioned by the Royal Horticultural Society (RHS) has highlighted that more than half of adults consider themselves to be ‘lonely’ because they are too busy or shy to socialise with others. Continue reading Make friends through plants at RHS Chelsea Flower Show

Make Blue Monday a new kind of Monday – get walking and boost your mental health

The organisers of The MoonWalk Scotland, health charity Walk the Walk, are urging women and men across the country to get walking – to boost their mental health.

Blue Monday is traditionally the third Monday in January and is dubbed the most depressing day of the year. After the excesses of the festive season, money worries, failed New Year’s resolutions and the cold, dark winter weather can take their toll on the mental health of many people.

Whilst walking is recognised as a near perfect way to keep fit and maintain a healthy weight, benefits for our emotional well-being are often overlooked. When we exercise, we release feel-good hormones known as endorphins into our bloodstream.

This natural high helps reduce stress and anxiety, calming and relaxing both the body and mind. Particularly at a time of year when money is tight, walking is one of the most accessible types of exercise around. It costs nothing, and can be done at anytime and anywhere.

Nina Barough CBE, Founder and Executive of Walk the Walk and organiser of The MoonWalk Scotland said: “Walking really is one of the most perfect forms of exercise there is – physically, it tones your body, strengthens your muscles and keeps your heart healthy.

“But it’s crucial for our mental health too. Going out for a daily walk can help reduce tension, stress and anxiety, which is an issue for so many of us, particularly at this time of the year. It sounds perverse, but this can be the best time of the year to get out walking, as the worse the weather is, the better it feels. It’s really empowering – as long as you’ve got the right clothes of course! Walking is a type of exercise which you can build up slowly – no matter your ability and it really is a cure for the January blues. Why not give yourself a goal and sign up for a walking challenge like The MoonWalk. Often having something to aim for can boost motivation and drive you to keep going!”

Lucie Joels has secondary breast cancer and completed The MoonWalk with a group of friends. She says that walking is incredibly important for her mental health: “For me, living with cancer, getting out of the house and walking is grounding. It’s an opportunity to look at the bigger picture.

“I’m in the fifth cycle of my latest round of chemotherapy, but when I am able, just walking the dog, watching the sunrise and seeing the clouds move across the sky is amazing. Yesterday I manage 4,000 steps and I was very happy with that – I feel like I’m winning!

“Being outside I am just a tiny part in a huge world whilst when I’m indoors I’m a big part of my small world and occasionally that can be overwhelming. I strongly believe that there is always something good in every day, no matter how small it seems. Sometimes it would be easy to get stuck in the gloom and have a pity-party, but I try not to stay there long enough to put the bunting up!”

The MoonWalk Scotland is an iconic night-time fundraising event, which sees women and men wearing brightly decorated bras as they walk 10K, 13.1 miles, 26.2 mile or 52.4 miles through the streets of Edinburgh at Midnight.

Walk the Walk makes grants to fund both research into breast cancer and to help improve the lives of those living with cancer now.

The MoonWalk Scotland 2020 takes places on Saturday 6th June.

Sign up at www.walkthewalk.org

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In an historic first, all 32 Emirates FA Cup third round fixtures this weekend will be delayed by one minute.

A new film narrated by His Royal Highness, The Duke of Cambridge will be played before the matches, encouraging football fans to ‘Take A Minute’ to start taking action to look after their mental health and that of their family and friends.

Continue reading “Take A Minute”: Late kick offs in FA Cup games

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Scottish Government sets out national vision for debt advice

Plans to develop a free debt advice system have been published by the Scottish Government. Continue reading Scottish Government sets out national vision for debt advice

‘Transformational change’ needed to tackle child mental health crisis, says SCSC

The NHS in Scotland failed to meet a maximum 18-week waiting time target for children and young people to receive treatment from mental health services
More than a third are waiting more than 18 weeks for treatment.
9 out of 14 health boards failed to meet the 18-week waiting time target: NHS Fife, NHS Grampian, NHS Highland, NHS Lanarkshire, NHS Lothian, NHS Tayside, NHS Ayrshire and Arran, NHS Greater Glasgow and Clyde Valley and NHS Forth Valley
204 children and young people waited more than a year prior to being seen for treatment, double that for the same quarter of last year.
More than one in five referrals for treatment are rejected.
Figures show only 0.56 per cent of NHS expenditure is spent on CAMHS, less than 7 per cent of the mental health budget.
Coalition calls for fundamental rethink and renewed focus on prevention and early intervention, including embedding mental health within education.

Latest waiting time figures have reinforced the call by a coalition of leading independent and third sector children and young people’s service providers for dramatically increased investment in mental health services to address the current mental health crisis.

The Scottish Childrens Services Coalition (SCSC) has also called for an urgent need to focus on prevention and early intervention in order to tackle what is one of the greatest public health challenges of our time.

The coalition, which campaigns to improve services for vulnerable children and young people, call comes as the latest waiting time figures from the Information Services Division, part of NHS National Services Scotland, highlight that thousands of children and young people are failing to treated within a Scottish Government waiting time target.¹With an increasing number of children and young people being identified with mental health problems they also highlight a postcode lottery for mental health treatment across the country.

Covering the quarter July to September 2019, the figures highlight that 3,901 children and young people started treatment at specialist child and adolescent mental health services (CAMHS) in this period. The NHS in Scotland, including 9 of the 14 regional health boards, failed to meet the Scottish Government 18-week waiting time target for children and young people to receive treatment from CAMHS. This target should be delivered for at least 90 per cent of patients.

While 64.5 per cent in the NHS in Scotland are being seen within this 18-week waiting time, still in itself far too long, more than a third (35.5 per cent) are failing to be seen within this period.

Individual health boards failing to meet this target are: NHS Fife (75.2 per cent), NHS Ayrshire & Arran (78.1 per cent), NHS Grampian (50.8 per cent), NHS Greater Glasgow & Clyde (71.2 per cent), NHS Highland (64.1 per cent), NHS Lanarkshire (51.9 per cent), NHS Lothian (55.9 per cent), NHS Tayside (54.2 per cent) and NHS Forth Valley (63.8 per cent).

The figures also indicate that 204 children and young people in the July to September quarter had been waiting for more than a year prior to being seen for treatment, an increase from 151 in the previous quarter (April to June) and more than double that from the same quarter of last year (93). ²

In addition, more than one in five (21.9 per cent) are having their referrals for treatment rejected, with no real understanding of what is happening to them after this.³

It should be noted that a mere 0.56 per cent of the NHS budget is spent on specialist CAMHS, amounting to £67.248 million.⁴In addition to this, only 6.61 per cent of the overall mental health budget is spent on CAMHS.

These very low figures are despite the fact that mental health services are creaking at the seams due to greatly increasing demand, as evidenced by these waiting time figures. 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), with 50 per cent of mental health problems established by the age of 14 and 75 per cent by the age of 24.⁵

While acknowledging the great efforts the Scottish Government is making, such as an additional £250 million of funding announced in the Programme for Government of 2018, the SCSC has called for the Scottish Government to greatly increased investment in CAMHS and for a more consistent approach to delivering these services across Scotland. ⁶

It has also called for a renewed focus on prevention and early intervention for those with mental health problem, reducing the need for referral to under-pressure specialist CAMHS.

This includes embedding mental health within education from an early age in order to strengthen knowledge and awareness of mental health, as well as reducing the stigma associated with mental health. Emotion and resilience classes should be provided to all students from primary one to teach students how to work through their emotions in a healthy way and there should be a whole-school approach, with training for all staff involved in education and providing counselling support.

A spokesperson for the SCSC said: “These latest waiting time figures highlight that fact in this mental health crisis we are continuing to fail thousands of children and young people with mental health problems, with more clearly needing to be done to address this epidemic.

“These newly released figures highlight that the NHS in Scotland, including nine of our health boards, are failing to meet what is already a lengthy waiting time. Yet we know that three children in every classroom has a clinically diagnosable mental health problem.

“There must be a radical transformation of our mental health services, with a focus on preventing such problems arising in the first place and intervening early, especially when we know that half of all mental health problems begin before the age of 14. This includes embedding mental health within education from an early age as well as providing training for all staff involved in education.

Scottish Conservative Health Spokesperson, Miles Briggs, didn’t miss the opportunity to comment. The Lothian MSP said: “In Scotland we are facing a child mental health crisis and over 10,000 children and young people are being failed by this SNP government.

“There is a postcode lottery across health boards for whether you child will get mental health support when they need it, with my own region of Lothian being particularly bad.

“I am regularly contacted by parents who are worried about their children and it is heart-breaking for them when they are told their child can’t be seen for over a year.

“A greater focus must be given to prevention and early intervention by having mental health on the curriculum for all schools in Scotland.”

¹NHS Information Services Division, Child and Adolescent Mental Health Services Waiting Times in Scotland (PDF link), 3^rd December 2019, Table 2, p. 7. Available at: https://www.isdscotland.org/Health-Topics/Mental-Health/Publications/2019-12-03/2019-12-03-CAMHS-WaitingTimes-Report.pdf? (accessed 3^rrdDecember 2019).

²Ibid., Table 1a in background tables, p.6.

³Ibid., Table 4 in background tables, p.6.

5 Mental Health Foundation, Mental Health Statistics: Children and Young People. Available at: https://www.mentalhealth.org.uk/statistics/mental-health-statistics-children-and-young-people (accessed 25th January 2016).

⁶BBC online, Sturgeon announces boost for mental health services, 4^th September. Available at: https://www.bbc.co.uk/news/uk-scotland-scotland-politics-45395739 (accessed 5th December).