Dame Denise Coia is chair of the Scottish Government’s Task Force on Children and Young People’s Mental Health and convenor of Children in Scotland’s Board

CHILDREN in Scotland’s children and young people’s advisory group, Changing our World, have told us loudly and clearly that new approaches are required to improve the mental health of young people.

As part of the charity’s 25 Calls campaign, the young people said: “All children and young people should be able to, and know how to, get support with their mental health and well-being when they need it, with people you can trust and who respect your right to privacy, and without discrimination.”

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We have some of the best government policy in the world on children and young people, such as Getting it Right for Every Child (GIRFEC), which is designed to ensure services work together to support children and their families. 

We have committed ministers. We have a caring community in Scotland. But the fine words and pledges on mental health aren’t enough, and on the ground people are saying it’s simply not working. 

The National:

Research shows mental health issues among young people have not improved as fast over the past few years as elsewhere in Europe, especially in relation to teenage girls. We are lagging behind despite ranking higher than those countries in relation to the resource we allocate to this work. This tells us our approach must change.

I have spoken to a number of young people with mental health problems over the past few months and I have heard some upsetting stories. 

They say they don’t want to be told a service is not suitable for them and then “signposted” elsewhere. It’s difficult enough to find the courage to ask for help without having to navigate a maze of services, tell your story several times and then face rejection. 

They don’t want to enter any “wrong doors” when they seek help. While it is good we are taking a rights-based approach to offering services, children and their families report a disconnect between what is promised and what is delivered.

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To make the right response, we need to understand the modern experience of growing up in Scotland, the opportunities and challenges that brings, the pressures young people face and how they deal with them. Fortunately, this generation of young people are more open about their mental health and seeking help. We need to listen.

This is why, in June 2018, the Cabinet Secretary for Health and Sport joined with the Convention of Scottish Local Authorities (Cosla) to set up a task force to make recommendations on young people’s mental health services. 

The title “task force” was deliberately chosen – not review or commission – because this means it is action-focussed and has to deliver change. We see ourselves as champions for children and young people – we expect to see real action to improve approaches, and it’s our role to push for this to happen.

But effective change is not possible without the direct involvement of young people, and with this in mind the taskforce is co-chaired by a young person and young people are involved in all of its work. 

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As part of this, we are creating a digital platform which will offer online support, information and champion the anti-

stigma work that is already happening. This resource will also provide feedback on how we are doing and what we need to do better, acting as the “eyes and ears” of the task force.

To support the development of our recommendations, the Youth Commission and the Scottish Youth Parliament are doing research on what’s out there for young people in terms of mental health support and their perception of what’s working well and what’s not. 

In this, Scotland is a world leader, putting young people at the forefront of a national change programme which will directly improve their lives. Many young people have spoken to the task force and it’s amazing how willing they have been to share their experience, good or bad, to make things better for other people.

The task force published its preliminary recommendations in September based on what people have told us and on the research evidence about what works. 

The task force knows we need to focus on prevention and intervening – if required – as early as possible. This means providing information about maintaining good mental health, support in schools and access to interventions locally. 

We need to make sure people get the right support and that if they need more specialist care it is easily available. 

In other words, we must ensure that there is a complete system of care available across our schools, communities and hospitals.

But developing good mental health is not always about seeking a service response. Understanding our unique emotional response and having someone support us through a difficult period may be all that is needed.

While serious mental illness in young people is not significantly increasing, emotional distress, which can be equally devastating, is on the rise. This calls for a different type of response focused on greater support in communities. 

PEOPLE can become anxious or depressed related to interactions with other young people in school or with their families at home. These issues may be best resolved locally with youth worker or third sector agency support, local nurses, social workers, or psychologists.

Another concern is ensuring that seldom-heard voices are listened to. Whilst we are increasingly aware of mental health issues facing young people, some children and young people find it hard to speak up either because they are unable to or perhaps they are frightened, ashamed or embarrassed. One of these groups consists of children who have experienced seriously bad and abusive experiences in early childhood, who may end up being in care, or living in poverty. These young people require additional help to enable them to access the opportunities available to other children in Scotland.

Other young people with serious mental illness may require more rapid access to specialist services and follow-up by community services. This is why the task force has developed a framework for approaching mental well-being which recognises four strands of mental health: emotional distress which may be dealt with through prevention and support; neurodevelopmental disorders such as autism that require early assessment; at-risk young people living in challenging environments who require wrap-around services; and serious mental illness which requires a fast diagnosis and specialist intervention.

By the end of the year our delivery plan will be in place for an ambitious programme of service redesign and improvement. Joined-up working across the public sector and third sector in education, justice, health and social care will be critical to achieving the taskforce’s aims. We hope everyone in Scotland is going to join us in taking these recommendations forward.

Ultimately, I would like to see children, young people and their families being able to understand how to get help, to be able to access support and care at the right time and to have their expectations met in relation to mental health services, all while being able to express their views on services and be directly involved in their design.

We should work together to create a mentally healthy society in Scotland where everyone feels valued and is encouraged to achieve their full potential. All young people have a right to thrive. Good mental health is essential to fulfilling that ambition.