Joint Strategic Board for Children and Family Mental Health minutes: 26 September 2024

Minutes from the meeting of the Joint Strategic Board September 2024


Attendees and apologies

Present

  • Stephen Gallagher, Director of Mental Health, Scottish Government, co-Chair
  • Hannah Axon, Policy Manager, COSLA
  • Angela Davidson, Deputy Director, Mental Health, Scottish Government
  • Carsten Mandt, Senior Programme Manager, Perinatal Mental Health Network
  • Cheryl Burnett, Chair, National Parent Forum of 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
  • Wendy Van Riet, Director, NHS Ayrshire and Arran
  • Kandarp Joshi, Psychiatrist, Royal College of Psychiatry of Scotland
  • Martin Crewe, Director, Bernardo’s
  • Roch Cantwell, Professional Adviser, Perinatal and Infant 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
  • Georgia de Courcy Wheeler, Team Leader, Children, Young People and Families Mental Health, Scottish Government
  • Peter Innes, Policy Manager, Children, Young People and Families Mental Health, Scottish Government
  • Judy Thomson, NHS Education Scotland
  • Haylis Smith, National Delivery Lead, Suicide Prevention
  • Ellen Moran, Principal Education Psychologist, Association of Scottish Principal Educational Psychologists
  • Diana Beveridge, Head of Children and Young People Improvement Collaborative, Scottish Government
  • Elizabeth Archibald, Professional Adviser, Scottish Government
  • Harriet Waugh, Team Leader Self-Harm Policy and Distress Interventions, Scottish Government
  • Mairi Macpherson, Deputy Director, Improving Health and Wellbeing, Scottish Government
  • Morag Williamson, Unit Head - Distress and Suicide Prevention, Scottish Government
  • Carrie Lindsay, Executive Director of Education and Children's Services, Fife Council
  • Jaki Lambers, Director (Scotland), Royal College of Midwives
  • Joanne Smith, Chair, Parent and Infant Mental Health Scotland and National Society for the Prevention of Cruelty to Children (NSPCC) Scotland
  • Anna Tajsiak, COSLA
  • Derek Brown, Chief Executive, Highland Council
  • Jenny Ferguson, COSLA
  • Joanne Edwards, NHS 24
  • Lauren Kennedy, NHS24
  • Malcom McGovern, Principal Educational Psychologist Stirling, ASPEP
  • Neil Gibson, Social Work Scotland
  • Vivien Thomson, Children and Families Policy and Practice Lead, Social Work Scotland

Secretariat

  • Leon Young, Secretariat, Children, Young People and Families Mental Health, Scottish Government
  • Alastair Douglas, Secretariat, Children, Young People and Families Mental Health, Scottish Government
  • Ross Cowan, Secretariat, Children, Young People and Families Mental Health, Scottish Government

Apologies

  • Carolyn McDonald, Chief Allied Health Professions Officer, Scottish Government
  • Nicola Dickie, Director of People Policy, COSLA
  • Leanne Blacklaw, Chief Inspector (Mental Health, Suicide Prevention, CYP), Police Scotland
  • Gillian Hamilton, Chief Executive, Education Scotland
  • Ollie Bray, Education Scotland
  • Donna Munro, Clinical Project Manager - Specialist CAMHS Pathways, Scottish Government

Items and actions

Welcome and introductions

Stephen Gallagher (SGA), co-Chair of the Joint Strategic Board for Child and Family Mental Health (JSB), welcomed everyone to the meeting. SGA shared that that Mae McCrae, Scottish Youth Parliament (SYP) spokesperson for the SYP Health, Wellbeing and Sport Committee may be joining later if available.

SGA invited any comments or amendments to the minute of the March 2024 JSB meeting.

Amendments from the board:

  • Selena Gleadow-Ware (SGW) – Raised a question regarding the inclusion of women, children and young people with lived experience  Georgia de Courcy Wheeler (GdeCW) confirmed that this has been picked up on and the previous minute will be amended to reflect that

SGA advised JSB members that since it last met the Mental Health and Wellbeing Strategy Leadership Board, which provides oversight of the national Mental Health and Wellbeing strategy has been stood up. The JSB sits below the Leadership Board in the same governance structure. The JSB will continue to play a critical role in oversight of key priorities and actions related to children, young people and family mental health and keep the Leadership Board supported, updated and advised of issues going forward.

Actions

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

Update on implementation groups and JSB timeline

GdeCW provided a progress update on JSB Implementation Groups. There was acknowledgement that these groups have taken longer to establish than anticipated due to capacity across the system, but progress is now being made.

Pieces/types of work identified by the Board have been grouped in a way that allows them to be taken forward. This will be done by establishing project specific groups and longer term implementation groups where appropriate as well, and allowing for official led work to be progressed and brought back to the JSB. There is also the opportunity to align with existing groups such as the Workforce Training and Education Group, Mental Health in Schools Working Group to avoid duplication.

Initially, a project specific group, chaired by Anne McFaden, has been created to consider a Perinatal Service Specification as well as three longer term implementation groups.

The three implementation groups are:

  • Barriers and Access to Support and Services group chaired by Aileen Blower. This group will prioritise work around access to crisis support and CAMHS for under five
  • Awareness Raising and Promotion group chaired by Stephen McLeod will look at pathways in terms of sharing information and getting information to those who need it. It will also build on Wellbeing for Wee Ones and promoting understanding of infant mental health across professionals
  • Whole System and Transitions group chaired by Roch Cantwell will initially look at regional structures for perinatal support

It will be key for implementation groups to work closely together and interdependencies are highlighted in the terms of reference.

Participation will remain central across the work. The Scottish Youth Parliament (SYP) are also supporting MSYP’s to participate within JSB structures. Additional support is being sought to facilitate lived experience engagement and an update will be provided to a later board meeting.

Terms of reference for implementation groups will be shared with the JSB.

We expect the first updates from implementation groups to come back to the JSB in March 2025.

Discussion

  • the board welcomed the work that had been done to formulate the groups
  • SGW raised the possibility of discussing broader determinants such as alcohol abuse, domestic violence in the Awareness implementation group and also referencing disadvantaged groups specifically around equality in the Barriers implementation group. GdeW responded that while equalities is part of the terms of reference it can be considered further. The Awareness implementation group is focused on services rather than wider social determinants
  • Judy Thomson (JT) raised the issue of training and the Mental Health Education and Training Strategic Advisory group and that it would be useful for the implementation groups to link in. Previous experience has shown that the subgroups will generate some education/training and it would be useful to pre-empt this. Hannah Axon (HA) shared that she has been in touch with the secretariat of the Mental Health Education group so there can be a two-way discussion and implementation groups are not duplicating activity

Actions

  • HA to meet with JT to discuss what working together with the Mental Health Education and Training Strategic Advisory group will look like

Children and families in a vulnerable situations update

HA updated the board on initial actions taken to consider care experience across the Board’s work. This includes an update on actions from the relevant paper shared in February.

JSB Chairs wrote to the Promise to highlight the potential benefits of coherence between the Promise plan and mental health policy development. A formal reply has not been received but the new Promise plan was published containing actions related to mental health consistent with the direction of travel of the JSB. HA highlighted that the board may wish to invite the author of the Promise Plan to attend the JSB as work progresses.

Officers have engaged with some practitioner groups to support understanding of barriers and gaps that may remain in development of support pathways including;

  • Promise Leads network
  • UASC forum
  • School Counselling providers
  • Perinatal and Mental Health Network

Barrier and gaps reflected included changes in placement, changing local authority areas and what it does to those therapeutic relationships, perception of long waiting lists even when they don’t exist, complexity of issues around finance and housing, navigating multiple agencies and time it takes, that kinship care was not always being captured in the understanding of care experience when support was offered and lack of certainty for the future.

The feedback is consistent with direction of travel within the mental health policy landscape and there are specific points around care that would be useful to draw into our work.

The changing demographics in the care experience community was also raised particularly around unaccompanied asylum seeker children (UASC) who currently make up a high proportion of children in care.

Discussion

  • the board welcomed the work that has been done so far
  • Joanne Smith (JS) shared that demographic of looked after children has changed over the last ten years. Almost 50% in CPO’s are under two years old and 25% under 20 days old. Should we be reframing this theme as Babies, Children and Families in a vulnerable situation? The response required for babies in care are very different from older age ranges. HA answered very young children sit through the work rather than being a group on its own but would be happy to meet and discuss further
  • Stephen McLeod (SMcL) noted that the way we provide placements for some can cause challenges when moving from different areas and that young people can provide remarkable peer support in residential care units and multiple foster care placements
  • Vivien Thomson (VT) raised that it would be useful at a future meeting to discuss what the current care context is

Actions

  • HA to meet with JS outside of JSB to discuss further the points raised regarding babies making up a larger proportion of children in care
  • HA to liaise with VT outside the JSB to discuss care context and how best to share  information on the demographics of care

Suicide prevention insight report

Jenny Ferguson (JF) presented an overview of the Suicide Prevention Scotland Insights Report, which collated and analysed the needs of young people affected by suicide, and outlined recommendations  for members on how the work of the Joint Strategic Board for Child and Family Mental Health (JSB) might support the wider children and families suicide prevention agenda.  .

In September 2022 COSLA and Scottish Government published the “Creating Hope Together” strategy and a three year action plan tackling suicide in Scotland. The action plan is delivered through Suicide Prevention Scotland.

An Insight Report was shared which shows a significant gap in service provision for children and young people in suicidal crisis/distress. This can be because CAMHS don’t suit them as they may not have a diagnosis and have nowhere to go for support. Young people and practitioners highlighted fears around stigma, discrimination and inequalities.

Since the report was published Suicide Prevention Scotland  has undertaken work to gather good and emerging practice stories on the whole school approach, curriculum delivery in schools and effective crisis support. In addition work has been taking place in the key settings highlighted by the report such as youth work and higher and further education.

In relation to the JSB going forward a paper was presented with recommended actions to enable alignment across work programmes. It was agreed we are now looking how to connect to two programmes of work together. This paper was accepted and it was agreed that:

  • learning from the Insight Report will be shared with the JSB and its implementation groups, as will further learning from Suicide Prevention Scotland connected to JSB priorities
  • regular updates will be provided to the JSB on progress on delivering the relevant actions within Creating Hope Together
  • key suicide prevention partners will be invited to sit on the relevant implementation groups, where their expertise will add value to the implementation, and allow strong connections across to suicide prevention work
  • in reporting to the JSB, the implementation groups will be asked how alignment to suicide prevention has been considered in their actions

Discussion

  • Kandarp Joshi (KJ) highlighted that for long time suicide and mental health been unhelpfully combined and report separates it out in very timely way
  • Cheryl Burnett thanked JF for the presentation and agreed it was insightful
  • Roch Cantwell (RC) offered to meet Haylis Smith (HS) outside of the JSB to make some further connections

Actions

  • RC to meet with HS to make some further connections

Early child development transformation programme

Diane Beveridge (DB) presented on the Early Child Development (ECD)Transformation programme and shared that she was particularly interested in where the group sees opportunities to connect.

The ECD programme recognises the importance of the critical window in people’s lives from pre-birth to three years old and can have profound effect on later life. A key element of the ECD programme is understanding variation in Scotland of developmental concerns among children and families, including impact of poverty, culture, environment and support for caregivers. Having an integrated approach is critical and there needs to be a cross policy approach to being better at sharing learning.

Discussion

DB asked for input on how the JSB might engage with the ECD programme

  • SGW shared that the UK is an outlier in Europe in terms of foetal exposure to alcohol. There needs to be a more universal approach in how we support specific issues such as parent with mental health issues and areas with high poverty. How to we maintain a universal approach while also targeting most at risk groups. DB agreed regarding the issues around alcohol and that they are currently looking at a population health strategy on how we get messages out to people
  • SMcL agreed that the data presented by DB was very useful and that the impact of poverty was stark with key programmes having been disinvested after the 2008 financial crisis
  • Jackie Lambers (JL) built on previous contributions that we know the impact of poverty and that it is in prevention we get the largest return on investment. Financial pressures can lead to things being pulled into acute care which makes it difficult to break cycles
  • DB noted the opportunity to come back for future discussions

AOB

No other business was raised.

Close

Chair thanked everyone for attending and their contributions. Shared that the next meeting will be in December with Minister for Minister for Social Care, Mental Wellbeing and Sport Ms Todd attending as well as Councillor Buchanan.

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