Issue 20


By Lynn Bell, CEO Love Learning and Member of the Scottish Children's Services Coalition

As we mark the beginning of this year’s Mental Health Awareness Week (13th May), it is fair to say that concerns over the increasing number of people diagnosed with mental health problems have never been more prominent. It is no exaggeration when it is noted that poor mental health is acknowledged as one of the greatest public health challenges of our time.

To address this, it is vital to acknowledge that many mental health symptoms begin to arise in early childhood. It is in fact estimated that one in 10 children and young people aged between five and 16, have a clinically diagnosable mental health problem and that half of mental health problems begin before the age of 14. Therefore, it seems obvious that the solution lies in prevention and early intervention.

Yet, a recent report from the Auditor General and Accounts Commission on Child and Adolescent Mental Health Services (CAMHS) notes that current service provision is patchy, being geared towards specialist care and responding to crisis, rather than preventing this through early intervention and prevention mechanisms. Additionally, it highlights that CAMHS is under significant pressure, overwhelmed with long waiting lists and that its services are complex and fragmented, which hamper access for children, young people and their families to get the support they need.

The outcomes many of these children face if these issues are not addressed early on are well documented, including long-term health, social and educational difficulties, with a resultant impact not only on the child concerned, but also on society as a whole.

In addition to this greatly increased demand on services, one in five children seeking mental health treatment have this rejected. According to an audit commissioned by the Scottish Association for Mental Health (SAMH) and the NHS Information Services Division, many of these young people’s needs are not viewed as being severe enough to warrant CAMHS, however appropriate alternative support for them is lacking.

We have expressed our concerns over the increased demand on CAMHS and the fact that such a high number of these children who are referred for treatment are having this rejected. This leaves thousands of vulnerable children and young people in a state of limbo. Many children, young people and their families have highlighted that they have received a rejection letter within a very short timescale, and feel angry, aggrieved, cheated and let down due to a feeling that no proper assessment process has been undertaken.

More disturbingly, it appears that some clearly require treatment, but this is being rejected, often without any face-to-face meeting with a specialist. In fact, only 31 per cent of those who undertook an online survey got a face-to-face assessment. There was also evidence of people who were self-harming, but whose condition was not deemed severe enough to warrant treatment. Given our commitment to improve services for those with mental health problems, we are naturally concerned about this situation.

It is when facing such a critical situation that the focus on mental health support should not only look at the increased provision of services, but also the greater resourcing of prevention and early intervention mechanisms, including more community-based support. As mentioned above, it is often at a young age when mental health issues start to arise, and children often struggle to cope with their mental health issues. Yet, if mental health problems are treated early, this provides a natural start to building resilience within a child’s emotional capacity, meaning that a spiral into serious mental health problems can often be avoided.

What would bring considerable benefit is providing support to parents on how they can build resilience in their child’s emotional wellbeing. In order to maximise the benefits of this, parents should be involved as early as the antenatal period, as well as while the child is growing up, educating them on how best to deliver this support.

School of course has a vital role to play in this process, developing good mental health and wellbeing through the curriculum. In addition, investing a fraction of the mental health budget on school-based counselling services has proven to have encouraging results in the pursuit of our society’s offspring being mentally healthy. In Wales, where counselling services are guaranteed in all secondary schools, 88 per cent of children and young people who received counselling did not require any form of onward referral once counselling sessions had been completed. To put this in context, the cost of five sessions of counselling is equivalent to just one contact with CAMHS.

School counselling helps to keep children in school and avoid an unnecessary and often stigmatising mental health diagnosis, as well as reducing the burden on already stretched and costly CAMHS provision. Additionally, mental health and wellbeing must be key aspects in all educational training in order to provide teachers with advanced skills to recognise signs and symptoms of poor mental health, allowing them to provide early support and facilitate necessary interventions.

We welcome the increased spending the Scottish Government has allocated for mental health services, but there is clearly more that can be done. The achievement of good outcomes for children and young people’s mental health demands a collaborative approach and significant improvements that can only be achieved through involving the government, local authorities, the NHS, the third sector and beyond. Working together and sharing their expertise in order to address mental health problems in full.

As noted previously, issues around mental health represent one of the greatest public health challenges of our time, and if our government is to deliver the support these children and young people require, we need greater investment not only in CAMHS but in alternative support services.

Good mental health is important to everyone living in Scotland. If we are to achieve our vision of Scotland being the best place in the world for vulnerable children and young people to grow up in, we need to ensure that we are providing the resourcing needed to turn this vision into a reality.

By Lynn Bell, CEO Love Learning and Member of the Scottish Children's Services Coalition

Issue 20

Issue 20


Let People Choose their GP Practice

General Practitioners are often a patient’s first and only contact with the NHS in Scotland. However, unlike hospitals which are owned and operated by the public sector, the vast majority of GP practices are actually private sector contractors to the NHS.


Looking for a previous issue? Use the menu below to select an issue.