The future of secure care and the single point of contact (SPOC) for victims in the Children's Hearings System

To build a system that is Promise-keeping and truly meets the needs of children and young people, we must reduce fragmentation across the services and settings they often experience simultaneously. Our work is therefore focused on creating stronger alignment between secure care and safe, therapeutic mental health provision. By integrating these approaches, we aim to deliver a coherent, rights-based framework that prioritises safety, wellbeing, and continuity of care.

Children and young people in, or approaching, secure care often present with complex trauma, acute distress, and significant mental health needs. It is essential that these needs are not treated in isolation, or as secondary to containment. The system faces challenges in providing, or accessing, timely and appropriate mental health assessment to inform what necessary ongoing individual, family or environmental and systemic supports or treatments are required to respond to these.

Secure care should provide a stable, safe, supportive environment where children have an opportunity to undergo assessment and receive treatment. Given that children and young people who are cared for in these locked environments don’t have ready access to Child and Adolescent Mental Health Services (CAMHS), this raises challenges with gaining support from specialist mental health services.

For those on the edge of secure care, early intervention and flexible support can prevent escalation and reduce the need for restrictive placements. Health Boards, and Integrated Joint Boards where health boards have delegated responsibility for delivery, have a responsibility to commission/provide secondary health care to children and young people in secure care, using the Responsible Commissioners Guidance. Difficulties in the practical application of these arrangements led the Scottish Government Mental Health Directorate to directly commission health boards who are responsible for providing health services in the three secure centres in Glasgow and Greater Clyde (GGC) to develop a specification, care pathway and CAMHS provision in these three centres (Good Shepherd Centre, Kibble and St Mary’s Kenmure). This year we have also provided funding to the North of Scotland to establish a CAMHS into Rossie pathway in line with what has been achieved in the West of Scotland.

The Scottish Government funding for CAMHS In-reach to secure care provides assessment and treatment for all severe and/or disabling mental health conditions presented by children whilst they are resident in any of the secure care centres within the West of Scotland. This input will be provided on behalf of all Scottish health boards. This dedicated multidisciplinary team will also work closely with the proposed regional community Forensic CAMHS network to provide oversight of mental health input and care-planning for children from the territorial board areas for whom secure care is being considered or who are leaving secure care.

The ‘Reimagining Secure Care’ report and government’s response emphasises the need for integrated, trauma-informed mental health care to be embedded across the continuum. Our commitment is to ensure that every child is cared for in an environment that can best meet their needs - safe, nurturing, and equipped to address both emotional wellbeing and behavioural risk.