Response 75750168

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About You

1. What is your name?

Harriet Hall

3. Are you responding as an individual or an organisation?

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Ticked Organisation

4. What is your organisation?

Children 1st

5. The Scottish Government would like your permission to publish your consultation response. Please indicate your publishing preference:

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1. Our framework sets out 8 priorities for a new Mental Health Strategy that we think will transform mental health in Scotland over 10 years. Are these the most important priorities?

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Ticked No
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If no, what priorities do you think will deliver this transformation?
Children 1st welcome the ambition to deliver significant improvements in the mental health of Scotland’s population and the particular focus on prevention, early intervention and children. For this ambition to succeed, we believe the new Mental Health Strategy must be underpinned by the robust scientific evidence about the importance of attachment relationships for long term mental wellbeing as well as the Scottish Government’s broader Getting it Right for Every Child (GIRFEC) approach to give children the best start in life. Scotland’s Former Chief Medical Officer, Sir Harry Burns, describes attachment as: “ individuals being able to manage themselves in stressful situations.” (1) Recent neuroscience shows that our brains are not complete at birth, but that experience of relationships shape our brain’s neural pathways, forming different styles of response to anxiety, known as self-regulation. Our styles of self-regulation are also shaped by the levels of oxytocin and cortisol hormones in our bodies depending on how often we feel content, safe and loved or anxious. While these patterns are established by experiences in the early years, it is possible to heal insecure attachment patterns at any age.(2) As Scotland’s National Children’s Charity, Children 1st support children and families at risk of, or experiencing abuse and trauma. Many of the parents we support are themselves experiencing the long term impacts of poor childhood attachment relationships and unresolved childhood trauma. As adults these childhood experiences may result in long term mental ill-health, alcohol and substance misuse, involvement in abusive adult relationships, poverty, isolation or a combination of any of these. For the families we work with being listened to, building on their strengths and fostering relationships within their wider families and local community is as vital as therapeutic support in improving their children’s outcomes and helping parents to recover from their own childhood experiences. Including a priority within the new Mental Health Strategy to support strong attachment relationships, not only in the early years, but throughout all life stages has the potential to transform Scotland’s mental health. (1) Dr Suzanne Zeedyk (2013) Sabre Tooth Tigers and Teddy Bears p11 H B Rutherford &Co, Dundee (2) Dr Suzanne Zeedyk (2013) Sabre Tooth Tigers and Teddy Bears H B Rutherford &Co, Dundee

2. The table in Annex A sets out a number of early actions that we think will support improvements for mental health.

Are there any other actions that you think we need to take to improve mental health in Scotland?
Giving children and their families the right help, at the right time, from the right people is central to GIRFEC. . Mental wellbeing, mental health and mental illness are all part of the same spectrum. But, within a climate of increasingly tight budgets, preventative services that support the strengthening of attachment relationships, resilience and children’s wellbeing are in decline, often leaving Child and Adolescent Medical Health Services (CAMHS) as the only available source of support. The potential consequence is an increasingly medicalised approach to all concerns about a child or young person’s mental wellbeing, regardless of severity. While 77% of children and young people are seen by a CAMHS service within the Scottish Government’s current waiting time target, ten weeks, the current average wait for a CAMHS service in Scotland , is a long time for those children and young people who need the service most. (3) Early actions taken under the Start Well framework of the proposed Mental Health Strategy should therefore encompass the whole spectrum of mental wellbeing, mental health and mental illness. More needs to be done to ensure that a wider range of professionals who come into contact with children and families are trauma informed: including teachers, social workers, health care professionals, GPs. Actions within the Mental Health Strategy should include specific activity to support mental wellbeing among communities, as well as individual families as underpinned by attachment theory. A clearer pathway which encompasses mental wellbeing, mental health and mental illness is needed which includes more abuse and trauma recovery services at community level and outwith the health service is needed. This should incorporate better links between services to ensure children do get the right help, at the right time, from the right people. (3) ISD Scotland, September 2016

3. The table in Annex A sets out some of the results we expect to see.

What do you want mental health services in Scotland to look like in 10 years' time?
The pattern of declining preventative services which support children and families mental wellbeing needs to be urgently reversed, if the aims of the proposed strategy are to be achieved. A good level of support and services need to be available across the broad spectrum of mental wellbeing, mental health and mental illness, so that we avoid unnecessarily clinicalising children and young people as mentally ill, when what they really need is broader based community support to build their mental wellbeing. This should also ensure that CAMHS services have more resource to devote to those children and young people who are in need of clinical support.