We drew upon evidence from our State of Child Health data and recommendations around mental health. We also highlighted our RCPCH position statement on mental health in CYP and our position statement on the Role of Paediatricians in Supporting Children and Young People's Mental Healthas these publications outline the key concerns and context around children and young people’s mental health in Wales and the UK.
Mental health problems are common and increasing in the child and adolescent population. Half of adult mental health problems start before the age of 14 and 75% start before the age of 24. Therefore, improving children and young people’s mental health should be everyone’s responsibility; professionals should be able to identify concerns to signpost to services and resources before they reach crisis.
The skills set out in our position statement provide a framework for thinking about the future need of paediatricians as part of a mental health workforce. In particular, it highlights the need for equipping paediatricians with the skills and training to recognise and support children’s mental health needs. They need to ensure integration with other professionals within multidisciplinary teams as well as CAMHS services, other statutory services (notably education and social care) and third sector services.
We highlighted the need for a particular focus on children and young people given different needs, service models and increasingly integrated ways of delivering care.
The policy and strategic landscape in Wales further necessitates an approach that includes the child mental health workforce specifically; with proper consideration given to the need to move towards integrated services and an upskilled child mental health workforce, including paediatricians. We welcome the focus within the plan on integration and on skills: this must also be considered specifically within the context of children and young people’s mental health.
The plan needs to be able to deliver the workforce required to support agreed and emerging models of care for children and young people including:
- The Whole School Approach to mental health and wellbeing that is a central part of the Welsh Government’s approach to children and young people’s mental health in Wales.
- The Nyth / Nest framework and ‘no wrong door’ approach to services, providing earlier help and support for young people’s mental and emotional health based on far more closely integrated services.
- Provision of “in reach” specialised mental health support to schools.
- The commitment made by the Welsh Government to testing how community sanctuary facilities can help support young people in crisis, which is part of the Welsh Government’s Children and Young People’s Plan
- The ALN framework which provides a single legislative system relating to the support given to children and young people aged 0 to 25 years who have additional learning needs (ALN) and are receiving education and/or training; and provides for Individual development plans (IDPs) which can include additional learning provision (ALP) agreed by health services, social services and other services, as well as education.
We recommended that:
- The actions around workforce supply and shape (including the proposed Future Mental Health Workforce report; and the review of postgraduate education and training numbers) specifically extend to community paediatrics and paediatric emergency care
- Modelling and scenario planning account for the emerging political and strategic framework for children and young people’s mental health. These may require upskilling groups of people other than those considered within the adult mental health frameworks identified in order to deliver the Whole School Approach, specialist in-reach programmes and the Nyth/Nest framework.
- Modelling and scenario planning engages with and builds upon the review of demand and capacity within ND services in Wales. It needs to consider whether there needs to be longer term intelligence gathering around demand and capacity within ND services.