Together members: Children’s Health Scotland and Children in Scotland
Every child and young person has the right to enjoy the best possible standard of health, including mental health. Governments must provide good quality healthcare and strive to ensure that every child and young person can access this.
“We recommend that the accessibility, availability and quality of mental health care must be ensured – for everyone regardless of where you live in Scotland as recommended by the UN Economic and Social Rights Committee to UK in its 2016 review. We recommend that provisions must be made to address reduced staff levels in line with increasing levels of referrals to CAHMS. We think it is important to ensure that young people have strong mental health support within educational settings, whether this means implementing improved teacher training, or placing mental health professionals within educational environments.”
Calum McArthur, Jack Norquoy, Craig Macauley and Emily Harle MSYPs (SYP Rights Review, April 2018.)
“I’m on a waiting list for CAMHS and have been told I’m waiting for them to hire a new psychiatrist! They’ve told me I’ll be waiting around 8-10 months. I’m nearly 18, so I bet I just get passed on again.”
(Anonymous young person, SYP ‘Our Generation’s Epidemic’)
Approximately one in 10 children and young people in Scotland have a diagnosable mental health problem. Many more experience low mood and stress. Without early and effective support, the effects of these mental health issues can grow. This can impact on a range of rights including the right to health (Article 24), education (Article 29) and the ability of young people to develop and reach their full potential (Article 6). Current evidence shows that most adult mental health problems start in teenage years.
While there has been increased attention on mental health provision recently, concerns have been raised around access to Child and Adolescent Mental Health Services (CAMHS). In 2016, a Scottish Youth Parliament survey of 1,400 young people found that 74% did not know what mental health services were available in their local area. Those who had sought support noted long waiting times, poor availability in rural areas and unwelcoming service environments. This reflects wider evidence around the number of rejected CAMHS referrals and changes to thresholds.
Research from Children in Scotland, Scottish Autism and the National Autistic Society Scotland reveals further problems faced by children and young people with autism when accessing mental health support. 71% of parents surveyed described instances where their child missed school for reasons other than common illness. Of these parents, 63% said the reason their child had missed school was due to anxiety. If we consider the additional needs faced by children and young people with disabilities, the lack of appropriate mental health support can also impact on Article 2 (non-discrimination) and Article 23 (rights to care and education for children with disabilities). The above report and SIGN Autism Guidelines (2016) emphasise that children and young people with additional needs must be able to access the mental health support services to which they are entitled.
Article 4 of the UNCRC is clear that governments must take action to ensure children’s rights are recognised in practice. This includes through providing sufficient resources and funding. In 2016, the UN Committee on the Rights of the Child recommended that the government “rigorously invest in child and adolescent mental health services” and make sure such support was accessible.
Recent moves have been made to try and improve the situation for children and young people. The Scottish Government published its Mental Health Strategy (2017-2027), listing 13 actions to specifically support children and young people’s mental health. Actions included the completion of a review of rejected CAMHS referrals, rolling out mental health training for those working with children and young people and a review of school-based counselling services. Scottish Government has also since provided funding for a Youth Commission on Mental Health and a Children and Young People’s Mental Health Taskforce to recommend improvements and work in partnership to develop a programme of sustainable reform. In September 2018, the First Minister announced £60m funding for mental health counselling in all Scottish schools.
Despite these developments, Scottish Government recognise there are still shortfalls in access to support. Given the recency of some new Scottish Government developments, it may take some time for children and young people to be able to benefit from changes. Incorporation would strengthen the above developments, ensuring that children with mental health problems are not overlooked and are provided with the specific support services they need. Incorporation would encourage child rights-based budgeting, helping to ensure that necessary funds and resources are allocated to CAHMS. As research shows that half of adults with mental health issues had experienced symptoms by the age of 15, pro-active and child rights-based approaches to mental health care could help alleviate pressure on adult mental health services, by focusing on early provision of support.