Committee discovers disturbing evidence of under-5s with mental health issues slipping through the net


Disturbing evidence that under-5s are not being monitored for mental well-being by statutory services has been highlighted in a Health and Sport Committee report published today.

The committee’s inquiry into child and adolescent mental health and well-being has evaluated mental health services for these groups in Scotland.

The committee was very concerned about the extent of problems provoked by recent changes to the health-visiting profession. With babies often no longer seeing a health visitor after eight weeks and a drastic drop in the number of health visitors, vital mental health and well-being assessments and intervention are being missed.

The committee expressed deep concern at the lack of progress in several areas of the national framework on child and adolescent mental health. In particular, the committee was concerned by an apparent lack of drive behind the implementation of the framework. The long-standing issue of waiting times and understaffing of teams in supporting children and adolescents should also be addressed. Equally, the committee believes there are far too many variations across Scotland in the quality of transitional services from adolescent to adult services.

Committee Convener Christine Grahame MSP said: “Child and adolescent mental-health services clearly need champions, having been a Cinderella service for many years. Despite the devotion and efforts of individuals in the field and the policy commitment of present and past governments, we need more drive in implementing these policies, especially from the NHS and local authorities.

"We heard evidence that substantial damage has been done by cutting numbers of health visitors, the very people who would have noted signs that merit intervention in the under-5s. The suggestion that this role can be fulfilled by social workers instead could be counter-productive in terms of public perception. We need urgent action to help what is a vulnerable group.”

The Committee also highlighted:

  • A need for the Government to re-examine how teacher training covers both awareness of and skills for dealing with mental health and well-being issues.
  • A need by the Government to establish the number of Child and Adolescent Mental Health Services staff per 100,000 of population in each NHS board area and to review its plans in light of this.
  • The need for a bespoke service for adolescents and young adults.

The Committee undertook a series of visits in 2008 to inform the remit of the inquiry. After the visits, to Edinburgh, Argyll & Bute, Dundee and Kirkcaldy, during which members met practitioners and service users, the committee agreed on a number of lines of inquiry. The inquiry looked at how children and adolescents potentially at risk of developing mental health problems are identified and how those problems should be prevented.

Changes to the health-visiting profession followed on from a report called Health for All Children. The fourth edition of the report was published in February 2003 and is referred to as “Hall 4”. This report, which recommended fewer routine universal checks for all infants and greater targeting of resources towards those with higher needs, was followed by Scottish Executive guidelines in 2005.

The framework referred to in the report is the Scottish Government’s 2005 publication, The Mental Health of Children and Young People: A Framework for Promotion, Prevention and Care.

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