The Mental Health Act Consultation: Our Response

Considering the mental health challenges and the difficulties of accessing support experienced by the children and young people we work with; we welcomed the opportunity to respond to the Scottish Government’s consultation on the Mental Health Act. We focused on its implications for children and young people, as it is vital to understand that their needs, experiences, and strengths are different to adults, and may require a different approach to ensure appropriate care.

We welcomed several commitments set out in the legislation. However, there is a challenging landscape ahead of us.

• Around half of mental health problems start before 15 years of age and 75% before 18.
• Nine out of ten children who have been abused or neglected at a young age will develop a mental health problem by the age of 18.
• 10% of children and young people in the general population have a clinically diagnosable mental problem.
• Almost half of care experienced children and young people meet the criteria for a psychiatric disorder, rising to 75% for those in residential homes.
• 65% of young people who have a mental health need are not currently receiving any statutory service support.

Despite this, Child and Adolescent Mental Health Services (CAMHS) make up less the 1% of the NHS budget. Many of those we support find themselves stuck in waiting lists as their needs and risks escalate – with no review of priority. It is known that “children and young people are not getting appropriate mental health care and treatment until they reach crisis point.” (Audit Scotland, 2018)

The Act must take account of this reality, and ensure:

• All children’s rights under the UNCRC (United Nations Convention on the Rights of the Child) are respected
• Their right to be heard under Article 12 is strengthened, with genuine recognition of children and young people’s capacity to inform their own care according to their communication needs and developmental level.
• The right to information is extended to children or young people under Article 17 – a precursor to Article 12.
• Children and young people and their voices are central to developing recommendations about the highest attainable standard of mental health, and the minimum obligations for economic, social, and cultural rights – as well as education rights.
• The voices of children and young people with experiences of poverty are amplified, in recognition of the established links between poverty, trauma and referral to CAMHS.
• Extension of duties in beyond patient care for the children and young people includes an integrated response in community settings or in their own home at times that work for them – particularly for those with experiences of multiple and frequent traumas.

“…I felt I always had to go to them and there were days when I could not face going out and I decided that it was not for me.” (Young person)

• The duty to provide independent advocacy includes connecting the dots between all the different systems children interface with.

“It was important to me to have someone not connected to the assessment to talk to about it – to be heard.” (Young Person)

• The establishment of a children and young person’s oversight group to inform planning and development of services intended for them.
• Measures which support the development of specific services and protections for neurodiverse children and young people.

“There are so many services offering a bit of this and that but nothing for kids on the spectrum with anger issues. You are trying to grapple with things and then you have far too many people involved. It is very exhausting…” (Parent)

• Standards and safeguards are developed to end the use of restraints on children and young people across all settings, including hospital detention.
• The policy and legislative context of children and young people’s lives is simplified, easy to understand and access.

The Mental Health Act has the opportunity to develop measures forming the foundation for a better future for children and young people’s mental health in Scotland. Ultimately, children and young people should be protected by laws that are developed with and for them.

You can access our full response here.