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There is no overall policy framework for mechanisms of early detection and signposting of young people facing health risks. The GIRFEC (Getting it Right for Every Child) approach (see ‘National strategy (ies)’ in ‘Healthy lifestyles and healthy nutrition’) advocates preventative work and early intervention to support children, young people and their families in all policy areas that affect children and young people.
Similarly, the 2017-2027 all-age mental health strategy (see ‘National strategy (ies)’ in ‘Mental health’) has a focus on ‘improving support for preventative and less intensive services to tackle issues earlier’.
Early detection mechanisms are applied locally through such services and organisations as the school nurse service, CAMHS (Child and Adolescent Mental Health Services), youth work services, general practitioner services, etc.
Young people are signposted to a wide range of projects and programmes operated at local level which are often operated by third sector organisations or charities with government funding.
The school nursing service forms part of the school health service provided by NHS Scotland. School nurses (along with teachers and lecturers) are recognised as often being in a position to detect problems early through their knowledge of their students. Other public health practitioner roles may include that of teenage pregnancy coordinator, responsible for working towards the aims of the local teenage pregnancy strategy.
Child and Adolescent Mental Health Services (CAMHS) involve cooperation between a range of professionals working with children and young people (see ‘Improving the mental health of young people’. The arrangement of the service in ‘tiers’ is designed to facilitate appropriate interventions at an early stage before problems escalate.
Guidance to stakeholders
The Royal College of Nursing has published a UK-wide toolkit for school nurses with advice and guidance, including on early recognition of risky behaviours in young people.
Target groups vary according to the intervention area. A report from the Scottish Collaboration for Public Health Research and Policy identifies risk and protective factors for young people’s engagement in risky behaviour.
The 2018/19 SALSUS mental health report published in June 2020 does not distinguish target groups but does acknowledge the role of societal inequalities in outcomes for variable studied.
There was a clear link between deprivation and emotional and behavioural problems. Pupils who lived in the least deprived areas were less likely than those in the most deprived areas to have a borderline or abnormal SDQ score.
Pupils who were young carers were considerably more likely to have a borderline or abnormal SDQ score and lower mental wellbeing than pupils without caregiving responsibilities.
Services to support the early detection, signposting and treatment of young people facing health risks, such as CAMHS and schools nurses, are funded by the Scottish Government – usually through the health budget provided to NHSScotland.