7.5 Mental health
On this page
On this page
The Welsh government took various steps to address the mental health of young people as a response to COVID-19 in 2020. In April 2020, they allocated £1.25 additional funding to school counselling services. In May 2020 mental health services were categorised as an essential service as part of the NHS Wales COVID operating framework.
In June 2020, the government created the Young Person’s Mental Health Toolkit online resource for children and young people in lockdown. The government also issued a guidance with information on safeguarding and vulnerable children during the pandemic.
At the time of writing (July 2020), the government is also running a nation-wide survey of children and young people aged 7-18 called Coronavirus and Me, covering different aspects of life during the pandemic including mental health.
The all-age mental health strategy for Wales, published in 2012, is based on the requirements of the Mental Health (Wales) Measure 2010, which places legal duties on health boards and local authorities to improve support for people with mental ill-health.
Together for Mental Health is deliberately inclusive of all age groups, while recognising the need for age-appropriate approaches. Previously there had been separate strategies for children, for adults of working age, and for older people, but service user feedback had identified the points of transition between services as being vulnerable to breakdowns in care and treatment, so the all-age approach has been adopted. For children and young people, the strategy states (p. 16) that services should ‘focus on the early detection of risk and the development of resilience and life skills, embedding the principles of the UNCRC’ (United Nations Convention on the Rights of the Child).
The strategy is implemented through three-year delivery plans, which set out the key actions for the Welsh Government and stakeholder agencies in the statutory and voluntary (third) sectors.
The current delivery plan covers the period of 2019-2022 and implementation is through partnerships between local authorities and local health boards. This is the third and final plan. The key priorities for 2019-2022 include:
- Reducing health inequalities, promoting equity of access and supporting the Welsh Language.
- Strengthening co-production and supporting carers.
- Developing a workforce plan in partnership with Health Education and Improvement Wales (HEIW) and Social Care Wales (SCW) to work with the third sector, local authorities and the NHS to support medium and longer-term service improvements and to ensure a stable and sustainable mental health workforce.
- Implementing the core data set to improve consistency, robustness and the focus on outcomes across all-age mental health services.
- Supporting the legislative context – making changes needed to implement known legal reform to the Mental Capacity Act 1983 and developing a strategic response to which changes to the Mental Health (Wales) Measure 2010 and the Mental Health Act are needed to deliver and drive our/the plan’s policy intentions and outcomes.
The priority areas for action include:
- Improving the access, quality and range of psychological therapies for children, working age and older adults – to deliver a significant reduction in waiting times by the end of this Government.
- Improving mental health and well-being and reducing inequalities – through a focus on strengthening protective factors.
- Improving access to support for the emotional and mental well-being of children and young people – improving access and ensuring sustainable improvements to timeliness of interventions, as well as supporting the new curriculum and whole school approach, extending the reach of NHS services into schools and filling gaps in services within both primary and secondary care through Child and Adolescent Mental Health Services (CAMHS).
- Further improvements to crisis and out-of-hours provision for children, working age and older adults – moving to a common, multi agency offer across Wales.
The Welsh Government’s all-age suicide and self-harm prevention strategy covers the period 2015 to 2020. Talk to Me 2 contains six general objectives:
- further improving awareness, knowledge and understanding of suicide and self-harm amongst the public, individuals who frequently come into contact with people at risk of suicide and self-harm and professionals in Wales
- delivering appropriate responses to personal crises, early intervention and management of suicide and self-harm
- providing information and support for those bereaved or affected by suicide and self-harm
- supporting the media in responsible reporting and portrayal of suicide and suicidal behaviour
- reducing access to the means of suicide
- continuing to promote and support learning, information and monitoring systems, and research, to improve understanding of suicide and self-harm in Wales and guide action.
Children and young people with a background of vulnerability are identified (p.20) as priority groups:
Children and young people with limited employment prospects and a background of vulnerability including adverse childhood experiences, socio-economic deprivation, low educational attainment, drugs and alcohol misuse and mental health issues are particularly at risk. Looked after children, care leavers, children and young people in contact with the youth offending system, and others – such as those who might find themselves not in education, employment or training - may also be exposed to many of these risk factors.
Local health boards, Public Health Wales, local authorities and the voluntary (third) sector are primarily responsible for implementation of the strategy.
Specific actions concerning children and young people identified in the strategy’s objectives supplement include:
- the development of a bilingual suicide and self-harm prevention website, to include specific sections addressing, for example, schools, young people and further education / higher education students
- the reduction of access to online information which promotes or encourages suicide and self-harm methods, including creating a safer online environment for children and young people, improvements to e-safety education, and the further raising of public awareness
- the promotion of staff and pupil awareness training, and the development of support and guidelines on managing the consequences of suicide and self-harm in schools.
Improving the mental health of young people
School counselling services: Under the School Standards and Organisation (Wales) Act 2013, local authorities have a duty to provide an independent counselling service in respect of health, emotional and social needs for children and young people in their area. For school-based services, this duty applies to all secondary school pupils.
Statutory guidance on the provision of independent counselling services was published by the Welsh Government in June 2013. Prior to the development of the statutory guidance, the British Association for Counselling and Psychotherapy and the Welsh Government jointly published an operating toolkit for school-based counselling in 2011.
The service is funded through the Revenue Support Grant to local authorities.
The school nursing service (see ‘Stakeholders’ in ‘Mechanisms of early detection and signposting of young people facing health risks’) also has a role in the promotion of emotional well-being and in supporting the mental health needs of school-age children. School nurses have a particular role in improving well-being and resilience.
Together for Children and Young People(T4CYP) is a multi-agency service improvement programme, launched in February 2015, and led by the National Health Service in Wales. It looks at ways to improve emotional and mental health services provided for children and young people in Wales.
Two of the areas which the programme focuses on are:
- promoting wellbeing and resilience
- early identification and intervention.
See the Together for Children and Young People framework for more information.
Child and Adolescent Mental Health Services (CAMHS): CAMHS offers assessment and treatment when children and young people have emotional, behavioural or mental health difficulties (See the section on ‘Health Care’ in ‘Access to Quality Services’ for more information on CAMHS).
In 2016, the Welsh Government issued non-statutory guidance, Collaborative Working between CAMHS and the Counselling Service (for children and young people). The guidance aims to improve joint working between these services and other partners to help ensure that children and young people are safeguarded and receive the most appropriate treatment.
A Higher Education Funding Council for Wales (HEFCW) circular provides information and identifies current practice on promoting and supporting mental health and well-being in higher education in Wales, in line with the Welsh Government’s mental health strategy Together for Mental Health. Higher education institutions’ tuition fee plans must reflect the principles of the strategy and include provision of appropriate support services.