INTERVIEW: Lynne Neagle MS, Deputy Minister for Mental Health and Wellbeing

We ask the Deputy Minister about her plans to improve mental health services for young people in Wales, the future of CAMHS and how we enhance support provided to young people by non-mental health professionals…

What are your aims for improving the mental health of young people during the sixth Senedd?

My aim is to focus on prevention and early intervention to prevent issues from escalating but also to ensure specialist services are accessible when needed. I have been an elected member of the Senedd, formerly the National Assembly for Wales, since its inception and have been advocating for children and young people’s mental health rights throughout each of its six terms and continue to do so in my role as the Deputy Minister for Mental Health and Wellbeing.

The past 18 months have been extremely challenging for many of our young people. Coronavirus and the necessary restrictions have impacted significantly on the lives of children and young people, this includes worrying about periods away from school, clubs, family and friends. I think it is important that we recognise that most young people won’t need specialist mental health services but we need to ensure that there is a range of support available across both the public and third sectors.

Our research has found that the CAMHS referral system often doesn’t work quickly enough for those in greatest need. How can we ensure that only appropriate referrals are made to CAMHS so that those with acute illnesses get help quickly?

I completely agree that we need to ensure that referrals to CAMHS should only be made when that level of support is the most appropriate solution for the young person. The NHS most definitely should not be seen as the first and automatic choice for referral which is why our whole system response is centred on ensuring there is an offer of emotional mental health support outside the NHS. I want to see support situated within services already familiar to young people, carers and families.

We have seen fluctuations in the average wait time for children and young people to access specialist CAMHS during the pandemic due to both the restrictions and a significant increase in referrals between October 2020 and January 2021. We also know that waiting times have continued to increase across many NHS services through 2021.

We will continue to work with Primary care, including GPs, and to work with teachers through the CAMHS Inreach programme in schools to facilitate a better understanding of when young people need a CAMHS referral and when other support can be more constructive.

Bearing in mind that CAMHS are there for a minority with more serious mental illnesses, how can we ensure that other young people who seek help for their mental health receive a positive referral to more suitable support?

I agree this will be key to ensure our CAMHS services are sustainable in the future. We now have single points of contact within each CAMHS service across Wales. This means that when a referral is received within the NHS, the young person’s
case is considered by professionals, in some areas this will be by a multidisciplinary panel. Following consideration, sometimes young people won’t be added to the list for a CAMHS appointment but will be signposted to more appropriate help elsewhere.

We have been developing better support in schools and youth clubs for a few years so many young people will already be able to access services such as school/community counselling or emotional wellbeing services provided by third sector organisations. But to build these type of services and ensure they are available wherever young people need them in Wales,
we are using the NEST Framework. This framework will help regions to develop services based on what is needed by young people in their area.

Many young people have told us that when they are experiencing difficulties they would prefer to turn to people they already know and trust (such as their teachers). Is there more we could do to improve support provided by non-­mental health professionals?

We have listened very carefully to young people and are continuing to support and train trusted adults in a variety of places ensuring teachers, youth workers and parents are well equipped to teach and support young people to find the right solution for them and to build their own resilience.

Our Framework for the Whole School Approach has been developed to support good emotional and mental wellbeing by promoting a positive cultural environment. We want our schools to provide an environment where children and young people can form positive relationships with staff and other learners, with other professionals working with the school and with the wider community that surrounds the school. We know it is important that young people have clear routes to ask for support.

After successfully piloting our CAMHS in­reach project in areas of Wales during 2019 and 2020, we are rolling out the service to all areas. This provides access for staff in schools (not just teachers) to support pupils’ mental health and well­being and improve schools’ access to specialist liaison, consultancy and advice when needed. Another example is through the Youth Support Grant. We also provided funding for local authorities to work with the voluntary sector to reach a wider range of young people where they are already spending their time. This will support youth workers to deliver early intervention and prevention services for those with low­-level emotional mental health and wellbeing issues, and be available all across Wales.

We increasingly live in a world where people view their experiences through a ‘mental health lens’. How can we work to avoid the “medicalisation” of experiences such as living through the COVID pandemic and growing up?

I consider the best way we can ensure we avoid medicalisation of growing up and design the right support for young people is to ensure that young people themselves are at the front and centre of the design of the services we intend to provide. We need young people to get involved in their areas, to reflect their clear views and keep us on track. The Nest framework will be delivered through Welsh Regional Partnership Boards. There are seven of them in Wales and each of them already has or will shortly be creating a young person’s subgroup/stakeholder group. Organisations such as Children in Wales with their Young Wales Programme and the Children’s Commissioner’s Super Ambassadors programme provide you with the opportunity to share your views and be a champion for young people’s views. Of course there is also the Welsh Youth Parliament that allows you to become part of the activity to make sure the way we design and provide services are right for you and your friends.