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Children and young people's mental health indicator set

A set of national mental health indicators for children and young people in Scotland has been established. This complements the mental health indicator set for adults.

Launched at an event at the Glasgow Royal Concert Hall on 25 November 2011, the children and young people's mental health indicators cover both the state of mental health (mental wellbeing and mental health problems) and the associated contextual factors. They are structured under two constructs (categories):

• high level constructs of mental health status – outcome measures
• contextual constructs – covering the risk and protective factors and the consequences of mental health. These are structured within five domains: individual, family, learning environment, community and structural.

The indicators provide for the first time a means of assessing and monitoring the mental health of Scotland's children and young people over time and will enable the development of the first national mental health profile for children and young people (aged from pre-birth to 17 years). Updated every four years, the profile will result in a greater understanding of the current and changing picture of mental health within this population and the factors that influence it.

The final briefing paper (2011) provides a summary of the final output from the work including the indicators, their measures and associated data sources and recommendations. Please note that since the launch of the indicators on 25th November 2011, there has been a minor revision to one of the measures for the Education Indicator. The measure concerned had related to P3, P5, P7 and S2 pupils and reading and writing. The revised measure relates to just P3, P7 and S2 pupils and only reading.

The Final report for the children and young people's mental health indicators and Appendices describe in detail the background to the work, the process undertaken in creating the indicators, the rationale and achievements of the project.

The report includes:

• the framework of constructs (categorising conceptual elements) within which the indicators are structured
• working understandings for the constructs, an overview of the evidence-base for the constructs and indicators
• the indicators
• measures and their data sources, including the questions and scales used
• the recommendations.

Overlaps with other Scottish policies and strategies for children and young people are also highlighted.

A next step is reporting on the indicators to create a national mental health profile. NHS Health Scotland is producing an update of the adult mental health profile. When this is completed in 2012, work on the children and young people's mental health profile will follow with a view to complete late 2013.

Event to launch the completed indicator set, 25 November 2011

The children and young people's mental health indicator set for Scotland was launched on 25 November 2011. The programme for the event included presentations by:

• Tam Baillie, Scotland’s Commissioner for Children and Young People - setting the scene for the conference
• Jane Parkinson, NHS Health Scotland - summarising the process undertaken, the indicators themselves, issues and next steps
• Geoff Huggins, Scottish Government - responding on behalf of the government's Mental Health Division
• Boyd McAdam, Scottish Government - linking the indicators to Getting it Right for Every Child (GIRFEC) and the Early Years Framework
• Derrick Bruce, Education Scotland - linking the indicators to Curriculum for Excellence
• Sir Harry Burns, Scottish Government - linking the indicators to creating mental health in early life featuring the assets-based model.

View videos of the presentations. The report on the event to launch the completed indicator set describes the event and provides a summary of the feedback from delegate discussions.

Background and process

Scottish Government commitment to these indicators was restated in Towards a Mentally Flourishing Scotland: Policy and Action Plan 2009-2011 (external link). The work followed a similar course to that for the adult mental health indicator set. As well as taking into account current policy, data, the evidence-base, expert opinion and theory the views of children and young people (through a literature review and focus groups) also informed the development of the indicators.

The process involved:

• reviewing the evidence, including that from children and young people, to determine a desirable set of indicators and a suitable framework
• consulting on a draft framework via a large national event with stakeholders, an electronic consultation with key experts, organisations and networks and focus groups with specific groups of children and young people whose views on what impacts on their mental health were inadequately represented in the literature
• reviewing and assessing the suitability of relevant administrative and survey data, currently collected nationally in Scotland, and of existing national indicators
• aligning with wider policy initiatives, specifically identifying overlaps with existing indicators sets and outcome measures in current policy and initiatives
• identifying robust indicators which can be reported on using existing data
• identifying additional data needs for desirable data-less indicators and priorities for new data collection to fill these data gaps
• exploring opportunities to collect the recommended new data, and working to influence existing data collection systems to fill these additional data needs
• ensuring the sustainability of data for the indicator set.

A launch event was held in April 2008 in Glasgow. An initiation document (2008) outlining initial thinking for the work together with a document showing some possible frameworks (2008) for the indicators were shared with delegates and informed debates around issues raised in the initiation document. The event report (2008) summarises the event and the feedback from delegate discussion around specific issues posed to delegates.

This feedback informed discussions with the expert advisory group for the Children and Young People's Mental Health Indicators programme. This led to the revision of some of the thinking outlined in the initiation document. The revised thinking and the background to the work are laid out in Children and Young People's Mental Health Indicators: Background Briefing May 2009.

A draft framework was consulted on (March – June 2010) and the findings informed the development of the final framework and indicator set.
The consultation consisted of:

• a large scale national event, 1 March 2010
• an electronic consultation, mid April to end of May 2010 (via a consultation document setting out the background to the work, the rationale (an overview of the evidence-base) for the constructs in the framework, a working understanding for each construct and possible indicators for illustration)
• commissioned consultation with specific groups of children and young people whose views, on what impacts on their mental health, are not adequately represented in the literature (see below for literature review)

Summaries of the main consultation comments are provided in Briefing Update September 2010.

Future steps

• reporting on the indicators
• maintenance of the indicators: maintaining the existing data (sustainability) and updating/revising the indicators, if required
• improving data for the indicators, including filling data gaps. To date, the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) was included in the Scottish Adolescents Lifestyle and Substance Use Survey (external link) (SALSUS) 2010
• support for local use of the indicators

Commissioned supporting work

• The Warwick-Edinburgh Mental Well-being Scale (WEMWBS) has being validated for use with individuals aged 13 to 16, in the WAVES project. Information on this work and the final report are available on the Measuring Mental Wellbeing page. The main recommendation is that: WEMWBS is suitable for use at a population level to measure mental wellbeing in teenagers amongst those aged 13 years and over. It is safe to use in samples of over 100 people. The Scottish Adolescents Lifestyle and Substance Use Survey (external link) included WEMWBS from 2010 enabling data on the mental wellbeing of S2 and S4 school children (mainly ages 13 and 15 years) to be collected.
• A critical review of the literature on children and young people’s views of the factors that influence their mental health (2009). This assessed both published peer-review journal articles and grey literature since 1999. Findings are being used to inform the framework for the indicators as well as the indicators themselves.
• Consultation with specific groups of children and young people on the draft children and young people's mental health indicators framework. This consulted with nine groups of children and young people whose views were inadequately represented in or absent from the literature. A Centre for Research on Families and Relationships (CRFR) briefing on the consutlation is available on the CRFR website (external link) and a young people's summary is also available. The findings informed the framework for the indicators as well as the indicators themselves.

Contact

If you have comments on the indicators project or require further information please contact Jane Parkinson – jane.parkinson@nhs.net.

Updated 22 May 2012