Transcript National and local perspectives on population indicators for children

National and local perspectives on population indicators for
children and young people’s mental health in Scotland
Dr Jane Parkinson
Public Health Adviser, NHS Health Scotland
and
Dr Allyson McCollam
Head of Health Improvement, NHS Borders
Scottish Faculty of Public Health Conference
Aviemore, 10th November 2011
www.healthscotland.com/scotlands-health/population/mental-health-indicators/children.aspx
Presentation Overview
• Background - aim and rationale
• Process
• Input from C&YP
• Indicators – framework, data gaps
• Issues and recommendations
• Relevance to other policy agendas
• Local perspective
• Final and future steps
Background - aim and rationale
• National, sustainable mental health indicators for C&YP
• TAMFS commitment 4
• MH profile – decision-making, policy development & accountability
• Mental health = wellbeing and problems
• Mental health state & associated contextual factors
• National level but….. suitable for local use where applicable
• Children and young people aged 0-17 (pre-birth, adults if impacts)
• General population of children and young people
Process
• Built on adult experience
• Mixed approach
• Views of children and young people
• Desirable set, data scoping, practical set, data gaps, new data
• Modified adult indicators framework – consultation 2010
HIGH LEVEL CONSTRUCTS
Mental wellbeing
Mental health problems
CONTEXTUAL CONSTRUCTS
Individual
Family
• Supporting work
• Expert advisory group
Learning Env’ment
Community
Structural
Children and young people’s input
• Review of views on impacts on mental health, Shucksmith et al
– largely agreed with content of draft framework
– informed development of framework & indicators
– limitation – some C&YP groups under represented or absent
• Focus group consultation on draft framework – Elsley & McMellon
– early years, BME, learning disabilities, carers, gypsy travellers, in care etc
– framework largely endorsed but certain areas talked about less
– strong emphasis on relations
– some issues specific to individual groups
– resource supplement indicators framework
HIGH LEVEL CONSTRUCTS
Mental wellbeing
Mental health problems
CONTEXTUAL CONSTRUCTS
Individual
Family
Learning
Environment
Community
Structural
Learning and
development
Family relations
Involvement
Participation
Equality
Healthy living
Family structure
Peer & friend
relationships
Social networks
Social inclusion
General health
Parental healthy
living
Educational
environment
Social support
Discrimination
Spirituality
Parental health
Pressure and
expectations
Trust
Physical
environment
Safety
Violence
Emotional
intelligence
Life events
Culture and
values
High Level
• Mental wellbeing
– Mental wellbeing
 some ages data-less
– Life satisfaction
– Happiness
– Pro-social behaviour
High Level
• Mental health problems
– Common mental health problems
– Emotional and behavioural problems
– Emotional symptoms
– Conduct problems
– Hyperactivity/inattention
– Sadness
– Alcohol dependency
– Drug-related disorders
– Suicide
– Self-harm
– Eating disorders
Individual
• Learning and development
– Play
– Readiness for school
• Healthy living
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Physical activity
Healthy eating
Obesity
Alcohol, drug, cigarette consumption
Sexual health
• General health
– Self-reported health
– Long-standing & limiting long-standing illness
• Spirituality, Emotional intelligence
• Life events
– Stressful life events
– Adverse childhood experiences
• Family relations
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Parent-child relationship
Nurturing adult
Family meals
Talking to mothers/fathers
Treatment by parent(s)
Parental discord
Caring for family members
Family
• Family structure
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Lone parent family
Reconstituted family
Contact with non-resident birth parent
Teenage parents
Parental imprisonment
• Parental healthy living
– Maternal smoking in pregnancy
– Maternal alcohol/drug use in pregnancy
– Parental problematic alcohol/drug use
• Parental health
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Parental mental wellbeing/common mental health problems
Post natal depression
Parental alcohol dependency
Parental limiting long-standing illness
• Engagement with learning
– Pre-school home learning environment
– School attendance
– Liking of school
• Peer and friend relationships
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Early years friendships
Close friends
Relationship with best friend
Peer relationships problems
Acceptance by peers
Experience of/participation in bullying
• Educational environment
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Treatment by teachers
Relationship with teachers
Relationship with all school staff
Control at school
School ethos
• Pressures and expectations
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Time pressures
Choice of how to spend free time
Pressure of school work
Pressure to succeed
Pressure to fit in
Learning
Environment
Community
• Participation
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Sense of agency
Respect of children’s rights
Influencing local decisions
Participation in clubs, groups, or organisations
• Social networks
– Contact with peers
• Social support
– Social support
• Trust
– Neighbourhood trust
– Community cohesion
– Informal social control
• Safety
– Neighbourhood safety
• Equality
– Absolute/relative/persistent poverty
– Income inequality
• Social inclusion
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Structural
Workless households, Homeless
Positive and sustained destinations, Education, School exclusion
Feeling lonely
Looked after children, Additional support for learning
• Discrimination
– Discrimination and harassment
– Perception of attitude of adults towards children and young people
– Stigma towards children and young people
• Physical environment
– Neighbourhood satisfaction, Free time places
– Greenspace
– House condition, Overcrowding
• Violence
– Domestic abuse, Child protection
– Neighbourhood violence
• Culture
– Perception of looks, Body image
– Culture and values
Key Issues
• Data source limitations
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disaggregation
limited age coverage
representativeness
sustainability
• What’s measurable v. what desirable – gaps in data coverage
- all ages, especially early years
- all areas, eg learning & dev’t, life events, maternity, discrimination, violence
- suitable assessment tools
• Raising awareness and Influencing data collection systems
- SALSUS - WEMWBS
• Maintaining links with other policy agendas
• Evidence-base
Recommendations
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43 recommendations – 38 data gaps
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Ranking exercise - criteria
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advisory group ranking
data improvement initiatives
policy imperative
ease of assessment – available methodology
feasibility of introducing new data collection
Classification
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essential
desirable and data initiatives to link with
desirable, if future data improvement opportunity consider
Links to other agendas
• Scottish Government strategic outcome indicators
• Getting it Right For Every Child (GIRFEC)
• Curriculum for Excellence
• Early Years Framework
• Equally Well
• Achieving Our Potential
• Youth Justice Framework
• Promoting Positive Outcomes
• Skills for Scotland: A Lifelong Skills Strategy
• Good Places, Better Health
• Government Economic Strategy
National Performance Framework - Greener
Good Places, Better Health
Sustainable
Development
indicators
Scottish Government strategic outcome indicators
Sustainable
Sustainable
development
development
Environmental
National Performance Framework Safer and Stronger
Social
capital
Volunteering
justice
Early years framework
Anti-social
behaviour
Physical
environment
Maternal & Infant
Nutrition Strategy
Lifestyles
Environment
Safety,
Trust
Health
Violence,
Domestic
abuse
Mental Health/
Indicators
Crime
NPF Healthier
Communities
Mental
health
Physical
health
Education
Social
justice
Equality
Relationships
Enterprise and
lifelong learning
Spirituality
Discrimination
Youth Justice
Framework
Skills and
learning
Social
inclusion
Rights of the child
Debt
National Performance Framework Wealthier and Fairer
Long term indicators for health inequalities
Employment
Work place
environment
GIRFEC
- SHANARRI
Curriculum for
Excellence
Achieving Our Potential
National Performance Framework - Smarter
Equally Well
Economic strategy – Learning, skills and wellbeing
Final and Future steps
• Final indicator set launch event 25th November 2011
• Dissemination and reporting on data
• Potential wider use
– Adults examples;
• Local mental health profile
• Strategic thinking
• Mental health improvement outcomes framework
• Strengthening the link to the determinants
• SOAs
• Future
Contact details
Dr Jane Parkinson – Mental health indicators
Public Health Adviser, NHS Health Scotland
[email protected]
Allyson McCollam – Chair of the Advisory Group
Head of Health Improvement, NHS Borders
[email protected]
Children and Young People’s Mental Health Indicators
www.healthscotland.com/scotlands-health/population/mental-health-indicators/children.aspx
WEMWBS
www.healthscotland.com/scotlands-health/population/Measuring-positive-mental-health.aspx