THE Scottish Government’s announcement of major investment in mental health services for children and young people – including specialist staff for schools and colleges – is welcome and overdue ("Action on mental health crisis in education at core of Government's programme", The Herald, September 5).

But it will not be effective unless it truly takes on the need to address childhood trauma and adverse childhood experiences (Aces) throughout those services. For many vulnerable young people, that will also mean integrating their mental health support with child protection, if they are currently at risk or in danger.

Barnardos’ recent audit of rejected referrals to the Children & Adolescent Mental Health Service (CAMHS) trenchantly reminded us: “It is estimated that one in three adult mental health conditions relate directly to Aces. We know that children’s behaviour is a form of communication which is often masking deeper underlying issues. Provision of mental health support for children and young people must keep pace with this knowledge and reflect the complexities of children’s lives – rather than continuing with a model based on diagnosis or disorder.”

Scotland’s health services are now officially committed to creating a trauma-informed workforce. The Scottish Government needs to ensure at least three actions are taken, to make this meaningful for young people.

1) CAMHS must be radically overhauled, to serve real young people’s needs. It is not fit for purpose. In particular it has been found both by NSPCC Scotland and Barnardos’ research to reject the very young people who display common signs of reaction to abuse, such as instability, substance misuse, emotional and behavioural problems. Barnardos say of CAMHS: “Life experiences and environmental factors are seen as unrelated to mental health, rather than inextricably linked.”

2) NSPCC Scotland’s 2017 report the Right to Recover, showing a severe lack of therapeutic services for sexually abused children, revealed that most generalist and specialist services were provided by the third sector. Not only are more such services urgently needed: the short-term insecure funding of such third sector agencies must be strengthened, as one vital part of the mental health improvement plan.

3) If distressed or acting-out children and teenagers are to reveal shameful issues such as sexual abuse and exploitation, or violence at home, they need confidence-building projects such as Stop to Listen. This was recently pioneered imaginatively in three Scottish local authorities, but its funding has now ended. And if school staff are to help these young people, they must finally stop being afraid to ask.

Sarah Nelson,

22 Seacraig Court,

Newport on Tay,