Empowering young people and supporting them to thrive, not just survive, will require a Human Rights approach in mental health care

Professor Dame Sue Bailey argues that Human Rights and values-based practice should be at the heart of mental health services for children and young people 

Autonomy, control and participation are all key to Human Rights values and are protected by the right to respect for private life. All the rights in the Human Rights Act apply to young people the same as they apply to adults. 

For those working outside the field of mental health, ‎up until very recently, mental health had not received the same attention as physical health. People with mental health problems frequently experience stigma and discrimination, not only in the wider community, but also from services. Only as recently as 2012 did mental health achieve "parity of esteem" in law with physical health, through the Health and Social Care Act.

The case for more funding and resourcing of prevention and reducing the risk of onset of mental health problems in the early years is well rehearsed as a cost-effective way to help deliver sustainable health care in the future. But surely the key reason is to uphold the Human Rights of all young people? Who would want to argue with giving every child the best start in life? But prevention still sits uncomfortably with commissioners and acute providers of services, as they struggle to resource health services day to day.

We know health inequalities are evident at early stages and inequalities accumulate. Is it not a Human Rights approach to support young people to thrive, not just survive?

The first two limbs of sustainability in health care are disease prevention and patient empowerment. Where better to ‎progress this than in CAMHS where, working with young people, we can also reduce waste whilst listening to their views about their care and treatment together; choosing wisely through shared decision-making?  

With the ongoing delivery of Future in Mind, the soon-to-be-delivered Green paper, ongoing concerns about out of area placements for children with acute mental illness, focus by the Care Quality Commission on standards of care and review of restrictive practice and restraint across mental health care‎, and extant review of the Mental Health Act, it is time to act on the 2016 recommendations of the Values-based child and adolescent mental health system commission.

Put simply, what we mean by "values" is what matters or what is important to those concerned‎. When differences in perspectives between all stakeholders in what matters or is important are openly acknowledged and understood by all parts of the system ‎it becomes possible to develop a framework of shared values within which balanced decisions can be made in partnership between those involved, acting in the best interests of children and young people and meeting their mental health needs. 

It is time to encourage practitioners and managers in child and adolescent inpatient services to understand restrictive practice and restraint and that young people having a say in their own care and treatment is a fundamental Human Rights matter.

‎Maybe in the Human Rights debate it's also time to think of young people's whole person care and see how we can challenge the current mind-body dualism. ‎Let’s look at how we can support all young people with any health problem to gain a sense of meaning, purpose, control and positive social identity across all areas of their life. No diagnosis of exclusion, no vulnerability ignored.

Prevention, protection, provision – only if done in partnership with the young person.

Professor Dame Sue Bailey is Chair of the Children and Young People’s Mental Health Coalition