Access to counsellors in secondary schools and children and young people’s community mental health services: summary report - January to June 2023

Due to the wide-ranging nature of the services involved in delivering support that meets the distinct needs of different communities, data may be recorded in various ways by the services. The information provided in the local authority reports and set out below reflects this, and means that subtotals and totals do not always add up to the same figure.

Access to counsellors in secondary schools

Children and young people accessing the service

In total across all returns, 14,290 children and young people were recorded as having accessed counselling services between January and June 2023.

There were more girls (63%) than boys (36%) recorded as accessing counselling provisions. 1% of young people who accessed counselling services did not identify as male/female or preferred not to specify their gender. This remains much the same split as with previous years.

For those local authorities who provided a breakdown of pupils by year group, the two year groups with the highest total number of service users were S2 and S3.

Year group	P6	P7	S1	S2	S3	S4	S5	S6
No of pupils	1166	1600	2032	2502	2730	2041	1352	744

A small number of pupils accessing the service were not attending school or did not specify which year group they were in.

Number of school counsellors

Authorities reported 591 school counsellors in post during this period. It is important to note that this figure relates to counsellor numbers rather than Full Time Equivalent (FTE). Between January and June 2023, authorities reported a total of 7,141 hours of counselling being provided per week across the country. This is higher than the figure of 6,285 hours in the second half of 2022. However, this rise might be attributed to data improvement over the period.

A few authorities highlighted they are working at capacity throughout the year and that the service is in high demand.

Outcomes

The overall picture on improving children and young people’s outcomes is positive. The returns from local authorities recognise that there are a number of pupils who are currently continuing to access counselling, and have not yet completed an evaluation. However, recognising this, it is clear that 7,372 children and young people have improved outcomes as a result of receiving counselling in this reporting period.

Referrals

The majority of recorded referrals came from school staff.

Referral	Total recorded across LA reports
Self-referral	1,544
School staff	11,097
Social services	43
GP	83
School nurse	29
Health professional	69
Other	328

Local authorities were also asked about onward referrals which were split between CAMHS, Child Protection and other services.

Onward referrals	Total recorded across LA report
CAMHS	545
Child Protection	215
Other Service	470

The onward referrals to ‘other services’ reflected the different services which are available in local authority areas, for example third sector organisations. Children and young people could also be referred on to other health services, for example GPs.

Reasons presented by children and young people

There was wide variation across local authorities on the reasons reported by children and young people accessing counselling services. Officials provided authorities with ten suggested reasons in which children and young people may present. The following table shows the total number of children and young people that presented with those reasons.

Reasons presented by children and young people	Total
Anxiety	7203
Emotional/behavioural difficulties	3188
Depression	2329
Exam stress	1899
Self-harm	1840
Bereavement	1603
Trauma	1492
Body image	1017
Gender identity	426
Substance use	336

Local authorities were invited to offer further categories based on their own locality needs. A total of 93 other reasons were reported, including reasons such as family issues, relationships, self-esteem, anger, bullying and identity. A full list is included below. This again confirms that young people are dealing with a wide range of concerns within their lives and continues to demonstrate the need for young people to be able to access support quickly, and effectively for their mental health and wellbeing.

The following is a combined list of further reasons reported by local authorities, for which children and young people sought the support of counselling services.

Additional presenting reasons	Total
Self-esteem	2002
Family	1807
Relationships	1640
Anger	1205
Low mood	831
Bullying	801
Suicide	753
Family relationships	610
Stress	507
Stress at Home	457
Interpersonal/Relationship	438
Self-worth	422
Eating Disorder	381
Peer relationships	311
Self Confidence	261
Negative coping strategies	257
Behaviour	216
Relationships with peers/teachers	203
Work/academic	193
Academic Issues	179
Loneliness	171
Loss	165
Sexual orientation/sexuality	161
Family breakdown/difficult relationships	159
Isolation/Loneliness	151
School Issues	139
Emotional regulation	134
Self Identity	130
Social Issues	129
Other	114
Health	107
Family difficulties	103
Sleep issues	97
Affected by another user’s substance use	94
Parental separation	88
Neurodiversity	84
Abuse	69
Welfare Issues	34
Social media bullying	32
Parental issues	31
Worry	25
Additional support needs	23
Attendance/avoidance	22
Self harm	22
Transition/loss	22
Unwanted sexual experiences	21
Relationships (bf/gf)	20
OCD	18
Attachment	17
Domestic abuse	16
Substance use	16
Illness	15
Overwhelmed	14
Carer	13
Incongruence and understanding of self	12
Confidence	10
Distress	10
Resilience	10
Phobias	9
Chronic illness	8
Low motivation	8
Boundaries	7
Intrusive thoughts	7
Risk taking behaviour	7
Medical	6
Sexual abuse	6
ADHD	5
Neglect	5
Panic attacks	5
Young carer pressure	5
Cognitive learning	4
Disability	3
General wellbeing	3
Homelessness	3
Hyperactivity	3
Living/welfare	3
Suicidal acted upon	3
Concentration	2
Impact of illness	2
Race	2
Sensory issues	2
Addiction	1
Care experienced	1
Covid/lockdown stress	1
Difficulty managing emotions	1
Dissociation	1
Family addiction issues	1
Financial concerns	1
Gang issues	1
PDA	1
Tics	1
Trust	1
Witnessed violence/aggression	1

Children and young people’s community mental health and wellbeing supports and services

People accessing the supports and services

Local authorities reported that 58,281 people used the community-based supports and services between January and June 2023 (up from 45,523 in the previous six months), 5373 of whom were family members and carers. 

51% of the service users were recorded as female and 46% as male, and 3% were recorded as having identified in another way. 51% of the service users were of secondary school age, 40% were of primary school age and under, and 9% were of post-school age.

Type of support or service accessed

77% of users accessed positive mental wellbeing services and 23% accessed emotional distress services. Positive mental wellbeing services are generally preventative supports that are self-completed or may form part of general wellbeing education, e.g. digital cognitive behavioural therapy, presentations and training. Emotional distress services are generally supports led by staff in either a one-to-one or group setting, e.g. counselling, art therapy and practitioner-facilitated support groups.

In respect of service users from at-risk groups (i.e. those known to be at higher risk of experiencing poor mental health, such as care-experienced children or LGBT+ young people), 65% accessed positive mental wellbeing services and 35% accessed emotional distress services.

Referral routes

The most common routes into the community supports and services were again recorded as being through schools and self-referrals. The number of people referred by CAMHS increased to 1022 from 234 in the six months prior.

Referrals in	Total
School staff	12,962
Self	10,477
Health professional	1165
CAMHS	1022
Other	1018
Family member or carer	1003
Social work or child protection	999
Youth work	675
Third sector partner	492
Local community group	218
Police	16

The table below shows the range of onward referrals recorded by the community supports and services.

Onward referrals	Total
Youth work	931
Other	562
Benefits or financial advice	537
Third sector partner	467
Non-school counselling	369
School counselling	347
Parenting support	260
Health professional	237
CAMHS	236
Local community group	179
Social work or child protection	175
Domestic abuse support	171
Alcohol or drugs support	160
Autism support	149
Bereavement support	144
Educational psychology	126
Young carers	109
Housing or homelessness	102
Occupational or other therapy	77

Reasons for accessing the supports and services

As with previous reporting periods, anxiety was the most common reason recorded for people accessing the community supports and services. The categories below do not reflect formal diagnoses of mental health conditions, but are the reasons given to the services as to why people have sought support. Individuals may have presented more than once and/or with a number of different concerns.

Presenting reasons	Total
Anxiety	6724
Self-esteem or confidence	5491
Social interaction or peer relationships	3296
Emotional or behavioural difficulties	3085
Depression or low mood	2687
Family relationships or issues at home	2673
School issues or exam stress	2112
Trauma	1813
Self-harm	1498
Body image or eating concerns	1475
Neurodevelopmental, ASD or ADHD	1427
Isolation or loneliness	1411
Distress	1336
Other	1170
Resilience	1028
Support for parents or parental mental health	990
Suicidal thoughts or actions	965
Anger	953
Physical health	947
Substance use by self or family	941
Poverty or homelessness	896
Bereavement	843
Sleep	758
Bullying, harassment or discrimination	691
Gender identity or sexuality	665
Emotional literacy	651
Routine and boundaries	536
Violence, domestic abuse or sexual offences	500
Learning support	280
Fears or phobias	242

Outcomes

Of the service users who were recorded as having used a positive mental wellbeing service, 15,086 (50%) said that they had an improved outcome. Of those who used an emotional distress service, 4863 (53%) said that they had an improved outcome.

Of the service users in at-risk groups who were recorded as having used a positive mental wellbeing service, 2733 (64%) said that they had an improved outcome. Of those who used an emotional distress service, 1500 (64%) said that they had an improved outcome.

It should be noted that these figures are unlikely to reflect the full impact of the supports and services. In some cases, the person will still have been in receipt of support and will not have been ready to be asked about outcomes. It is also particularly challenging to assess the impact of supports that are preventative in nature, as is the case for many positive mental wellbeing services. In addition, local authorities are not obliged to report data on at-risk groups.