Access to counsellors in secondary schools and children and young people’s community mental health services: summary report – January to June 2022

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, 14,508 children and young people were recorded as having accessed counselling services between January and June 2022. 

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.

P5	P6	P7	S1	S2	S3	S4	S5	S6
24	1348	1817	1721	2292	2572	2104	1248	691

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 432 school counsellors in post during this period. It is important to note that this figure relates to counsellor numbers rather than FTE. Between January-June 2022, authorities reported a total of 5025 hours of counselling being provided per week across the country. This is significantly higher than the figure of 2250 hours in the second half of 2021. 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 6325 children and young people have improved outcomes as a result of receiving counselling. 

Referrals 

The majority of recorded referrals came from school staff. 

Referral	Total recorded across LA reports
Self-referral	1038
School staff	11,304
Social services	15
GP	116
School nurse	26
Health professional	47
Other	287

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	414
Child protection	104
Other service	143

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. 

Issues presented by children and young people

There was wide variation across local authorities on the issues reported by children and young people accessing counselling services. Officials provided authorities with ten suggested categories of issues with which children and young people may present.

• exam stress
• trauma
• bereavement
• gender identity
• substance use    
• self-harm
• depression 
• anxiety 
• emotional/behavioural difficulties 
• body image

Local authorities were invited to offer further categories based on their own locality needs. A total of 77 other issues were reported, including issues 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 issues reported by local authorities, for which children and young people sought the support of counselling services. 

Number	Additional presenting issues	Total
1	Family	2843
2	Anger	1136
3	Self-worth	902
4	Bullying	757
5	Self-esteem	605
6	Relationships	604
7	Interpersonal/relationship	499
8	Stress	468
9	Peer relationships	443
10	Low mood	425
11	General wellbeing	406
12	Eating disorder	280
13	Stress at home	275
14	Suicidal	208
15	Self and identity	178
16	Suicidal ideation	171
17	Work/academic	166
18	Behaviour	163
19	Negative coping strategies	148
20	School issues	131
21	Health	93
22	Sleep issues	85
23	Social issues	78
24	Parental separation	74
25	Cognitive learning	65
26	COVID/lockdown stress	55
27	Isolation/loneliness	49
28	Transition/loss	49
29	Abuse/online	43
30	Attention difficulties	37
31	Attendance/avoidance	29
32	Sexual orientation/sexuality	28
33	Additional support needs	25
34	Sexuality issues	23
35	Social media bullying	22
36	Sexual trauma	21
37	Care-experienced	20
38	Panic attacks	18
39	Incongruence and understanding of self	17
40	Racist abuse	15
41	Loss	14
42	Attachment	13
43	Domestic abuse	13
44	Neurodiversity	12
45	Parental issues	11
46	Witnessed violence/aggression	11
47	Unwanted sexual experiences (online)	10
48	Dyslexia	9
49	Suicidal acted upon	8
50	Achievement	5
51	Compulsive behaviours	5
52	School refusal	4
53	Unwanted sexual experiences	4
54	Illness	3
55	Personality problems	3
56	Sexual abuse	3
57	"Overthinking"	2
58	Child protection	2
59	Difficulty managing change	2
60	Emotional regulation	2
61	Living/welfare	2
62	Other mental health diagnosis	2
63	Stress at work	2
64	Welfare issues	2
65	Young carer pressure	2
66	Auditory/visual hallucinations	1
67	Gang issues	1
68	Hallucinations	1
69	Health eating	1
70	Historic sexual abuse	1
71	Homelessness	1
72	Impact of illness	1
73	Intimate image shared without consent	1
74	Neglect	1
75	OCD	1
76	Offending	1
77	Online grooming	1

Mental Health in Schools Working Group update

In 2019, the Mental Health in Schools Working Group was established to support the Scottish Government’s ongoing commitment to supporting positive mental health in children and young people in school. The Working Group has overseen the development of new resources for school staff. This includes the Children and Young People’s Mental Health and Wellbeing: A Professional Learning Resource For All School Staff. This online resource is primarily aimed at school staff to support the wellbeing of children and young people within their schools, but anyone who wishes to upskill can access the learning. The working group has also developed a Whole School Approach Framework, to assist schools in responding to and supporting children and young people’s mental health.

In September 2023, the total number of users registered for the Professional Learning Resource was 3438. 

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

People accessing the supports and services

Local authorities reported that 38,342 people used the community-based supports and services during the reporting period (up from 18,578 in the previous six months). 4922 of these people were family members and carers (up from 762 previously). 

52% of the service users were recorded as female and 43% as male, and 5% were recorded as having identified in another way. 56% of the service users were of secondary school age, 38% were of primary school age and under, and 6% were of post-school age.

Type of support or service accessed

71% of users accessed positive mental wellbeing services and 29% 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), 57% accessed positive mental wellbeing services and 43% accessed emotional distress services.

Referral routes

The most common routes into the community supports and services were recorded as being through school staff and referral by self, family or carer. The number of people referred by CAMHS and other health professionals was 1857 (up from 1037 in the previous six months).

Referrals in	Total
School staff	6929
Self, family or carer	5506
Health professional	1478
Police	1411
Social work	949
CAMHS	379
Other	1823

The table below shows recorded onward referrals from the community supports and services, most of which were made to other organisations such as those in the third sector.

Onward referrals	Total
Non-school counselling	246
Social work or child protection	224
Youth work	210
CAMHS	130
School counselling	116
Autism support	83
Educational psychology	52
Young carers	29
Other	2002

Reasons for accessing the supports and services

The most commonly recorded reasons for people using the supports and services were anxiety, family relationships or home issues, and seeking support for parents. 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	5033
Family relationships or home issues	4023
Support for parents	3445
Self-esteem or confidence	2860
Emotional or behavioural difficulties	2431
Social interaction or peer relationships	2247
Depression or low mood	2107
School issues or exam stress	2105
Resilience	1566
Trauma	1525
Self-harm	1425
Poverty or homelessness	1201
Isolation or loneliness	1193
Distress	909
Body image or eating concerns	892
Bereavement	802
Suicidal thoughts	767
Bullying	764
Routine and boundaries	748
Substance use by self or family	745
Neurodevelopmental	592
Anger	556
Violence or abuse	555
Sleep	534
Gender identity or sexuality	474
Learning support	353
Emotional literacy	307
Physical health	204
Fear or phobias	84
Other	1179

Outcomes

Of the service users who were recorded as having used a positive mental wellbeing service, 7030 (28%) said that they had an improved outcome. Of those who used an emotional distress service, 2718 (27%) 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, 1360 (42%) said that they had an improved outcome. Of those who used an emotional distress service, 792 (33%) 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.