Access to counsellors in secondary schools and children and young people’s community mental health services: summary report – July to December 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, 13,150 children and young people were recorded as having accessed counselling services between July and December 2022. 

There were more girls (64%) than boys (35%) 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. 

Where a breakdown of pupils by year group is available, the two year groups with the highest total number of service users were S3 and S4.

<P5	P6	P7	S1	S2	S3	S4	S5	S6
167	830	1119	1531	2192	2593	2275	1628	846

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 546 school counsellors in post during this period. This compares with 432 counsellors in post during the first half of 2022 and 405 counsellors in the second half of 2021. It is important to note that this figure relates to counsellor numbers rather than FTE. Between July and December 2022, authorities reported a total of 6285 hours of counselling being provided per week across the country. This compares with 5025 hours of counselling provided per week in the first half of the year. 

A few authorities highlighted that 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. Recognising this, it is clear that 5916 children and young people have improved outcomes as a result of receiving counselling during this period. 

Referrals 

The majority of recorded referrals came from school staff. 

Referral	Total recorded across LA reports
Self-referral	1367
School staff	10,781
Social services	117
GP	85
School nurse	25
Health professional	75
Other	294

Local authorities were also asked about onward referrals. Referrals to CAMHS in this period (374) were lower than in the first half of 2022 (414) although higher than the same period in 2021 (328). There has been an increase in referrals to child protection, rising from 91 in the second half of 2021 to 104 in the first half of 2022 and 176 in the second half of 2022. Onward referrals to other services in this period (175) were higher than the first half of 2022 (143), although lower than the same period in 2021 (318). 

Onward referrals	Total recorded across LA report
CAMHS	374
Child protection	176
Other services	175

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 63 other issues were reported, including issues such as family, 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.

Number	Additional presenting issues	Total
1	Family	2994
2	Self-esteem	2612
3	Relationships	2013
4	Bullying	1021
5	Anger	977
6	Stress	687
7	Suicidal ideation	519
8	Low mood	511
9	Eating disorder	429
10	Other	311
11	School refusal	241
12	Self-worth	236
13	Self-identity	233
14	Relationships with peers/teachers	163
15	Parental issues	148
16	Work/academic	134
17	Sleep issues	130
18	Social issues	125
19	Behaviour	111
20	Interpersonal/relationship	103
21	Someone else's substance use	94
22	Health	83
23	Negative coping strategies	77
24	Suicidal	72
25	Sexual orientation	69
26	Sexuality issues	65
27	Abuse	42
28	Attendance/avoidance	29
29	Social media bullying	28
30	Emotional regulation	23
31	Illness	23
32	Confidence	22
33	Welfare issues	20
34	Domestic abuse	15
35	Sexual abuse	15
36	Unwanted sexual experiences	13
37	Distress	12
38	Young carer pressure	12
39	Other people's mental health	11
40	School issues	10
41	Suicide plans/actions	9
42	Risk taking behaviour	7
43	Transition/loss	7
44	Self-regulation	6
45	Compulsive behaviours	5
46	Concentration	4
47	Difficulty engaging	4
48	Sexual trauma	4
49	Living/welfare	3
50	OCD	3
51	Cognitive learning	2
52	Loneliness	2
53	Trust	2
54	Adverse childhood experience	1
55	COVID	1
56	Finance/poverty	1
57	Isolation/loneliness	1
58	Neglect	1
59	Noise sensitivity	1
60	Online behaviour	1
61	Personality problems	1
62	Tourette's	1
63	Witnesses violence/aggression	1

Presenting reasons were largely similar with previous years, other than two notable increases. Children and young people presenting with exam stress rose from 12% in the first half of 2022 to 19% in late 2022. Children and young people presenting with bereavement as an issue rose from 10% in early 2022 to 21% in late 2022. There was also a rise from 605 children and young people presenting with self-esteem as an issue in early 2022 to 2612 in the second half of 2022. 

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

People accessing the supports and services

Local authorities reported that 45,523 people used the community-based supports and services during the reporting period (up from 38,342 in the previous six months), 4298 of whom were family members and carers. 

51% of the service users were recorded as female and 44% as male, and 5% were recorded as having identified in another way. 56% of the service users were of secondary school age, 39% were of primary school age and under, and 5% were of post-school age.

Type of support or service accessed

72% of users accessed positive mental wellbeing services and 28% 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), 45% accessed positive mental wellbeing services and 55% accessed emotional distress services.

Referral routes

The most common routes into the community supports and services were recorded as being by self-referral and through school staff.

Referrals in	Total
Self	10,569
School staff	9752
Health professional	1268
Social work or child protection	1083
Police	986
Other	951
Family member or carer	774
Third sector partner	240
CAMHS	234
Youth work	234
Local community group	132

The table below shows that recorded onward referrals from the community supports and services were made to a range of different places.

Onward referrals	Total
Other	670
Parenting support	503
Local community group	481
Third sector partner	264
Social work or child protection	237
Health professional	234
CAMHS	221
Benefits or financial advice	212
Autism support	192
Non-school counselling	144
School counselling	127
Bereavement support	97
Youth work	87
Young carers	63

Reasons for accessing the supports and services

The most commonly recorded reasons for people using the supports and services were anxiety and family relationships or issues at home. 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	5265
Family relationships or issues at home	3848
Emotional or behavioural difficulties	3114
Self-esteem or confidence	3004
Support for parents or parental mental health	2773
Poverty or homelessness	2674
Depression or low mood	2622
Social interaction or peer relationships	2166
School issues or exam stress	1763
Trauma	1745
Self-harm	1435
Other	1223
Suicidal thoughts or actions	1145
Emotional literacy	1139
Resilience	1018
Violence, domestic abuse or sexual offences	924
Neurodevelopmental, ASD or ADHD	856
Isolation or loneliness	853
Bereavement	804
Body image or eating concerns	789
Substance use by self or family	772
Routine or boundaries	711
Bullying, harrassment or discrimination	706
Distress	661
Sleep	599
Anger	580
Gender identity or sexuality	521
Physical health	260
Learning support	250
Panic attacks	128

Outcomes

Of the service users who were recorded as having used a positive mental wellbeing service, 10,382 (45%) said that they had an improved outcome. Of those who used an emotional distress service, 3617 (40%) 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, 1054 (34%) said that they had an improved outcome. Of those who used an emotional distress service, 933 (24%) 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.