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

An analysis of information provided by local authorities on the school counselling service and community mental health support in their area from 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.


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. 


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
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
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
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


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.

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