Mental Health and Wellbeing Strategy: Initial Monitoring Report and Monitoring Framework
The first monitoring report outlining progress towards Scotland’s Mental Health and Wellbeing Strategy outcomes, supported by an accompanying monitoring framework.
Short-term outcome 8: People know that it is okay to ask for help and have someone to talk to and listen to them.
Short-Term Outcome 8 (STO8) of the Mental Health and Wellbeing Strategy outlines that people know that it is okay to ask for help and have someone to talk to and listen to them.
Metrics for monitoring STO8 are grouped under two core components of the outcome:
1. People know that it is okay to ask for help
2. People have someone to talk to and listen to them
Table 24 presents the specific metrics grouped under each component.
Table 24: Metrics for Monitoring Short-term Outcome 8
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Core components |
Metrics |
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People know that it is okay to ask for help |
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People have someone to talk to and listen to them |
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The following sections present each of these components and associated metrics in detail, offering insight into baseline measures and observed changes related to STO8.
1. People know that it is okay to ask for help
The first component on Short-Term Outcome 8 outlines that people know that it is okay to ask for help. There are five metrics used to monitor this component.
It is important to note that while increases in these measures may indicate improved awareness and willingness to ask for help, they may also reflect rising demand for services due to increasing levels of need.
Number of children and young people self-referring to school counselling
The Scottish Government collects data from local authorities on access to school-based counselling. The latest report covers an interim nine-month period (July 2023 to March 2024), as reporting transitions from six-monthly to annual cycles aligned with the financial year. This change limits direct comparison with previous years.
Self-referral data to school counselling provides insight into the extent to which children and young people are able and willing to seek help for mental health concerns.
Between July 2023 and March 2024, 2,077 children and young people self-referred to school counselling services.
Number of people self-referring to community mental health services
The Scottish Government collects data from local authorities on access to community-based mental health support for children, young people and their families. The latest report covers an interim nine-month period (July 2023 to March 2024), as reporting transitions from six-monthly to annual cycles aligned with the financial year. This change limits direct comparison with previous years.
Self-referral data to community-based support and services provides insight into the extent to which people are able and willing to seek help from these services for mental health concerns.
Local authorities reported that 82,938 people used the community-based supports and services between July 2023 and March 2024, 10,120 of whom were family members and carers.
Between July 2023 and March 2024, 13,110 people self-referred to community supports and services. Self-referral was the second most common route into community supports and services after referral by school staff (21,494 referrals).
Percentage of GP patients whose last treatment or advice from their General Practice was for a mental health reason
Accessing primary care is often the first step for people experiencing mental health concerns, with most support being sought through self-referral (Audit Scotland, 2023). The proportion of GP consultations for a mental health reason provides an indication of whether people feel able to ask for help.
Data from the 2023/24 HACE survey show that among people who received treatment or advice from their GP, 10% reported that their most recent consultation was for a mental health reason.
Number of calls to NHS 24 for a mental health reason
The number of calls to NHS 24 for a mental health reason provides insight into whether people feel able to ask for help and access support when needed.
Operational statistics from NHS 24 started publishing data on calls to the Mental Health Hub [1] in the week starting 5 May 2024, with data updated weekly.
Between the week ending 5 May 2024 and the week ending 4 May 2025, a total of 149,416 calls were made to the Mental Health Hub. Analysis of the data shows that this is 2,819 calls on average per week. The lowest weekly total was 2,525 calls in the week ending 7 July 2024, while the highest was 3,500 calls in the week ending 5 January 2025.
Percentage of GP patients contacting out-of-hours services for a mental health reason
The HACE survey asks GP patients about their most recent attempt to get treatment when their GP was closed in the past 12 months. Monitoring out-of-hours contacts provides insight into whether individuals feel able to seek mental health support from other sources.
Among people seeking support for a mental health reason, NHS 24 was the most common out-of-hours contact, used by 63% of respondents, compared to 74% for people seeking care for other reasons. Contacting a family member or friend for advice was reported by 23% of mental health patients, compared with 11% for those seeking care for other reasons.
2. People have someone to talk to and listen to them
The second component of STO8 outlines that people have someone to talk to and listen to them. There are six metrics used to monitor this component.
Percentage of GP patients who feel listened to and were able to ask questions during mental health appointments
The HACE survey asked GP or out-of-hours patients about whether they felt listened to and were able to ask questions during their appointment.
Monitoring whether people feel heard and able to ask questions provides insight into whether individuals feel they have someone to talk to about their mental health.
In 2023/24, of those who contacted in-hours GP appointments for a mental health reason:
- 81% reported that they felt listened to.
- 82% reported being able to ask questions if they wished.
In 2023/24, of those who contacted out-of-hours services for a mental health reason:
- 69% reported that they felt listened to.
- 71% reported being able to ask questions if they wanted.
Number of Distress Brief Intervention (DBI) referrals
The Distress Brief Intervention (DBI) programme provides timely, compassionate, and practical support to people in distress, helping them feel heard and supported. Level 2 DBI services offer face-to-face support within 24 hours of referral, providing an opportunity for individuals to discuss their concerns with a trained professional. The number of DBI referrals gives insight into how many people are accessing support and have someone to talk to when in distress.
- As of 30 September 2024, there had been 73,926 referrals to the DBI Level 2 service (face-to-face support following an initial contact), including 21,949 via NHS 24 and 1,393 via the Scottish Ambulance Service. This compares to 40,280 referrals as of 31 March 2023.
- The average monthly referrals rose from 1,244 for the period from 1st October 2022 to 31st March 2023 to 1,913 in the first nine months of 2024.
Percentage of school-aged children who report always having an adult they can trust and talk to about personal problems
The 2022 HBSC survey provides insight into the level of support and trusted relationships among young people aged 11, 13, and 15. Pupils were asked whether they had a trusted adult in their life with whom they could discuss things that bothered them.
- 61% of children reported that they always had an adult they could talk to about personal problems, while nearly 1 in 10 (9%) said they did not have a trusted adult.
Measures of family and peer support were also collected:
- 56% of children reported high family support
- 76% found it easy to talk to their mother
- 67% to their father
- 50% reported high peer support.
All measures of relationships and support were linked to family affluence, with young people from higher affluence families more likely to report strong family and peer support, easier communication with parents, and having a trusted adult to talk to.
Percentage of adults living in Scotland who agree they could turn to someone in their neighbourhood for advice or support
The Scottish Household Survey asks adults living in Scotland whether they agree they can turn to someone in their neighbourhood for advice or support.
In 2024, 75% of adults agreed with this statement, a 6-percentage point decrease from the baseline year of 2022 (81%).
Number of Whole Time Equivalent (WTE) CAMHS and Psychology services staff in post in Scotland
Workforce capacity is a key factor in ensuring people can access someone to talk to and be listened to when needed. NHS Education for Scotland (NES) workforce data show that the number of WTE staff in both CAMHS and Psychology Services, who are key providers of formal talking support. Data from NES reveals that for the quarter ending September 2025:
- CAMHS had 1493.8 WTE staff employed across all professional groups. This is an 10% increase from quarter ending June 2023.
- Psychology had 1702.0 WTE staff employed across all professional groups. This is an 6% increase from the quarter ending June 2023.
Number of school counsellors in post
The number of school counsellors is a key factor in ensuring children and young people have someone to talk to and be listened to.
The Scottish Government collects data from local authorities on access to school-based counselling. The latest report covers an interim nine-month period (July 2023 to March 2024), as reporting transitions from six-monthly to annual cycles aligned with the financial year. This change limits direct comparison with previous years.
Between July 2023 and March 2024, local authorities reported 518 school counsellors in post. During this period, a total of 6,687 hours of counselling were provided per week across Scotland.
Reflections on Short-Term Outcome 8
Short-Term Outcome 8 focuses on whether people know it is okay to ask for help and have someone to talk to and listen to them. Most available data covers 2023 and 2024, with some 2025 workforce data, providing a baseline for understanding early patterns in help-seeking and support availability.
The evidence suggests that multiple routes for seeking support exist, and many people are actively engaging with them. This indicates that, for some, there is a recognition that it is acceptable to reach out for help. Many children, young people, and adults appear willing to reach out, using services such as school-based counselling, community supports, primary care, and NHS 24. Awareness of these services seems established, although engagement varies by service type.
People also report having access to someone they can talk to about mental health concerns, whether through professional services or trusted adults. Children and young people often rely on trusted adults in their family or school, while adults report supportive networks within their communities. Workforce capacity in key services such as CAMHS and Psychology Services appears to be increasing, helping to ensure that people who do seek help are able to find someone to listen
Data gaps
There are two overarching data gap that limits the ability to fully monitor STO8.
- Mental health literacy: Limited data on people’s confidence to seek help and whether they feel heard across a wider range of mental health services beyond primary care, including community, school, and crisis services.
- Range of support and services: Lack of systematic data on the availability, use, and impact of informal support from family, friends, and community networks in helping people feel able to ask for help and be listened to.
Footnotes
[1] The Mental Health Hub is a service provided by NHS 24 that offers telephone-based psychological triage and support to people of all ages across Scotland. It is staffed by Psychological Wellbeing Practitioners, supported by mental health nurses, and acts as a first point of contact for mental health concerns.