National Suicide Prevention Advisory Group: annual report 2024-2025

6. NSPAG report: Reflections on last year's NSPAG recommendations and their progress

NSPAG's 2023-24 report helpfully set out the policy background to Scotland’s Suicide Prevention Strategy. Two annual reports have now been published on the progress of the Suicide Prevention Scotland, with their year two report published in August 2025.

This latest annual report outlines the extent of the ongoing work to raise awareness of suicide and to embed suicide prevention across Scotland. The report highlights the considerable work of Suicide Prevention Scotland with minoritised and often marginalised groups, their involvement of those with lived and living experience of suicide, including young people, and their work to build a wide network of connections. The report also highlights the work of the Academic Advisory Group, as well as the work ongoing to share and use data more effectively and the work to raise awareness of and get the public talking about the issue of suicide through public information campaigns.

In 2023-24 our group made the following recommendations, which were welcomed by the Scottish Government and COSLA. It has been helpful to review the Creating Hope Together annual report 2025 to assess progress on the recommendations. We note that good progress has been made on Recommendation 1; some progress has been made on Recommendation 2 specifically by Suicide Prevention Scotland; but our concerns about Child and Adolescent Mental Health Services (CAMHS) persist. We don’t feel that Recommendation 3 has been addressed as yet. These latter two will continue to be listed among our recommendations for the next action plan.

Recommendation 1: Using its new tackling inequalities prioritisation framework, Suicide Prevention Scotland’s engagement work should move as early as possible in 2024/25 to testing and delivering measurable action with the specific groups and communities most at risk of suicide and impacted by the tragedy it brings.

We note evidence from Suicide Prevention Scotland’s second annual report that this recommendation has led to a range of work that we feel is making good progress in testing and delivering measurable action including:

• Community Led Action Research (CLAR) undertaken with organisations supporting people who experience stigma, discrimination, inequalities and the socio-economic determinants of suicide including refugees and people seeking asylum, young people, people experiencing poor mental health and people experiencing poverty.
• Engagement with organisations working with a range of communities including young women, women who have experienced domestic abuse, men, LGBTQ+ and racialised communities.
• A webinar raising awareness of the suicide prevention needs of neurodiverse people have allowed them to improve their understanding of the impact of stigma, discrimination and inequalities.
• Exploration of ways to improve and make better use of data and intelligence around suicide including testing implementation of suicide reviews in five areas across Scotland.
• There have also been learning sessions with:
  • the Gypsy Traveller team from MECOPP
  • trauma informed practice leads
  • The Promise leads network
  • the Poverty Alliance

Recommendation 2: Urgent attention and resourcing be focussed by the Scottish Government on improvement in the capacity and performance of Scotland’s Child and Adolescent Mental Health Services (CAMHS), in order to reduce the risk of and prevent suicide among children and young people.

• We feel that good progress is being made in involving young people in suicide prevention activity and ensuring that their voices are heard through involvement of the Youth Advisory Group. We also commend the considerable work in education settings, both in schools and higher education and the launch of the resource to support suicide prevention in schools, which will no doubt improve the situation for some young people. We also commend the work to make DBI more accessible to all, including those under 18.
• However, we remain concerned about CAMHS. Statistics show that 90% of young people start treatment within 18 weeks, the current referral to treatment target (RTT) standard. We note that this data includes children and young people who are seen urgently (same day or next day) which is estimated to be 50% of children and young people treated each quarter. The median wait for treatment to start is currently 4 weeks.
• For young people with mental health issues and who may be in extreme distress we still consider 18 weeks to be an unacceptable wait time and so are pleased that the CAMHS offers urgent appointments immediately and the median wait time is much less at 4 weeks. For those waiting longer, we recognise that during that time support will be provided by parents or carers and GPs that may put an unacceptable burden of responsibility on them. GPs only have ten minutes per appointment and while many will spend longer with a young person in distress, this is not an ideal solution.
• It is also important to acknowledge and highlight the other sources of support that may come into play upstream, with the aim of preventing an issue from escalating, including schools counselling and community supports. There should also be supports available during the waiting period for CAMHS, and some already exist including one or more of school nurses, pastoral care teachers or youth workers all of whom who provide vital support. The availability of these supports needs to be made clearer, and they need to be consistently available across the country.
• We understand that in recent years CAMHS has become a very specialised service that aims to respond quickly to acute needs. We are not convinced that this has been communicated well to GPs or to members of the public, specifically parents and carers who may still view CAMHS as the main route to access mental health support for young people. We would hope that all of the other sources of support can be highlighted so that there is increased awareness of them and how to access them.
• We also understand from colleagues working in Psychiatry that young people who would benefit from assessment and treatment and other interventions may be routed onto other waiting lists which can be months or years long and for which there are no treatment target times. We note that the work of the National Taskforce on Neurodevelopmental Services for Children and Young People is currently considering the requirements to fully implement the National Neurodevelopmental Specification.
• We recognise that Suicide Prevention Scotland alone cannot influence waiting lists for CAMHS so we would urge Scottish Government to prioritise reducing the wait for a first appointment. We feel urgent attention should be paid towards resourcing of CAMHS and importantly to other statutory and third sector services that may be appropriate alternative sources of referral for some young people so that once triaged young people can access some form of support or treatment quickly. This should also be considered as part of any future public service reform.

Recommendation 3: In 2024/25 work is being undertaken by Suicide Prevention Scotland to develop and introduce a process for costing implementation plans under the Suicide Prevention Strategy 2022-2032. This should begin with the Delivery Plan 2024/25 and the results should inform both the resources allocated by the Scottish Government and COSLA to support the plans and the process of prioritising action.

• As a group we don’t feel this recommendation has been delivered as yet and will retain it as part of our recommendations in this current report.
• The Scottish Budget for 2025-26 puts an emphasis on addressing factors, such as poverty and housing, which act as key determinants of mental health and suicide prevention, however, it is challenging to directly attribute the impact of budgets to suicide prevention outcomes. We still feel it would be helpful to know the total amount invested in the current budget to tackle inequalities across different policy areas, and how this contributes to suicide prevention work, including the work of Suicide Prevention Scotland.
• The Scottish Government is piloting a Fairer Funding approach for the third sector to provide 2-year funding to some third sector organisations to provide more certainty and allow for longer-term planning and project management. Over the coming year we would like to understand whether this is making a positive impact on their ability to deliver suicide prevention activity in a more sustainable way.