Publication - Strategy/plan

Supporting children and young people experiencing a mental health crisis: framework

Published: 18 February 2026
From: Director of Mental Health
Directorate: Mental Health Directorate
Topic: Children and families, Health and social care
ISBN: 9781806437948

This Framework provides the principles of what cohesive and effective support for children and young people experiencing a mental health crisis should look like across Scotland.

Supporting documents

Further Resources

Who is this document for?

This document is for anyone who may encounter a child or young person experiencing a mental health crisis.

What will this document support you to do?

This document will provide more information around training resources, the evidence context and national policy positions

When might this document be most helpful?

This document will be most helpful for when looking to learn more about the background to the Framework and for accessing relevant professional development.

Background and Context

As mentioned earlier, Scotland currently lacks detailed data on the types and timing of crisis presentations.

We know that in relation to Community Mental Health and Wellbeing Supports and Services for Children and Young People, Local Authorities have reported that nearly a quarter of service users in 2024-25 accessed emotional distress services. 2,143 people sought support for distress when presenting to services in the same period.

There is some evidence on different crisis presentations from across the UK:

Self-harm: In England, over half (53%) of child and adolescent mental health admissions in 2021–22 were due to self-harm, such as overdose or self-injury requiring hospital care^[30]. In Scotland, the Scottish Health Survey^[31] shows that the proportion of 16–24-year-olds reporting ever deliberately self-harming has risen from 4% in 2008/09 to 18% in 2023/24, though down from 29% in 2021/22.
Timing of crises: Some evidence suggests that child and adolescent mental health crises often occur outside normal office hours, typically in the evenings or at night, which increases reliance on emergency departments and on-call services^[32].

To provide the support which is required, we need to find the right balance of digital and in-person supports. The Children and Young People’s Mental Health and Wellbeing Joint Delivery Board’s Insight Report (2023) highlighted that choice of support was important for children and young people when accessing support for their mental health, with a mix of digital and face-to-face preferred (though face-to-face was still felt to be the priority).

We are mindful that when it comes to providing support during a mental health crisis, face-to-face support should be seen as a priority due to the immediacy of support required, and because of the potential risk in relation to escalation of need. This has been reaffirmed through the Sweep 11 Growing Up in Scotland study (GUS) which highlight that more young people had sought support for their mental health from important people in their lives, such as friends, family, teachers and their primary care doctor, in comparison to accessing support from a helpline.^[33]

We know that children and young people with disabilities, and neurodivergent children and young people, have an increased risk of experiencing mental health difficulties^[34], as well as increased risk of stigma, fear and isolation. However, evidence relating to the accessibility of crisis supports is less clear. Services must ensure that disabled children and young people are not only considered in design and delivery, but that their diverse needs are actively addressed through inclusive, flexible, and responsive approaches.

Background: How this Framework fits in with the National Policy Position

In this section, we have set out the wider strategic context for delivery of this Framework across relevant policy priorities. This builds on the national policies and resources outlined in “The Role of the Workforce in Supporting Children and Young People Experiencing a Mental Health Crisis” document.

The Scottish Government has worked in partnership with COSLA on a number of key strategies and approaches which have informed the development of this Framework.

The Population Health Framework^[35] sets out Scottish Government's and COSLA’s long-term collective approach to improving Scotland’s health and reducing health inequalities for the next decade. This Framework is aligned to the four guiding principles, particularly the ones of Focus and Deliver by aiming to illustrate good practice which takes a whole system approach which is inclusive of all children and young people presenting in crisis.

Scotland’s first dedicated Self-Harm Strategy and Action Plan (2023-2027)^[36] aims that for anyone affected by self-harm to receive compassionate, recovery-focused support without fear of stigma or discrimination. It is jointly owned by Scottish Government and COSLA. The approach outlined in this strategy retains an important connection to the joint work on suicide prevention through the Suicide Prevention Strategy and to improving population level mental health and prevention through the Mental Health and Wellbeing Strategy and its Delivery Plan. Priority 2 of the strategy is to continue to build person-centred support and services across Scotland to meet the needs of people affected by self-harm.

Creating Hope Together Suicide Prevention Strategy 2022 – 2032 ^[37] is our ten year suicide prevention strategy jointly led with COSLA and sets out a clear plan to reduce suicides in Scotland and address the inequalities which lead to suicide. We have created an innovative partnership model - Suicide Prevention Scotland - to lead the delivery of the Suicide Prevention Action Plan, and create a suicide prevention community for everyone working on suicide prevention in Scotland. Effective partnership working is crucial to our approach to suicide prevention. This Framework represents a collective effort, shaped by the work of Suicide Prevention Scotland and insights from wider partners across sectors.

The Health and Social Care Service Renewal Framework^[38] seeks to work towards a Scotland where people live longer, healthier, and more fulfilling lives. It sets out the structure for changes within systems across a ten year period The principles of the Service Renewal Framework are central to how we will implement the Framework. The principle of People is particularly relevant given the Framework’s focus on supportive, compassionate responses wherever a child or young person presents in crisis and through the focus on bringing GIRFEC into the heart of crisis responses.

The National Performance Framework^[39] (NPF) is developed and published by the Scottish Government and is Scotland’s way to localise the Sustainable Development Goals. It currently sets out 11 National Outcomes with associated indicators which are tracked and publicly reported on. The NPF is for all of Scotland and sets out a vision for collective wellbeing. While we anticipate that the work of this Framework will contribute to a variety of the National Outcomes, it will have a particular focus on:

we grow up loved, safe and respected so that we realise our full potential.
we are healthy and active.
we respect, protect and fulfil human rights and live free from discrimination.
we live in communities that are inclusive, empowered, resilient and safe.

The Promise and Plan 24-30 was published in June 2024. Plan 24-30 is a website designed to map out the actions and milestones to 2030, when the promise must be kept. Plan 24-30 has 25 route maps organised around the five foundations of the promise. It is intended to guide organisations with a responsibility to keep the promise through the work required. The route maps were updated in December 2025 and were developed in collaboration with a range of stakeholders, work will continue to develop these to ensure they set out the milestones, who is responsible and when progress is expected. The route maps are intended to strengthen transparency and accountability across all areas of work, so the remaining distance to travel is visible and the barriers in the way can be identified and addressed. The health route map was informed by insights from the Barriers and Access to Supports and Services Implementation Group.

Additional Knowledge and Skills

Supporting Children and Young People

SWAYs include One Good Adult, First Point of Contact and the Getting it right for every child (GIRFEC) and Children's Rights learning site. More information can be found here - Supporting Children and Young People – Sways | The Knowledge

Trauma

The National Trauma Transformation Programme (NTTP) and the NES workstreams that are focused on children and young people have collaborated to create a range of both universal and targeted training resources to support the workforce to develop confidence and competence in trauma informed and responsive practice, which is a foundational part of an evidence based response to children and young people in crisis. More information can be found here –

children-and-young-people-nes-trauma-resources-nov-22.pdf

Sowing Seeds: Trauma Informed Practice for Anyone Working with Children and Young People on Vimeo

Developing your trauma skilled practice 2 : trauma in children and young people | Turas | Learn

Mental Health Improvement, Self-Harm and Suicide Prevention

Knowledge and Skills Framework for Mental Health Improvement, Self-Harm and Suicide Prevention

Informed Practice Resources

eLearning module - Ask Tell Respond - Promoting children & young people’s mental health & preventing self-harm & suicide.
Ask, Tell Respond Animations - Children and Young People

Three animations to support learning about mental health, self-harm, and suicide prevention specifically for the wider Children and Young People’s workforce.

Translations available: Polish, Urdu and BSL.

Facilitation package – (available via application) - Ask Tell Respond - Promoting children & young people’s mental health & preventing self-harm & suicide available via application – Turas Learn - Informed level facilitation : children and young people | Turas | Learn

Skilled Practice Resources

Supporting People at Risk of Suicide Learning Byte, Part B includes additional information about children and young people who may be at risk of suicide. Associated Facilitation package is also available (on application ) - Ask, Tell Respond - Supporting a person at risk of suicide - Adult Suicide prevention facilitation package [Adult] | Turas | Learn and Children and Young People - Suicide prevention facilitation package [CYP] | Turas | Learn
Supporting People at Risk of Self-Harm Learning Byte Associated Facilitation package available (on application) - Ask, Tell Respond - Supporting a person at risk of self-harm - Self-harm prevention facilitation package | Turas | Learn
Supporting People in Distress and Crisis Learning Byte Associated Facilitation package available (on application) - Ask, Tell Respond - Supporting a person at risk of distress or crisis Distress and crisis facilitation package [Adult] | Turas | Learn

Masterclasses and Webinars

A range of recorded masterclass sessions for people whose work role requires them to further develop skills and knowledge at the enhanced and specialist level of the mental health improvement and prevention of self-harm and suicide framework, which include:

Nonsu nding and working with autistic individuals in mental health and suicidal crisis- Becki Choat, Project Lead- SWAN Understanding and working with autistic individuals in mental health and suicidal crisis- Becki Choat, Project Lead- SWAN | Turas | Learn

Child and Adolescent Mental Health Services (CAMHS)

Essential CAMHS sited on Turas Learn. Modules 1-3 provide foundational knowledge relevant to all professionals working with children and young people including knowledge of children’s rights, GIRFEC framework, mental health including risk and protective factors. Modules 4-5 designed primarily for Specialist CAMHS staff includes risk formulation, safety planning and interventions. More information can be found here - CAMHS | Turas | Learn

New to forensics: Working with Children sited on Turas Learn. This online learning program is aimed at staff who work with children who are at risk of harming others.

More information can be found here - New to forensics: working with children | Turas | Learn

Neurodivergent Children and Young People

Neurodivergent children and young people have an increased risk of being in crisis related to mental health. They face distinct challenges and barriers when seeking support. More information can be found here - Autism and neurodivergence across the lifespan | Turas | Learn

Additional training resources have also been developed by The National Autism Implementation Team (NAIT) which is a practitioner researcher partnership based at Queen Margaret University. Their work supports local implementation of evidence informed practice across the life span within a neurodiversity paradigm. More information can be found here - NAIT | ThirdSpace

NES Psychology has published a guide to adapting psychological therapies for Autistic / neurodivergent people in their new MATRIX which is a comprehensive guide to evidence-based psychological interventions