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Mental Health in Scotland
Our office has been focusing on children’s mental health as a key priority since we created our strategic plan for 2020-2024. We worked closely with young people who identified mental health as a priority and who told us how many children and young people in Scotland don’t receive the necessary help for their mental health issues. In 2020, almost one-quarter of young people in Scotland experienced two or more psychological problems in a single week. About 1 in 10 children and young people between the ages of five and 16 had a mental illness that could be diagnosed clinically, but they lacked the services to support them. The situation became even worse due to the Covid-19 pandemic and its aftermath, as well as the current cost of living crisis. Approximately one-quarter of children in Scotland live in poverty, which can cause poorer physical and mental health, impacting their education and access to other rights.
What does the UNCRC say?
Just like anybody else, children and young people have the right to the best mental health possible. That doesn’t mean not having a mental health condition, like anxiety or depression. It means being supported to have positive mental well-being.
The United Nations Convention of the Rights of the Child (UNCRC) sets out a number of rights you have to good mental health.
Article 2 of the UNCRC states you must be protected from all kinds of discrimination. Mental health services should be provided for everyone regardless of their age, gender, religion or disability. You shouldn’t be discriminated against because you have poor mental health or a mental health condition.
Article 6 of the UNCRC says you have the right to be alive, survive and develop. The government has a responsibility to keep you safe from harm.
Article 24 of the UNCRC states that you have the right to the best possible standard of health and that governments must provide good quality healthcare and education on health and well-being so that you can stay healthy. If you are ill, you have a right to good health services. You have the right to live in a safe, healthy environment which helps you stay well.
Article 27 of the UNCRC says the government must make sure that you have a decent standard of living that allows you to develop fully – physically, mentally, emotionally, spiritually and socially.
General Comment 4
The Committee on the Rights of the Child is clear in its General Comment 4 that any state that has signed up to the UNCRC should provide children and young people with the necessary services to treat depression, eating disorders and ‘self-destructive behaviours’.
It also talks about some of the things that have to happen so that young people can enjoy their rights.
Among these are that young people need:
- community awareness of the early signs and symptoms of poor mental health
- protecting from undue pressures, including psychosocial stress (such as the death of someone close or parents divorcing)
- good enough treatment and a good enough chance to recover
The Committee is also clear that states have a duty to combat stigma around mental disorders.
Our Position and Work
We have frequently argued that before the pandemic and the cost of living crisis, mental health services for children and young people were already stretched in Scotland. Children and young people have consistently told us that they need mental health support before they reach crisis point. That means investing in community-based mental health services that are accessible as well as providing more support in schools.
Investigation: Counselling in Schools
In 2021, our Young Advisors met to consider how to use the Commissioner’s investigation powers to highlight an issue that was important to them. They worked with the Commissioner’s Advice and Investigations team to explore issues around children and young people’s mental health and the services that are provided. They exercised the Commissioner’s legal investigation powers to ensure they accessed the evidence they needed to make recommendations on what needs to change. They expressed the view that they wanted to focus on school counselling. Specifically, to consider whether and to what extent the current model is sufficient to deliver a rights-based approach to mental health provision given the increased need post-pandemic.
Data was requested from all 32 local authorities by summer 2022, but one did not have school counselling services in place until January 2022, so was unable to respond. After examining the evidence from the 31 authorities who responded, the Mental Health Investigators published a report in May 2023, recommending that all children should have a right to access counselling at school, and that local authorities should ensure that counselling is available outside school hours, during school holidays, and outside school premises.
The group also recommended that the Scottish Government should expand school counselling provision to all primary and special schools in Scotland, and that all local authorities should have clear waiting times for children who want to access services, and information should be child-friendly. The investigators presented their report to the Convenor of the Education Committee, Sue Webber MSP, and Convenor of the Health Committee, Clare Haughey, at the Scottish Parliament.
Funding for mental health was insufficient even before the pandemic, but Covid the situation became even worse, making it difficult for young people to access the support they required. We expressed the view that the promises made by the Scottish Government in 2018 would not be enough to address the challenges brought on by the pandemic. We stressed the need for more support and resources in schools and communities. We urged the Scottish Government to make a political commitment to urgently improve the situation and ensure better and faster access to school counsellors. It was concerning that some schools had only one counsellor for 800 pupils, which we argued was not enough.
Given the dire circumstances caused by COVID, we requested an independent child rights impact assessment on the pandemic from the Observatory of Children’s Human Rights Scotland. The assessment revealed that many more children would require mental health support for a significant period. We argued that the current model of mental health provision would not meet children’s rights to the highest standard of health. We urged the Scottish Government to invest in comprehensive, community-based mental health services that are accessible to children and young people at all times, not just during crises. We stressed the need for a level of service that bridges the gap between receiving a leaflet in school and receiving treatment.
We also supported young consultants from A Place in Childhood (APiC) on the #ScotYouthandCOVID2 project. They highlighted the changes Scotland needs after experiencing the global pandemic and encouraged other young people to contribute to a manifesto for change.
Key themes for the young consultants included:
- Establish a helpline for children and young people to discuss well-being, seek advice, and improve mental health.
- Recognise the challenges faced during the pandemic, providing time and space for recovery, especially regarding remote schooling and unclear expectations.
- Create opportunities for young people to reconnect with their youthfulness and embrace their playful nature.
- Improve mental health support and services by addressing long waiting lists.
In September 2018, we supported young people in attending the annual conference of the European Network of Ombudspersons for Children. Together with a group of young people from Scotland and 10 other European countries, we helped develop recommendations to improve support for young people’s mental health. The young people from Scotland suggested the need for a national standard for mental health in educational settings. Around the same time, the Scottish Government pledged to introduce 350 counsellors in schools and invest over £60 million in additional school counselling services throughout Scotland. Our office advocated for a model that ensured all counsellors had proper qualifications and highlighted the importance of support beyond the school environment.