We’re calling for school mental health support teams (MHST) to have a clear referral pathway to funded counselling.

It comes as a new report by Dame Rachel de Souza, the Children's Commissioner for England, includes a recommendation for the continued roll-out of MHSTs to every school in England.

Jo Holmes, our Children, Young People and Families Lead, said the proposal needed to include the availability of school counselling provision to refer children who were caught between MHSTs and the higher-tiered CAMHs services.

School counselling

We’ve long campaigned for a paid counsellor to be available in every secondary school, academy and FE college in England, which lags behind Scotland, Wales and Northern Ireland in its provision of funded school counselling.

Jo said counselling should be built into the MHST plans, and that our members are ready to step into paid therapy roles.

She said: “It’s no surprise there continues to be a postcode lottery for children and young people accessing mental health services across England, at every stage in a child’s mental health journey.

“This is why we continue to call on the Government for funded counselling provision in both schools, colleges and community hubs.

“We welcome the commissioner’s recommendation that mental health support teams be rolled out to all areas in England, but this must come with an added caveat.

Funded provision

“Mental health support teams need a clear referral pathway to funded counselling provision and this must be built into the MHST offer.

“The roll-out of these teams also needs to be speeded up as they currently only reach 35% of schools and colleges, adding to that postcode lottery.  

“There’s a children and young people counselling and psychotherapy workforce that can step into additional counselling roles and take on paid work, complementing MHSTs, if funding was made available. Having multi-disciplinary teams available to schools would be a huge step forward and relieve pressure on school staff.

“We’re working closely with organisations such as the NAHT, who agree that schools need additional resources such as counselling services and that the roll-out of MHSTs should include counselling in their offer.


“We continue to raise these issues with Government and health commissioners, highlighting that access to funded counselling provision could help reduce NHS waiting lists, via the Single Point of Access (SPA) referral approach.”

Jo was commenting as findings from The Big Ask – the largest survey of children of its kind – were made public by Dame de Souza. 

In the survey 40% of 16 and 17-year-old girls said they were unhappy with their mental health. NHS  data also suggests 31% of girls and young women aged 17 to 24 now have a ‘probable mental health disorder’.  

Dame de Souza’s report shows average waiting times between children being referred to mental health services and starting treatment are increasing again for the first time since 2017. It also shows wide variation in service provision among NHS Trusts.  

Data on the use of inpatient mental health care is included in this year's mental health briefing, as well as on the quality of care received by children admitted to these settings, building on the findings of the Children's Commissioner's independent Family Review, published last year. The review highlighted the benefits of being part of a stable family on a child's outcomes and recommended that support services should be designed to reflect the positive characteristics of strong families.

Survey findings

Other findings include: 

  • An increase in children being referred to CYPMHS to 734,000 children in 2021-22 from 498,000 in 2020-21, which could reflect a methodology change and the increase in the prevalence of probable mental health disorders;  
  • Fewer than half (48%) of the 1.4 million children estimated to have a mental health disorder received at least one contact with children and young people's mental health services (CYPMHS); 
  • An increase in percentage of children whose referrals were closed before any treatment, and wide variation across England: as high as 50% in NHS North Cumbria to as low as 5% of referrals in NHS East Sussex; 
  • Average waiting times between a child being referred to CYPMHS and starting treatment increased from 32 days in 2020-21 to 40 days in 2021-22; and 
  • Spending on children's mental health services, adjusted for inflation, has increased each year since 2017, with Clinical Commissioning Groups (CCG) spending on average 1% of their total 
  • budget on CYPMHS in 2021-22, or £927 million. 45% of CCGs spent more than 1% of their  individual budgets in 2021-22, up from 30% the year before. 

Other recommendations for improving children and young people's mental health services (CYPMHS) include a greater role for schools in Integrated Care Partnerships, review by NHS England of family visiting in inpatient settings to understand how these can be made more welcoming, and a focus on the needs of children in the Government's recently announced Major Conditions Strategy.

Read the full report.