More than 250,000 children in Scotland have no access to school-based counselling services, a BBC investigation has discovered.
It found that 14 local authorities had no on-site counsellors and provision by other councils was irregular.
The data revealed school counsellors dealt with thousands of cases including substance abuse, self-harm and depression in the past year.
A government review into school counselling services is now under way.
Unlike Scotland, counselling services were guaranteed in all secondary schools in Northern Ireland and Wales a decade ago.
Earlier this year the Scottish government launched a new mental health strategy which stated that “support from teachers and other school staff can be vital in helping ensure the mental wellbeing of children and young people”.
But new data – obtained by the BBC via a series of coordinated freedom of information requests – revealed that 14 councils, including South Lanarkshire and Highland, have no formal school-based counselling services for their 254,000 students.
However the number of students who do not have access to these services across Scotland is likely to be far higher.
The responses from the Scottish local authorities that do offer on-site counselling reveal that provision was often irregular even across their own network of schools.
For example, data obtained by BBC Scotland reveals that Inverclyde provides services in one of its six secondary schools, and North Ayrshire currently has two counsellors in nine of its secondary schools.
Edinburgh and Glasgow councils had services in 43% and 93% of its secondary schools respectively.
Overall, on-site services were present in only 40% of Scottish secondary schools – or 10% of all primary and secondary schools.
But the regional discrepancy was most apparent when looking at the neighbouring councils of South and North Lanarkshire, who respectively had on-site counsellors in none, and all, of their secondary schools.
Other councils such as Clackmannanshire, East Lothian, East Renfrewshire, Fife, Renfrewshire, Scottish Borders and West Dunbartonshire said it had counsellors in all of their secondary schools.
The two councils of Dumfries and Galloway and Orkney Islands have yet to respond to the freedom of information request.
Jo Anderson, from the Scottish Association for Mental Health, said the data shows how “patchy” counselling is in schools across Scotland, illustrating the need for a consistent national approach.
She said: “There’s a commitment in the Scottish government’s mental health strategy to review schools-based counselling, but there’s no timeframe on when they will do this, nor indeed a commitment to providing access.
“So we think Scotland’s young people are already missing out.
“The situation is urgent, it’s not getting better, and it’s got to change.”
‘I felt a bit pushed aside by the school’: A case study
“When the depression set in I was just finding it hard to find the joy in anything any more.”
Zoe Mason says she was in the fourth year of high school when her downward spiral began.
Not only were exams rapidly approaching, but she was also stressed by thoughts of what to do with her life after leaving school.
“I was finding it hard to leave the house, to get the bus to school. I was starting to withdraw from my friends because even just having a conversation was hard.”
Zoe says she looked for support from her teachers but that they didn’t know how to help.
“It wasn’t that they didn’t care, I just don’t think they had the skills or the knowledge to know how best to support or advise me.
“So I did feel a bit pushed aside by the school, like I was a problem that they didn’t want to have to deal with.
“I genuinely do think that that is because of a lack of knowledge around mental health in schools.”
Zoe said she only got the help she needed when her mother pushed her to see her GP – they in turn referred her to her local health board’s Child and Adolescent Mental Health Service (CAMHS).
However she says other teenagers may find reaching out to their GP intimidating.
“But if the counselling service is right there in your school, and teachers know that it exists, then it’s really easy to access and you’re able to take less time off school.
“There’s also huge waiting lists for CAMHS, so if you can get support within your school then it’s not going to have a detrimental impact on your education.”
Now 19, Zoe says an on-site counselling service would not only have saved her years of struggling with her mental health. It might have saved her grades.
“I ended up not going to university straight from school like I’d planned as I’d not been able to keep up at school.
“If a counselling service had been there my life would be so much so different to what it is now”.
Maureen Watt, the Scottish government’s mental health minister, said: “We want every child and young person to have appropriate access to emotional and mental well-being support in school – our new, ambitious Mental Health Strategy sets out clearly how we can improve early intervention, and ensure better access to services.
“Education authorities and all those working in our schools have a responsibility to support and develop the mental wellbeing of pupils, with decisions on how to provide that support taken on the basis of local circumstances and needs.
“Some will provide access to school based counselling – others will utilise the skills of pastoral care staff and liaise with the Educational Psychological Services and health services for specialist support when required.
“Whether in schools, workplaces, communities or care facilities, the new strategy will see us take forward an initial 40 actions to shape change and ensure mental health has true parity of esteem with physical health.”
Stress and self-harm
Responses from Scottish councils also revealed not only the number of referrals in some schools, but also the type of issues children were reporting.
The data showed that on-site services were accessed at least 2,812 times – but with many councils providing only partial data, that figure is likely to be higher.
In the last year, Glasgow’s counselling services were accessed 797 times – 17% of these instances were related to stress, and 10% were depression-related.
Services in Fife’s schools were accessed 480 times – 47% of these referrals were substance-related.
Schoolchildren in East Renfrewshire’s secondary schools accessed services 89 times in the last school year – a fifth of these were related to self-harm.
One of the government’s key actions in its ten-year strategy is to “roll out improved mental health training for those who support young people in educational settings”.
However, as with school-based counselling services, only a fraction of schools across Scotland have teachers who have undergone formal Scottish Mental Health First Aid (SMHFA) training.
For example, only five teachers in Inverclyde’s 26 schools had taken SMFHA training in the last five years; in Angus, there are just three in the council’s 61 schools.
A Highland Council spokesperson said: “There are some voluntary counselling services offering support to some schools… None of these services are based in the schools.
“We do however provide a Primary Mental Health Worker Service which has, as part of its remit, time to build capacity in schools and to both support and train guidance staff and others, to help them better support children and young people with mental health issues.
“They have already trained a number of staff across Children’s Services and by June 2017, 16 of the 29 secondary schools in Highland had accessed Mental Health First Aid Training.”
A spokesperson for Inverclyde said that while the council “does not have counselling services based in individual schools every single child and young person has access to mental health support and counselling.”
They added: “There is a wide variety of support available including educational psychologists employed by the council who undertake direct therapeutic work with individual children and young people.
“School staff are also undergoing training to spot the early signs of mental health issues so that support can be offered as soon as possible.”
South Lanarkshire council told BBC Scotland in its original freedom of information response that the local authority “does not provide counselling services within schools nor does it employ or contract counsellors or counselling services.”
But in a separate press statement, the council’s head of education said a formal school-based service was provided by NHS Lanarkshire.
Anne Donaldson said: “This is done on a case by case basis and is dependent on the level of support required by individual children and young people.”
While the data shows many schools do not have school-based counselling services, most councils did stress that they had referral frameworks in place allowing children access to the authority’s educational psychology services.
All schools with no on-site support can also refer pupils to their health board’s CAMHS team.
But official data reveals that, as of March 2017, nearly 17% of children had been waiting over 18 weeks to see someone.
An NHS report shows that four out of the 14 health boards are failing to meet the government’s 18-week standard.
NHS Grampian and NHS Lothian respectively saw 45% and 47% of children referred to them within 18 weeks.
Ms Anderson from SAMH said: “There are some great examples from across the UK where young people have got guaranteed access to schools-based counselling, and there is growing evidence that this is really helping young people where they’re getting access on-site, and not having to sit on a waiting list for a CAMH service.
“So we know it’s helping people in other parts of the UK so we think we should be doing the same in Scotland.”