Mental health and wellbeing
Vision statement six: Scotland must seek to uphold the wellbeing of care-experienced children and young people and ensure that there is timely access to mental health support before crisis point so that children can enjoy good mental health.
What children and young people say
This section presents the evidence through an experience lens, focusing on what mental health support has felt like for care experienced children and young people as reported in the included materials, available since 2020. Click on the take me to navigation pane and jump to different sections here, including sources.
Across the materials reviewed, while some young people described feeling listened to and encouraged by trusted adults, others described feeling stuck, unseen or judged, often linked to long waits, inconsistent support or decisions being made without them. Much of the evidence reflects the combined impact of school pressures, stress at home and barriers within mental health support. Together, these accounts highlight the importance of early help, trauma-informed approaches and supportive, relational interactions with trusted adults and professionals.
To see what changes Scotland is making and still has to make for the promise to be kept, click on the health route map in Plan 24-30. See more about the work of change across Scotland here.
Feeling overwhelmed was often linked to a lack of stability, support or understanding. Sudden changes, or decisions made without involving young people, could trigger past experiences and make situations feel much heavier. When home life is difficult and there is no safe space to talk, stress can build quickly. Relationships matter deeply, but without the right support they can feel unpredictable or fragile. This feeling was intensified when adults did not understand what care experience meant for young people, or when young people feared they would not be listened to, believed or treated with respect when they asked for help.
Children and young people described how their wellbeing and self-worth are affected when school environments do not fully recognise or respond to individual needs. Feeling judged by behaviour alone, left out or doubted can lead to stress, isolation and a loss of confidence. These pressures were made worse when schools were unaware of what young people were dealing with at home and responded without understanding the wider context, making school feel overwhelming rather than supportive.
Feelings of isolation grew when young people did not have regular, meaningful contact with the people who support them. Disruptions to routines, such as those experienced during the pandemic, intensified these feelings for many. When support from trusted adults changes, becomes less consistent or feels rushed, young people can feel forgotten and disconnected from the help they need.
Navigating mental health support was often described as confusing and exhausting. Long waits, gaps between services and strict thresholds can leave young people without help at critical moments. When early support is not available, worries can grow and difficulties can escalate, leaving young people feeling let down by systems they expected to help and protect them.
The materials reviewed highlighted children and young people feeling supported when they felt those around them understood them and responded to them with care. When adults recognised early signs of distress and offered help in ways that work for the young person, it created a sense of safety and calm. Trauma-informed support helped young people feel heard and seen, strengthening wellbeing. Trust grew when relationships were built over time, rather than rushed or based on assumptions, making difficult moments easier to manage.
Confidence grows through trusting, supportive relationships. Young people described feeling safer to talk about their mental health when they had adults who listened without judgement and showed belief in them. Being able to speak openly beyond decision-making contexts helped young people feel valued and more in control of their lives. This strengthened self-worth, built hope and supported confidence in facing future challenges.
What this tells Scotland
This section draws together what the evidence shows about how experiences of mental health support are felt by care experienced children and young people, and how these experiences shape wellbeing, trust, confidence and hope. It is intended to be informative, helping to show why these experiences matter and why they should inform what happens next. The focus is on naming impact and consequence as described in the evidence, drawing attention to patterns that remain unresolved and where continued attention is needed.
The evidence shows that uncertainty about how to access mental health support, long waits and inconsistent responses contribute to feelings of overwhelm and anxiety for care experienced children and young people. When plans change unexpectedly or support is unclear, existing stress linked to home life, relationships or past experiences can intensify. This uncertainty undermines emotional safety and makes it harder for young people to ask for help at an early stage.
Children and young people describe school as a significant part of their mental health experience. When behaviour is responded to without understanding what is happening beneath the surface, school can become a source of distress rather than support. Feeling misunderstood, doubted or judged in educational settings affects wellbeing, confidence and engagement, particularly when school staff are unaware of pressures at home or changes in family life.
The evidence highlights how quickly feelings of isolation can grow when contact with trusted adults becomes infrequent, inconsistent or overly time-limited. Loss of routine, reduced access to friends and support delivered in ways that feel rushed or impersonal leave young people feeling alone with their worries. Over time, this disconnection can make it harder to reach out and ask for help.
Children and young people consistently describe feeling trapped by long waits, gaps between services and rigid thresholds for support. Being passed between services, or falling between age-related boundaries, leaves some without help at critical moments. When early support is unavailable, difficulties can escalate, reinforcing feelings of frustration, powerlessness and being let down.
Across the evidence, trusting relationships with adults emerge as a key protective factor for mental health. Young people feel more supported when adults take time to understand their experiences, recognise early signs of distress and respond with care. Having access to safe spaces and adults who are not solely focused on decision-making allows young people to speak openly and feel emotionally safe.
The accounts show that confidence grows when young people feel believed in, encouraged and included in decisions about their lives. Early, trauma-informed support that responds to what matters to them helps young people feel calmer, more in control and better able to cope with challenges. These experiences foster self-worth, strengthen hope for the future and reduce the likelihood of distress escalating into crisis.
Sources Referenced
The purpose of the below citations and summaries is to ensure that sources used are clear and accessible. Web links to the sources are provided, where possible.
Document summaries are provided for any document where analysis produced more than ten ‘coded segments’. ‘Coded segments’ refer to portions of a document that analysts identified and labelled as relevant to the key themes for each Vision Statement.
All documents that have informed the development of the Vision Statement, even if they had fewer than 10 coded segments, are cited in the ‘Additional Sources’ box below.
This Care Inspectorate report looks at how children and young people are cared for in secure care and what needs to improve to ensure their rights are respected, including whether new rules made by the Scottish Government are helping young people and staff.
Approximately 200 people participated in the study, including young people, family members, professionals and Local Authority representatives. The journeys of 30 young people were also tracked over a one-year period.
The Care Inspectorate found that progress has been made in meeting the aims of the secure care Pathway and Standards, but significant gaps remain across the full journey into, through and out of secure care. The new rules have had the strongest impact for those in secure care, where most young people experienced improved safety, felt listened to, had their rights upheld, and benefited from specialist support and education. Some positive preventative effects were noted—where intensive, relationship-based community support and clear risk-planning processes helped prevent admission.
However, the greatest weaknesses were found after young people leave secure care. Many experienced a sharp drop in support, struggled to access health and wellbeing services, lost educational progress, and faced homelessness or serious safety risks, leading to re-admissions. Ongoing problems included unequal access to community resources, inconsistent understanding of secure care’s therapeutic purpose, lack of stable relationships, and variation in restrictive practices.
Secure Care Pathway Review. Care Inspectorate, 2023. https://web.archive.org/web/20260214164358/https://www.careinspectorate.com/images/documents/7293/Secure%20care%20pathway%20review%202023.pdf.
This report, prepared by The Lines Between for Scottish Attachment in Action (SAIA), evaluates the Wee BREATHERS project. The evaluation aimed to assess the project's effectiveness against its intended outcomes for various stakeholders, including staff, leadership teams, young people, and families.
Wee BREATHERS, developed by SAIA, provides attachment-informed, trauma-sensitive supervision to staff in schools and early years settings. This support is offered through one-to-one and group sessions, creating a safe space for reflection and learning. The project seeks to improve staff understanding of attachment theory and trauma, ultimately benefiting young people and school culture.
The evaluation gathered data through online surveys and interviews with staff from early years, primary, and secondary school settings, as well as supervisors. Key findings indicate that Wee BREATHERS positively impacts staff wellbeing, confidence, and understanding of children's developmental issues and behaviours. Staff reported improved relationships at work and a different mindset that extended to their personal lives.
The project's engaging delivery model, characterised by safe and non-judgmental spaces, was highly valued. Supervisors also reported positive experiences, noting the significant need for such support within the education sector. Challenges included the practicalities of freeing up staff time and ensuring suitable private spaces for sessions.
Overall, Wee BREATHERS is seen as a valuable initiative that helps education staff reflect, learn, and adapt their practices to better support pupils. It contributes to a more inclusive school culture and significantly impacts the professional and personal lives of participants.
The Lines Between. Evaluation of Wee BREATHERS. Scottish Attachment in Action, 2025. https://scottishattachmentinaction.org/wee-breathers-2/.
This report looks at the mental health experiences of young people in Glasgow who have been in care. It was written by Social Marketing Gateway for Glasgow City Health and Social Care Partnership, working with PAC (People Achieving Change), a group of care experienced young people. The aim was to listen to young people and understand what helps or prevents them from getting the right mental health support.
Young people said the COVID-19 pandemic had a strong negative effect on their mental health. Many felt anxious, stressed and lonely due to changes in routine, less contact with friends, and reduced support from adults and services. These challenges made existing mental health problems worse.
A key message from the report is that many young people didn’t feel able to speak openly with social workers about their mental health, worrying it might affect decisions about their care. Many said they wanted a trusted person to talk to, either one-to-one or in a group, but separate from social work services.
The report also highlights problems with current mental health services, including long waiting times, short appointments, and staff who do not understand what it means to grow up in care. Moving from children’s services to adult services was described as a particularly difficult time, with many young people feeling unsupported.
The young people recommended having specialist mental health workers for care experienced young people, regular mental health check-ups, quicker and more flexible access to support, better trained staff, stronger help during transitions, and more face-to-face contact.
Social Marketing Gateway (SMG). Glasgow People Achieving Change (PAC) Mental Health Research: Final Report February 2022. Glasgow City Health and Social Care Partnership (GCHSCP), 2022. https://glasgowcity.hscp.scot/publication/glasgow-pac-mental-health-research-2022.
This report was written by a team of researchers from the University of Stirling, Lancaster University, and the Association for Fostering, Kinship and Adoption (AFKA) Scotland. It was funded by the Nuffield Foundation and an anonymous donor.
The report was written to understand how children who needed care in Scotland are doing as they grow up. It looks at what helps them feel safe and settled, and what makes a difference to their lives. The main goal is to share what was learned to help improve rules and practices for children, their families, and the people who look after them. It builds on an earlier study (Phase 1) that looked at these children when they were younger.
The study followed 1,836 children who needed care when they were five years old or younger in 2012-13. It explores where these children are living ten years later, how well they are doing, and what connections they have with important people in their lives. The report uses different kinds of information, including official records, surveys, and interviews with children, their carers and birth parents, to get a full picture of their experiences.
Whincup, Helen, Linda Cusworth, Maggie Grant, et al. Permanently Progressing? Building Secure Futures for Children: Phase 2 Middle Childhood. Key-Findings from Phase 2: final report. University of Stirling, 2024. https://permanentlyprogressing.stir.ac.uk/key-findings-from-phase-2-final-report-and-accessible-summaries/.
This interim report, published by the Scottish Government in December 2024, presents a qualitative assessment of the Scottish Mentoring and Leadership Programme (SMLP). The report aims to evaluate the effectiveness of the SMLP, which includes two main initiatives: Motivation Commitment Resilience (MCR) Pathways and Columba 1400 Young People’s Leadership Academies (YPLAs). MCR is a charity which offers school-based mentoring for disadvantaged young people. The SMLP was established to support young people, particularly those with care experience or in challenging circumstances, by enhancing their relationships and capabilities to improve their wellbeing and future outcomes.
The evaluation found that both MCR Pathways and Columba 1400 positively impacted young participants, primarily by boosting their confidence, especially social confidence and self-belief. Both programmes were generally successful in reaching their intended participants, though engaging some care experienced young people remained a challenge.
Implementation of both interventions was largely as planned, with MCR Pathways benefiting from school-based coordinators and MCR leading recruitment. Columba 1400 success was attributed to its flexible approach and skilled staff. However, the overall rollout of the SMLP was slower and less extensive than intended, mainly due to a less favourable financial climate and the unsustainability of the original funding model. Suggestions for improvement included better information for parents and staff, and enhanced support for mentors.
Scottish Mentoring Leadership Programme-Interim Report-Qualitative Process Impact Assessment. Scottish Government, 2024. https://www.gov.scot/publications/smlp-interim-report-qualitative-process-impact-assessment/.
This report was written by Aberdeen City Council, the Champions Board of West Dunbartonshire Council, The City of Edinburgh Council, Future Pathways, Social Work Scotland, and Who Cares? Scotland. It aims to establish a foundation for a consistent, trauma-informed, rights-based approach for organisations responding to requests for care records. The project seeks to improve how people with care experience access their records in Scotland, building on previous research and addressing the distinct legislative context. Information was collected using surveys, interviews, focus groups, and document analysis. 141 people with care experience participated in an online survey, and 16 took part in interviews and focus groups.
The findings highlight the profound personal significance of records for care experienced individuals, who often seek them to understand their past, form their identity, and gain closure. However, the process can be emotionally challenging, sometimes resurfacing past traumas or leading to anger and mistrust, especially when records are incomplete or heavily redacted. Many participants felt record holders did not fully grasp the importance of these documents.
Key recommendations include recognising record access as an integral part of ongoing care, developing specific policies for care experienced individuals, and creating a rights-based framework for transparent access. The report also calls for comprehensive support, including trained personnel and clear pathways to counselling, and opportunities for individuals to contribute to their records. It stresses the need for sensitive communication when records are lost or compromised, aiming to ensure that every person accessing their records does so safely and with adequate support.
Aberdeen City Council, Champions Board of West Dunbartonshire Council, The City of Edinburgh Council, Future Pathways, Social Work Scotland, and Who Cares? Scotland. Accessing Records in Scotland: What People with Care Experience Tell Us about the Right of Access. Social Work Scotland, 2024. https://socialworkscotland.org/wp-content/uploads/2024/07/RTA-LONGFORM-REPORT-15-12-23-1.pdf.
Who Cares? Scotland—a national independent membership organisation for care experienced people, dedicated to supporting, empowering and amplifying the voices of Scotland’s care community—provided targeted analysis of their existing evidence for The Promise Story of Progress, sharing material that mapped to the relevant vision statements and contributed insight into how their internal data, participation activity, and qualitative evidence could inform the experiential strand of the Promise Story of Progress.
Their reports reflected advocacy work carried out between 1st January 2020 and 30th June 2025, during which time Who Cares? Scotland advocacy workers supported around 4,800 individuals. Although the report findings do not represent the experience of every care experienced individual in Scotland, they highlight issues that need continued attention as Scotland works to understand what is changing and what still needs to be addressed.
An anonymised and abridged collation of these reports is available at: Who Cares? Scotland. The Promise Story of Progress: Vision Statement advocacy reports by Who Cares? Scotland (abridged). The Promise Scotland, 2025. https://www.plan2430.scot/media/5hnlt5ye/wcs-vision-statement-advocacy-reports-abridged.pdf
Dalkeith Parents and Carers: Whole Family Support Feedback Session - June 2025. Children First, 2025.
100 Days of Listening. Scottish Throughcare and Aftercare Forum (Staf), 2024. https://www.staf.scot/Handlers/Download.ashx?IDMF=36c14562-d65a-4866-b6bf-685d0462974b.
Aberlour Mother & Child Recovery Houses: Annual Review December 2023 December 2024. Aberlour, 2025. https://www.aberlour.org.uk/publications/mother-child-recovery-houses-annual-review-2023-24.
Alternative Routes Impact Report 2024-2025. Aberlour, 2025. https://www.aberlour.org.uk/publications/alternative-routes-cashback-impact-report-2024-2025.
Callaghan, Prof. Jane, Tanya Beetham, and Chris Gray. The Implementation of “Attain”: A Mentoring Scheme for Care Experienced Young People and Young People on the Edge of Care in Renfrewshire. Aberlour; Renfrewshire Council, 2022. https://www.aberlour.org.uk/publications/implementation-attain-renfrewshire.
Cross Border Thematic Review: July 2024. Care Inspectorate, 2024. https://www.careinspectorate.scot/strategic-scrutiny/library/strategic-reports/cross-border-thematic-review-2024.
Ellis, Sioned, and Natalie Williams. State of the Nation’s Foster Care: Spotlight on Scotland Report 2024. The Fostering Network, 2025. https://www.thefosteringnetwork.org.uk/policy-and-campaigns/state-of-the-nations/state-of-the-nations-foster-care-2024/.
Evaluation of the Hub for Success. The Hub for Success, 2024. https://hubforsuccess.org/wp-content/uploads/2024/02/HfS-Evaluation-2024-FINAL.pdf.
Fowler, Dr Nadine, and Dr Robert Porter. Evaluation of the Lifelong Links Trial in Scotland. CELCIS, 2024. https://www.celcis.org/knowledge-bank/search-bank/evaluation-lifelong-links-trial-scotland.
Guinchard, Sydney. “Experiences of Parents in ‘The Village,’ an Online Support Network for Care- Experienced Parents: A Thematic Analysis.” Scottish Journal of Residential Child Care 23, no. 2 (2024).
https://www.celcis.org/application/files/1717/3141/3237/SJRCC_2024_Vol_23_No_2_Guinchard_S_Experience_of_parents_in_the_village.pdf
Learning Reviews for Children and Adults in Scotland: Summary Report 2025. Care Inspectorate, 2025. https://www.careinspectorate.scot/resources-data/publications-and-statistics/library/learning-reviews-summary-report-2025.
Matter of Focus. Impact Report Year 3: Includem’s ADAPT for Cashback Project. Includem, 2024.
https://cashbackforcommunities.org/wp-content/uploads/2020/04/Includem-ADAPT-for-CashBack-Annual-report-2022-23.pdf.
Mitchell, Mary, Camille Warrington, John Devaney, Peter Yates, and Jennifer Lavoie. North Strathclyde Bairns Hoose Evaluation: Phase One Report. 2023. https://researchonline.gcu.ac.uk/ws/portalfiles/portal/92593848/92438102.pdf.
Morris, Mary. “Seldom Seen Sibling Support: Exploring the Changing Experiences of Siblings in Scottish Residential Childcare Services.” Scottish Journal of Residential Child Care 21, no. 2 (2022).
https://www.celcis.org/application/files/3016/6810/1801/2022_Vol_21_No_2_Morris_M_Seldom_seen_sibling_support_exploring_the_changing_experiences_of_siblings_in_Scottish_residential_childcare_services.pdf
Process Evaluation of Siblings Reunited (STAR): Final Report. Association for Fostering, Kinship and Adoption (AFKA) Scotland, 2023. https://www.standupforsiblings.co.uk/2023/12/20/star-siblings-reunited-project-evaluation/.
Reimagining Secure Care - Final Report: A Vision for the Reimagined/Future World. Children and Young People’s Centre for Justice (CYCJ), 2024. https://www.cycj.org.uk/wp-content/uploads/2024/09/Reimagining-Secure-Care-Final-Report.pdf.
Roesch-Marsh, A, K McGhee, and F Gillon. The Digital Divide: The Impact on the Rights of Care Leavers in Scotland. 2021. https://www.celcis.org/application/files/5516/1158/7905/The_digital_divide_The_impact_on_the_rights_of_care_leavers_in_Scotland_Inform.pdf.
Russell, Linda, Fiona Turner, Ruchika Gajwani, and Helen Minnis. “‘Everything Is Fear Based’: Mothers with Experience of Addiction, Child Removal and Support Services.” Child and Youth Services Review 170 (2025). https://www.sciencedirect.com/science/article/pii/S0190740925000441?via%3Dihub.
Social Value Lab. Evaluation of Tayside Family Financial Wellbeing Project: A Report for Aberlour Children’s Charity. Aberlour, 2024. https://www.aberlour.org.uk/publications/aberlour-family-financial-wellbeing-tayside-pilot-evaluation.
Social Value Lab. Evaluation of the Falkirk Intensive Perinatal Support Service. Aberlour, 2024. https://www.aberlour.org.uk/publications/intensive-perinatal-evaluation-2024.
Social Value Lab. Helping to Keep the promise That Scotland Must Strive to Become a Nation That Does Not Restrain Its Children: Evaluation of The Promise Rethinking Restraint Pilot Report for Aberlour Childcare Trust and Kibble. Aberlour; Kibble, 2023. https://web-backend.aberlour.org.uk/wp-content/uploads/2023/05/The-Promise-Report-Final-V3.pdf.
Spolander, Gary, Janine Bolger, and Joanna Santos-Petiot. Upstream Scotland Pilot Evaluation. Rock Trust, 2025. https://www.rocktrust.org/download/upstream-scotland-pilot-evaluation-2025/.
The Challenges Facing Scottish Schools and Children’s Mental Health. Place2Be, 2024. https://www.place2be.org.uk/media/ylhimahc/place2be-education-briefing.pdf.
Transitions for Care Experienced Young People: A Thematic Review. Care Inspectorate, 2024. https://www.careinspectorate.scot/strategic-scrutiny/library/strategic-reports/care-experienced-young-people-thematic-review.
Who Cares? Scotland. “Exclusion Labelled as Support”: Care Experienced Children in Scotland’s Education System. Children and Young People’s Commissioner Scotland, 2025. https://www.celcis.org/news/news-pages/care experienced-children-struggling-access-right-education-scotland.