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 is happening
Across the sources reviewed, organisations describe work underway to support the mental health of children and young people. This includes efforts to improve how mental health support is designed, delivered and experienced across Scotland. The accounts reflect a range of approaches being developed in response to what children, young people and families say matters to them, alongside work to strengthen existing support. Together, these descriptions show signs of change and increasing efforts to work in more joined-up ways, while also highlighting where challenges remain.
Click on the take me to navigation pane and jump to different sections here, including sources. 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.
Across the sources reviewed, trauma-informed approaches are described as an increasingly important part of how organisations support children and young people who have experienced adversity. Training for staff draws on psychological and trauma-informed models to build understanding of how trauma affects children, young people and families. This learning is intended to shape day-to-day practice, particularly how adults respond to distress, build relationships and support emotional regulation.
The extent to which services take a trauma-informed or trauma-responsive approach varies depending on their role and remit. However, the overall direction described across the sources is towards more compassionate, informed and relational ways of working. As understanding of trauma improves, staff are described as becoming more confident in recognising triggers, responding with greater sensitivity and avoiding responses that might unintentionally escalate or retraumatise.
Some organisations provide therapeutic spaces where children and young people can feel safe, supported and able to explore difficult experiences. These spaces are described as supporting emotional wellbeing and helping young people make sense of past experiences at a pace that feels manageable for them. Alongside this, there are examples of more specialised approaches being developed to respond to complex needs, recognising that generic support does not always meet the needs of children and young people who have experienced significant adversity.
Across the sources reviewed, organisations describe investing in workforce support and development as an important part of strengthening mental health support for children and young people. This includes trauma awareness training, reflective practice and opportunities for staff to develop skills in understanding and responding to emotional distress. Adjustments are described to help ensure training and reflective spaces are accessible to staff working different patterns, including part-time roles.
Supervisors and managers are described as playing a key role in creating spaces where staff feel able to reflect on their work, process emotional impact and gain perspective on challenging situations. Where reflective supervision is available, staff are better able to make sense of pressures, recognise their own limits and approach complex situations with greater confidence and care.
The sources also highlight that staff across education, health and care settings often face sustained emotional and relational demands. In many cases, access to reflective supervision or similar support remains uneven. Where these supports are in place, they are described as helping staff feel valued, supported and more able to remain well in their roles, supporting continuity and relationship-based practice with children, young people and families.
The sources reviewed describe ongoing efforts to improve how mental health support is delivered through more integrated and accessible approaches. Collaboration across services is described as helping respond to the complex needs of children, young people and their families, particularly where early help can reduce escalation and pressure on specialist support.
Local partnership and community-based approaches are described as enabling services to work together more effectively. These approaches bring together mental health, education, social care and community support so that help can be offered earlier and in ways that fit better with children and young people’s lives. Multi-agency teams are described as working across community settings, schools and care environments, supporting emotional wellbeing alongside wider family circumstances.
Access to specialist mental health support remains a key focus. Alongside efforts to improve access to specialist services, organisations describe developing a wider range of supports to respond to increasing demand for one-to-one emotional and psychological help. These include approaches that connect children and young people to community-based supports as part of a broader response to wellbeing.
What is being learned about change
This section draws together learning from the materials reviewed about how change is being understood and shaped in practice. It reflects what is emerging across accounts of work underway, rather than evaluating effectiveness or setting direction. The focus is on identifying patterns in how approaches are being adapted, what appears to make a difference to experience, and where learning continues to develop.
The evidence suggests that trauma-informed approaches are most effective when they are embedded across practice rather than treated as one-off interventions or training activities. Learning across the sources highlights the importance of understanding how trauma shapes behaviour, emotions and relationships, and of creating emotionally safe spaces alongside timely, responsive support.
Key elements of success
Examples
What to stop and what to change
The evidence suggests that prioritising workforce wellbeing and development supports more effective mental health practice. Learning across the sources highlights the importance of providing staff with opportunities to reflect, develop understanding of trauma and manage emotional load, helping sustain compassionate and consistent support.
Key elements of success
Examples
What to stop and what to change
Learning across the evidence suggests that mental health support is more effective when it is joined up, accessible and offered early. Integrated approaches help reduce fragmentation, support continuity and enable services to respond before difficulties reach crisis point. Seeing children and young people within the context of their family and community supports more meaningful and sustained responses.
Key elements of success
Examples
What to stop and what to change
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://www.careinspectorate.scot/strategic-scrutiny/library/strategic-reports/secure-pathway-review-2022-2023.
This report was published by the University of Glasgow in October 2022. The study aimed to understand the health of children and young people in Scotland who have experienced care, comparing them to those who haven't. It uses a wide range of data from 1990 to 2016 to highlight health differences and inform policies, especially in light of The Promise Scotland's vision for improving the care ‘system’.
The research found that children with care experience generally face worse health outcomes, including higher rates of death, mental health issues, chronic conditions, and injuries. These problems often persist even when accounting for the fact that these children are more likely to come from poorer areas. For example, hospitalisations for mental health problems and poisonings increase sharply around age 18 for care experienced individuals, coinciding with leaving formal care.
The report emphasises that many of these adverse health events are preventable with better support. It recommends more help for families managing chronic conditions, increased support for children in residential care, and better management of transitions into and out of care. The study also highlights the need for continued support for young people after they leave care to prevent avoidable hospitalisations and deaths. It concludes that improving the health of care experienced children is crucial for Scotland's future wellbeing and economy.
Allik, Mirjam, Denise Brown, Edit Gedeon, Alastair H Leyland, and Marion Henderson. Children’s Health in Care in Scotland (CHiCS): Main Findings from Population-Wide Research. University of Glasgow, 2022. https://eprints.gla.ac.uk/279347/.
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/.
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
Brown, D, E Gedeon, M Henderson, A Leyland, P Wilson, and A Mirjam. “Mortality Outcomes of Children and Young People Who Have Spent Time in Care: Evidence from Children’s Health in Care in Scotland, a Population-Wide Administrative Data Cohort Study.” Pub Med, 2025. https://pubmed.ncbi.nlm.nih.gov/40473467/.
Care Inspectorate. “Children’s Rights, Care Experience and Corporate Parenting.” https://www.careinspectorate.com/index.php/corporate-parenting.
Children and Young People Monitoring Report 2023-24: Admissions of Young People under the Age of 18 to Non-Specialist Wards in Scotland. Mental Welfare Commission for Scotland, 2024. https://www.mwcscot.org.uk/news/continuing-fall-numbers-young-people-admitted-adult-wards-mental-health-treatment-scotland.
Children and Young People’s Contact with the Police- Public Briefing. Scottish Police Authority, 2023. https://www.spa.police.uk/publication-library/children-and-young-people-s-contact-with-the-police/.
Cusworth, Linda, Linda Hooper, Gillian Henderson, Helen Whincup, and Karen Broadhurst. Born into Care in Scotland: Circumstances, Recurrence and Pathways. Scottish Government, 2022. https://www.gov.scot/binaries/content/documents/govscot/publications/research-and-analysis/2022/04/born-care-scotland-circumstances-recurrence-pathways/documents/born-care-scotland-circumstances-recurrence-pathways/born-care-scotland-circumstances-recurrence-pathways/govscot%3Adocument/born-care-scotland-circumstances-recurrence-pathways.pdf.
Galloway, Susan, and Rachel Love. #Keeping the promise to Infants, 0-3 Years. NSPCC Scotland, 2023. https://learning.nspcc.org.uk/research-resources/2023/keeping-the-promise-to-infants-in-scotland.
Guinchard, Sydney. “Why Not? Trust Response to ‘Promise Story of Progress: Data Information Form (Care Community).’” The Why Not? Trust, 2025.
Impact Evaluation Phase 5 (2020 to 2023) CashBack For Communities Final Report. CashBack for Communities, 2023. https://cashbackforcommunities.org/wp-content/uploads/2023/12/CashBack-Phase-5-Final-Evaluation.pdf.
Joint Inspections of Services for Children and Young People at Risk of Harm: Review of Findings from the Joint Inspection Programme 2021-2025. Care Inspectorate, 2025. https://www.careinspectorate.scot/strategic-scrutiny/library/strategic-reports/review-of-findings-from-the-joint-inspection-programme-2021-2025.
McTier, Dr Alex, Mihaela Manole, Jane Scott, et al. Children’s Services Reform Research: Scotland’s Children’s Services Landscape: The Views and Experiences of the Children’s Services Workforce. CELCIS, 2023. https://www.celcis.org/knowledge-bank/search-bank/childrens-services-reform-research-scotlands-childrens-services-landscape-views-and-experiences-childrens-services-workforce.
McTier, Dr Alexander, Carol Ann Anderson, and Emma Young. Births to Care Experienced Teenagers and Women Aged 14-24 in Scotland: An Estimation. CELCIS, 2023. https://www.celcis.org/knowledge-bank/search-bank/births-care experienced-teenagers-and-women-aged-14-24-scotland.
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.
Ottaway, Heather, Alexander McTier, Mihaela Manole, et al. Children’s Services Reform Research: Learning and Implications for Scotland. CELCIS, 2023. https://www.celcis.org/knowledge-bank/search-bank/childrens-services-reform-research-concluding-report.
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/.
Promise Partnership Insights. Corra Foundation, 2025.
Public Health Scotland: Corporate Parenting Vision and Plan 2025-2028. Public Health Scotland, 2025.
https://publichealthscotland.scot/media/32354/phs-corporate-parenting-vision-and-plan.pdf
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.
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/.
Update on Progress: #KeepingThePromise PHS Contribution February 2024. Public Health Scotland, 2024.
Update on Progress: Correspondance to Fiona Duncan- The promise. Police Scotland, 2024.
Update on Progress: Email Response from the Scottish Police Authority. The Scottish Police Authority, 2024.
Update on Progress: Update on the promise Plan. The Scottish Fire and Rescue Service, 2024.
Whitelaw, Dr Ruby, and Ross Gibson. Preparing to Keep The promise: A Comparative Study of Secure Care and Young Offender Institutions in Scotland. Children and Young People’s Centre for Justice (CYCJ), 2023. https://www.cycj.org.uk/resource/preparing-to-keep-the-promise-a-comparitive-study-of-secure-care-and-young-offender-instituions-in-scotland/.
Whyte, Dr Emily, and Dr Lisa Craig. Cyrenians Youth Justice and Rights and a Supportive Workforce: Two Learning Accounts. Corra Foundation, n.d.
Whyte, Dr Emily, and Dr Lisa Craig. Dundee Kinship Care Team: A Learning Account. Corra Foundation, n.d.
Whyte, Dr Emily, and Dr Lisa Craig. Insight Briefing: Shining a Light on Practice. Corra Foundation, 2025.
Whyte, Dr Emily, and Dr Lisa Craig. Scottish Attachment in Action Wee BREATHERS: A Learning Account. Corra Foundation, n.d.
Whyte, Dr Emily, and Dr Lisa Craig. Why Not? Trust Thinking Space: A Learning Account. Corra Foundation, n.d.