The alternative assessment system in schools is driving senior pupils to self-harm and suicidal thoughts, a GP has warned.

The Borders-based doctor said there had been a marked deterioration in the wellbeing of local young people.

She told The Herald that an increase in mental health issues could be traced to the Easter holidays, when it became clear there would be a period of “exam-style tests” as teachers gather evidence for provisional results that will be submitted to the Scottish Qualifications Authority (SQA).

Stressing that colleagues had also observed the trend, the GP said it was her belief that the situation at practices across Scotland would be similar and warned “fragmented” support services meant many young people were facing waits of up to a year to access help.

She added that teachers were also suffering due to the workload associated with current assessment arrangements.

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“What we’ve been seeing among senior secondary school pupils is generalised anxiety, low mood, low self-esteem, stress and symptoms in keeping with depression,” said the GP, who asked not to be named.

“There has also been more self-harm and there have been some cases of suicidal ideation – young people thinking or saying that there’s no point in going on. And the young people will say when they speak to [my colleagues or me] that the [alternative] assessment process is making them stressed and seriously affecting their mental health.

“The first thing they’ll talk about is the Covid situation more generally, but those in senior secondary school will then tell us that the [alternative] testing and assessment programme at school is making them feel worse. At the local high school, pupils were put through three lots of tests over a six-week period, with no study leave. I’ve heard reports of pupils bursting into tears while sitting tests.”

The Herald: Pupils are being assessed under an alternative certification model after this year's exams were cancelled.Pupils are being assessed under an alternative certification model after this year's exams were cancelled.

The GP said anxiety had been an issue for young people over the past 12 months but added that the problem had worsened noticeably in recent weeks.

“I would say that, perhaps starting just before the Easter holidays this year and certainly since then, my colleagues and I have seen an increase in presentations of mental health and emotional wellbeing issues,” she added.

“That’s anecdotal, of course, but it’s based on what I and my colleagues have observed, and there are 12 of us in this practice. We’re seeing an increase in mental health problems across all age groups, but particularly among those in the senior stage of secondary school.

“There has been a rumbling of anxiety over the last year among pupils in S4-6 because of events last summer with the exam results, and not knowing what they would be facing this year.

“But that has certainly increased in the last two months, I would say – when it became clear that what we thought was going to be continuous assessment would, in fact, be exam-style tests ... I wouldn’t say the situation will be dramatically different across the rest of the Scottish Borders or, indeed, Scotland.

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“I would say that, at the moment, each of us here in my general practice is seeing one or two cases a week – which might not seem like a lot but, if you multiply that by the number of general practices across the Scottish Borders, it’s a serious figure.

“And, of course, it’s not just pupils but teachers as well. Teachers’ mental health is suffering due to additional workload and not being able to manage that workload in terms of the extra assessments they’re putting on and having to mark.”

A spokeswoman for NHS Borders said: “Our CAMHS team is working closely and regularly with Scottish Government on a plan to implement the National Service Standards published last year. This and tackling our waiting times will be supported by additional funding recently announced by the Scottish Government. Already our CAMHS has successfully progressed a recruitment programme, established a Stakeholder Reference Group and work is under way to improve pathways.

The Herald: There are fears for the mental health of pupils as a result of the Covid-19 pandemic.There are fears for the mental health of pupils as a result of the Covid-19 pandemic.

“For the duration of the pandemic, all urgent and emergency referrals have been seen within an appropriate timescale including those patients who presented as meeting the CAMHS criteria with significant risk. This remains unchanged.

“Additionally, a Clinical Interface Group has been formed to help establish a mutual understanding of patients who present across the healthcare system, their needs and how our services can co-operate to provide appropriate treatment and support to our patients.”

Lesley Munro, service director for young people, engagement and inclusion at Scottish Borders Council, said: “We’re alarmed to hear these concerns from respected GP colleagues as the health and wellbeing of these young people is of the utmost importance to us.

"We have an extensive range of support measures in place for pupils and we will continue to expand this range with direct input from the young people themselves, to ensure they are designing the services and support they need.” 

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An SQA spokesman said: “We fully appreciate that the impact of Covid has been extremely challenging for learners. 

"Everyone is working hard to ensure young people across Scotland get the qualifications they deserve. 

"We’ve developed the approach to certification with the National Qualifications 2021 Group, which includes parents and learners.”

The SQA has also created an opportunity to submit provisional results by September 3. This will be open to those unduly disadvantaged by severe disruption to learning and teaching, and who have not been able to complete assessment evidence in time for the June 25 submission date.

Additional support will be available through the agency's new appeals service.