The COVID-19 pandemic worsened the mental health of Slovaks, as confirmed by data from the National Health Information Centre (NHIC) in 2023. Following the outbreak, there was an increase in both outpatient and hospitalised cases among young people aged 15–19, likely linked to insufficient prevention and support in schools. According to the NHIC, teenagers consistently account for the majority of suicide attempts. In 2024, two children under the age of 14 and 11 adolescents aged 15–19 took their own lives. The crisis helpline IPčko reported a dramatic rise of almost 97% in 2021 in contacts from young people seeking help with self-harm. The sharpest increase was among children aged 10–14, from 16.3% (2022) to 37.5% (2023). The long-term HBSC Study (Health Behaviour in School-aged Children) found that in 2021–2022, around one in five children aged 13–15 was at risk of depression, one third did not view life positively, and the same proportion suffered from anxiety. Symptoms of eating disorders appeared in one quarter of girls. As many as 67% of Slovak children reported problems with concentration, emotions and behaviour.

Based on findings from selected schools, national auditors identified the most pressing problems and conducted a survey, with 75% of the 2,064 schools contacted responding. Of the 1,005 schools with a school support team, 99% found the creation of such teams beneficial. However, schools face staffing challenges. Nearly three quarters of schools said they needed additional specialist positions, but financial constraints and a shortage of professionals remain major obstacles. Almost every school without a psychologist (667 schools) stated that this position should be filled as soon as possible, while even schools with psychologists reported a need for additional capacity. Shortages extend across several professions, threatening the effectiveness of the support system.

Schools also lack clear rules for prevention. While legislation defines the responsibilities of teachers and professional staff, practical application in the area of prevention and mental health care remains legally unclear. “Although support for mental health in schools has begun, it is often provided by staff without adequate training or expertise. In the long term, it is essential that these services are delivered by qualified professionals – school psychologists or special education teachers. If this serious matter is not in the hands of experts, we are indirectly gambling with children’s minds and the future of young people,” said Ľubomír Andrassy, President of the national external audit authority.

The audit found that the Ministry of Education failed to ensure a sufficient number of school psychologists to meet the recommended ratio of one per 500 pupils. In 2024, this standard was met in only 13 districts. Of 205 large schools (with over 500 pupils) responding to the survey, nearly one third had no psychologist at all or only part-time, underlining the persistent shortage of staff. Without comprehensive long-term data on children’s mental health, it is impossible to assess how many pupils the state has been able to help.

A key condition for sound decision-making in children’s mental health is knowledge of their actual situation and environment. Yet Slovakia has so far lacked such data. The first nationwide representative data collection is expected only through the Data Project, scheduled to conclude with a national report in 2027. Auditors warned that the absence of data during policy design was a major weakness in prevention and support efforts. They recommend a review of the support system for children’s mental health once the project is completed, as activities were launched without prior collection of comprehensive data. Prevention at national level only began recently through the ePoradenstvo (eCounselling) platform and its prevention modules. Until February 2025, activities operated only locally, without central guidance or evaluation. The entire mental health system is further complicated by the involvement of numerous stakeholders and fragmented funding, relying on a mix of EU funds, state budget allocations, and special financing mechanisms for teaching assistants and support team members.

The SAO found that the Ministry of Education also lacks comprehensive data on annual spending on children’s mental health in schools. National auditors calculated expenditure at more than €351 million, two thirds from the state budget and the remainder from EU funds. This amount covered mainly support teams, teaching assistants, the Research Institute for Child Psychology and Pathopsychology, and counselling and prevention centres. The Ministry also did not record funding sources or the working hours of professional staff, making it impossible to track real use, particularly in smaller schools where experts work part-time across multiple institutions. “Without accurate and comprehensive financial data, it is impossible to plan and manage public policy on children’s mental health effectively and systematically. Moreover, motivating secondary school graduates to study psychology or special education remains a challenge. Financial incentives could help, but with a starting salary of around €1,300 per month for school psychologists, the path is currently blocked,” added Andrassy.

A positive development is that Slovakia is gradually shifting the financing of teaching assistants and school support teams from EU funds to the state budget to ensure sustainability, a condition set by the European Commission when approving the national project. According to the SAO, from the 2024/2025 school year, 7,881 school assistants have been funded exclusively from the state budget. Between September and December 2024, €52 million was allocated for this purpose. However, the audit authority warns that primary schools requested more than 18,000 such specialised positions. The risks are not only financial but also the availability of qualified staff. Support teams will continue to be financed by EU funds until the 2026/2027 school year, after which their operation should be covered by national resources.