The number of children referred to emergency mental healthcare in England has soared by more than 50% in three years, according to data laying bare the impact of lengthy waiting lists for regular NHS treatment.
There were 32,521 emergency and urgent referrals to child and adolescent mental health services crisis teams in 2022-23, analysis of official data by the Royal College of Psychiatrists revealed. In 2019-20, the year before the Covid pandemic, the figure was 21,242.
The increase means more than 600 mentally ill children a week are deteriorating to such a state that they have reached crisis point.
Many of the children requiring emergency care – some suicidal or seriously ill as a result of eating disorders – have been stuck on waiting lists for an average of five months, and in the worst cases as long as two years, the college said.
MPs and health leaders said the NHS figures exposed a “devastating explosion” of untreated severe mental ill health among children, and should be a wake-up call for the government. There was now a serious risk that the alarming surge in children reaching crisis point before being able to access help was becoming “the new norm”, they added.
“No one should have to watch their child’s mental health deteriorate while they wait for care,” the president of the Royal College of Psychiatrists, Dr Lade Smith, told the Guardian. “It’s completely unacceptable that this is the reality facing so many families.”
Ministers must take urgent action to provide targeted support to every child in need of mental healthcare and “turn the tide” on the country’s growing children’s mental health crisis, Smith said.
“We want to provide young people with effective care as soon as they need it, not once they’ve already developed a serious illness which could have been prevented,” she added.
“That’s why we need to see government focus on prevention and reversing the rising rates of mental illness, as well as ensuring sufficient resourcing of specialist services.”
Record numbers of children and young people are seeking help for mental health problems. In 2022 alone, 1.4 million were referred to child and adolescent mental health services (Camhs) for treatment of anxiety, depression, eating disorders and other psychological problems.
But as demand soars for children’s mental healthcare and support, Camhs teams are struggling to see or treat children quickly enough. Experts say that is leading to thousands of under-18s getting even sicker while on waiting lists, prompting a 53% rise in emergency and urgent referrals for Camhs crisis care.
An emergency referral is normally made if a child needs to be seen within 24 hours. They might be a risk to themselves due to suicidal feelings, have a significant health risk because of an illness such as anorexia or have another serious mental health condition, experts said.
Emergency referrals to Camhs are mostly made by GPs and doctors in A&E departments, which are seeing rising numbers of mentally ill children arrive with nowhere else to turn, although schools and social services can also do so.
Dr Elaine Lockhart, the chair of the college’s child and adolescent faculty, said: “It’s unacceptable that so many children and young people are reaching crisis point before they are able to access care. We cannot allow this to become the new norm.
“Severe mental illness is not just an adult problem. The need for specialist mental health services for children and young people is growing all the time.”
Many of the conditions arising in children could be prevented or treated if prompt support and access to care were available, Lockhart said.
“The evidence shows us that children who receive support quickly are less likely to develop long-term conditions that negatively affect their education, social development and health in later life.
“Government and integrated care boards must commit to reducing the rate of mental illness among children by setting an achievable target. This needs to be backed by an expansion of the mental health workforce and additional funding for services.”
The college welcomed last year’s government announcement of an extra £5m to improve access to early support hubs for people aged 11 to 25.
But it said an extra £125m to £205m would be needed to establish hubs in every local authority, with running costs of at least £114m a year.
“Every young person should be able to access the help they need when they need it,” said Laura Bunt, the chief executive of YoungMinds, a children’s mental health charity. “The government must prioritise young people’s mental health and make it much easier for them to get support.”
Daisy Cooper MP, the Lib Dem health spokesperson, said: “This devastating explosion of mental ill health among children should be a wake-up call for the government. Conservative ministers have neglected children’s mental health during and after the pandemic, leaving mental health services and families in crisis.”
NHS England said it was treating more young people than ever before, and was expanding mental health services as quickly as possible to meet increasing demand.
A spokesperson said: “Early support for children and young people with mental health issues is a priority for the NHS, and plans are in place to ensure more than one in two pupils and learners in schools and colleges are covered by an NHS mental health support team by spring 2025 – significantly ahead of the original target.”
The Department of Health and Social Care said it was determined to support children with their mental health, and was investing an extra £2.3bn a year into NHS mental health services.
“This funding will also help expand the number of mental health support teams in schools to reach at least 50% of pupils in England by the end of March 2025,” a spokesperson added.
